- Following a low carbohydrate diet can lead to remission of type 2 diabetes after six months.
- A review of the studies confirmed that the low-carb diet is the best option, but the benefits may diminish after one year.
- More research needs to be done on the long-term effects of the diet.
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A strict low-carbohydrate diet may be the best bet for patients with type 2 diabetes to go into remission, suggests a new analysis of studies.
The findings of the meta-analysis, published Wednesday in the BMJ, are consistent with the American Diabetes Association’s official recommendation that cutting carbohydrates is the best approach to lowering blood sugar.
The analysis summarized data from 23 randomized controlled trials involving more than 1,300 participants with type 2 diabetes. Most studies compared a low-carb or very low-carbohydrate diet – defined as less than 26% or 10% of daily carbohydrate calories. , respectively – with low-fat diets.
Overall, patients who followed a low-carb diet for six months achieved higher rates of remission than those who tried other dietary changes.
Dr. Mark Cucuzzella, a professor at the University of West Virginia School of Medicine who has published several studies on dietary changes and diabetes, said that reducing carbohydrate intake and eating more nutrient-rich foods can help patients reverse the course of the disease.
“The good news about diabetes is that it is a food disorder, so it is reversible with lifestyle measures that target carbohydrates,” said Cucuzzella, who was not affiliated with the study. “This meta-analysis is just another collection of studies that shows that it is possible to do this.”
People with type 2 diabetes are “carbohydrate intolerant”
Although the term doctors often use to describe type 2 diabetes is “insulin resistance”, Cucuzzella said that another way to see this is that people with the disease are “carbohydrate intolerant”.
“Their bodies do not metabolize and respond well to carbohydrates, and the end result is high insulin levels, which precede high hyperglycemia or high blood sugar levels,” explained Cucuzzella.
Fats and proteins do not cause blood sugar levels to rise like carbohydrates, so reducing the consumption of sweets and starches can help patients keep diabetes under control, along with medication.
Other options for controlling diabetes include bariatric surgery – removing the stomach and intestines – or subsisting on an 800-calorie shake a day, so reducing carbohydrate intake is a relatively simple solution, said Cucuzzella.
Maintaining a low-carb lifestyle is the difficult part
Most of the benefits of a low-carbohydrate diet seen after six months – such as weight loss, improved body fat and reduced drug use – have decreased in 12 months, according to the analysis.
The decrease in benefits may be due to patients not following the diet over time, the authors hypothesized, but more research needs to be done to explore adherence and long-term effects. Some participants also reported lower quality of life and worse cholesterol levels after 12 months.
Keeping diabetes in remission is like holding a beach ball underwater, said Cucuzzella. If patients let their dietary changes go, the disease can easily recover. However, he said the short-term benefits bode well for the overall effectiveness of the diet and pointed to patient support as the next step.
“If you can show that something works for six months, when nothing else works other than not eating and getting your stomach out, then we have to figure out how to help support people to stay on this plan.”