By Andrew A. Skolnick

Patients with type-2 diabetes may have better blood glucose control and weight loss without adversely affecting their serum lipid levels if they substitute saturated fats for carbohydrate in their diets.

Researchers reviewed the medical records of over 150 patients with type 2 diabetes, who had completed a one year follow-up after a dietary prescription for a high saturated fat diet with avoidance of carbs. The patients were compared with 132 historical control subjects, who had been allowed unlimited monounsaturated fat and restricted starch.

While haemoglobin A1c levels improved in both the diet and control groups, patients in the diet group had an additional decrease, the researchers reported. Use of a hydroxymethylglutaryl-coenzyme A reductase inhibitor was associated with a reduction in total cholesterol level. However, the diet group had an additional decrease. The investigators found no significant effect of the diet on the patients’ triglyceride, low-density lipoprotein, or high-density lipoprotein levels.

Although it was not statistically significant, patients on Metformin therapy showed a trend for weight loss. An additional weight loss was noted in the diet group.

“Addition of saturated fat and removal of starch from a high-monounsaturated fat and starch-restricted diet improved glycaemic control and were associated with weight loss without detectable adverse effects on serum lipids,” the researchers concluded.

Endocrinololgy Practice May June 2002; 8: 177-183