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Low-carbohydrate diet in diabetes mellitus treatment


Authors: Hana Krejčí 1,2;  Jan Vyjídák 3,4;  Matej Kohutiar 5
Authors place of work: III. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze 1;  Gynekologicko-porodnická klinika 1. LF UK a VFN v Praze 2;  Berkeley Research Group (Healthcare), London, UK 3;  FN Olomouc 4;  Ústav lékařské chemie a klinické biochemie 2. LF UK a FN Motol, Praha 5
Published in the journal: Vnitř Lék 2018; 64(7-8): 742-752
Category: Reviews

Summary

There has been an increasing amount of information about the positive results of low-carbohydrate diet in the treatment of diabetes, pre-diabetes, metabolic syndrome and obesity in the form of randomized trials, their meta-analysis and case studies. Many of these indicate that low carbohydrate diets are safe, could significantly improve the compensation of both types of diabetes and the overall health of the diabetic patients. In successful therapy, this diet leads to weight loss, lower medication doses or prescribing, and in some cases of type 2 diabetes also to remission. However, the low carbohydrate diet is not recognized in Czech diabetology, and concerns remain particularly about its safety. This article is a summary of the current knowledge about low-carbohydrate diet, its benefits, risks and contraindications, and aims to initiate a discussion about its use as one of the options for dietary treatment of diabetics.

Key words:

diabetes mellitus – ketogenic diet – low-carbohydrate diet – metabolic syndrome – obesity


Zdroje
  1. Kahleova H, Levin S, Barnard N. Cardio-Metabolic Benefits of Plant-Based Diets. Nutrients 2017; 9(8. pii: E848. Dostupné z DOI: <http://dx.doi.org/10.3390/nu9080848>.
  2. Hever J, Cronise RJ. Plant-based nutrition for healthcare professionals: implementing diet as a primary modality in the prevention and treatment of chronic disease. J Geriatr Cardiol 2017; 14(5): 355–368. Dostupné z DOI: <http://dx.doi.org/10.11909/j.issn.1671–5411.2017.05.012>.
  3. Martin K, Jackson CF, Levy RG et al. Ketogenic diet and other dietary treatments for epilepsy. Cochrane Database Syst Rev 2016; 2: CD001903. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD001903.pub3>.
  4. Barañano KW, Hartman AL. The Ketogenic Diet: Uses in Epilepsy and Other Neurologic Illnesses. Curr Treat Options Neurol 2008; 10(6): 410–419.
  5. Di Lorenzo C, Coppola G, Bracaglia M et al. Cortical functional correlates of responsiveness to short-lasting preventive intervention with ketogenic diet in migraine: a multimodal evoked potentials study. J Headache Pain 2016; 17: 58. Dostupné z DOI: <http://dx.doi.org/10.1186/s10194–016–0650–9>.
  6. Paoli A, Rubini A, Volek JS et al. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur Jour Clin Nutr 2013; 67(8): 789–796. Dostupné z DOI: <http://dx.doi.org/10.1038/ejcn.2013.116>. Erratum in Eur J Clin Nutr 2014; 68(5):641.
  7. Feinman RD, Bernstein RK, Westman EC et al. Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition 2015; 31(1): 1–13. Dostupné z DOI: <http://dx.doi.org/10.1016/j.nut.2014.06.011>.
  8. McKenzie AL, Hallberg SJ, Creighton BC et al. A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes. JMIR Diabetes 2017; 2(1): e5. Dostupné z DOI: <http://dx.doi.org/10.2196/diabetes.6981>.
  9. Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr 2013; 97(3): 505–516. Dostupné z DOI: <http://dx.doi.org/10.3945/ajcn.112.042457>.
  10. Nielsen JV, Gando C, Joensson E et al. Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit. Diabetol Metab Syndr 2012; 4(1): 23. Dostupné z DOI: <http://dx.doi.org/10.1186/1758–5996–4–23>.
  11. Stentz FB, Brewer A, Wan J et al. Remission of pre-diabetes to normal glucose tolerance in obese adults with high protein versus high carbohydrate diet: randomized control trial. BMJ Open Diabetes Res Care 2016; 4(1): e000258. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjdrc-2016–000258>.
  12. Mlejnková V. Obezita a nadváha. Dostupné z WWW: <http://is.mendelu.cz/zp/portal_zp.pl?prehled=vyhledavani;podrobnosti=22233;download_prace=1>.
  13. England CY, Thompson JL, Jago R et al. Dietary changes and associations with metabolic improvements in adults with type 2 diabetes during a patient-centred dietary intervention: an exploratory analysis. BMJ Open 2014; 4(6): e004953. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2014–004953>.
  14. Saslow LR, Kim S, Daubenmier JJ et al. A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. PLoS One 2014; 9(4): e91027. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0091027>.
  15. Unwin D, Unwin J. Low carbohydrate diet to achieve weight loss and improve HbA1c in type 2 diabetes and pre-diabetes: experience from one general practice. Practical Diabetes 2014; 31(2): 76–79. <https://doi.org/10.1002/pdi.1835>.
  16. Noakes TD. Low-carbohydrate and high-fat intake can manage obesity and associated conditions: occasional survey. S Afr Med J 2013; 103(11): 826–830. Dostupné z DOI: <http://dx.doi.org/10.7196/samj.7302>.
  17. Nielsen JV, Joensson E. Low-carbohydrate diet in type 2 diabetes: stable improvement of body weight and glycemic control during 44 months follow-up. Nutr Metab (Lond) 2008; 5: 14. Dostupné z DOI: <http://dx.doi.org/10.1186/1743–7075–5–14>.
  18. Coulston AM, Hollenbeck CB, Swislocki AL. Deleterious metabolic effects of high-carbohydrate, sucrose-containing diets in patients with non-insulin-dependent diabetes mellitus. Am J Med 1987; 82(2): 213–220.
  19. Česká diabetologická společnost ČLS JEP. Doporučený postup dietní léčby pacientů s diabetem. DMEV 2012; 15(4): 235–243. Dostupné z WWW: <http://www.diab.cz/dokumenty/standard_dietni_lecba.pdf>.
  20. Qian F, Korat AA, Malik V et al. Metabolic Effects of Monounsaturated Fatty Acid-Enriched Diets Compared With Carbohydrate or Polyunsaturated Fatty Acid-Enriched Diets in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Diabetes Care 2016; 39(8): 1448–1457. Dostupné z DOI: <http://dx.doi.org/10.2337/dc16–0513>.
  21. Brunerova L, Smejkalova V, Potockova J et al. A comparison of the influence of a high-fat diet enriched in monounsaturated fatty acids and conventional diet on weight loss and metabolic parameters in obese non-diabetic and Type 2 diabetic patients. Diabet Med 2007; 24(5): 533–540. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1464–5491.2007.02104.x>.
  22. Heinemann L. Variability of insulin absorptin and insulin action. Diabetes Technol Ther 2002; 4(5): 673–682. Dostupné z DOI: <http://dx.doi.org/10.1089/152091502320798312>.
  23. Ranjan A, Schmidt S, Damm-Frydenberg C et al. Short-term effects of a low carbohydrate diet on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes: A randomized open-label crossover trial. Diabetes Obes Metab 2017; 19(10): 1479–1484. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12953>.
  24. Ferrannini E, Baldi S, Frascerra S et al. Shift to fatty substrate utilization in response to sodium-glucose cotransporter 2 inhibition in subjects without diabetes and patients with type 2 diabetes. Diabetes 2016; 65(5): 1190–1195. Dostupné z DOI: <http://dx.doi.org/10.2337/db15–1356>.
  25. Frayn KN. Metabolic Regulation: A Human Perspective. 3rd ed. Wiley-Blackwell (UK) 2010. ISBN 978–1405183598.
  26. Hron BM, Ebbeling HA, Feldman HA et al. Relationship of insulin dynamics to body composition and resting energy expenditure following weight loss. Obesity (Silver Spring) 2015; 23(11): 2216–2222. Dostupné z DOI: <http://dx.doi.org/10.1002/oby.21213>.
  27. Kahleova H, Belinova L, Malinska H et al. Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomised crossover study. Diabetologia 2014; 57(8): 1552–1560. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–014–3253–5>. Erratum in Erratum to: Eating two larger meals a day (breakfast and lunch) is more effective than six smaller meals in a reduced-energy regimen for patients with type 2 diabetes: a randomised crossover study. [Diabetologia. 2015]
  28. Sumithran P, Prendergast LA, Delbridge E et al. Ketosis and appetite-mediating nutrients and hormones after weight loss. Eur J Clin Nutr 2013; 67(7): 759–764. Dostupné z DOI: <http://dx.doi.org/10.1038/ejcn.2013.90>.
  29. Kosinski C, Jornayvaz FR. Effects of Ketogenic Diets on Cardiovascular Risk Factors: Evidence from Animal and Human Studies. Nutrients 2017; 9(5). pii: E517. Dostupné z DOI: <http://dx.doi.org/10.3390/nu9050517>.
  30. Hall KD, Chen KY, Guo J et al. Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men. Am J Clin Nutr 2016; 104(2): 324–333. Dostupné z DOI: <http://dx.doi.org/10.3945/ajcn.116.133561>.
  31. Ebbeling CB, Swain JF, Feldman HA et al. Effects of Dietary Composition During Weight Loss Maintenance: A Controlled Feeding Study. JAMA 2012; 307(24): 2627–2634. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2012.6607>.
  32. Unwin DJ, Cuthbertson DJ, Feinman R et al. A pilot study to explore the role of a low-carbohydrate intervention to improve GGT levels and HbA1c. Diabesity in Practice 2015; 4(3): 102–108.
  33. Storoni M, Plant GT. The Therapeutic Potential of the Ketogenic Diet in Treating Progressive Multiple Sclerosis. Mult Scler Int 2015; 2015: 681289. Dostupné z DOI: <http://dx.doi.org/10.1155/2015/681289>.
  34. Prins M. Diet, ketones and neurotrauma. Epilepsia 2008; 49(Suppl 8): S111-S113. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1528–1167.2008.01852.x>.
  35. White H, Venkatesh K, Venkatesh B. Systematic Review of the Use of Ketones in the Management of Acute and Chronic Neurological Disorders. Neurol Neurosci 2018, 8: 2. Dostupné z DOI: <http://dx.doi.org/10.21767/2171–6625.1000188>.
  36. Cotter DG, Schugar RC, Crawford PA. Ketone body metabolism and cardiovascular disease. Am J Physiol Heart Circ Physiol 2013; 304(8): H1060-H1076. Dostupné z DOI: <http://dx.doi.org/10.1152/ajpheart.00646.2012>.
  37. Aubert G, Martin OJ, Horton JL et al. The Failing Heart Relies on Ketone Bodies as a Fuel. Circulation 2016; 133(8): 698–705. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.115.017355>.
  38. Zinman B, Wanner C, Lachin JM et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373(2): 2117–2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>.
  39. Johnson WA, Weiner MW. Protective effects of ketogenic diets on signs of hypoglycemia. Diabetes 1978; 27(11): 1087–1091.
  40. Kahleová H. Diabetes a nutrice. Dia euni 2017. Dostupné z WWW: <https://dia.euni.cz>.
  41. Dyson P. Low Carbohydrate Diets and Type 2 Diabetes: What is the Latest Evidence? Diabetes Ther 2015; 6(4): 411–424. Dostupné z DOI: <http://dx.doi.org/10.1007/s13300–015–0136–9>. Erratum in Erratum to: Low Carbohydrate Diets and Type 2 Diabetes: What is the Latest Evidence? [Diabetes Ther. 2015]
  42. Santos FL, Esteves SS, da Costa PA et al. Systematic review and meta-analysis of clinical trials of the effects of low carbohydrate diets on cardiovascular risk factors. Obes Rev 2012; 13(11): 1048–1066. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1467–789X.2012.01021.x>.
  43. Bueno NB, de Melo IS, de Oliveira SL et al. Very-low-carbohydrate ketogenic diet v. low-fat diet for long-term weight loss: a meta-analysis of randomised controlled trials. Br J Nutr 2013; 110(7): 1178–1187. Dostupné z DOI: <http://dx.doi.org/10.1017/S0007114513000548>.
  44. Naude CE, Schoonees A, Senekal M et al. Low carbohydrate versus isoenergetic balanced diets for reducing weight and cardiovascular risk: a systematic review and meta-analysis. PLoS One 2014; 9(7): e100652. Dostupné z DOI: <http://dx.doi.org/10.1371/journal.pone.0100652>.
  45. Yancy WS, Olsen MK, Guyton JR et al. A lowcarbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann Intern Med 2004; 140(10): 769–777.
  46. Sharman MJ, Kraemer WJ, Love DM et al. A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men. J Nutr 2002; 132(7): 1879–1885. Dostupné z DOI: <http://dx.doi.org/10.1093/jn/132.7.1879>.
  47. Hellerstein MK. Carbohydrate-induced hypertriglyceridemia: modifying factors and implications for cardiovascular risk. Curr Opin Lipidol 2002; 13(1): 33–40.
  48. Kossoff EH, Turner Z, Doerrer S et al. The Ketogenic and Modified Atkins Diets: treatment for epilepsy and other disorders. 6th ed. Demos Health: 2016. ISBN 978–1936303946.
  49. Reddy S T, Wang CY, Sakhaee K et al. Effect of low-carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. Am J Kidney Dis 2002; 40(2): 265–274. Dostupné z DOI: <http://dx.doi.org/10.1053/ajkd.2002.34504>.
  50. Foster GD, Wyatt HR, Hill JO et al. Weight and Metabolic Outcomes After 2 Years on a Low-Carbohydrate Versus Low-Fat Diet: A Randomized Trial. Ann Intern Med 2010; 153(3): 147–157. Dostupné z DOI: <http://dx.doi.org/10.7326/0003–4819–153–3–201008030–00005>.
  51. Brinkworth GD, Wycherley TP, Noakes M et al. Long-term effects of a very-low-carbohydrate weight-loss diet and an isocaloric low-fat diet on bone health in obese adults. Nutrition 2016; 32(9): 1033–1036. Dostupné z DOI: <http://dx.doi.org/10.1016/j.nut.2016.03.003>.
  52. Wells AS, Read NW. Influences of fat, energy, and time of day on mood and performance. Physiol Behav 1996; 59(6): 1069–1076.
  53. Butki BD, Baumstark J, Driver S. Effects of a carbohydrate-restricted diet on affective responses to acute exercise among physically active participants. Percept Mot Skills 2003; 96(2): 607–615. Dostupné z DOI: <http://dx.doi.org/10.2466/pms.2003.96.2.607>.
  54. Brinkworth GD, Luscombe-Marsh ND, Thompson CH et al. Long-term effects of very low-carbohydrate and high- carbohydrate weight-loss diets on psychological health in obese adults with type 2 diabetes: randomized controlled trial. J Intern Med 2016; 280(4): 388–397. Dostupné z DOI: <http://dx.doi.org/10.1111/joim.12501>.
  55. Burke LM, Cox GR, Culmmings NK et al. Guidelines for daily carbohydrate intake: do athletes achieve them? Sports Med 2001; 31(4): 267–299.
  56. Noakes T, Volek JS, Phinney SD. Low-carbohydrate diets for athletes: what evidence? Br J Sports Med 2014; 48(14): 1077–1078. Dostupné z DOI: <http://dx.doi.org/10.1136/bjsports-2014–093824>.
  57. Volek JS, Freidenreich DJ, Saenz C et al. Metabolic characteristics of keto- adapted ultra-endurance runners. Metabolism 2016; 65(3): 100–110. Dostupné z DOI: <http://dx.doi.org/10.1016/j.metabol.2015.10.028>.
  58. Kapp E. Diabetes, Ironman and nature’s forces. 2013. Dostupné z WWW: <http://t1diabetictriathlete.weebly.com/blog/diabetes-ironman-and-natures-forces>.
  59. Gerhard GT, Ahmann A, Meeuws K et al. Effects of a low-fat diet compared with those of a high-monounsaturated fat diet on body weight, plasma lipids and lipoproteins, and glycemic control in type 2 diabetes. Am J Clin Nutr 2004; 80(3): 668–673. Dostupné z DOI: <http://dx.doi.org/10.1093/ajcn/80.3.668>.
  60. De Natale C, Annuzzi G, Bozzetto L et al. Effects of a plant-based high-carbohydrate/high-fiber diet versus high-monounsaturated fat/low-carbohydrate diet on postprandial lipids in type 2 diabetic patients. Diabetes Care 2009; 32(12): 2168–2173. Dostupné z DOI: <http://dx.doi.org/10.2337/dc09–0266>.
  61. Unwin D, Haslam D, Livesey G. It is the glycaemic response to, not the carbohydrate content of food that matters in diabetes and obesity: The glycaemic index revisited. J Insul Resist 2016; 1(1): a8. Dostupné z DOI: <https://doi.org/10.4102/jir.v1i1.8>.
  62. Mark S, du Toit S, Noakes TD et al. A successful lifestyle intervention model replicated in diverse clinical settings. S Afr Med J 2016; 106(8): 763–766. Dostupné z DOI: <http://dx.doi.org/10.7196/SAMJ.2016.v106i8.10136>.
  63. Bernstein RK. Dr Bernstein’s Diabetes Solution: A Complete Guide To Achieving Normal Blood Sugars. 4th ed. Little Brown (US) 2011. ISBN 978–0316182690.
Štítky
Diabetology Endocrinology Internal medicine
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