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Background: While a low-carbohydrate diet (LCD) reduces HbA1c in patients with type 2 diabetes (T2D), the associated high intake of fat may adversely affect cardiovascular risk factors. To address this, we examined the effect of a non-calorie-restricted LCD high in fat on endothelial function and markers of low-grade inflammation in T2D over 6 months. Methods: In an open-label randomized controlled trial, 71 patients with T2D were randomized 2:1 to either a LCD (< 20 E% carbohydrates, 50–60 E% fat) or a control diet (50–60 E% carbohydrates, 20–30 E% fat) for six months. Flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID) were assessed by ultrasound in the brachial artery together with plasma interleukin-6 (IL-6) and serum high-sensitivity C-reactive protein (hsCRP) in the participants at baseline (n = 70) and after six months (n = 64). Results: The FMD and NID were unaltered in both groups after six months, and there were no between-group differences in change of either FMD (p = 0.34) or NID (p = 0.53) in response to the interventions. The circulating hsCRP and IL-6 levels decreased only in response to LCD (both p < 0.05). However, comparing changes over time with the control diet, the LCD did not reduce either IL-6 (p = 0.25) or hsCRP (p = 0.07) levels. The lack of changes in FMD and NID in response to LCD persisted after adjustment for cardiovascular risk factors. Conclusion: A LCD high in fat for six months does not adversely affect endothelial function or selected markers of low-grade inflammation, which suggests that this nutritional approach does not increase the risk of cardiovascular disease. Trial registration ClinicalTrials.gov (NCT03068078).

TidsskriftCardiovascular Diabetology
Antal sider10
StatusUdgivet - 17. aug. 2023

Bibliografisk note

Funding Information:
We would like to thank L. Hansen and C. B. Olsen, the Steno Diabetes Center Odense, Odense University Hospital, as well as A. R. Madsen, Department of Endocrinology, Odense University Hospital, for their skilled technical assistance. We also owe great thanks to professor DHJ Thijssen and ACCM van Mil for expertise and training in FMD measurements.

Funding Information:
Open access funding provided by University Library of Southern Denmark. The present study was supported by grants from the Region of Southern Denmark, Odense University Hospital, the Danish Diabetes Academy funded by the Novo Nordisk Foundation, the Novo Nordisk Foundation, University of Southern Denmark, the AP Møller Foundation, Overlæge Johan Boserup og Lise Boserups Legat and Christenson-Cesons Familiefond.

Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.


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