Short term low carbohydrate diet linked to remission of type 2 diabetes

January 13, 2021

Patients with type 2 diabetes who follow a strict low carbohydrate diet for six months may experience greater rates of remission compared with other recommended diets without adverse effects, suggests a study published by The BMJ today.

The researchers acknowledge that most benefits diminished at 12 months, but say doctors might consider short term strict low carbohydrate diets for managing type 2 diabetes, while actively monitoring and adjusting diabetes medication as needed.

Type 2 diabetes is the most common form of diabetes worldwide and diet is recognised as an essential part of treatment. But uncertainty remains about which diet to choose and previous studies have reported mixed results.

To address this evidence gap, a team of international researchers set out to assess the effectiveness and safety of low carbohydrate diets (LCDs) and very low carbohydrate diets (VLCDs) for people with type 2 diabetes, compared with (mostly low fat) control diets.

Their findings are based on analysis of published and unpublished data from 23 randomised trials involving 1,357 participants.

LCDs were defined as less than 26% daily calories from carbohydrates and VLCDs were defined as less than 10% daily calories from carbohydrates for at least 12 weeks in adults (average age 47 to 67 years) with type 2 diabetes.

Outcomes were reported at six and 12 months and included remission of diabetes (reduced blood sugar levels with or without the use of diabetes medication), weight loss, adverse events and health related quality of life.

Although the trials were designed differently, and were of varying quality, the researchers were able to allow for this in their analysis.

Based on low to moderate certainty evidence, the researchers found that patients on LCDs achieved higher diabetes remission rates at six months compared with patients on control diets, without adverse events.

For example, based on moderate certainty evidence from 8 trials with 264 participants, those following a LCD experienced, on average, a 32% absolute risk reduction (28 fewer cases per 100 followed) in diabetes remission at 6 months.

LCDs also increased weight loss, reduced medication use, and improved body fat (triglyceride) concentrations at six months.

However, most of these benefits diminished at 12 months, a finding consistent with previous reviews, and some evidence showed worsening of quality of life and cholesterol levels at 12 months.

This study used robust methods to increase the precision and overall certainty of the effect estimates. But the authors acknowledge some limitations, such as the ongoing debate around what constitutes remission of diabetes, and uncertainty over the longer term effectiveness and safety of LCDs.

They also stress that their results are based on moderate to low certainty evidence.

As such, they suggest clinicians "might consider short term LCDs for management of type 2 diabetes, while actively monitoring and adjusting diabetes medication as needed."

"Future long term, well designed, calorie controlled randomised trials are needed to determine the effects of LCD on sustained weight loss and remission of diabetes, as well as cardiovascular mortality and major morbidity," they conclude.
-end-
Peer reviewed? Yes
Evidence type: Systematic review and meta-analysis
Subjects: People with type 2 diabetes

BMJ

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.