Low carb diet shows potential in reversing type 2 diabetes: Study

A recent study published in BMJ Nutrition, Prevention & Health showed that a low-carbohydrate diet was effective in achieving glycemic control in people living with type 2 diabetes.

Besides, more than half of the participants adopting the low-carbohydrate diet achieved type 2 diabetes remission, which meant they were able to eventually stop taking medications.

Type 2 diabetes is associated with a progressive decline in the ability to control blood glucose levels, requiring the use of a more significant number of medications with time. Doctors regard type 2 diabetes as an incurable and lifelong condition, however, the study has shown that long-term remission of type 2 diabetes is possible.

Study author Dr David Unwin, of Norwood Surgery, United Kingdom, told Medical News Today, "Incredibly, 77% of those adopting a low-carb approach in the first year of their [type 2 diabetes] achieved remission. This represents a really important 'window of opportunity' for further investigation."

The study consisted of 186 clinic patients with type 2 diabetes opting for the low-carbohydrate approach for diabetes management over an average follow-up period of 33 months. During routine visits over the follow-up period, the clinicians provided the patients with advice on maintaining a low-carbohydrate diet and shared information about how this diet could help achieve better blood glucose control.

Dr Ari Eckman, endocrinologist and medical director of endocrinology services at Holy Name Medical Center in Teaneck, NJ, not involved in this study, noted that the results are "very significant given the fact that many patients with type 2 diabetes mellitus would like to eventually come off of their medications."

"This article [in The BMJ journal] provides a blueprint for how many patients were successful in controlling their diabetes with diet alone," he added. "Hopefully, it will be interesting to see how this diet can be integrated with our own patients in controlling and managing their diabetes."

Studies have shown that weight loss by reducing calorie intake can lead to the remission of type 2 diabetes, involving the return of blood glucose (sugar) levels to prediabetic levels in the absence of medications.

A recent primary care-based cohort study showed that about 97% of type 2 diabetes patients who adopted a low-carbohydrate diet experienced improvements in blood glycemic control.

About 51% of the type 2 diabetes patients achieved remission on the low-carbohydrate diet, with individuals diagnosed with type 2 diabetes within the previous year more likely to achieve remission than those with diabetes for a longer duration.

These findings suggest that a low-carbohydrate diet could be a viable non-pharmacological option for achieving good glycemic control and potentially remission in people with type 2 diabetes.

Such a remission of diabetes refers to a return to prediabetic HbA1c — below 48 millimoles per mole (mmol/mol) or 6.5% — and blood glucose levels in the absence of medication use for at least 3 months.

However, it must be noted that diabetes remission does not imply that the condition is cured and blood glucose levels can potentially revert to diabetic levels.

Individuals with type 2 diabetes show inadequate control of blood sugar levels due to the inability of the body to effectively use insulin and absorb sugar. As a result, individuals with diabetes have elevated blood sugar levels and glycated hemoglobin or hemoglobin A1c levels (HbA1c).

About 80-90% of individuals with type 2 diabetes are overweight or obese. Studies have shown that weight loss achieved by bariatric surgery or through restriction of calorie intake can lead to the remission of type 2 diabetes.

Excessive intake of energy leads to the accumulation of fat around the liver. The accumulation of fat is associated with reduced sensitivity of the liver to glucose and, subsequently, reduced secretion of insulin by the pancreatic beta-cells.

Studies suggest that reducing energy intake can induce type 2 diabetes remission by reducing the levels of liver fat and improving the function of pancreatic beta-cells.

Adopting a healthy diet could help individuals with type 2 diabetes achieve remission, but there is conflicting evidence about the effectiveness of the various diets. One of the dietary approaches to weight loss includes reducing the intake of carbohydrates.

A low-carbohydrate diet involves restricting the intake of foods that are high in sugars, those that lead to a surge in blood glucose levels.

Specifically, such a diet involves limiting the intake of carbohydrates such as bread, rice, and potatoes while promoting the intake of green leafy vegetables, fish, meat, nuts, and fruits.

There is evidence to suggest that a low-carbohydrate diet can help people with type 2 diabetes achieve remission in the short term.

Besides improving pancreatic beta-cell function and reducing fat accumulation, a low-carbohydrate diet can also help achieve sustained weight loss by reducing hunger and increasing energy expenditure.

This is important because preventing the return of lost weight is one of the biggest challenges for individuals with type 2 diabetes.

However, there are also studies that suggest that carbohydrate intake may not be a factor in blood glucose control in people with type 2 diabetes. Moreover, there are also concerns that individuals may find it difficult to adhere to a low-carbohydrate diet over longer durations.

In the present study, the authors evaluated clinical data collected from their primary care clinic in the UK over the previous 8 years to further assess the ability of a low-carbohydrate diet to induce remission in type 2 diabetes patients.