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Saturday 4 June 2011

A low-carbohydrate diet can help kidneys part 1.

An obese patient with type 2 diabetes whose diet was changed from the recommended high-carbohydrate, low-fat type to a low-carbohydrate diet showed a significant reduction in bodyweight, improved glycemic control and a reversal of a six year long decline of renal function. The reversal of the renal function was likely caused by both improved glycemic control and elimination of the patient's obesity.

"In January 2004 his diet was changed radically by reducing dietary carbohydrates to 80–90 g per day, consisting only of vegetables and small amounts of hard bread (crisp bread). Potatoes, bread, pasta, rice and cereals were excluded, and the caloric requirements were covered by protein and fat. To ease the transition the patient was supplied with a number of meal recipes suggesting a caloric restriction to about 1800 calories per day. The per cent proportions of carbohydrates, fat and protein in the recipes were 20 : 50: 30.

Less than two weeks later the patient discontinued his insulin treatment and 6 months later his bodyweight had decreased by 19 kg. HbA1c had dropped to 6.5 % after 3 months, and the steady rise of his serum creatinine stopped. The creatinine has since – for two-and-a-half years – been stable as seen in the figure. When insulin was discontinued rosiglitazone was prescribed. In the Table measured parameters are shown before the dietary change, and now. As of late 2005 there was no sign of proliferative disease in the patient's retinopathy."

"The present case report shows that a low-carbohydrate, high-fat diet improves glycemic control, reduces body weight and may prevent the development of end-stage renal failure in an overweight patient with type-2 diabetes. Furthermore, it raises the concern that the obesity caused by the combination of a high-carbohydrate diet and insulin may have contributed to the patient's failing kidney function."



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