1862-P: Remission of Type 2 Diabetes and Metabolic Parameters Changes with a High-Protein Diet

The purpose of this study was to determine if remission of type 2 diabetes(T2D) 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), weight loss, body composition, and metabolic parameters in this randomized controlled clinical trial feeding study for 6 month(mo) in obese T2D adults.

T2D adults age 20-65 years 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(RMR) -500 calories/day. Oral Glucose Tolerance Tests (OGTT) were performed at Baseline (BL) and 6 mo to determine T2D/NGT status. A BL ≥126 mg/dl and HbA1c ≥6.5% and 2 hr glucose >199mg/dl was considered T2D and remission was 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.The T2D subjects on HP diet had 100% remission to NGT while the HC diet subjects had 33% remission. Both diet groups had significant weight loss (HP =15.4±5 lb, HC=19.9±5 lb), improvement in insulin sensitivity determined by 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)] and blood pressure improvement S/D [HP (BL 129/85, 6 mo 117/78)], [HC(BL 130/85; 6 mo 117/78)]. HP group had a 2.7%± 0.4% increase in lean body mass and 2.9± 0.4% decrease in fat mass while the HC group had a 1.9%±0.3 and 3.3±0.9 % decrease in lean and fat mass respectively.

Both diets resulted in weight loss, improvement in glucose tolerance and insulin sensitivity but only the HP diet produced 100% remission of T2D to NGT.