The acute effects of a DASH diet and whole food, plant-based diet on insulin requirements and related cardiometabolic markers in individuals with insulin-treated type 2 diabetes

Diabetes Res Clin Pract. 2023 Aug:202:110814. doi: 10.1016/j.diabres.2023.110814. Epub 2023 Jul 5.

Abstract

Aims: There is limited research regarding insulin dosing changes following adoption of plant-based diets. We conducted a nonrandomized crossover trial utilizing two plant-based diets (Dietary Approaches to Stop Hypertension, or DASH, and Whole Food, Plant-Based, or WFPB) to assess acute changes in insulin requirements and associated markers among individuals with insulin-treated type 2 diabetes.

Methods: Participants (n = 15) enrolled in a 4-week trial with sequential, one-week phases: Baseline, DASH 1, WFPB, and DASH 2. Each diet was ad libitum and meals were provided.

Results: Compared to baseline, daily insulin usage was 24%, 39%, and 30% lower after DASH 1, WFPB, and DASH 2 weeks respectively (all p < 0.01). Insulin resistance (HOMA-IR) was 49% lower (p < 0.01) and the insulin sensitivity index was 38% higher (p < 0.01) at the end of the WFPB week before regressing toward baseline during DASH 2. Total, LDL, and HDL cholesterol, leptin, urinary glucose, and hsCRP decreased to a nadir at the end of the WFPB week before increasing during DASH 2.

Conclusions: Adopting a DASH or WFPB diet can result in significant, rapid changes in insulin requirements, insulin sensitivity, and related markers among individuals with insulin-treated type 2 diabetes, with larger dietary changes producing larger benefits.

Keywords: DASH Diet; Insulin Resistance; Medical Nutrition Therapy; Plant-Based Diet; Type 2 Diabetes Mellitus; Vegan Diet.

MeSH terms

  • Diabetes Mellitus, Type 2* / drug therapy
  • Diet
  • Diet, Vegetarian
  • Dietary Approaches To Stop Hypertension*
  • Humans
  • Hypertension*
  • Insulin / therapeutic use
  • Insulin Resistance*
  • Insulin, Regular, Human

Substances

  • Insulin
  • Insulin, Regular, Human