Andrew Mente, PhD; Sonia S. Anand, MD, PhD, FRCPC
In patients with newly diagnosed type 2 diabetes, is a low-carbohydrate Mediterranean-style (MED) diet better than a low-fat diet (LFD) for glycemic control?
Randomized controlled trial. ClinicalTrials.gov NCT00725257.
Blinded (outcome assessors).*
Diabetes clinic in a teaching hospital, Naples, Italy.
215 patients 30 to 75 years of age (mean age 52 y, 51% women) who had newly diagnosed type 2 diabetes, body mass index > 25 kg/m2, hemoglobin (Hb) A1c level < 11%, stable weight in the past 6 months, physical activity < 1 h/wk, no involvement in weight-reduction programs, and no previous use of antihyperglycemic drugs. Exclusion criteria included positive antibodies to glutamate decarboxylase or fasting plasma C-peptide levels < 0.25 pmol/L (0.76 ng/L); abnormal laboratory tests (e.g., liver enzyme levels > 3 times the upper limit of normal); use of investigational drugs in the past 3 months or drugs affecting glycemic control; and pregnancy or breastfeeding.
Low-carbohydrate MED diet that included vegetables, whole grains, poultry, and fish (n = 108), or LFD that included whole grains with limited fats, sweets, and high-fat snacks (n = 107).
Start of glucose-lowering drug therapy (when HbA1c levels > 7% at 2 consecutive visits). Other outcomes included weight, HbA1c levels, and coronary risk factors.
91% (intention-to-treat analysis).
The main results are in the Table.
A Mediterranean-style diet reduced the need for glucose-lowering drugs and improved short-term glycemic control more than a low-fat diet in overweight patients with newly diagnosed type 2 diabetes.
Low-carbohydrate Mediterranean diet (MED) vs low-fat diet (LFD) in overweight patients with newly diagnosed type 2 diabetes†
†Abbreviations defined in Glossary. RRR, NNT, and CI calculated from data in article.
‡Adjusted for weight change.
§When hemoglobin A1c > 7% at 2 consecutive 3-mo assessments.
||93% follow-up for these outcomes at 1 year; < 80% follow-up after 1 year.
¶Corrected CI provided by author.
Andrew Mente, Sonia S. Anand. A Mediterranean-style diet reduced need for glucose-lowering drugs more than a low-fat diet in type 2 diabetes. Ann Intern Med. 2009;151:JC6–5. doi: 10.7326/0003-4819-151-12-200912150-02005
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Published: Ann Intern Med. 2009;151(12):JC6-5.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.
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