Issue 115 Item 8 Substituting Saturated Fat For Starch May Help With Glycemic Co

Hemoglobin A1c levels improved in both the diet and control groups Patients with type 2 diabetes may have better blood glucose control and weight loss without adversely affecting their serum lipid levels if they substitute saturated fats for starch in their diets.

Researchers led by J.H. Hays at the Christiana Care Health Services, Inc., in Newark, Delaware in the United States, retrospectively reviewed the medical records of 151 patients with type 2 diabetes, who had completed a one year follow-up after a dietary prescription for a high saturated fat diet with avoidance of starch. The patients were compared with 132 historical control subjects, who had been allowed unlimited monounsaturated fat and restricted starch.

The researchers compared the hemoglobin A1c levels, serum lipid levels, and weight loss or gain among patients in the diet group and historical controls. bcrad@baptisthealthsystem.org They also looked for associations between these clinical measurements and other therapy, including metformin, sulfonylurea, insulin, troglitazone, or lipid lowering drugs.

While hemoglobin A1c levels improved in both the diet and control groups, patients in the diet group had an additional decrease, the researchers reported. Use of a hydroxymethylglutaryl-coenzyme A reductase inhibitor was associated with a reduction in total cholesterol level. However, the diet group had an additional decrease. The investigators found no significant effect of the diet on the patients’ triglyceride, low-density lipoprotein, or high-density lipoprotein levels.

Although it was not statistically significant, patients on metformin therapy showed a trend for weight loss. An additional weight loss was noted in the diet group.

"Addition of saturated fat and removal of starch from a high-monounsaturated fat and starch-restricted diet improved glycemic control and were associated with weight loss without detectable adverse effects on serum lipids," the researchers concluded. Endocr Pract 2002; 8: 177-183.