Conclusion
This study reinforces what has previously been well known- ie that benefits of a healthy lifestyle should not be ignored, despite recent discoveries of newer anti-diabetic drugs.
All diabetics should understand that lifestyle changes are essential in the management of diabetes. In the long run, patients are much better off if the dietary advice they receive is more along the lines of a Mediterranean diet.
However, even though the results of the above study are great, one has to be practical. The patients in the above study received intense nutritional support for a long time, something that is not normally available or affordable by most patients in North America. In the study, dieticians and nutritionists frequently emphasized diet and lifestyle changes. Whether similar advice from physicians only will deliver such good results remains to be seen.
There is little doubt that the role of diet and lifestyles can have a marked improvement in diabetics. All diabetics need to know about portion amounts (supersize is out), nutritional values of whole foods and role of exercise. Perhaps with this news, health care professionals will start to be more forceful and reinforce benefits of lifestyle and diet.
For the most part, health care workers have always emphasized medical therapy alone as a key to success. With this study comes an important reminder. Patient management is a complex synergistic interaction between medical therapy and life style changes. Both need to be emphasized to achieve the best results.
http://www.medscape.com/cardiology
Thursday, September 10, 2009
Is the Mediterranean diet good for Diabetic Patients? Part 2
The results
Of the 155 patients who had a raised HbA1c level of >7% at the onset, less than 1/5th (only 22 individuals) still had raised HbA1c level after three months. At the end of six months, individuals on both diets had decreased levels of HbA1c.
Individuals consuming both diets, lost weight and had decreases in blood glucose and HbA1c levels, but the reductions were more noteworthy in those who consumed the Mediterranean-diet.
The Mediterranean diet also postponed the need for high blood pressure medications irrespective of weight loss. Further, more patients who consumed the Mediterranean diet also had higher increases in HDL-cholesterol levels (good cholesterol) and lowering of fats.
Overall, the results showed that with sustained nutritional guidance, only 44% of newly diagnosed diabetic patients on a Mediterranean diet vs. 70% of those on a low-fat diet needed drug treatment as well as diet to manage their diabetes. Moreover, individuals on the Mediterranean diet also had a significant decrease in some risk factors that affect the heart.
Of the 155 patients who had a raised HbA1c level of >7% at the onset, less than 1/5th (only 22 individuals) still had raised HbA1c level after three months. At the end of six months, individuals on both diets had decreased levels of HbA1c.
Individuals consuming both diets, lost weight and had decreases in blood glucose and HbA1c levels, but the reductions were more noteworthy in those who consumed the Mediterranean-diet.
The Mediterranean diet also postponed the need for high blood pressure medications irrespective of weight loss. Further, more patients who consumed the Mediterranean diet also had higher increases in HDL-cholesterol levels (good cholesterol) and lowering of fats.
Overall, the results showed that with sustained nutritional guidance, only 44% of newly diagnosed diabetic patients on a Mediterranean diet vs. 70% of those on a low-fat diet needed drug treatment as well as diet to manage their diabetes. Moreover, individuals on the Mediterranean diet also had a significant decrease in some risk factors that affect the heart.
Is the Mediterranean diet good for Diabetic Patients? Part 1
The incidence of diabetes has skyrocketed globally in the last 3 decades. Further, there are millions more individuals with diabetes that have not been diagnosed. To date, the treatment of type 2 diabetes is done with drugs and sometimes insulin. Now, there is some evidence that by consuming a low carbohydrate Mediterranean diet, recently diagnosed diabetic patients may postpone the need for pharmaceutical drugs to control this chronic disorder.
There has been a lot of evidence gathered over the past 2 decades that the Mediterranean diet does improve risk factors for heart disease and diabetes. Further, the American Diabetes Association fervently advocates a low carb or a low fat diet in overweight individuals with type 2 diabetes. However, there have not been many studies that have compared the two diets in diabetic individuals.
A recent study from italy just published has fascinating results (Annals of Internal Medicine (Sept 1, 2009).
The Study
To evaluate the effectiveness of these two accepted diets in delaying anti diabetic drug therapy, researchers in Italy studied 215 obese patients with newly diagnosed type 2 diabetes. All patients had sedentary lifestyles, had a body mass index > 25 kg/m2, and had a HbA1c of between 7-11%. The conclusion of the study was to look at the time when anti diabetic drugs were introduced to control blood sugars. Other data also looked at weight changes, control of blood pressure and levels of blood glucose and cholesterol. All individuals received regular solid advice from dieticians on the value of diet and exercise and were educated how to make different diets at home.
The individuals in the study were then arbitrarily allocated to one of the following diets for four years:
- A Mediterranean diet that consisted of whole grains,
vegetables, fruits, less red meat but ample poultry, fish.
Less than 30 percent of calories were from derived from olive oil.
- A low-fat diet based on American Heart Association
recommendations that included whole grains, high fat snacks, and
limited number of sweet foods. Less than thirty percent of
calories were obtained from fat.
Status of diabetes was determined by measurement of HbA1c levels at baseline and every three months.
There has been a lot of evidence gathered over the past 2 decades that the Mediterranean diet does improve risk factors for heart disease and diabetes. Further, the American Diabetes Association fervently advocates a low carb or a low fat diet in overweight individuals with type 2 diabetes. However, there have not been many studies that have compared the two diets in diabetic individuals.
A recent study from italy just published has fascinating results (Annals of Internal Medicine (Sept 1, 2009).
The Study
To evaluate the effectiveness of these two accepted diets in delaying anti diabetic drug therapy, researchers in Italy studied 215 obese patients with newly diagnosed type 2 diabetes. All patients had sedentary lifestyles, had a body mass index > 25 kg/m2, and had a HbA1c of between 7-11%. The conclusion of the study was to look at the time when anti diabetic drugs were introduced to control blood sugars. Other data also looked at weight changes, control of blood pressure and levels of blood glucose and cholesterol. All individuals received regular solid advice from dieticians on the value of diet and exercise and were educated how to make different diets at home.
The individuals in the study were then arbitrarily allocated to one of the following diets for four years:
- A Mediterranean diet that consisted of whole grains,
vegetables, fruits, less red meat but ample poultry, fish.
Less than 30 percent of calories were from derived from olive oil.
- A low-fat diet based on American Heart Association
recommendations that included whole grains, high fat snacks, and
limited number of sweet foods. Less than thirty percent of
calories were obtained from fat.
Status of diabetes was determined by measurement of HbA1c levels at baseline and every three months.
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