Diabetes is a condition characterised by elevated levels sugar in the bloodstream, derived primarily from sugars and starches in the diet. One obvious approach to this condition would be, then, to cut back on carbohydrate intake. I have known many, many diabetics take this approach and reap the reward in terms of better blood sugar control and less need for medication. In the case of type 2 diabetes, I’ve seen many individuals who were previously on medication, find they have no need for it after all once their diets are essentially devoid of offending foods.
In a recent study a low-carb diet (less than 20 grams of carb a day) was tested in a group of obese type 2 diabetics. The group also received nutritional supplementation, group support and recommendations regarding exercise. The study randomised other type 2 diabetics to another diet, this one being based on foods of low glycaemic index (GI), and restricted in calories (individuals were to eat 500 calories less per day than would be required to maintain their weight). As with the other group, the low GI eaters received nutritional supplements, group support and exercise recommendations. The study lasted for 24 weeks.
One of the main outcome measures used in this study was levels of HBA1c (also known as glycosylated haemoglobin). This gives a measure of blood sugar control over the preceding 3 months or so. This measure fell significantly more in the low-carb versus the low GI group (by 1.5 v 0.5 per cent). Weight loss was also greater in the low-carb group (an average of about 11 kg v about 7 kg) even though the low-carb group was not instructed to restrict calories and the low GI group was. The low-carb group also saw a rise in levels of supposedly ‘healthy’ HDL cholesterol, while the low GI group did not. All in all, the low carb group won hands down.
Another outcome measure the authors of this study used was whether or not individuals were able to reduce or discontinue their diabetes medication(s). In the case of the low-carb group, more than 95 per cent were able to do so (compared to 62 per cent of the low GI, calorie restricted group). I see these results as pretty astounding: almost all the type 2 diabetics on the low carb regime were able to kiss goodbye to their meds.
This study is, I think, a clear vindication of the low-carb approach in type 2 diabetes, despite being relatively small in size (84 people were enrolled in the study and 49 completed it). And it adds some scientific validation (should we require it) to the common sense of diabetics eating less of the very foods they have difficulty handling metabolically.
Westman EC, et al. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & Metabolism 2008;5:36