201-OR: Remission of Type 2 Diabetes and Decreased Inflammatory Markers with a High-Protein Diet

The purpose of this study was to determine if remission of type 2 diabetes(T2D) and a decrease in inflammatory cytokines (IC) can be achieved by macronutrients dietary changes without diabetes medications. High Protein (HP)(30% protein, 30% fat, 40% carbohydrates) or High Carbohydrate (HC)(15% protein, 30% fat, 55% carbohydrates) diets were used to study remission of type 2 diabetes(T2D) to Normal Glucose Tolerance(NGT), inflammatory cytokines, weight loss, body composition, and metabolic parameters in this randomized controlled clinical trial feeding study for 6 month(mo). Obese, age 20-65 years subjects withT2D were randomized to a HP or HC diet for 6 mo with all food provided. Caloric need for weight loss was determined by Resting Metabolic Rate-500 calories/day. Oral Glucose Tolerance Tests (OGTT) were performed at Baseline (BL) and 6 mo to determine T2D/NGT status. Glucose BL≥126 mg/dl and HbA1c≥6.5% and 2 hr glucose >199mg/dl was considered T2D and remission at 6 mo was glucose BL<126 mg/ml and HbA1c<6.5% and 2 hr glucose <140 mg/dl. DXA was done at BL and 6 mo. Food pick up and weight checks were weekly.T2D subjects on HP diet had 100% remission to NGT while HC diet subjects had 16% remission. IC were significantly decreased in HP compared to HC subjects at 6 mo for TNFa pg/ml (p=0.001) [HP 3.9±0.7 vs. HC 12.6±1.9] and IL-6 pg/ml (p=0.005) [HP 4.7±0.5 vs. HC 9.1±0.9]. Both diet groups had improvement in insulin sensitivity: HOMA IR [HP(BL 5.3±0.29; 6 mo 2.1±0.13)], [HC(BL 5.2±0.27; 6 mo 4.4±0.26)] and decrease in HbA1c [HP(BL 7.7±.05; 6 mo 5.6±.02)], [HC(BL 7.8±.04; 6 mo 6.6±.06)]. While both HP and HC groups has similar weight loss (HP =15.4±5 lb, HC=19.9±5 lb), HP group had a 2.7± 0.4% increase in lean body mass(LM) and 2.9± 0.4% decrease in fat mass(FM) while the HC group had a 1.9±0.3% LM and 3.3±0.9 % FM decrease respectively. The HP diet demonstrated improvement in glucose tolerance and insulin sensitivity with 100% remission of T2D to NGT and a significant decrease in inflammatory cytokines.