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Should a Low Carbohydrate Diet be Recommended for Diabetes Management?

So asked the authors of a new study from the London Metropolitan University as they set out to evaluate if restricting carbohydrate intakes was a safe and effective management strategy for diabetes.

 

The authors, Michelle McKenzie and Sarah Illingworth from London Met's School of Human Sciences, conducted a systematic review of previous intervention studies with the aim to use a literature review to analyse changes to participant's glycated haemoglobin levels following a switch to a lower carbohydrate diet

 

The literature review was conducted using primary electronic databases to identify randomised control trials and intervention studies published between 2001-2015.

 

They included studies involving adults with diabetes and assessed the impact of restricted carbohydrate intakes on metabolic outcomes.

 

They also specified the amount of carbohydrates in grams per day or percentage of total daily energy intake (TEI).

 

The study found that:

  • Glycaemic fluctuations are unavoidable when consuming even moderate intakes of carbohydrates, exacerbating hyperglycaemia and dyslipidemia* both of which are associated with the development of diabetic complications.
  • Significant reductions in glycated haemoglobin levels were reported across the literature with the greatest reduction (2·2 per cent) correlating with the lowest carbohydrate intakes (30gm/d).
  • Effects on fasting blood glucose were immediate dropping from 11·7 mmol/l to 7·0 mmol/l requiring an immediate reduction in medication.
  • Decreases in bodyweight ranged from −8·6 kg to −0·9 kg with greater reductions reported at two years in subjects following the low carbohydrate diet (−4·7 kg) compared to the low fat diet (−2·9 kg).
  • Effects on fasting blood glucose were immediate dropping from 11·7 mmol/l to 7·0 mmol/l requiring an immediate reduction in medication.
  • 52 % of subjects consuming 14 % (TEI) from carbohydrates reduced their medication compared to 21 % following a diet of 53 % (TEI).

 

The authors go on to say:

A carbohydrate restricted diet can provide a safe and effective solution for improving diabetes management and should have a place within the diabetic guidelines.

 

The diet was effective in reducing postprandial hyperglycemia and glycaemic variability resulting in low levels of glycaemia without the risk of hypoglycaemia.

 

The ability of the diet to reduce the symptoms of dyslipidemia is of particular importance and when compared to the traditional low fat diet for weight loss, the low carbohydrate diet was comparable and in some instances better.

 

There were significant reductions or cessation of diabetic medication reported throughout the literature alongside a reduction in the psychological aspects of living with a long-term disease.

 

The study concludes by saying that it is possible that the current dietary advice may actually accelerate beta cell exhaustion with elevated blood glucose diminishing the islet cells ability to produce insulin.

 

What this means for people with diabetes:

The main outcome of this literature review was that a low carbohydrate diet can have a place in diabetes management guidelines, not that low carbohydrate diets should be the only diet for people with diabetes. There is no one size fits all diet for diabetes and you need an individualised approach to match your individual condition.

 

It is important to remember the studies in this review are conducted with close supervision and support of a health professional, if you are considering trying a low carbohydrate diet to help manage your diabetes it is important you talk to an Accredited Practising Dietitian who can help tailor your diet to your own condition and ensure you are also getting all the nutrients you need to live well. 

 

 

*Dyslipidemia is an abnormal amount of lipids (e.g.,triglycerides, cholesterol and/or fat phospholipids) in the blood.

Access the full study 

 

Dr Brinkworth, co-author Pennie Taylor and the CSIRO launched a Low Carb Diet Book, with recipes and advice arising from their research.

 

 

 

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