A vegan diet may do a better job of reducing cardiovascular disease in diabetic patients than a diet recommended by the American Diabetes Association (ADA), according to a new study.

Two out of three people with diabetes die of a heart attack or stroke, so reducing cardiovascular disease is a priority. The study was in part funded by the Physicians Committee for Responsible Medicine, which promotes a vegan diet.

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For 22 weeks, participants followed either a low-fat, low-glycemic vegan diet or guidelines prescribed by the ADA. All 99 participants had type 2 diabetes. Both men and women participated and were recruited through a newspaper ad in the Washington, D.C., area.

Participants reported what they ate at the start of the trial and throughout the trial. Researchers took the data and calculated scores based on the Alternate Healthy Eating Index (AHEI). Scores were calculated at the beginning of the 22 weeks and again at the end. There was no difference in the scores between the two groups at the start of the study.

Past research has shown a correlation between AHEI and cardiovascular disease. The AHEI is a nine-component dietary index used to rate foods and macronutrients related to chronic disease risk. The higher the AHEI score, the lower the risk of cardiovascular disease. The vegan dieters saw significant improvements in their AHEI scores; the ADA group did not.

The vegan group improved significantly in every AHEI category, including increased intake of vegetables, fruits, nut and soy protein, and cereal fiber, and a decrease in trans fat intake.

Both groups were able to reduce their weight and their hemoglobin A1c, a measure of blood sugar levels over a prolonged period of time. However, the vegan group experienced more significant reductions in both categories.

“The results of this study suggest that, if followed for the long-term, a low-fat vegan diet may be associated with a reduced risk of major chronic diseases, particularly cardiovascular disease,” the study concludes.

Neither diet resulted in adequate intake of vitamins D or E, or of calcium. Patients attempting to follow either eating plan should consult with their doctor and make sure they are getting adequate amounts of these nutrients.

People with type 2 diabetes who need insulin to control their blood glucose levels can choose either human insulin or a structurally similar synthetic version to do the job, a study shows.

“There is no difference between premixed human insulin and premixed insulin analogues,” Dr. Rehan Qayyum from Johns Hopkins Hospital, Baltimore, told Reuters Health.

Qayyum and colleagues reviewed clinical studies of the effectiveness and safety of premixed insulin analogues compared with other anti-diabetes agents in adults with type 2 diabetes.

Premixed insulin analogues provided tighter glucose control than long-acting insulin and non-insulin agents, according to the investigators’ report in the Annals of Internal Medicine. Premixed insulin analogues were comparable to premixed human insulin in lowering A1C levels, an indicator of relatively long-term glucose control.

The occurrence of episodes of too-low glucose levels, i.e., hypoglycemia, was similar with premixed insulin analogues and with premixed human insulin.

“I have found in my previous comparative research that the benefits of new treatments and interventions are often exaggerated by industry and academia (unfortunately),” Qayyum added.

“Studies with longer follow-up are needed to determine whether the effects observed early in treatment are sustainable long-term,” the team concludes.

SOURCE: Annals of Internal Medicine, online September 15, 2008