Reduction in urinary albumin excretion with a moderate low-carbohydrate diet in patients with type 2 diabetes: a 12-month intervention
Hajime Haimoto,1 Tae Sasakabe,2 Hiroyuki Umegaki,3 Kenji Wakai4
1Department of Internal Medicine, Haimoto Clinic, Kasugai, 2Department of Clinical Nutrition, Haimoto Clinic, Kasugai, 3Department of Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, 4Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
Introduction: Urinary albumin excretion (UAE) is a marker of the early phase of diabetic nephropathy. Although a low-carbohydrate diet (LCD) has been shown to effectively improve glycemic control in patients with type 2 diabetes (T2DM), its effects on UAE remain unknown.
Patients and methods: A total of 124 patients (mean age ± standard deviation, 61.6 ± 9.2 years) with T2DM were instructed to consume a moderate LCD (1734 ± 416 kcal/d; % carbohydrate:fat:protein = 38:37:19) for 12 months. We measured the levels of UAE, hemoglobin A1c, fasting plasma glucose, fasting serum insulin (IRI), and the serum lipid profiles in the patients and recorded their dosages of antidiabetic drugs during this 12-month period.
Results: Of the 124 patients, 68 were normoalbuminuric, 50 were microalbuminuric, and six were macroalbuminuric at baseline. The patients had relatively good compliance with the moderate LCD diet. After 12 months, the mean levels of hemoglobin A1c, fasting plasma glucose, IRI, homeostasis model assessment-estimated insulin resistance, and the body mass index of all participants significantly decreased (P = 0.003 for IRI and P < 0.001 for the other parameters). Among the microalbuminuric patients (n = 50), remission to normoalbuminuria was frequently achieved (52%) and the geometric mean UAE significantly decreased by 53% (95% confidence interval: 43, 62) over 12 months (P < 0.001). After patients taking an angiotensin 2 receptor blocker were excluded, the UAE significantly decreased by 41% (n = 26, 95% confidence interval: 25, 54; P < 0.001). Moreover, the reduction in UAE was significantly and positively correlated with a reduction in homeostasis model assessment-estimated insulin resistance levels (rs = 0.308; P = 0.031).
Conclusion: A moderate LCD (38% carbohydrate diet) achieved a remarkable reduction in UAE over 12 months in microalbuminuric patients with T2DM.
Keywords: glycemic control, microalbuminuria, angiotensin 2 receptor blockers, insulin resistance
This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php
Readers of this article also read:
Enriquez GG, Rizvi SAA, D’Souza MJ, Do DP
Published Date: 10 April 2013
Effects of endotoxemia on the pharmacodynamics and pharmacokinetics of ketamine and xylazine anesthesia in Sprague–Dawley rats
Veilleux-Lemieux D, Beaudry F, Hélie P, Vachon P
Published Date: 5 October 2012
A randomized, placebo-controlled, double-blind study to confirm the reversal of hepatorenal syndrome type 1 with terlipressin: the REVERSE trial design
Boyer TD, Medicis JJ, Pappas SC, Potenziano J, Jamil K
Published Date: 16 July 2012
Comparison with ancestral diets suggests dense acellular carbohydrates promote an inflammatory microbiota, and may be the primary dietary cause of leptin resistance and obesity
Published Date: 6 July 2012
The therapeutic potential of synthetic human atrial natriuretic peptide in nephrotic syndrome: a randomized controlled trial
Kanzaki M, Wada J, Kikumoto Y, Akagi S, Nakao K, Sugiyama H, Makino H
Published Date: 5 June 2012
Published Date: 1 May 2012
Published Date: 10 January 2012
Rat model of nonalcoholic steatohepatitis created by methionine and choline deficiency: biochemical and histological analyses
Nagai S, Iwamoto J, Suzuki M, Seki A
Published Date: 18 July 2011
Effects of a moderate low-carbohydrate diet on preferential abdominal fat loss and cardiovascular risk factors in patients with type 2 diabetes
Sasakabe T, Haimoto H, Umegaki H, Wakai K
Published Date: 29 April 2011
Radha Andukuri, Andjela Drincic, Marc Rendell
Published Date: 21 July 2009