While diabetics are often advised to eat a diet rich in carbohydrate, common sense dictates that this is not likely to be the best dietary approach for managing their condition (seeing as diabetes is primarily a problem with carbohydrate regulation, specifically a tendency to raised blood sugar levels). In type 2 diabetes, the underlying issue is either a failure of the body to respond to the action of the hormone insulin (insulin resistance) and/or a failure of the pancreas to produce sufficient quantities of insulin (pancreatic exhaustion). But whatever the precise underlying mechanism, the logical approach would be to reduce the carbohydrate quantity in the diet.
Not just common sense, but also science, has found a carb-restricted diet to be effective in managing type 2 diabetes. You can read about a couple of pertinent studies here and here. The results of the first of these studies are particularly impressive, I think, in that they revealed that a very low carbohydrate diet allowed 95 per cent of individuals to ditch their medications. I was disappointed to see that this study did not get more in the way of media exposure. The problem is, I suppose, that it doesn’t really pay anyone for these sorts of studies to get a wide audience.
Another study attesting to the benefits of carbohydrate restriction in the management of type 2 diabetes was published earlier this month on-line in the journal Nutrition and Metabolism. Here, a group of 33 type 2 diabetics with an average age of 59 were encouraged to eat a 30 per cent carbohydrate diet for a period of 6 months. One key measurement used in this study was the HbA1c (also known as glycosylated haemoglobin) which gives a measure of blood sugar control over the preceding 2-3 months. In the ideal world, HbA1c levels should be below 5 per cent. In diabetes, the target is often to get HbA1c levels to less than 7 per cent.
In this study, the average level was 10.9 per cent at the start of the study. This would suggest poor blood sugar control. 3 months into the study, average HbA1c levels were 7.8 per cent. At 6 months, levels had decreased further to 7.4 per cent. There was no control group (a group of people not adopting a lower carb diet against which the results could be compared), but even so, these results look mightily impressive to me. According to this chart, the change in HbA1c equates to an average blood glucose of 311 mg/dl falling to 186 mg/dl (17 mmol/L falling to 10 mmol/L) over 6 months.
This study, adds further weight to the argument for treating diabetes with a carb-restricted diet. Even though the only people to benefit from this approach will be the diabetics themselves.
Haimoto H, et al. Effects of a low-carbohydrate diet on glycemic control in outpatients with severe type 2 diabetes. Nutr Metab 2009 May 6;6(1):21. [Epub ahead of print publication]