Low-Carbohydrate Nutrition Approaches in Patients with Obesity, Prediabetes and Type 2 Diabetes

Low Carb Nutrition - Queen's Units

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2 Overview Prevalence of Target Diseases • The prevalence of prediabetes and type 2 diabetes has increased dramatically over several decades in parallel with the increasing prevalence of obesity. • Most recent estimates in 2011 state that 35% of adults in the UK have prediabetes (hemoglobin A1c 42-47 mmol/mol) and 6.4% have type 2 diabetes (hemoglobin A1c ≥48 mmol/mol or on diabetes medication). • Obesity, prediabetes and type 2 diabetes are all risk factors for cardiovascular disease (CVD), and their increasing prevalence is now leading to an increase in the prevalence of CVD. Key Points and Scope • Low-carbohydrate eating patterns are recognized in scientific literature and expert treatment guidelines as effective nutritional therapies for obesity, prediabetes and type 2 diabetes. • Because low- and very-low-carbohydrate eating patterns are effective treatments for these risk factors, plus risk factors such as hypertriglyceridaemia and low high density lipoprotein (HDL) cholesterol (metabolic syndrome), their use has real potential for reducing CVD. • Low- and very-low-carbohydrate eating patterns can have potent lowering effects on blood glucose and blood pressure, which can lead to hypoglycemia or hypotension in people taking diabetes or blood pressure medications, respectively. Therefore, medication reduction, or deprescribing, is often required at the onset of dietary change, as is ongoing monitoring and medication management. • Numerous additional nuances to the use of these nutritional approaches have led to the production of this pocket guide, which is intended to assist practitioners in the safe and effective use of low-carbohydrate nutrition. • This pocket guide will define and describe low-carbohydrate nutritional approaches, identify appropriate target patient populations, and summarize recommended practices for the use of such eating patterns in adults, particularly adults with obesity, prediabetes or type 2 diabetes. • This pocket guide is not intended for treatment of children or people with type 1 diabetes, who may require adjustments to the approaches described.

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