Effect of Low Carbohydrate Diet (LCD) for Diabetic Patients with Hypertriglycemia

Background: Arguments have continued for long concerning low carbohydrate diet and calorie restriction (calorie-restricted diet). Authors have reported clinical studies of low carbohydrate diet on ketone bodies, glucose variability and Morbus value so far. Subjects and methods: Subjects are 28 patients with Type 2 diabetes mellitus, which were 20/8 (M/F) with 48.3 ± 13.9 years old with serum triglyceride more than 250 mg/dL on blood sampling with overnight fasting. They were admitted for 14 days and the protocol was as follows: 1) calorie-restricted diet on day 1 and 2, which had 60% carbohydrates, 2) low carbohydrate diet on day 3-14 days which is so-called super-low carbohydrate diet formula with 12% carbohydrates. Results: Mean HbA1c was 8.0 ± 1.7% and mean fasting glucose was 177 ± 52 mg/dL. Median data days 2 to 4 were 208 to 147 mg/dL in average glucose, 146 to 21 in Morbus (M) value and 123 to 94.5 mg/day in urinary Cpeptide. Median data days 2 to 14 were 366 to 159 mg/dL in Triglyceride, 46 to 42 mg/dL in HDL-C and 111 to 120 mg/dL in LDL-C. Remnant-like particle cholesterol on day 2 was 15.9 mg/dL in median. Significant correlations on day 2 were shown between Triglyceride and HDL-C (p<0.05), Triglyceride and LDL-C (p<0.05). Remnant-like particle cholesterol-C showed significant positive correlation with Atherogenic Index (AI) and triglyceride (p<0.01), significant negative correlation with HDL (p<0.05). Significant correlations were shown on day 2 and 14 in Triglyceride and LDL-C/HDL-C Ratio (p<0.01). Discussion and conclusion: Decrease of blood glucose indicated short effect of low carbohydrate diet only for 2 days from calorie restriction to low carbohydrate diet. Apparent large decrease of M value would be useful for clinical management and research. Analyses of correlations among RLP-C, triglyceride, HDL-C, LDL-C, AI and LDL-C/HDL-C Ratio would become the fundamental data for clinical research and give the hint for research direction in the future.