Overweight Individuals With Type 2 Diabetes | Keto Diet versus Plate Method Diet

Recently a study was conducted by Saslow LR and colleagues to study whether a very low carbohydrate ketogenic diet with lifestyle factors (intervention) or a “Create Your Plate” diet (control) recommended by American Diabetes Association (ADA) would improve glycemic control and other health outcomes among overweight individuals with type 2 diabetes mellitus (T2DM).

This article was published in February 2017 in a very reputed journal ‘Journal of Medical Internet Research’. In 2017, the impact factor of this journal was 4.671. For those of you who don’t know what an impact factor is or have never heard of, it simply means the number of times recent articles published in that journal in a year were cited by others. If the impact factor is high, it is considered to be a highly ranked journal.

Now coming back to the study, it was a parallel-group, balanced randomization (1:1) trial. This trial was approved by the University of California, San Francisco, Institutional Review Board and registered with ClinicalTrials.gov (NCT01967992).

In this study, glycemic control, operationalized as change in glycated hemoglobin (HbA1c) was the primary outcome.

They also assessed body weight, cholesterol, triglycerides, diabetes-related distress, subjective experiences of the diet, and physical side effects.

As mentioned earlier the investigators divided the eligible participants into two groups (intervention group and control group).

The interventional group were asked to follow a very low carb keto diet restricting their carbohydrate intake to 20-50 grams. As you all must be aware that in keto diet we restrict carb intake so that you reach a stage called nutritional ketosis wherein your body burns fat cells and releases ketone bodies. In this study also the main purpose of restricting carbohydrate intake to 20-50 grams was to make the participant reach nutritional ketosis stage. Also some lifestyle modifications were also recommended.

During the study the participants were asked to measure urinary acetoacetate (one type of ketone  bodies that can be measured in urine) test kits (KetoStix). Basically there are three types of ketone bodies. Other two types of ketone bodies are acetone and beta-hydroxybutyrate.

The other group i.e. the control group were asked to follow “Create Your Plate” diet recommended by ADA. What does this ADA diet consists of? Well, ADA recommends a low fat diet which includes green vegetables, lean protein sources, and limited starchy and sweet foods. Most of the doctors worldwide follow ADA guidelines and recommend this particular diet to their patients.

In fact, when I was diagnosed with T2DM my diabetologist also recommended low fat diet with a caloric restriction of 1800 calories. But he never advised me how to restrict my calories to 1800 or what should I eat.  I was totally confused. Also he prescribed a couple of oral antidiabetic drugs and a statin. I followed his instructions for couple of weeks and the result was that within 2 weeks I developed side effects of the drugs. I immediately STOPPED all my medications and started following a keto diet. Finally, I was able to reverse my T2DM. Anyway, that’s a separate story.

Coming back to the study, all the parameters were measured at baseline before randomization in both the groups. Again, all the parameters were measured after 16 and 32 weeks of intervention.

So what conclusions were drawn from this study. Let me list the results of this study in bullet points for better understanding.

  • The investigators observed that there was a significant greater reductions in HbA1cthose who followed ketogenic diet after 16 as well as 32 weeks
  • Similarly, those who were on keto diet lost more weight than those who followed conventional ADA diet (12.7 kg versus 3 kg)
  • Also, triglycerides level was much lower in the ketogenic group compared to ADA diet followers

This study showed that those who followed ketogenic diet, had several health benefits including lower HbA1c, body weight, and triglyceride levels.

There were few limitations in this study. The number of participants were very less (25 participants) and the follow-up duration of the study was not long.

Despite all limitations, the conclusion we can draw from this study is that low-carbohydrate ketogenic diet and lifestyle changes is beneficial in individuals who are overweight with T2DM.

If you have any queries or any experience to share please type in the comment box. I will try to reply to all your queries.

If you have enjoyed reading this article, I would request you to share with your friends and colleagues who are diagnosed with T2DM. I am sure by reading this article, they will be motivated that it’s not the end of the world if they are diagnosed with T2DM.

With dietary and lifestyle modifications, it is possible to reverse your T2DM.

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Anupam Ghose, a physician by training, was diagnosed with Type 2 Diabetes Mellitus (T2DM) in 2017. After the diagnosis of T2DM he followed a low carbohydrate high fat (ketogenic) diet and reversed his T2DM within a year. Now he is on a mission to educate people and spread awareness about T2DM. Since he could reverse his T2DM following ketogenic diet, now he is  doing extensive research on ketogenic diet and expanding his knowledge on this particular topic. His main goal is to make people understand that the conventional method of treating T2DM is incorrect and it is very much possible to reverse T2DM through diet and lifestyle modification.

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