The effect of a low carbohydrate energy-unrestricted diet on weight loss in obese type 2 diabetes patients – A randomized controlled trial

SummaryBackground & aimsTrials assessing the effectiveness and safety of the Atkins diet for weight loss in obese diabetic patients are limited and adherence is problematic. The current trial compared an Atkins-like diet to a conventional ADA-recommended diet over a one year period.Methods52 type 2 diabetes patients, aged 35–75, BMI 30–39.9 kg/m2, HbA1c > 7%, treated by diet or oral medication, were initially placed on a DASH diet for one month, then randomly assigned to a modified Atkins diet (ATK) with unrestricted calorie intake or a standard American Diabetes Association (ADA) calorie-restricted diet. Weight, fasting blood glucose, lipid profile, blood pressure, and microalbuminuria were measured at baseline and after 1.5, 3, 6 and 12 months, and compliance with the diets was assessed.ResultsSimilar weight loss and decrease in HbA1c were observed in both groups. Improvement in glycemic control and cardiovascular risk factor levels accompanied the modest weight reduction, with no significant between-group differences. ATK was not associated with untoward renal effects. Substantial drop-out in both groups was noted.ConclusionThere was no statistically significant advantage in terms of weight loss or glucose control for the Atkins-like diet. Adherence to a very low carbohydrate diet in a population accustomed to a Mediterranean-type diet rich in fruits and vegetables was modest, thus restricting its applicability to selected obese diabetes patients.