ICMR-INDIAB Study on Diabetes Remission and Prevention

Lowering carbohydrates and increasing protein intake can result in diabetes remission and prevention, a recent national study by the Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) has reported.

The ICMR-INDIAB study is a population-based study and included 18,090 adults across different states in India and is the country's largest epidemiological study on diabetes. The study was conducted to derive macronutrient recommendations for remission and prevention of type 2 diabetes (T2D) in Asian Indians using a data-driven optimization approach.

Different assessments, including dietary, behavioral, and demographic, were performed. Along with these, fasting and 2-hour post glucose challenge capillary blood glucose and glycosylated hemoglobin (HbA1c) were estimated.

The study obtained various glycemic categories, such as newly diagnosed diabetes (NDD), prediabetes (PD), and normal glucose tolerance (NGT). Macronutrient recommendations were formulated to compute optimal macronutrient compositions that would reduce the sum of the difference between the estimated HbA1c and the targets for remission and prevention of progression in T2D in PD and NGT groups.

Salient Findings of the Study

• Diabetes remission can be achieved in NDD if carbohydrate content is reduced to 49-54% while increasing protein intake by 19-20% and maintaining fat consumption at 21-26%.
• Reducing carbohydrate consumption by 50-60% and increasing protein by 18-20% and fat by 21-27% is recommended for the remission of PD to NGT.
• For the prevention of Type 2 Diabetes Mellitus in PD and NGT: reduction of carbohydrate intake by 54–57% and 56–60%; increasing protein intake by 16–20% and 14–17%, respectively; and fat 20–24% for PD and NGT is sufficed.

To conclude, the study's finding reaffirms a reduction in carbohydrates (%E) and an increase in protein (%E) for both T2D remissions and prevention of progression to T2D in PD and NGT groups.

Reference

Ranjit Mohan Anjana, Seshadhri Srinivasan, Vasudevan Sudha, et.al, ICMR-INDIAB Collaborative Study Group; Macronutrient Recommendations for Remission and Prevention of Diabetes in Asian Indians Based on a Data-Driven Optimization Model: The ICMR-INDIAB National Study. Diabetes Care 2022; dc220627. https://doi.org/10.2337/dc22-0627