PMID- 34101004 OWN - NLM STAT- MEDLINE DCOM- 20211109 LR - 20220531 IS - 1436-6215 (Electronic) IS - 1436-6207 (Linking) VI - 60 IP - 8 DP - 2021 Dec TI - Body weight and metabolic risk factors in patients with type 2 diabetes on a self-selected high-protein low-carbohydrate diet. PG - 4473-4482 LID - 10.1007/s00394-021-02605-0 [doi] AB - PURPOSE: We previously reported beneficial glucoregulatory effects of a fully provided carbohydrate-reduced, high-protein (CRHP) diet in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 x 6-week trial, in which patients maintained their body weight. Here, we investigated physiological changes during an additional 6-month period on a self-selected and self-prepared CRHP diet. METHODS: Twenty-eight patients with T2DM were instructed to consume a CRHP diet (30% of energy from carbohydrate and 30% from protein) for 24 weeks, after an initial 2 x 6-week trial when all food was prepared and provided to them. Patients received dietary advice every 2 weeks. At weeks 0, 6, 12 and 36, they underwent a 3-h intravenous glucose tolerance test, a 4-h mixed meal test, and a 48-h continuous glucose monitoring. Liver, muscle, pancreas, and visceral fat contents were measured by magnetic resonance imaging. RESULTS: During the 24-week self-selected diet period (weeks 12-36), body weight, visceral fat, liver fat, and glycated haemoglobin were maintained at the same levels achieved at the end of the fully provided diet period, and were still lower than at baseline (P < 0.05). Postprandial insulinaemia and insulin secretion were significantly greater (P < 0.05). At week 36, fasting insulin and C-peptide levels increased (P < 0.01) and daily glycaemia decreased further (P < 0.05) when compared with the end of the fully provided diet period. CONCLUSION: Substituting dietary carbohydrate for protein and fat has metabolic benefits in patients with T2DM. These beneficial effects are maintained or augmented over the next 6 months when patients self-select and self-prepare this diet in a dietitian-supported setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT02764021. CI - (c) 2021. Springer-Verlag GmbH Germany, part of Springer Nature. FAU - Alzahrani, Ahmad H AU - Alzahrani AH AD - Department of Nutrition, Exercise and Sports, Kobenhavns Universitet, Copenhagen, Denmark. AD - Department of Physiology, Faculty of Medicine, The University of Jeddah, Jeddah, Saudi Arabia. FAU - Skytte, Mads J AU - Skytte MJ AD - Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark. FAU - Samkani, Amirsalar AU - Samkani A AD - Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark. FAU - Thomsen, Mads N AU - Thomsen MN AD - Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark. FAU - Astrup, Arne AU - Astrup A AD - Department of Nutrition, Exercise and Sports, Kobenhavns Universitet, Copenhagen, Denmark. FAU - Ritz, Christian AU - Ritz C AD - Department of Nutrition, Exercise and Sports, Kobenhavns Universitet, Copenhagen, Denmark. FAU - Chabanova, Elizaveta AU - Chabanova E AD - Department of Radiology, Copenhagen University Hospital Herlev Gentofte, Copenhagen, Denmark. FAU - Frystyk, Jan AU - Frystyk J AD - Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark. AD - The Research Unit for Endocrinology, Department of Endocrinology, Odense University Hospital, Odense, Denmark. FAU - Holst, Jens J AU - Holst JJ AD - Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark. FAU - Thomsen, Henrik S AU - Thomsen HS AD - Department of Radiology, Copenhagen University Hospital Herlev Gentofte, Copenhagen, Denmark. FAU - Madsbad, Sten AU - Madsbad S AD - Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark. AD - Department of Internal Medicine, Copenhagen University Hospital Amager Hvidovre, Copenhagen, Denmark. FAU - Haugaard, Steen B AU - Haugaard SB AD - Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark. AD - Department of Internal Medicine, Copenhagen University Hospital Amager Hvidovre, Copenhagen, Denmark. FAU - Krarup, Thure AU - Krarup T AD - Department of Nutrition, Exercise and Sports, Kobenhavns Universitet, Copenhagen, Denmark. AD - Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark. FAU - Larsen, Thomas Meinert AU - Larsen TM AD - Department of Nutrition, Exercise and Sports, Kobenhavns Universitet, Copenhagen, Denmark. FAU - Magkos, Faidon AU - Magkos F AUID- ORCID: 0000-0002-1312-7364 AD - Department of Nutrition, Exercise and Sports, Kobenhavns Universitet, Copenhagen, Denmark. fma@nexs.ku.dk. AD - Department of Nutrition, Exercise and Sports, Kobenhavns Universitet, Rolighedsvej 26, 1958, Frederiksberg C, Denmark. fma@nexs.ku.dk. LA - eng SI - ClinicalTrials.gov/NCT02764021 PT - Clinical Trial PT - Journal Article DEP - 20210608 PL - Germany TA - Eur J Nutr JT - European journal of nutrition JID - 100888704 RN - 0 (Blood Glucose) RN - 0 (Dietary Carbohydrates) RN - 0 (Insulin) SB - IM MH - Blood Glucose MH - Blood Glucose Self-Monitoring MH - Body Weight MH - *Diabetes Mellitus, Type 2 MH - *Diet, High-Protein Low-Carbohydrate MH - Dietary Carbohydrates MH - Humans MH - Insulin MH - Risk Factors OTO - NOTNLM OT - Ectopic fat OT - Glucose metabolism OT - Glycated haemoglobin OT - Insulin secretion OT - Low-carbohydrate high-protein EDAT- 2021/06/09 06:00 MHDA- 2021/11/10 06:00 CRDT- 2021/06/08 12:28 PHST- 2020/09/03 00:00 [received] PHST- 2021/06/02 00:00 [accepted] PHST- 2021/06/09 06:00 [pubmed] PHST- 2021/11/10 06:00 [medline] PHST- 2021/06/08 12:28 [entrez] AID - 10.1007/s00394-021-02605-0 [pii] AID - 10.1007/s00394-021-02605-0 [doi] PST - ppublish SO - Eur J Nutr. 2021 Dec;60(8):4473-4482. doi: 10.1007/s00394-021-02605-0. Epub 2021 Jun 8.