The effect of a low-carbohydrate high-fat diet and ethnicity on daily glucose profile in type 2 diabetes determined by continuous glucose monitoring
Background and aims
Nutrition is an integral part of type 2 diabetes (T2DM) treatment, but the optimal macronutrient composition is still debated and previous studies have not addressed the role of ethnicity in dietary response. The current study aims were to compare the effect of short-term glycemic response to low-carbohydrate high-fat (LC-HF) diet vs. high-carbohydrate low-fat (HC-LF) diet using continuous glucose monitoring (CGM) and to evaluate the response of individuals with T2DM of Yemenite (Y-DM) and non-Yemenite origin (NY-DM).
Twenty T2DM males, ten Y-DM and ten NY-DM underwent meal tolerance test and indexes of insulin resistance and secretion were calculated. Subsequently, patients were connected to CGM to assess daily glycemic control and glucose variability in response to isocaloric HC-LF or LC-HF diet, receiving each diet for 2 days by providing prepared meals. Daily glucose levels, area under the glucose curve (G-AUC) and parameters of glucose variability [standard deviation (SD), mean amplitude of glycemic excursions (MAGE) and mean absolute glucose (MAG)] were evaluated.
The LC-HF resulted in a significantly lower G-AUC (p < 0.001) and in lower variability parameters (p < 0.001) vs. the HC-LF diet. However, Y-DM showed less reduction in glucose variability indices upon diet-switching vs. NY-DM; MAGE decreased, respectively, by 69% vs. 89%, p = 0.043 and MAG by 34% vs. 45%, p = 0.007 in Y-DM compared to NY-DM.
These results suggest that LC-HF diet is effective in reducing glycemic fluctuation in T2DM and that ethnicity may have a role in the response to dietary regime.
KeywordsDiabetes Diet High carbohydrate Low carbohydrate Glycemic variability Ethnicity
American Diabetes Association
Area under the curve
Body mass index
Continuous glucose monitor
Area under the glucose curve
Gastric inhibitory polypeptide
High carbohydrate low fat
Low carbohydrate high fat
Mean absolute glucose
Mean amplitude of glycemic excursions
Yemenite diabetes mellitus
Non-Yemenite diabetes mellitus
Type 2 diabetes mellitus
The authors wish to thank Ronit Harris for the statistical analysis.
MBM and NR designed the research, conducted the research, analyzed the data and wrote the paper. TZ contributed to the design conduction and analysis of the data. ZM designed the research, analyzed the data, reviewed/edited manuscript. HK designed the research, analyzed the data, and wrote the manuscript. All authors read and approved the final manuscript.
This work was supported by the E’ELE Betamar organization Clinical Trial Registry: WHO—http://www.who.int/ictrp/unambiguous_identification/utn/en/ The Universal Trial Number (UTN): U1111-1124-0079.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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