I recently submitted this case study to the Australian Diabetes Educators Association to be considered for inclusion in their National conference program.
This submission was unfortunately unsuccessful. Still makes interesting reading though.

Reduced Carbohydrate Diet Results in Weight Loss and Improved Glycaemic Control in a Patient with Poorly Controlled Type 2 Diabetes.

Jennifer Elliott

Abstract

Background: Evidence suggests that a reduction in carbohydrate intake is an effective strategy to reduce BGLs in people with Type 2 diabetes.

Case study: A 38 year old man with poorly controlled diabetes (HbA1c 10.7%), BMI 51.9 and features of MetS (central obesity, hypertension, HDL 0.8 mmol/l and Tg 1.85 mmol/l) presented for dietary advice.

Education included an explanation of pathways of carbohydrate metabolism and the effects of insulin resistance on hunger, appetite, energy levels, central weight gain, snoring, blood lipids and moods. The rationale for reducing carbohydrate intake to reduce insulin levels was explained and a 2-week trial of non-ketogenic carbohydrate restriction commenced. The diet intervention restricted carbohydrate foods to one meal per day, with other meals and snacks consisting of foods with a minimal carbohydrate content. This eating plan was well accepted by the patient, who chose to continue it for longer.

 

Results after 7 weeks:

1. 13 kg weight loss (150 to 137 kg)

2. Cessation of insulin injections. (At initial consultation, insulin regimen was Lantus 32 u/s evening and Novorapid 22 u/s with meals).

3. FBG reduced from 14-19 mmol/l to 5 - 7 mmol/l

4. Pre-meal BGLs reduced from 15-20 mmol/l to 5-7 mmol/l

5. HbA1c reduced from 10.7% to 7.7%

6. CRP reduced from 16 to 12.9 mg/l

7. ESR reduced from 21 to 5 mm/hr

8. AST reduced from 79 to 40 u/l

9. ALT reduced from 82 to 45 u/l

10. GGT reduced from 256 to 38 u/l

11. Alk Phos reduced from 163 to 96 u/l

12. Reduced snoring

13. Reduced hunger

14. Improved moods

Conclusion: A reduced carbohydrate intake for the management of Type 2 diabetes resulted in weight loss, improved glycaemic control, reduction in diabetes medication and was well accepted by the patient.

Note: Diet change was the only lifestyle intervention in the 7 weeks reported. The client did no regular exercise before or during the trial.