A RESTRIÇÃO DE CARBOIDRATO NO AUXÍLIO AO TRATAMENTO DE DIABETES MELLITUS 2

Marcela Augusta Rodrigues Guimarães, Michele Ferro de Amorim Cruz, Dayanne da Costa Maynard

Resumo


RESUMO

Diversos estudos têm mostrado uma relação entre a restrição de carboidrato e a melhora dos biomarcadores relacionados ao Diabetes Mellitus 2. O presente artigo trata de uma revisão bibliográfica sobre a restrição de carboidrato no auxílio ao tratamento de Diabetes Mellitus 2 com o objetivo de analisar os impactos de uma dieta restrita em carboidrato no controle da patologia e suas complicações. Para a coleta de dados, foi realizada uma pesquisa bibliográfica de artigos em periódicos nacionais e internacionais, publicados entre 2009 e 2019 em três idiomas e em quatro bases de dados eletrônicos científicos. Como resultado, notou-se que uma pequena redução do consumo de carboidratos na dieta é uma estratégia eficaz para a melhoria dos biomarcadores relacionados ao Diabetes Mellitus 2 e suas complicações, bem como para redução significativa do uso de medicamentos antidiabéticos. Concluiu-se, portanto, que a restrição de carboidrato pode ser uma possível estratégia a ser utilizada como terapia coadjuvante para o tratamento do Diabetes Mellitus 2, embora essa temática deva ser melhor avaliada por estudos prospectivos, randomizados e de longo prazo.

 

ABSTRACT

Several studies have been shown a relationship between carbohydrate restriction and the improvement of biomarkers related to Diabetes Mellitus 2. This article deals with a reflective review on carbohydrate restriction in the treatment of Diabetes Mellitus 2 to analyze the impacts of a carbohydrate-restricted diet on disease control and its complications. For data collection, it was performed a bibliographic search of articles in national and international journals, published between 2009 and 2019 in three languages and four electronic scientific databases. As result, it was noted that a small reduction in carbohydrate intake in the diet is an effective strategy to improve the biomarkers related to Diabetes Mellitus 2 and their complications and to significantly reduce the use of antidiabetic drugs. It was concluded, therefore, that carbohydrate restriction may be a possible strategy to be used as adjunctive therapy for the treatment of Diabetes Mellitus 2, although this theme should be better evaluated by prospective, randomized, and long-term studies.

 

Figshare DOI: 10.6084/m9.figshare.12838064


Palavras-chave


Diabetes Mellitus, Insulina, Glicemia, Carboidrato e Dieta com Restrição de Carboidratos

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Referências


World Health Organization [homepage na internet]. Diabetes [acesso em 28 ago 2019]. Disponível em:http://www.who.int/topics/diabetes_mellitus/en/va

VIGITEL Brasil 2018: Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico [acesso em 29 ago 2019]. Disponível em:http://portalarquivos2.saude.gov.br/images/pdf/2019/julho/25/vigitel-brasil-2018.pdf

Imamura F, O'Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju SN, Forouhi NG. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BJM. 2016;50(8):496-504.

World Health Organization. The World Health Organization Report 2002: reducing risks, promoting healthy life [acesso em 29 ago 2019]. Disponível em:https://www.who.int/whr/2002/en/

International Diabetes Federation. IDF Diabetes Atlas 7th Edition (2015) [acesso em 29 ago 2019]. Disponível em:https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/13-diabetes-atlas-seventh-edition.html

Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, Peters AL, Tsapas A, Wender R, Matthews DR. Management of hyperglycemia in type 2 diabetes: a patient-centered approach. Diabetes Care, 2012;35(6):1364-1379.

Sociedade Brasileira de Diabetes. Medicamentos orais no tratamento do diabetes mellitus: como selecioná-los de acordo com as características clínicas dos pacientes. [acesso em 22 dez 2019]. Disponível em:https://www.diabetes.org.br/profissionais/images/pdf/diabetes-tipo-2/006-Diretrizes-SBD-Medicamentos-Orais-pg48.pdf

Tay J, Luscombe-Marsh ND, Thompson CH, Noakes M, Buckley JD, Wittert GA, Yancy WS Jr, Brinkworth GD. Comparison of low- and high-carbohydrate diets for type 2 diabetes management: a randomized trial. The Am J Clin Nutr, 2015;102(4):780-790.

Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, Accurso A, Frassetto L, Gower BA, McFarlane SI, Nielsen JV, Krarup T, Saslow L, Roth KS, Vernon MC, Volek JS, Wilshire GB, Dahlqvist A, Sundberg R, Childers A, Morrison K, Manninen AH, Dashti HM, Wood RJ, Wortman J, Worm N. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015;31(1):1-13.

Ben-Avraham S, Harman-Boehm I, Schwarzfuchs D, Shai I. Dietary strategies for patients with type 2 diabetes in the era of multi-approaches; review and results from the Dietary Intervention Randomized Controlled Trial. Diabetes Res and Clin Pract, 2009;86(1):41-48.

Haimoto H, Sasakabe T, Wakai K, Umegaki H. Effects of a low-carbohydrate diet on glycemic control in outpatients with severe type 2 diabetes. Nutr Metab (Lond). 2009;6(1):21.

Wylie-Rosett J, Aebersold K, Conlon B, Isasi CR, Ostrovsky NW. Health effects of low-carbohydrate diets: where should new research go? Curr Diab Rep, 2013; 13(2):271-278.

Forouhi NG, Sharp SJ, Du H, van der A DL, Halkjaer J, Schulze MB, Tjønneland A, Overvad K, Jakobsen MU, Boeing H, Buijsse B, Palli D, Masala G, Feskens EJ, Sørensen TI, Wareham NJ. Dietary fat intake and subsequent weight change in adults: results from the european prospective investigation into cancer and nutrition cohorts. The Am J Clin Nutr. 2009;90(6):1632-1641.

Howard BV, Van Horn L, Hsia J, Manson JE, Stefanick ML, Wassertheil-Smoller S, Kuller LH, LaCroix AZ, Langer RD, Lasser NL, Lewis CE, Limacher MC, Margolis KL, Mysiw WJ, Ockene JK, Parker LM, Perri MG, Phillips L, Prentice RL, Robbins J, Rossouw JE, Sarto GE, Schatz IJ, Snetselaar LG, Stevens VJ, Tinker LF, Trevisan M, Vitolins MZ, Anderson GL, Assaf AR, Bassford T, Beresford SA, Black HR, Brunner RL, Brzyski RG, Caan B, Chlebowski RT, Gass M, Granek I, Greenland P, Hays J, Heber D, Heiss G, Hendrix SL, Hubbell FA, Johnson KC, Kotchen JM. Low-fat dietary pattern and risk of cardiovascular disease: the women’s health initiative randomized controlled dietary modification trial. JAMA. 2006 ;295(6) :655-666.

Howard BV, Manson JE, Stefanick ML, Beresford SA, Frank G, Jones B, Rodabough RJ, Snetselaar L, Thomson C, Tinker L, Vitolins M, Prentice R. Low-fat dietary and weight change over 7 years: the women’s health initiative dietary modification trial. JAMA. 2006;295(1):39-49.

Tinker LF, Bonds DE, Margolis KL. Low-Fat Dietary Pattern and Risk of Treated Diabetes Mellitus in Postmenopausal WomenThe Women's Health Initiative Randomized Controlled Dietary Modification Trial. Arch Intern Med. 2008;168(14):1500-1511

Bahia LR, Araujo DV, Schaan BD, Dib SA, Negrato CA, Leão MPS, Ramos AJS, Forte AC, Gomes MB, Foss MC, Monteiro RA, Sartorelli D, Franco LJ. The costs of type 2 diabetes mellitus outpatient care in the brazilian public health system. Value Health. 2011;14(5):137-140.

National Institute of Diabetes and Digestive and Kidney Diseases. Health Information [acesso em 29 ago 2019]. Disponível em: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/all-content

Seshasai RKS, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N, Whincup PH, Mukamal KJ, Gillum RF, Holme I, Njølstad I, Fletcher A, Nilsson P, Lewington S, Collins R, Gudnason V, Thompson SG, Sattar N, Selvin E, Hu FB, Danesh J; Emerging Risk Factors Collaboration. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Engl J Med. 2011;364(9):829-841.

Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet. Med. 1998;15(7):539-553.

Sociedade Brasileira de Diabetes. Diretrizes da Sociedade Brasileira de Diabetes [acesso em 02 dez 2019]. Disponível em:https://www.diabetes.org.br/profissionais/images/2017/diretrizes/diretrizes-sbd-2017-2018.pdf

Cuppari L. Guias de medicina ambulatorial e hospitalar da EPM-UNIFESP: nutrição. 3 ed. São Paulo: Manole; 2014.

Mahan LK, Escott-Stump S, Raymond JL. Krause: alimentos, nutrição e dietoterapia. São Paulo: Elsevier; 2013.

Lyra R, Cavalcanti N. Diabetes Mellitus. 3. ed. São Paulo: Ac Farmacêutica; 2013.

Sociedade Brasileira de Diabetes. O teste de hemoglobina glicada (A1C): o que é e para que serve. [acesso em 22 dez 2019]. Disponível em:https://www.diabetes.org.br/publico/ultimas/656-o-teste-de-hemoglobina-glicada-a1c-o-que-e-e-para-que-serve

Manual MDS [homepage na internet]. Obesidade [acesso em 22 dez 2019]. Disponível em:https://www.msdmanuals.com/pt-br/profissional/dist%C3%BArbios-nutricionais/obesidade-e-s%C3%ADndrome-metab%C3%B3lica/obesidade

Ministério da Saúde. IMC em adultos. [acesso em 22 dez 2019]. Disponível em:http://www.saude.gov.br/component/content/article/804-imc/40509-imc-em-adultos

Ministério da Saúde. Só o IMC não diz como você está. [acesso em 22 dez de 2019] Disponível em:http://www.saude.gov.br/component/content/article/804-imc/40508-so-o-imc-nao-diz-como-voce-esta

Pereira, R. A relação entre Dislipidemia e Diabetes Mellitus tipo 2. Cadernos UniFOA. v. 6, n. 17, p. 89-94, 2017.

Lima, ES; Couto, RD. Estrutura, metabolismo e funções fisiológicas da lipoproteína de alta densidade. Jornal Brasileiro de Patologia e Medicina Laboratorial. 2006;42(3), p. 169-179. v. 42, n. 3, p. 169-178, 2006.

Sociedade Brasileira de Cardiologia. Atualização da Diretriz Brasileira de Dislipidemias e Prevenção d Aterosclerose – 2017. [acesso em 22 dez 2019]. Disponível em:http://publicacoes.cardiol.br/2014/diretrizes/2017/02_DIRETRIZ_DE_DISLIPIDEMIAS.pdf

Davis NJ, Tomuta N, Schechter C, Isasi CR, Segal-Isaacson CJ, Stein D, Zonszein J, Wylie-Rosett J. Comparative study of the effects of a 1-year dietary intervention of a low-carbohydrate diet versus a low-fat diet on weight and glycemic control in type 2 diabetes. Diabetes Care. 2009;32(7):1147-1152.

Dashti HM, Mathew TC, Khadada M, Al-Mousawi M, Talib H, Asfar SK, Behbahani AI, Al-Zaid NS. Beneficial effects of ketogenic diet in obese diabetic subjects. Mol Cell Biochem.2007; 302(1-2):249-256.

NORDLI JR, Douglas R.; DE VIVO, Darryl C. The ketogenic diet revisited: back to the future. Epilepsia. 1997;38(7):743-749., v. 38, n. 7, p. 743-749, 1997.

Liga Brasileira de Epilepsia. ABC da epilepsia. [acesso em: 22 dex 2019]. Disponivel em: http://epilepsia.org.br/wp-content/uploads/2019/06/ABC-Dieta-JUL-04.pdf

Gomes, TK DC., Oliveira, SLD., Ataíde, TDR., & Trindade Filho, EM. O papel da dieta cetogênica no estresse oxidativo presente na epilepsia experimental. Journal of Epilepsy and Clinical Neurophysiology, 2011;17(2): 54-64.

Atkins, RDC. Dr. Atkins’ new diet revolution. Government Institutes; 2002.

Eades MR, Eades MD. Protein power: the high-protein/low carbohydrate way to lose weight, feel fit, and boost your health-in just weeks. Nova York: Bantam; 2009.3.

Agatston A. The south beach diet: the delicious, doctor-desigced, foolproof plan for fast and healthy weight loss. Nova York: Macmillan; 2005.

Huhmann MB, Yamamoto S, Neutel JM, Cohen SS, Ochoa Gautier JB. Very high-protein and low-carbohydrate enteral nutrition formula and plasma glucose control in adults with type 2 diabetes mellitus: a randomized crossover trial. Nutr Diabetes. 2018;8(1):45.

Guldbrand H, Dizdar B, Bunjaku B, Lindström T, Bachrach-Lindström M, Fredrikson M, Ostgren CJ, Nystrom FH. In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss. Diabetologia. 2012;55(8):2118-2227.

Saslow LR, Kim S, Daubenmier JJ, Moskowitz JT, Phinney SD, Goldman V, Murphy EJ, Cox RM, Moran P, Hecht FM. A randomized pilot trial of a moderate carbohydrate diet compared to a very low carbohydrate diet in overweight or obese individuals with type 2 diabetes mellitus or prediabetes. PloS one [periódico online], 2014 Abr [capturado 2014 Abr 09; 9(4). Disponível em: https://doi.org/10.1371/journal.pone.0091027

Hussain TA, Mathew TC, Dashti AA, Asfar S, Al-Zaid N, Dashti HM. Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes. Nutrition, 2012;28(10):1016-1021.

Westman EC, Yancy WS Jr, Mavropoulos JC, Marquart M, McDuffie JR. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutr Metab (Lond). 2008; 5(1):36.

Zadeh, MAM, Kargarfard, M, Marandi, SM, & Habibi, A. Diets along with interval training regimes improves inflammatory & anti-inflammatory condition in obesity with type 2 diabetes subjects. Journal of Diabetes & Metabolic Disorders. 2018; 17(2): 253.

Dastbarhagh, H., Kargarfard, M., Abedi, H., Bambaeichi, E., & Nazarali, P. (2019). Effects of food restriction and/or aerobic exercise on the GLUT4 in type 2 diabetic male rats. International journal of preventive medicine. 2019; 10: 139.

Zdrodowska, B., Leszczyńska, K., & Leszczyński, R. The influence of exercises on rehabilitation and reconditioning tables on carbohydrate management in type 2 diabetic patients. Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego. 2018; 45(270), 242-247.


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Revista Brasileira de Pesquisa em Ciências da Saúde - RBPeCS - ISSN: 2446-5577


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