糖尿病与临床实践杂志

抽象的

Effects of Low Carbohydrate Diet in Individuals Medicated for Type 2 Diabetes on Long-term Glycemic Control and Medication Usage in Context of Workplace Sponsored Wellness Program

Nathan J Savage, Mont Didericksen, Brant Fonnesbeck

Purpose: Examine effectiveness of adding structured low-carbohydrate diet to low-intensity aerobic exercise on long-term glycemic control in individuals medicated for type 2 diabetes within context of workplace-sponsored wellness program.

Methods: Forty-three individuals medicated for type 2 diabetes participated in workplace-sponsored wellness program. Participants analyzed according to group (exercise-only or diet plus exercise). Longitudinal data analysis conducted using multilevel growth modeling with 4 waves of data collected from baseline through 3-months. Primary outcome measure was changes in laboratory measured glycosylated hemoglobin (HbA1c) levels.

Results: Participants in diet plus exercise group (n = 30) had statistically significant and clinically meaningful reductions in HbA1c levels while reducing usage of anti-glycemic medication compared to exercise-only group at 3 months. Final multilevel growth model revealed reductions in HbA1c levels in participants in diet plus exercise group of -1.19 points (95 % CI -1.92 to -0.47; P = 0.002) compared to exercise-only group. Interaction between treatment group, medication effect score, and time revealed faster monthly reductions in HbA1c values while reducing usage of anti-glycemic medication for participants in diet plus exercise group of -0.13 points (95 % CI -0.19 to -0.07; P = 0.000) compared to exercise-only group. Participants in diet plus exercise group experienced significant reductions in body mass index, percentage of weight loss, body fat percentage, waist circumference, resting heart rate, and blood pressure compared to exercise-only group. Higher proportion of participants in diet plus exercise group achieved successful clinical outcome based on Global Rating of Change scores (Χ2 = 9.9; P = 0.000) compared to exercise-only group.

Conclusions: Combining structured low-carbohydrate diet with low-intensity aerobic exercise in individuals medicated for type 2 diabetes provides statistically significant and clinically meaningful improvements in long-term glycemic control while reducing need for anti-glycemic medication within context of workplace-sponsored wellness program.