© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Clinical Benefit of a Short Term Dietary Oatmeal Intervention in Patients with Type 2 Diabetes and Severe Insulin Resistance: A Pilot Study
first decision 31.05.2007
20 December 2007 (eFirst)
Aims/hypothesis: To evaluate the potential effectiveness of ‘carbohydrate days’ as a dietary intervention to overcome insulin resistance in type 2 diabetes.
Materials and Methods: Patients (n=14) with uncontrolled type 2 diabetes and insulin resistance as defined by a dosage of more than 1 IU/day*kg BW were consecutively enrolled in this prospective study. Primary outcomes were daily insulin requirement and mean blood glucose levels which were evaluated before, after, and 4 weeks after the intervention.
Results: All patients had a metabolic syndrome, 75% had microvascular and 57.1% macrovascular complications. Hospital setting and diabetes adapted diet alone led to improved glycemic control with a mean blood glucose 158±47 mg/dl. Intervention with two days of oatmeal diet further decreased mean blood glucose to 118±37 mg/dl (p<0.05). This was associated with a significant reduction of insulin dosage by 42.5% (before: 145±68.9 U/d, after 83±34.2 U/d, p<0.001) as well as a significant reduction (-26.4%, p<0.01) of serum leptin levels.After the four weeks outpatient period, insulin dosage remained significantly decreased (83±20.2 U/kg*d, p<0.01). Glycemic control was comparable (mean blood glucose141±20.78 mg/dl) to glucose levels within the hospital setting. Adiponectin levels increased significantly by 53.8% (p<0.05).
Conclusions: In this uncontrolled pilot study, hospital admission and diabetes adapted diet followed by oatmeal intervention achieved a ∼40% reduction of insulin dosage required to achieve controlled glucose levels. This effect was conserved after a 4 week outpatient phase with normal diet.