Acute Effects of a DASH Diet and Whole Food Plant-Based Diet on Insulin Requirements and Related Cardiometabolic Markers in Individuals With Insulin-Treated Type 2 Diabetes
abstract
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Access this abstract now Full Text Available for ClinicalKey SubscribersAIMS
There is limited research regarding insulin dosing changes following adoption of plant-based diets. We conducted a nonrandomized crossover trial utilizing two plant-based diets (Dietary Approaches to Stop Hypertension, or DASH, and Whole Food, Plant-Based, or WFPB) to assess acute changes in insulin requirements and associated markers among individuals with insulin-treated type 2 diabetes.
METHODS
Participants (n=15) enrolled in a 4-week trial with sequential, one-week phases: Baseline, DASH 1, WFPB, and DASH 2. Each diet was ad libitum and meals were provided.
RESULTS
Compared to baseline, daily insulin usage was 24%, 39%, and 30% lower after DASH 1, WFPB, and DASH 2 weeks respectively (all p <0.01). Insulin resistance (HOMA-IR) was 49% lower (p <0.01) and the insulin sensitivity index was 38% higher (p <0.01) at the end of the WFPB week before regressing toward baseline during DASH 2. Total, LDL, and HDL cholesterol, leptin, urinary glucose, and hsCRP decreased to a nadir at the end of the WFPB week before increasing during DASH 2.
CONCLUSIONS
Adopting a DASH or WFPB diet can result in significant, rapid changes in insulin requirements, insulin sensitivity, and related markers among individuals with insulin-treated type 2 diabetes, with larger dietary changes producing larger benefits.
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Additional Info
Disclosure statements are available on the authors' profiles:
The Acute Effects of a DASH diet and Whole Food, Plant-Based diet on Insulin Requirements and Related Cardiometabolic Markers in Individuals with Insulin-Treated Type 2 Diabetes
Diabetes Res. Clin. Pract. 2023 Jul 05;[EPub Ahead of Print], TM Campbell, EK Campbell, J Attia, K Ventura, T Mathews, KH Chhabra, L Blanchard, N Wixom, TS Faniyan, DR Peterson, DK Harrington, SD WittlinFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Diet = strong medicine for reducing insulin
This was a small study but with powerful findings. Small studies allow for a more controlled environment. Patients with insulin-dependent type 2 diabetes were provided healthy meals to show the power of nutrition on insulin dosing, insulin sensitivity, and inflammation.
Each intervention was for 7 days. The baseline diet was followed by the dietary approaches to stop hypertension (DASH) diet for 7 days, then a whole food, plant-based diet (WFPB) for 7 days, and then a return to the DASH diet for 7 days. Daily insulin doses were reduced by 24% with the first DASH diet, 39% with the WFPB diet, and 30% with the second DASH diet. Insulin resistance was reduced by 30% with the initial DASH diet and 49% with the WFPB diet. C-reactive protein was lower than baseline for all diets but had the greatest reduction (42%) after the WFPB diet.
The main difference between the DASH and the WFPB diet was the amount of fiber. The WFPB diet contained 32 g/1000 kcal versus 20 g/1000 kcal in the DASH diet. The baseline fiber intake before dietary intervention was 11 g/1000 kcal. Fiber can have a significant effect on reducing HbA1C and improving insulin sensitivity. Diets found to have the greatest effect at reducing inflammation and insulin resistance have been found to be high in fiber and are plant-based.
A colleague in our department calculated that, for the price of a GLP-1 agonist, we could provide two WFPB diets daily to diabetic patients.
Let food be thy medicine.