Cut Down on Carbohydrate Usage in the Diet of Type 2 Diabetes - Mechanisms of Effective Therapy of Diabetes by Selective Choice of Macronutrients - The Phenotype Study

Conditions

Type 2 Diabetes

Brief summary

Scientific evidence for the dietary treatment of type 2 diabetes is insufficient. The investigators hypothesize that a lower carbohydrate content in the diabetic diet than the recommended 55 E% will decrease the postprandial glucose excursion, decrease insulinotropic factors like incretin hormones and decrease their insulinotropic effects due to their glucose dependency. This will reduce postprandial insulin concentration, resulting in an improved insulin sensitivity and glucose metabolism. This clinical study will examine in diabetic, prediabetic and healthy subjects the acute effects of short term highly controlled dietary low carbohydrate intervention on metabolic pathways with respect to insulin action, pancreatic islet function, lipid metabolism, incretin hormones, low grade inflammation in plasma and novel measures of fatty acid metabolism.

Mads N. Thomsen, Mads J. Skytte, Amirsalar Samkani, Arne Astrup, Mogens Fenger et al. (14 authors)

Frontiers in Nutrition2022-08-1911 citations

10.3389/fnut.2022.933118

The clinical effects of a carbohydrate-reduced high-protein diet on glycaemic variability in metformin-treated patients with type 2 diabetes mellitus: A randomised controlled study.

Thomsen MN, Skytte MJ, Astrup A, Deacon CF, Holst JJ, Madsbad S, Krarup T, Haugaard SB, Samkani A.

2020-08-0111 citations

10.1016/j.clnesp.2020.07.002

The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial.

Samkani A, Skytte MJ, Anholm C, Astrup A, Deacon CF, Holst JJ, Madsbad S, Boston R, Krarup T, Haugaard SB.

2018-12-276 citations

10.1186/s12944-018-0953-8

Interventions

OTHERLow carbohydrate meals

Meal macronutritional energy composition: Carbohydrate 30% Protein 30% Fat 40%

OTHERStandard carbohydrate meals

Meal macronutritional energy composition: Carbohydrate 55% Protein 15% Fat 30%

Study design

Allocation

RANDOMIZED

Intervention model

CROSSOVER

Primary purpose

BASIC_SCIENCE

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to 70 Years

Healthy volunteers

Yes

Inclusion criteria

* Men age 18-70 years * Postmenopausal women age 55-70 years * Non-smoker (abstinent at least 6 months) * HbA1c \< 74 mmol/mol * Fasting blood glucose \< 11 mmol/L (mean of 3 measurements) * Negative (\<25 IU/L) plasma glutamate decarboxylase (GAD-65) antibodies (IgG) * Hemoglobin \> 7.5 mmol/L (men); \> 6.8 mmol/L (women) * Normal thrombocytes (140-400 x 109/L) * eGFR \> 45 ml/min per 1.73 m2 * Alkaline phosphatase \< 140 IU/L * Alanine aminotransferase \< 70 IU/L * Normal International Normalized Ratio (0.9-1.2)

Exclusion criteria

* Critical illness * Anti-diabetic drugs other than metformin (maximum of 2000 mg / day) * Steroid treatment e.g. prednisolone * Reported or journalized severe food allergy or intolerance * Reported or journalized gut disease e.g. Crohn's disease, Coeliac disease * Reported or journalized alcohol dependence syndrome

Design outcomes

Primary

Measure	Time frame	Description
Insulin sensitivity	Measured during meal tests (2 days with each intervention)	Insulin sensitivity as measured by the oral minimal model applied to the meal test

Countries

Denmark

Outcome results

None listed