Diabetes and obesity go
hand in hand. The epidemic is rampant globally, engulfing both developed and
developing countries. Westernized eating habits and lifestyle are the factors
predominantly held responsible for this. Diets with low fat content and high amounts of
carbohydrates are recommended by official guidelines although these have never
been proved effective. A diet restricted in fat content and enriched in
carbohydrates have not shown any effect in reducing heart disease connected
Reducing weight is an effective intervention to
treat type 2 diabetes but this is difficult to achieve. Diabetic patients are
often put on insulin and this cause an increase in body weight. Increased body
weight further elevates the required doses of insulin injections. High insulin
doses have also known to produce poor metabolic results.
is not good for the heart either. It results in raised levels of triglycerides
and small dense LDL (bad-cholesterol) and low levels of HDL (good-cholesterol).
Such an altered lipid profile increases the risk of heart diseases. It would
therefore be wiser to adhere to a carbohydrate-restricted diet rather than the
standard low fat-high carbohydrate intervention.
belongs to the recently introduced group of antidiabetic drugs called GLP-1
analogues. GLP-1 analogues facilitate weight reduction by inducing satiety.
They also avoid hypoglycemia, a common side effect of anti-diabetic
medications. Another drug called metformin is commonly used orally to treat
type 2 diabetes.
patients with advanced diabetes, who failed to improve even on two oral anti-diabetic
drugs or insulin treatment, were enrolled
in a recent 24-weeks trial. The ongoing treatment was modified. Insulin and the
oral anti-diabetic drugs (except metformin) were stopped. The patients were put
on a carbohydrate-restricted diet and a combination of
metformin and liraglutide. They were reviewed during follow-up visits at one,
two, three and six months.
completed the study. A drop in HbA1c (an
important marker of the diabetic status, values lower than 7.0% are good) and
body weight were noticed in most of the participants. Patients were all
satisfied with the treatment
. Lipid profile remained largely unaffected.
The trial was designed
as proof-of-concept study without control group. This may also be viewed as a
limitation of the study. However the study finding brings good news to diabetic
patients since it enables reduction in medications. Patients with short
duration of diabetes are benefited better. Low
carb-diets alone or in conjunction with metformin may be used to treat newly
diagnosed diabetes type 2 showing HbA1c values of around 9%.
Patients with long
lasting diabetes whose standard treatments failed to produce metabolic control
could now possibly switch to this alternative diet regimen, after consulting
restricted diet in conjunction with metformin and liraglutide is an effective treatment in
patients with deteriorated type 2 diabetes mellitus: Proof-of-concept study