DANIEL F. O’NEILL,1 ERIC C. WESTMAN, M.D., M.H.S.,1 and RICHARD K. BERNSTEIN, M.D.2

ABSTRACT

The Diabetes Complications and Control Trial (DCCT) established that diabetic complica- tions could be reduced by improvement in glycemic control. The ideal diabetes treatment protocol would maintain blood glucose levels in normal ranges without resulting in frequent hypoglycemia. Because several studies suggest an inverse relationship between carbohydrate consumption and the level of glycemic control, the effects of an intensive treatment program, which included dietary carbohydrate restriction, are examined in this paper. A chart review was performed of 30 patients who self-reported the consumption of 30 g of carbohydrate daily, followed a strict insulin regimen, monitored blood glucose levels at least four times daily, and had follow-up clinical visits or phone calls with their physician. For both type I and type II diabetics, there were significant improvements in glycemic control and mean fast- ing lipid profiles at follow-up. The mean hemoglobin A1c decreased by 27.8% from 7.9 to 5.7 (p < 0.001). The LDL cholesterol decreased by 16.5%, from 155.4 to 129.7 mg/dL (p = 0.004). The triglycerides decreased by 31.1%, from 106.8 to 73.6 mg/dL (p = 0.005). The HDL cholesterol increased by 43.3%, from 50.4 to 72.2 mg/dL (p < 0.001). The cholesterol/HDL ratio decreased by 31.5%, from 4.99 to 3.42 (p < 0.001). A carbohydrate-restricted regimen improved glycemic control and lipid profiles in selected motivated patients. Therefore, further investigation of the effects of this protocol on treating diabetes mellitus should be considered. Additionally, the reduction of insulin afforded by this diet could theoretically lead to a reduction in hypo- glycemic events.

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