The use of low-carbohydrate diet in type 2 diabetes  – benefits and risks

Czyżewska-Majchrzak, Łucja; Grzelak, Teresa; Kramkowska, Marta; Czyżewska, Krystyna; Witmanowski, Henryk

doi:10.5604/1232-1966.1108597

Cited by 20 publications

(18 citation statements)

References 29 publications

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“…Accordingly, the consumption of khorasan wheat products also resulted in a significant decrease in LDL cholesterol and total cholesterol. Alterations in lipid metabolism in T2DM (associated with IR) do not necessarily affect LDL cholesterol levels, but the risk of LDL oxidation, due to increased ROS and an impaired antioxidant scavenging system, is elevated [5, 12, 14]. …”

Section: Discussionmentioning

confidence: 99%

“…Although carbohydrates (also derived from cereals) are generally viewed with some degree of trepidation by diabetics, the long-term risks of low carbohydrate diets (usually combined with higher protein intake) are well-described and include mineral, vitamin and fiber deficiencies, and increased cardiovascular risk and related mortality [5]. However, the above-mentioned beneficial effects attributable to carbohydrates are dependent on the source (wholegrain cereals and not those with added fats, sugar and sodium) [5, 6]. Although evidence is inconclusive for an ideal amount of carbohydrate intake for people with diabetes [6], the emphasis is on the quality of the source.…”

Section: Introductionmentioning

confidence: 99%

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A khorasan wheat-based replacement diet improves risk profile of patients with type 2 diabetes mellitus (T2DM): a randomized crossover trial

et al. 2016

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PurposesThe aim of the present study was to examine whether a replacement diet with products made with organic ancient khorasan wheat could provide additive protective effects in reducing glucose, insulin, lipid and inflammatory risk factors, and in restoring blood redox balance in type 2 diabetes mellitus (T2DM) patients compared to diet with product made with modern organic wheat.MethodsWe conducted a randomized, double-blinded crossover trial with two intervention phases on 21 T2DM patients (14 females, 7 males). The participants were assigned to consume products (bread, pasta, crackers and biscuits) made using semi-whole flour from organic wheat that was either from ancient khorasan wheat or modern control wheat for 8 weeks in a random order. An 8-week washout period was implemented between the interventions. Laboratory analyses were performed both at the beginning and at the end of each intervention phase.ResultsThe metabolic risk profile improved only after the khorasan intervention period, as measured by a reduction in total and LDL cholesterol (mean reduction: −3.7 and −3.4 %, respectively), insulin (−16.3 %) and blood glucose (−9.1 %). Similarly, there was a significant reduction in circulating levels of reactive oxygen species (ROS), vascular endothelial growth factor (VEGF) and interleukin-1ra, and a significant increase of total antioxidant capacity (+6.3 %). No significant differences from baseline were noted after the modern control wheat intervention phase. The change (from pre- to post-intervention) between the two intervention arms was significantly different (p < 0.05) for total and LDL-c, insulin and HOMA index.ConclusionsA replacement diet with ancient khorasan wheat consumption provided additive protection in reducing total and LDL cholesterol, insulin, blood glucose, ROS production, and some inflammatory risk factors, which are all key factors warranting of control in secondary prevention of T2DM compared to a diet with products made with modern wheat.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A khorasan wheat-based replacement diet improves risk profile of patients with type 2 diabetes mellitus (T2DM): a randomized crossover trial

et al. 2016

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“…There have also been reports of negative LCD outcomes, manifested by an increased risk of vitamin and mineral deficiencies and an insufficient fibre intake. When used long term, this diet may be associated with very high levels of protein which, in turn, raises the risk of renal dysfunction and the appearance of irregularities in the water and electrolyte balance [14]. The use of a low-carbohydrate and high--protein diet carries the risk of nephropathy, which should be taken into account when dealing with patients already at risk of kidney failure due to diabetes.…”

Section: Low-carbohydrate Diet: Risks and Benefitsmentioning

confidence: 99%

Use of low-carbohydrate diets in patients with type 2 diabetes

Oleszko

Szczepańska

Jośko-Ochojska

2018

Ann. Acad. Med. Siles.

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The treatment of type 2 diabetes should be supported with a proper diet paired with physical activity at every stage of therapy. Carbohydrates are key macronutrients with a direct effect on the level of postprandial glycaemia. For the past several decades, dietary intervention studies investigating and comparing the effects of limiting carbohydrate intake in favour of other macronutrients have been carried out. A low-carbohydrate diet has been and still is suggested by some experts as well as patient organizations as the most effective option that is associated with the smallest risk of side effects. The recommendations, however, have not been supported with evidence from high quality randomized control trials. The aim of this work is to review the published meta-analyses of randomized control trials, which compared the parameters relevant for the treatment of diabetes, including fasting plasma glucose, glycated haemoglobin, the lipid profile and weight loss. Currently, there is insufficient scientific evidence allowing a uniform recommendation to be made regarding the optimum amount of carbohydrates in the daily diet, hence the relevant recommendations should be tailored to each patient. In dietary interventions among type 2 diabetes, lowering the patient's diet energy content is of primary importance, as well as the quality of ingested macronutrients, especially carbohydrates and fats.

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“…The majority of patients with type 2 diabetes mellitus (T2dM) have the characteristics of high blood lipids in addition to high glucose (1,2). High plasma free fatty acids (FFAs) are associated with insulin resistance, inflammation and oxidative stress, which are a result of advanced diabetes mellitus (3).…”

Section: Introductionmentioning

confidence: 99%

LncRNA uc.48+ is involved in the diabetic immune and inflammatory responses mediated by P2X7 receptor in RAW264.7 macrophages

Wen

Jiang

et al. 2018

Int J Mol Med

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High glucose combined with high FFAs can contribute to the unfavorable development of type 2 diabetes mellitus (T2DM) and monocytes/macrophages are important in the occurrence and development of T2DM, which is regarded as a type of low‑grade inflammation. Although our previous study demonstrated that increased expression of P2X7 receptor (P2X7R) in peripheral blood monocytes may alter the innate immune system and that long non‑coding (lnc)RNA uc.48+ was involved in diabetic neuropathic pain, the involvement of uc.48+ mediated by the P2X7R in monocyte/macrophages during T2DM has not been reported. In the present study, the effectsof uc.48+ small interference RNA (siRNA) on factors, including the mRNA and protein expression of P2X7R, apoptosis and proliferation, levels of reactive oxygen species (ROS), cytokine levels, and expression of phosphorylated (p‑) extracellular signal‑regulated kinase (ERK)1/2, were examined in RAW264.7 macrophages following exposure to high glucose and high plasma free fatty acids (FFAs). After RAW264.7 cells were transfected with uc.48+ siRNA under high glucose conditions and FFAs treatment, the mRNA expression levels of uc.48+ and P2X7 receptor were detected by reverse transcription‑polymerase chain reaction. The protein mass of P2X7 receptor and ERK signaling pathway were assessed by western blotting. ROS and calcium concentrations, and culture supernatant cytokine content [tumor necrosis factor‑α, interleukin (IL)‑10, IL‑1β] were detected by fluorescent probes and ELISA respectively. Cell viability and apoptosis were determined by MTS test and flow cytometry, respectively. It was found that treatment of RAW264.7 cells with high glucose and FFAs, which exhibited increased expression of uc.48+, evoked P2X7R‑mediated immune and inflammatory responses through several means, including cytokine secretion, ROS formation, and activation of the ERK signaling pathway. The uc.48+ siRNA regulated these factors and thus influenced the course and outcome of the immune and inflammatory responses mediated by P2X7R.

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The use of low-carbohydrate diet in type 2 diabetes – benefits and risks

Cited by 20 publications

References 29 publications

A khorasan wheat-based replacement diet improves risk profile of patients with type 2 diabetes mellitus (T2DM): a randomized crossover trial

A khorasan wheat-based replacement diet improves risk profile of patients with type 2 diabetes mellitus (T2DM): a randomized crossover trial

Use of low-carbohydrate diets in patients with type 2 diabetes

LncRNA uc.48+ is involved in the diabetic immune and inflammatory responses mediated by P2X7 receptor in RAW264.7 macrophages

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