These Italian and UK investigators compared the effects of a low- carbohydrate Mediterranean-style or a low-fat diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes in an unblinded randomized trial. They enrolled 215 overweight people with newly diagnosed type 2 diabetes who were never treated with antihyperglycemic drugs and had hemoglobin A1c (HbA1c) levels less than 11%. Mediterranean-style diet was less than 50% of daily calories from carbohydrates (n = 108) and low-fat diet was less than 30% of daily calories from fat (n = 107).
They found: "After 4 years, 44% of patients in the Mediterranean- style diet group and 70% in the low-fat diet group required treatment (absolute difference -26.0 percentage points, hazard ratio 0.63, hazard ratio adjusted for weight change 0.70). Participants assigned to the Mediterranean- style diet lost more weight and experienced greater improvements in some glycemic control and coronary risk measures than did those assigned to the low- fat diet."
The authors concluded: "Compared with a low-fat diet, a low- carbohydrate, Mediterranean-style diet led to more favorable changes in glycemic control and coronary risk factors and delayed the need for antihyperglycemic drug therapy in overweight patients with newly diagnosed type 2 diabetes."
Diabetic diet education should be changed to reflect this new evidence.
For the full abstract, click here.
Annals of Internal Medicine 151(5):306-314, 1 September 2009 © 2009 to the American College of Physicians
Effects of a Mediterranean-Style Diet on the Need for Antihyperglycemic Drug Therapy in Patients With Newly Diagnosed Type 2 Diabetes-A Randomized Trial. Katherine Esposito, Maria Ida Maiorino, Miryam Ciotola, et al. Correspondence to: Dr. Giugliano: dario.giugliano@unina2.it
Category: T. Endocrine/Metabolic/Nutritional. Keywords: Mediterranean diet, diabetes mellitus type 2, antihyperglicemic medication, hemoglobin A1c, glicemic control, weight loss, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor September 15 2009
