There is low to high ( majority moderate ) certainty for small improvements of unclear clinical importance in plasma glucose , triglycerides , and HDL concentrations favoring low-carbohydrate food at half of the prespecified time points .
There was little to no difference in LDL concentration or any of the secondary outcomes ( body weight , waist circumference , blood pressure , quality of life ) in response to either of the diets ( very-low- to high-certainty evidence ) .
Conclusions Currently available data provide low- to moderate-certainty evidence that dietary carbohydrate restriction to a maximum of 40 % yields slightly better metabolic control of uncertain clinical importance than reduction in fat to a maximum of 30 % in people with T2D .
Background It remains uncertain which diet is best for people with type 2 diabetes ( T2D ) .
Objective We compared the effects of dietary carbohydrate restriction with fat restriction on markers of metabolic syndrome and quality of life in people with T2D .
Persistence of Hypertriglyceridemic Effect of Low-Fat High-Carbohydrate Diets in NIDDM Patients
Although low-fat high-carbohydrate diets are recommended for patients with non-insulin-dependent diabetes mellitus ( NIDDM ) in an effort to reduce the risk of coronary artery disease ( CAD ) , the results of short-term studies have shown that these diets can lead to changes in carbohydrate and lipid metabolism associated with an increased risk of CAD . This study has extended these earlier observations by determining the metabolic effects of such diets over a longer period in these patients . The comparison diets contained either 40 or 60 % of the total calories as carbohydrates , with reciprocal changes in fat content from 40 to 20 % consumed in r and om order for 6 wk in a crossover experimental design . The ratio of polyunsaturated to saturated fat and the total cholesterol intake were held constant in the two diets . Plasma glucose and insulin concentrations were significantly ( P < .001 ) elevated throughout the day when patients consumed the 60 % carbohydrate diet , and 24-h urinary glucose excretion more than doubled ( 0.8 vs. 1.8 mol/24 h ) . Fasting plasma total and very-low-density lipoprotein ( VLDL ) triglyceride ( TG ) concentrations increased by 30 % ( P < .001 ) after 1 wk on the 60 % carbohydrate diet , and the magnitude of carbohydrate-induced hypertriglyceridemia persisted unchanged throughout the 6-wk study period . Total plasma cholesterol concentrations were similar after both diets . However , VLDL cholesterol ( VLDL-chol ) was significantly increased , whereas both low-density lipoprotein ( LDL- ) and high-density lipoprotein ( HDL- ) chol concentrations were significantly decreasedafter consumption of the 60 % carbohydrate diet . Consequently , neither total-chol-to-HDL-chol nor LDL-chol-to-HDL-chol ratios changed . The results of this study indicate that high-carbohydrate diets lead to several changes in carbohydrate and lipid metabolism in patients with NIDDM that could lead to an increased risk of CAD , and these effects persist for > 6 wk . Given these results , it seems reasonable to suggest that the routine recommendation of low-fat high-carbohydrate diets for patients with NIDDM be reconsidered
There is low to high ( majority moderate ) certainty for small improvements of unclear clinical importance in plasma glucose , triglycerides , and HDL concentrations favoring low-carbohydrate food at half of the prespecified time points .
There was little to no difference in LDL concentration or any of the secondary outcomes ( body weight , waist circumference , blood pressure , quality of life ) in response to either of the diets ( very-low- to high-certainty evidence ) .
Conclusions Currently available data provide low- to moderate-certainty evidence that dietary carbohydrate restriction to a maximum of 40 % yields slightly better metabolic control of uncertain clinical importance than reduction in fat to a maximum of 30 % in people with T2D .
Background It remains uncertain which diet is best for people with type 2 diabetes ( T2D ) .
Objective We compared the effects of dietary carbohydrate restriction with fat restriction on markers of metabolic syndrome and quality of life in people with T2D .