Does a high-carbohydrate diet have different effects in NIDDM patients treated with diet alone or hypoglycemic drugs?
Study Goal
The researchers aimed to compare the effects of a high-carbohydrate diet on blood glucose and plasma lipids in NIDDM patients with varying degrees of glucose intolerance.
Results Summary
The high-carbohydrate diet significantly increased postprandial blood glucose in patients on glibenclamide and raised fasting plasma triglyceride concentrations in both groups, but had no effect on fasting plasma cholesterol or HDL. Postprandial insulin levels increased significantly in the diet-only group.
Population
Eighteen NIDDM patients (9 on diet alone, 9 on diet plus glibenclamide).
Effective Dosage
60% energy from carbohydrate, 20% from fat (high-carbohydrate diet); 40% energy from carbohydrate, 40% from fat (low-carbohydrate diet).
Duration
15 days per diet phase (crossover design).
Interactions
Interaction noted with glibenclamide (increased postprandial blood glucose).
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
high-carbohydrate/low-fiber diet | increase | postprandial blood glucose | patients on glibenclamide | 13.6 +/- 1.4 vs. 11.0 +/- 1.8 mmol/l | produced a significant increase | #1 |
high-carbohydrate/low-fiber diet | no change | postprandial blood glucose | group on diet alone | 9.7 +/- vs. 8.9 +/- 0.6 mmol/l | no difference was recorded | #2 |
high-carbohydrate/low-fiber diet | increase | Postprandial insulin levels | group on diet alone | 248 +/- 32 vs. 192 +/- 28 pmol/l | were significantly higher | #3 |
high-carbohydrate/low-fiber diet | no change | Postprandial insulin levels | other group | 226 +/- 19 vs. 202 +/- 24 pmol/l | no significant differences were observed | #4 |
high-carbohydrate/low-fiber diet | increase | fasting plasma triglyceride concentrations | both groups | 1.36 +/- 0.2 vs. 1.12 +/- 0.2 mmol/l and 1.4 +/- 0.3 vs. 1.1 +/- 0.1 mmol/l | induced a significant increase | #5 |
high-carbohydrate/low-fiber diet | no change | fasting plasma cholesterol and HDL | both groups | - | No differences were observed | #6 |
OBJECTIVE: To compare the effects of a nigh-carbohydrate diet on blood glucose and plasma lipids in NIDDM patients with either mild or severe glucose intolerance. RESEARCH DESIGN AND METHODS: A crossover design with a 15-day intervention diet was used. Eighteen patients were separated into two groups on the basis of hypoglycemic treatment (diet, n = 9, or diet plus glibenclamide, n = 9) and were assigned to a 15-day treatment with a high-carbohydrate/low-fiber diet containing 60% energy from carbohydrate and 20% from fat or a low-carbohydrate/low-fiber diet with 40% energy from carbohydrate and 40% from fat and then crossed over to the other diet for 15 more days. RESULTS: The high-carbohydrate diet produced a significant increase in postprandial blood glucose in patients on glibenclamide (13.6 +/- 1.4 vs. 11.0 +/- 1.8 mmol/l, P < 0.002, while no difference was recorded in the group on diet alone (9.7 +/- vs. 8.9 +/- 0.6 mmol/l). Postprandial insulin levels were significantly higher after the high-carbohydrate diet in the group on diet along (248 +/- 32 vs. 192 +/- 28 pmol/l, P < 0.01), while no significant differences were observed in the other group (226 +/- 19 vs. 202 +/- 24 pmol/l) The high-carbohydrate diet also induced a significant increase in fasting plasma triglyceride concentrations in both groups (1.36 +/- 0.2 vs. 1.12 +/- 0.2 mmol/l, P < 0.05 and 1.4 +/- 0.3 vs. 1.1 +/- 0.1 mmol/l, P < 0.05). No differences were observed in fasting plasma cholesterol and HDL. CONCLUSIONS: The effects of the high-carbohydrate diet on blood glucose control in NIDDM patients differ according to severity of glucose intolerance.