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The impact of low-carbohydrate diet on glycemic control in Native Americans

Authors Khairi S, Torabi Sagvand B, Nasser SK

Received 24 June 2015

Accepted for publication 15 July 2015

Published 24 August 2015 Volume 2015:5 Pages 119—123


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Mingzhao Xing

Shafaq Khairi,1 Babak Torabi Sagvand,2 Syed Kamal Nasser3

1Southeastern Regional Physician Services, Lumberton, NC, 2Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 3Southeastern Regional Medical Center, Lumberton, NC, USA

Abstract: Many studies have shown that a low-carbohydrate diet (LCD) is a safe and effective intervention to improve glycemic control. However, published data are limited regarding the use of carbohydrate restriction in the treatment and prevention of type 2 diabetes mellitus (DM) in the Native Americans, in a real-world clinical practice setting. We evaluated the efficacy of an LCD on 50 obese Native Americans with either type 2 DM or impaired fasting blood glucose (IFG) in a primary care/obesity medicine practice. The primary intervention was an LCD defined as an intake of <20 g of carbohydrates per day. The intervention involved providing an educational handout and behavioral counseling assisted by a dedicated weight loss coordinator. We evaluated the effects of this intervention on hemoglobin A1c, body weight, blood pressure, and lipid parameters. The subjects were evaluated at baseline and 6 months. The subjects underwent additional safety and counseling visits throughout the study. Subjects were considered completers if they had baseline and 6-month measurements. The mean age was 55.0±10.9 years, and 66.7% were female. Subjects had significant improvements in hemoglobin A1c (-1.4%±0.9%, in subjects with DM, P<0.0001), fasting blood glucose (-15±4.9 mg/dL, in subjects with IFG, P<0.0001), and body mass index (-4.0±1.7 kg/m2, P<0.0001). An LCD can lead to clinically and statistically significant improvement in glycemic control and body weight among obese subjects with type 2 DM or IFG over a 6-month period. The results suggest that carbohydrate restriction can be an effective real-world intervention in a primarily Native American clinical practice. However, further studies are needed to assess long-term compliance and potential weight regain.

Keywords: diabetes mellitus, impaired fasting glucose, diet

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