Mediterranean Diet May Be Best for Type 2 Diabetes

02 sept 2009-- The Mediterranean diet, long touted as a healthy eating plan, may help people with type 2 diabetes stay off blood sugar-lowering medications, as well as help them lose weight and lower cardiovascular risk factors.

Those are the major findings from Italian researchers who found that while 70 percent of people with type 2 diabetes following a low-fat diet eventually needed diabetes medications, just 44 percent of those following the Mediterranean diet needed such drugs.

"Eating Mediterranean prevented anti-hyperglycemic drug therapy in about one-third of patients," said study author Dr. Dario Giugliano, a professor of endocrinology and metabolic diseases at the Second University of Naples in Italy. He called the diet, "a safe and tasty means to delay the introduction of anti-diabetic drug therapy in newly diagnosed type 2 diabetic people."

Beyond its ability to help control blood sugar, "the Mediterranean diet has been associated with a number of healthful outcomes, including reduced risk of cardiovascular disease, cancer and mortality," Giugliano added. "Given that patients with type 2 diabetes still have a twofold risk of death as compared to the non-diabetic population, these potential benefits are intriguing," he noted.

Results of the study are published in the September issue of the Annals of Internal Medicine.

Type 2 diabetes is fast becoming a pandemic, with as many as 380 million cases estimated by 2025, according to background information in the study. However, lifestyle changes can help prevent the disease and possibly reverse its course when instigated soon after diagnosis. Regular exercise and changes in diet are among the most important lifestyle changes that can help manage type 2 diabetes.

Although dietary modification is recommended, little research has compared low-fat diets to low-carbohydrate diets in the management of type 2 diabetes, according to the study.

To assess which type of diet might help people with type 2 diabetes better manage their condition, Giugliano and his colleagues compared 107 people on a low-fat diet to 108 who were eating a Mediterranean diet.

"The Mediterranean-type diet is a diet high in plant foods, such as fruits, nuts, legumes and cereals, and fish, with olive oils as the primary source of monounsaturated fat and low to moderate intake of wine, as well as low intake of red meat and poultry," he said.

All of the study participants had just recently been diagnosed with type 2 diabetes, and they stayed in the study for four years. This study wasn't "blinded," which means that the researchers who were responsible for prescribing medications also knew who was in which dietary group.

After four years, 26 percent fewer people needed to go on diabetes medication in the Mediterranean diet, compared to the low-fat group. That translates into a 37 percent decreased risk of needing medication for the Mediterranean diet group, according to the study.

At the end of the study, weight as measured by body-mass index (BMI) was down 1.2 points for those in the Mediterranean diet group compared to 0.9 for the low-fat diet group, the study found. Cholesterol levels and blood pressure readings were also more improved in the Mediterranean diet group vs. the low-fat group.

"Everyone is looking for a magic bullet, but really the only magic bullet for diabetes is carbohydrate counting," said registered dietician and certified diabetes educator Carolyn Grubb, from the Scott & White Specialty Clinic, in Round Rock, Texas. "You need to find something you can live with and stay with. There's no one-size-fits-all in diabetes. Most patients do best with as little change as possible."

So, if you like these foods and think a Mediterranean diet might work for you, that's great, she said. But, if this would represent a huge change for you, it might not work as well. Grubb recommended that all people with diabetes work with a dietician to come up with an individualized eating plan that takes into account likes and dislikes.

Giugliano said he would recommend the Mediterranean diet for people with type 2 diabetes because in addition to being lower in carbohydrates, the diet seems to have an effect on insulin sensitivity beyond its carbohydrate composition.