Another study attests to the value of low-carb eating in diabetes

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.

References:

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]

6 Responses to Another study attests to the value of low-carb eating in diabetes

  1. Penguinista 16 May 2009 at 1:33 pm #

    “..Even though the only people to benefit from this approach will be the diabetics themselves.”

    Ah the crux of the matter. Reminds me low dose naltrexone as therapeutic aid for Crohns, MS, some cancers etc..

    Show me the money… Oops there’s none… Hence not a lot of media coverage.

  2. John 16 May 2009 at 3:08 pm #

    I can personally attest, being type 2 db myself, that the individual can do a lot to manage their own condition. Been diagnosed 5/6 years now and still not on prescribed meds. It is not easy and I mess up sometimes. It’s life that compromises things.
    Most of the T2dbs I know are just content to go along with the status-quo though, and accept drug therapy as the path of least resistance.Tthis action absolves them of the responsibility they owe to themselves. So long as society is prepared to continue paying for that .. …They get free scrips whereas I must pay.

    I was thinking back to cholera, disease, and John Snow in Victorian London. It is interesting that infectious (communicable) diseases precipitated an effective response. Efforts soon got to the root of the cause. The solution was multi-factorial, engineering to clean up London, and development of effective pharma’ interventions in the decades that followed.

    With chronic NCDs (noncomminicable diseases) things seem different. Is it me or are the balance of efforts more intent on developing and/or selling us interventions to ‘manage’ these conditions rather than establish a cause? Are the powers that be stupid, or is it a conspiracy?

    If you had a flood in your kitchen you would look to a cause, be that faulty washer, faulty dishwasher or simply a dripping tap.

    In a parody of actuality you would call in a consultant who would suggest you need to mop up on a daily basis, better still he can refer you to someone who can do it for you for as long as the flood is there. And it gets better, because neither he nor you need pay! You are at their mercy. You were neither directed, nor ever thought for yourself, to CHECK THE BLOOMIN’ TAP!

  3. Dan 16 May 2009 at 4:21 pm #

    “…a very low carbohydrate diet allowed 95 per cent of individuals to ditch their medications.”

    Not good for drug company profits. The media won’t bite the hand that feeds it. :)

  4. Trinkwasser 16 May 2009 at 6:11 pm #

    The ADA’s Position Statement on Medical Nutrition Therapy used to give a maximum A1c reduction of 1 – 2%. Since they partly relented on their 60% carbs recommendation and reduced it to a minimum of 135g/day they have changed the statement to read 1 – 2.9%

    Yet ON THEIR VERY OWN FORUMS as well as almost all other diabetes newsgroups and forums we regularly read of 5 – 8% improvements and I’ve seen over 10% on occasion.

    Worse still

    http://scholar.google.co.uk/scholar?q=gannon+nuttall&hl=en&lr=&btnG=Search

    check the date of one of these studies funded by the ADA. 2004. yet they are still saying that low carb diets are only suitable for weight loss in the short term, and “the long term effects are not known”

    SAY WHAT??? they have had over five years to carry out a long term study, during which time they have not done so, and Gannon and Nuttall have been relegated to a locked filing cabinet in a basement behind the sign saying beware of the leopard rather than front page news on their site.

    Quite apart from the utter lack of logic that a doctor NOT recommending a high carb diet to a carbohydrate intolerant person “to control your BG levels” would face disciplining, yet the same doctor prescribing penicillin to an allergic individual “to keep your allergy levels under control” would soon lose their licence, there’s a major cognitive dissonance going on.

    My GP crows with joy over my BG, BP and lipids *until* she discovers how I control them, and has told me she is “not permitted” to prescribe test strips and “not allowed” to recommend other than the Heart Healthy diet. My previous doctor was so appalled at my rapid decline that I was actually accused of “failing to comply” with that diet when the problem was that I WAS complying, which was causing the damage not to mention weight gain for the first time in my life.

    This story is soooo common anecdotally, yet there is a serious lack of studies quantifying the anecdotes. I pointed this out in the BMJ where GPs were whining about their inability to collect their bribes if their diabetics were not better controlled, and pointed out this simple protocol

    http://loraldiabetes.blogspot.com/2009/04/test-test-test.html

    which is available from many places on the internet and dates back around a decade. Strangely they refused to publish my comment.

  5. Kristine Franklin-Ross 17 May 2009 at 5:29 pm #

    After just over a year of low carb eating my latest A1C was normal, my blood sugars never go above 7.9 and are mostly steady at 6.0 all day. I eat lots of fat, good meat from grass fed/free range animals, 4 eggs a day and a few veges here and there, lost a stone and a half too :-) Only thing my GP is worried about is my cholesterol, it was 8.5 at the last test. I won’t be going down the statin route.

  6. Trinkwasser 18 May 2009 at 7:25 pm #

    TChol test is cheap but useless. For all you know you may have superbly high HDL, and possibly high trigs which would respond well to a further carb lowering. See if you can’t get a Full Lipid Panel which would indicate actions you could take (but expect to be refused, they save money on the tests in order to afford the statins)

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