High Protein LoBAG Diet for Type II Diabetes

When doing some protein research in the whole high protein v. high fat LC debate, I came across the following article:

Effect of a High-Protein, Low-Carbohydrate Diet on Blood Glucose Control in People With Type 2

These researchers call their diet LoBAG which stands for Low BioAvailable Glucose.  

This particular study was on moderately overweight men (average weight in the high 2-teens) with untreated T2 diabetes.  For five weeks, the men followed one of two diets:  

LoBAG = 30% Protein / 50% Fat / 20% Carb

Control = 15% Protein / 30% Fat / 55% Carb

The LoBAG diet was designed to provide enough carbs to prevent ketosis which was checked with ketostix to confirm the absence of this.  The study was intended to be consuming a weight stable diet, but both groups lost around 4 lbs during the course of the study.  Unfortunately the actual diets are not stated, but for men of this weight I would presume around 2500 to 3000 cal/day to maintain.  This would equate to 188 - 225g protein and 125 - 150g carb for the LoBAG group.  This was a cross-over study so each participant served as their own control consuming both diets with a "washout" period between.

Select Excerpts:

This was a decrease {of 24-h total integrated insulin area} of 40% from the pre-LoBAG value (P < 0.01). The mean 24-h total integrated insulin area response decreased by 25%.

In the present study, the diet contained the same 30% of food energy as protein. However, the carbohydrate content was further reduced from 40 to 20% of total food energy. The control diet in both studies is a diet that is recommended for the general population as a means of reducing one’s risk for coronary heart disease (9).

In the present study, the lower carbohydrate diet not only reduced the postmeal glucose concentration but also considerably reduced the overnight fasting glucose concentration. It is interesting that the 29% decrease observed in the present study is similar to the 34% decrease that we observed previously after a 36-h fast in people with type 2 diabetes (5). The overall result was a striking decrease in the 24-h integrated glucose concentration (Fig. 2). In addition, the percentage of glycohemoglobin concentration at the end of the 5-week study period was decreased from a mean of 9.8 to 7.6 (Fig. 4).

1.  Cutting carb levels somewhat in their previous study did not alter fasting glucose, but this relatively moderate further carb restriction reduced FBG 29% -- similar to 36 hr fasting!

2.  The probable protein consumption was considerable and likely in excess of needs.  The reduction in FBG and 24-h integrated area glucose response would seem to indicate that this excess does not get converted to sugar in these diabetics.  

3.  This was not intended to be a weight loss study, but modest losses (avg ~0.8 lb/week) occurred with each diet.  Yet the 24-hr insulin area (total exposure) decreased 25% averaged over the 5 week period for LoBAG, and a whopping 40% by the 5th week.  Such a change should have resulted in more weight loss if insulin levels are the controlling factor for "fat accumulation".