The effect of high carbohydrate, low fat diets on lipoprotein lipids, apoproteins, nutritional status and diabetic control in insulin dependent (Type I) diabetes mellitus Public Deposited

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  • Recently, high carbohydrate diets were recommended for the treatment of diabetes mellitus. All aspects of these diets, however, have not been fully tested — particularly in insulin dependent diabetes mellitus (IDDM). The present study was designed to investigate the effects of high carbohydrate, low fat diets (HCLFD) on blood glucose regulation, lipoprotein and apoprotein concentrations and nutritional status in IDDM. Six women with IDDM were studied in the Clinical Research Center for ten weeks. The study was divided into a control diet (CD) with 45% CHO, 40% fat, and 15% protein for four weeks, and a HCLFD with 65% CHO, 20% fat, and 15% protein for six weeks. Subjects were allowed free selection of their carbohydrate and fiber sources during both diet periods. The resulting selections produced diets with approximately equal proportions of complex and simple carbohydrates (49% and 51%, respectively) and moderate quantities of dietary fiber (50 g) during the HCLFD. Weekly fasting and pre-prandial serum glucose and glycosylated hemoglobin, and daily 24 hr. urine glucose excretion and insulin dose were not significantly different between the two periods. Total plasma, LDL and HDL cholesterol concentrations (p<.05). and apopproteins AI (p<.001), B (p<.01) and CIII (p<.05) were significantly lower, VLDL cholesterol (p<.05), total plasma (p<.01) and VLDL (p<.001) triglycerides were significantly higher, and apoproteins AII and E were unchanged during the HCLFD. Lipoprotein and apoprotein concentrations were independent of glycemic control. There were no significant changes in any of the nutritional parameters tested. All except vitamin B₆ were within their respective normal ranges. Whole blood and plasma vitamin B₆, and pyridoxal 5'-phosphate fell below the lower limits, even though dietary intakes were adequate. The present study suggest that HCLFD did not adversely affect glycemic control in IDDM, and demonstrated a potentially beneficial lowering of total and LDL cholesterol concentrations independent of glycemic control. Finally, nutritional status appeared unaltered as a result of HCLFD. The lower levels of the B₆ vitamers in IDDM demonstrated in this study suggest that the relationship between diabetes and vitamin B₆ status needs to be investigated further.
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