Effects of Changing Amount of Carbohydrate in Diet on Plasma Lipoproteins and Apolipoproteins in Type II Diabetic Patients

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Abstract
Eight type II (non-insulin-dependent) normolipidemic diabetic patients (aged 45 ± 15 yr, body mass index 22 ± 2 kg/m2, means ± SD) treated with diet alone or diet plus oral hypoglycemic agents were given, in random order for periods of 15 days, two diets with different carbohydrate (CHO) (40 vs. 60% of total calories) and fat (20 vs. 40%) levels. Simple CHO, fiber, saturated fat, cholesterol, and polyunsaturated-saturated fat ratio were similar in the two diets. Total plasma cholesterol was not significantly affected by dietary changes; conversely, plasma triglyceride (1.38 ± 0.59 vs. 1.11 ± 0.39 mM, P < 0.05) and apolipoprotein Cll (3.8 ± 1 · 4 vs, 3.3 ± 0.8 mg/dl) increased significantly after the high-CHO low-fat diet. Among the various lipoproteins, very-low-density lipoprotein (VLDL) was the most affected by diet: VLDL cholesterol concentrations increased from 0.30 ± 0.19 to 0.43 ± 0.28 mM (P < 0.05), and triglyceride concentrations increased from 0.62 ± 0.33 to 0.88± 0.53 mM (P <0.05). In conclusion, increasing the amount of complex CHO in the diet induces an elevation of VLDL in normolipidemic, nonobese, mildly type II diabetic patients.