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Tuesday 25 March 2014

Southport GP Paper on Low Carb

"Patients with diabetes have long been exhorted to give up sugar, encouraged instead to take
in fuel as complex carbohydrate such as the starch found in bread, rice or pasta (especially if
‘wholemeal’). However, bread has a higher glycaemic index than table sugar itself. There are
no essential nutrients in starchy foods and people with diabetes struggle to deal with the
glycaemic load they bring. The authors question why carbohydrate need form a major part of
the diet at all. The central goal of achieving substantial weight loss has tended to be
overlooked. The current pilot study explores the results of a low carbohydrate diet for a case
series of 19 type 2 diabetes and pre-diabetes patients over an eight-month period in a
suburban general practice.

A low carbohydrate diet was observed to bring about major benefits. Blood glucose
control improved (HbA1c 51±14 to 40±4mmol/mol; p<0.001). By the end of the study period
only two patients remained with an abnormal HbA1c (>42mmol/mol); even these two had
seen an average drop of 23.9mmol/mol. Weight fell from 100.2±16.4 to 91.0±17.1kg
(p<0.0001), and waist circumference decreased from 120.2±9.6 to 105.6±11.5cm (p<0.0001).
Simultaneously, blood pressure improved (systolic 148±17 to 133±15mmHg, p<0.005; and
diastolic 91±8 to 83±11mmHg, p<0.05). Serum gamma-glutamyltransferase decreased from
75.2±54.7 to 40.6±29.2 U/L (p<0.005). Total serum cholesterol decreased from 5.5±1.0 to
4.7±1.2mmol/L (p<0.01).

This approach is easy to implement in general practice, and brings rapid weight loss and
improvement in HbA1c"

http://www.practicaldiabetes.com/SpringboardWebApp/userfiles/espdi/file/March%202014/PP%20Unwin%20final%20proofs%20revised.pdf


John


4 comments:

Anonymous said...

Very poor paper - how they got that through a peer review is a mystery!

Anonymous said...

It really is a bad paper. No mention of how many carbs, self reported results regarding food choices.
LC with porridge, potatoes? Minimal amounts of cheese.
Were they supplied with test strips?

Sounds like a Mediterranean Diet with alterations to me.

Lowcarb team member said...

From acorns oak trees grow. I suspect the GP is recommending a modest cut back in carbs, rather than very low. This will be more acceptable for many.

Slowly slowly catchy monkey I reckon.

Eddie

Anonymous said...

If he relied on HBA1c then did he think about possible spikes.
It worries me that people will think that they can eat potatoes and porridge if they are not testing.

If he is relying on a "modest cut back on carbs" that is what most of the posters on DCUK follow, even the ones that you describe as antis.
If this paper ever becomes mainstream, which I doubt owing to the flaws, it is far from low carb.