10 / 40
RESEARCH ARTICLE
SA JOURNAL OF DIABETES & VASCULAR DISEASE
52
VOLUME 16 NUMBER 2 • NOVEMBER 2019
evaluation system test: reliability, validity, sensitivity, and specificity for identifying
individuals with Parkinson disease who fall.
Phys Ther
2011;
91
(1): 102–113.
16. Wrisley D, Walker M, Echternach J, Strasnick B. Reliability of the dynamic gait
index in people with vestibular disorders.
Arch Phys Med Rehabil
2003;
84
(10):
1528–1533.
17. Yim-Chiplis, P, Talbot, L. Defining and measuring balance in adults.
Biol Res Nurs
2000;
1
(4): 321–331.
18. Meijer J, Smit J, van Sonderen E, Groothoff J, Eisma H, Links T. Clinical diagnosis
of diabetic polyneuropathy with the diabetic neuropathy symptom and diabetic
neuropathy examination scores.
Diabetes Care
2003;
26
: 697–701.
19. Pandit JC. Testing acuity of vision in general practice: reaching recommended
standard.
Br Med J
1994;
309
(6966): 1408.
20. Jáuregui-Renaud K, Sánchez B, Olmos A, González-Barcena D. Neuro-otologic
symptoms in patients with type 2 diabetes mellitus.
Diabetes Res Clin Pract
2009;
84
(3): 45–47.
21. Gravesande J, Richardson J. Identifying non-pharmacological risk factors for
falling in older adults with type 2 diabetes mellitus: a systematic review.
Disabil
Rehabil
2017;
39
(15): 1459–1465.
22. Ahn S, Song R. Effects of tai chi exercise on glucose control, neuropathy scores,
balance, and quality of life in patients with type 2 diabetes and neuropathy.
J
Altern Complement Med
2012;
18
(12): 1172–1178.
23. Walley M, Anderson E, Pippen M, Maitland G. Dizziness and loss of balance in
individuals with diabetes: relative contribution of vestibular versus somatosensory
dysfunction.
Clin Diabetes
2014;
23
(2): 76–77.
24. Wilson S, Garner J, Loprinzi P. The influence of multiple sensory impairments on
functional balance and difficulty with falls among U.S. adults.
Prev Med
2016;
87
:
41–46.
25. Lin M, Gutierrez P, Stone K, Yaffe K, Ensrud K, Fink H, et al. Vision impairment
and combined vision and hearing impairment predict cognitive and functional
decline in older women.
J Am Geriatr Soc
2004;
52
(12): 1996–2002.
Reduced carbs help type 2 diabetes patients regulate blood
sugar levels
P
atients with type 2 diabetes improve
their ability to regulate blood sugar
levels if they eat food with a reduced
carbohydrate content and an increased
share of protein and fat. This is shown
by a small recent study conducted at
Bispebjerg Hospital in collaboration
with, among other partners, Aarhus
University and the Department of
Nutrition, Exercise and Sports at the
University of Copenhagen. The findings
are contrary to the conventional dietary
recommendations for type 2 diabetics.
Nutritional therapy is important to
treat type 2 diabetes optimally, but the
recommendations are unclear. According
to the Danish Health Authority, up to
85% of newly diagnosed patients with
type 2 diabetes are overweight, and
they are typically advised to follow a diet
focused on weight loss: containing less
calories than they burn, a low fat content
and a high content of carbohydrates with
a low ‘glycaemic index’ (which indicates
how quickly a food affects blood sugar
levels).
A central aspect in the treatment of
type 2 diabetes is the patient’s ability to
regulate their blood sugar levels, and
new research now indicates that a diet
with a reduced carbohydrate content
and an increased share of protein and
fat improves the patient’s ability to
regulate his or her blood sugar levels
compared with the conventional dietary
recommendations. In addition, it reduces
liver fat content and also has a beneficial
effect on fat metabolism in type 2
diabetes patients.
‘The purpose of our study was to
investigate the effects of the diet without
“interference” from a weight loss. For
that reason, the patients were asked to
maintain their weight. Our study confirms
the assumption that a diet with a reduced
carbohydrate content can improvepatients’
ability to regulate their blood sugar levels
– without the patients concurrently losing
weight,’ explains senior consultant, Dr
Thure Krarup, from the Department of
Endocrinology at Bispebjerg Hospital. He
continues: ‘Our findings are important,
because we’ve removed weight loss
from the equation. Previous studies have
provided contradictory conclusions, and
weight loss has complicated interpretations
in a number of these studies.’
A diet with a reduced carbohydrate
content, a high protein content and a
moderately increased fat content reduces
liver fat content. A diet with a reduced
carbohydrate content may be beneficial
to patients with type 2 diabetes – even
if it does not lead to weight loss. The
study forms part of CutDM, which,
supported by a grant of DKK 4m from
Arla Food for Health, examined whether
a diet with reduced carbohydrate content
and increased protein and fat content
improved type 2 patients’ blood sugar
regulation.
Twenty-eight patients with type 2
diabetes participated in the study over a
total period of 12 weeks. For six weeks,
the patients were given a conventional
diabetes diet with a high carbohydrate
content, and, for the other six weeks,
they were given a diet with a reduced
carbohydrate content, high protein
content and moderately increased fat
content. The patients were given the diet
types in random order.
Based on the growing body of
evidence, we might rethink the dietary
recommendations for patients with type
2 diabetes, stresses Thure Krarup. ‘The
study shows that by reducing the share of
carbohydrates in the diet and increasing
the share of protein and fat, you can both
treat high blood sugar and reduce liver
fat content. Further intensive research is
needed in order to optimise our dietary
recommendations for patients with type
2 diabetes,’ says Thure Krarup, stressing
that the findings should be confirmed in
large-scale, long-term, controlled trials.
A diet with a reduced carbohydrate
content, high protein content and
moderately increased fat content improves
glycaemic control (the ability to regulate
blood sugar) by reducing blood sugar
after meals and ‘long-term blood sugar’
(measured by HbA
1c
level, which is a blood
test used to measure the average blood
sugar level over approximately the past
two months).
Source: Medical Brief 2019