Carbohydrate restriction (CR) confers greater benefit on health outcomes for adults with T2D if done more frequently throughout 1 year. For a study that examined the extent to which ongoing CR is needed to sustain health improvement, adults with T2D counseling on CR reported adherence measures by blood beta-hydroxybutyrate (BHB) regularly via a mobile app. Patients enrolled 1 year with a mean BHB greater than 0.3 mM in the first 3 months were split into quartiles based on the percent of BHB logs greater or equal to 0.3 and 0.5 mM during months 4-12. The study team conducted analyses of variance to compare the groups’ percent change in weight and A1C from baseline to 1 year. They found that all groups had clinically significant improvements on average in weight and A1C, but the percent change statistically differed by group. Participants who reported CR more often experienced greater benefit at 1 year. Using a 0.3 mM BHB cutoff and a very consistent restriction (≥ 95% of the time) yielded significantly greater benefit. A 0.5 mM cutoff demonstrated greater benefit with lower frequencies of reporting (≥ 38% for weight and ≥ 66% for A1C).
