Every year, about 1.5 million Americans are diagnosed with diabetes. Most of them have type 2 diabetes, in which the body produces insulin but doesn’t use it well. Could a low-carb diet help people overcome this metabolic malfunction?
Low-Carb Diet Can Lead to Remission:
A meta-analysis of 23 randomized clinical trials of low and very low carbohydrate diets found that those who follow such a diet for six months may be able to achieve remission of their disease (BMJ, Jan. 13, 2021). Data are sparse on whether people are able to maintain these benefits after a year. Many people find it harder to stick with a very low-carb diet for an extended period.
At 12 months, investigators found that blood lipids, especially LDL levels, were higher. However, the difference did not reach statistical significance. The authors are concerned about the potential long-term consequences, which are still unknown.
As a result, they conclude:
“clinicians might consider short term LCDs [low carbohydrate diets] for management of type 2 diabetes, while actively monitoring and adjusting diabetes medication as needed.”
Controversies Over What to Eat:
Diet, it turns out, is a hot-button issue. That’s especially true for people with diabetes, who are bombarded with advice. Too bad so much of it conflicts, making every meal an anxiety-provoking situation. Yet the foods we choose have a profound impact on our physiological reactions.
Every so often a medical professional takes us to task for leaving something important out of an answer. Rarely are we chastised for overlooking or failing to mention a simple approach that is completely under the patient’s control. (Keep in mind that many simple things are not necessarily easy!) That’s why we were actually pleased to get this scolding from a physician:
Q. You recently answered a question from a woman who asked about her husband’s blood sugar control. She reported that they were forced to choose between food and drugs.
You should have told her that the majority of non-insulin dependent diabetics who stop eating processed carbs, grains and rice are no longer hyperglycemic. I see them every day in my medical practice.
The forces working against this simple approach are massive-incomprehensible ignorance on the part of my fellow physicians and huge amounts of money from the pharmaceutical and food industries.
Low-Carb Diet Can Be Helpful:
A. Thank you so much for pointing out the value of a low-carb diet in controlling blood sugar. A randomized trial confirms that such an approach can indeed help people with type 2 diabetes and allow for reductions in diabetes medicine (American Journal of Clinical Nutrition, Oct. 2015). The low-carb diet in this year-long study was high in unsaturated fat and low in saturated fat as well as low in carbohydrates.
Dutch investigators confirmed that a six-month pilot program of intensive dietary counseling and cooking classes to help people follow a low-carb diet was successful (BMJ Nutrition, Prevention & Health, May 14, 2019). Approximately half of the volunteers with type 2 diabetes reduced or eliminated their glucose-lowering medications.
Dilemmas of Dining Out:
We have recently been impressed with just how big a role processed carbs such as bread, pasta, pizza, rice, cookies, crackers and sweets play in the standard American diet. If you scratched those off the menu, you would find very little to eat at the average diner or fast-food restaurant.
People with diabetes or pre-diabetes are not the only ones who could benefit from a low-carb diet. People with celiac disease or gluten intolerance also need food that is not made with white flour, and almost all of us would benefit if we ate less sugar. Isn’t it about time customers starting demanding healthier food choices?
