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Bispebjerg Hospital - en del af Københavns Universitetshospital

Body weight and metabolic risk factors in patients with type 2 diabetes on a self-selected high-protein low-carbohydrate diet

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


  • Ahmad H Alzahrani
  • Mads J Skytte
  • Amirsalar Samkani
  • Mads N Thomsen
  • Arne Astrup
  • Christian Ritz
  • Elizaveta Chabanova
  • Jan Frystyk
  • Jens J Holst
  • Henrik S Thomsen
  • Sten Madsbad
  • Steen B Haugaard
  • Thure Krarup
  • Thomas Meinert Larsen
  • Faidon Magkos
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Purpose: We previously reported beneficial glucoregulatory effects of a fully provided carbohydrate-reduced, high-protein (CRHP) diet in patients with type 2 diabetes mellitus (T2DM) in a crossover 2 × 6-week trial, in which patients maintained their body weight. Here, we investigated physiological changes during an additional 6-month period on a self-selected and self-prepared CRHP diet. Methods: Twenty-eight patients with T2DM were instructed to consume a CRHP diet (30% of energy from carbohydrate and 30% from protein) for 24 weeks, after an initial 2 × 6-week trial when all food was prepared and provided to them. Patients received dietary advice every 2 weeks. At weeks 0, 6, 12 and 36, they underwent a 3-h intravenous glucose tolerance test, a 4-h mixed meal test, and a 48-h continuous glucose monitoring. Liver, muscle, pancreas, and visceral fat contents were measured by magnetic resonance imaging. Results: During the 24-week self-selected diet period (weeks 12–36), body weight, visceral fat, liver fat, and glycated haemoglobin were maintained at the same levels achieved at the end of the fully provided diet period, and were still lower than at baseline (P < 0.05). Postprandial insulinaemia and insulin secretion were significantly greater (P < 0.05). At week 36, fasting insulin and C-peptide levels increased (P < 0.01) and daily glycaemia decreased further (P < 0.05) when compared with the end of the fully provided diet period. Conclusion: Substituting dietary carbohydrate for protein and fat has metabolic benefits in patients with T2DM. These beneficial effects are maintained or augmented over the next 6 months when patients self-select and self-prepare this diet in a dietitian-supported setting. Trial registration: NCT02764021.

TidsskriftEuropean Journal of Nutrition
Udgave nummer8
Sider (fra-til)4473-4482
Antal sider10
StatusUdgivet - dec. 2021

Bibliografisk note

Funding Information:
The study was funded by grants from Arla Food for Health; the Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen; the Department of Clinical Medicine, Aarhus University; the Department of Nutrition, Exercise and Sports and the Department of Biomedical Sciences, University of Copenhagen; the Copenhagen University Hospital, Bispebjerg; and a fund from The University of Jeddah, Jeddah, Saudi Arabia. Arla Foods, JAN Import A/S, Royal Greenland and Danish Crown contributed with ingredients included in the study meal production.

ID: 66134603