Low-carb diet shown to be hugely effective for type 2 diabetics

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.

References:

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

28 Responses to Low-carb diet shown to be hugely effective for type 2 diabetics

  1. Neil 8 January 2009 at 3:53 am #

    I wonder how the anti saturated fat proponents will rationalise those outcomes?

  2. Nigeepoo 8 January 2009 at 1:58 pm #

    I was informed by a Nutritionist with letters after her name:-
    “As a health and fitness scientist, I have to agree with the overwhelming body of peer reviewed evidence that shows high fat diets are dangerous over a long period of time, and that an athletic diet includes complex carbs taken regularly throughout the day.”

    Obviously, athletes have different dietary requirements to fat people with type 2 diabetes. However, this is what doctors and “health and fitness scientists” are still being taught. I guess none of them ever read Dr Diana Schwarzbein M.D.’s intro:- http://www.schwarzbeinprinciple.com/pgs/dr_schw/sp_I_intro.html

    “In medical training, I was taught that a low-fat diet high in complex carbohydrates prevented weight gain and disease. I believed what my professors said. Early on, I advocated low-fat diets. But this soon changed.”

    Keep up the good work!
    Cheers, Nige.

  3. simona 8 January 2009 at 5:18 pm #

    There are some proponents of the raw food movement in the states (Gabriel Cousens, I think, Mike Adams on natural news has published something on the subject) that say that they could reverse diabetes mellitus in a similar way, take people off the meds with a raw diet.
    Dr. Briffa, I am really interested in what do you think of the raw foodists? Are you reading dr. Mercola’s articles on his site or have you heard of functional medicine, of Mark Hyman and his work? Is this approach (functional medicine) having any influence on the medical world in the British Isles?

  4. Hilda Glickman 9 January 2009 at 11:49 pm #

    Neil : If you see this can you tell me what you mean by what you said. Are you assuming that a low carb diet means high fat? This is not so as the two are not connected. Low carb means eating fruit , veg, fish, etc not fried sausages and balck pudding.

  5. Richard 10 January 2009 at 3:53 pm #

    Hi Simona

    I don’t think raw food diets are a magic bullet to cure disease, or are an optimum diet.

    But they do eliminate foods that may cause problems for many people, like grains, hydrogenated fats and processed foods etc. (This is also the case with ‘Paleo’ style diets except cooked food is included as well as meat and seafood).

    Exclusion of foods like those mentioned above, along with the weight loss raw foodists experience, probably explains why they experience improvements in their health at some point.

    I myself was seduced by the ideas of raw foodism and it’s promise of ultimate health and experimented with it by going ‘raw’ for 6 months. I experienced loosing too much weight and the inability to maintain a healthy weight, decline in tooth condition (through fruit acid erosion and eating raw plant matter). I also suffered loose stools from consuming large amounts of plant matter and a (not uncommon) drop in body temperature to 35.5 Celsius (not far above hypothermia with the possibility of heart irritability, normal is close to 36.8). Not to mention people commented on how thin and unhealthy I looked.

    If you adopt a raw food diet you have to rely on machines, like blenders, to chew up your food and it you may be difficult covering all nutritional bases. Also a host of ‘super foods’ are promoted to raw foodists, which are not foods we have evolved on, how beneficial or detrimental to us are these? A raw food diet may have benefits in the short term, like weight loss and also give your gut a good scrub, but long term no one really knows. I don’t recommend a 100% raw diet or a high raw diet.

  6. The other (non-dietician)Kate 10 January 2009 at 6:19 pm #

    The raw food movement is interesting. But, the main problem is that a person who is interested in embarking on a raw food diet has to buy a lot of very expensive equipment. Juicers, blenders and a dehydrator.
    I have MS and I did try it for 5 months. My symptoms were greatly improved but I wasn’t a vegan. To join the raw food ‘club’ you are encouraged to be a vegan and people with MS can’t digest pulses- even sprouted pulses as the lectins cross the blood-brain barrier.

    The whole movement is rather similar to a religion – the more raw you become, the more pure your body feels. For those who are unable to be vegans, the raw food society becomes increasingly uncomfortable to be a part of.

    I don’t have type2 diabetes, but I’m at high risk of developing it, as I have metabolic syndrome. Rawfooding may ‘cure’ type 2 diabetes, but it is difficult to sustain for long periods. If you read ‘Beyond Vegetarianism’ in all its wordy glory, then you will find accounts of those who suffered from Vitamin B12 deficiency.

    I’m sticking to a low-carb paleo diet. Staying pulse and gluten free seems to keep my blood sugars balanced and my nerve pain in check.

  7. John Adler 11 January 2009 at 2:05 am #

    I find this report very interesting – and it makes a lot of sense. What I’d appreciate are suggestions on what to eat – especially for breakfast. Are you suggesting that an Israeli-style breakfast with salads, fish, cheese etc is a good idea?

  8. Kristine Ross 11 January 2009 at 3:51 am #

    I was diagnosed type 2 diabetic after a stroke 8 months ago, put on drugs by the hospital doctors, which played merry hell with my blood sugars. I stopped taking all the drugs and went on a low carb diet, High fat, medium protein and very little in the way of carbs at all, just the odd avocado and a few veg and maybe a strawberry with loads of cream. This upset my diabetic nurse, but she very quickly lost interest in me when my blood sugars became perfectly normal. As far as I am concerned I am no longer diabetic, I had some Christmas goodies and my blood sugars were within normal levels despite this, I wouldn’t make a habit of it though.

  9. simona 13 January 2009 at 2:17 pm #

    Thank you Richard for sharing your experience. I do not intend to change my eating habits and to only eat raw food. It’s not really feasible, I do not believe it’s healthy in the long term unless you include raw animal produce, I suppose, and I agree with your comment on the ‘superfoods’ , although just because something wasn’t consumed during our evolution doesn’t mean it’s not beneficial for us (in moderation)

    thank you Kate for your response,
    yes, they seem to drink blended green juices a lot, and it does sound like a spiritual movement, some of them do not seem to be very tolerant or inclusive. I read articles on the Beyond Vegetarianism website and I found them very enlightening.
    I think that raw food is important and people should eat more of it anyway.

    Hilda,
    I think too that low carb means higher fat, because you can’t eat too much protein. Low carb means, in this article, less than 20 grams, which is a very small amount, to get you into the ketogenic phase. You can’t really eat fruit or other starchier vegetables on that, an apple has on average 10 grams already, green salads, green beans, spinach, broccoli.
    The thing is though that, to my knowledge, one can’t stay on a ketogenic diet, so what happens with these diabetics after this study?

    Thank you nigeepoo
    for your link to dr. Schwarzbein’s site.

  10. Hilda Glickman 14 January 2009 at 7:02 am #

    I DO DESPAIR !!!Low carb does not have to mean 20 gms fat and if it does it is the wrong diet for people. Does no-one on this site have any common sense? Do you really think that you should be on any diet in which you can’t eat an apple? Also you should NOT be on a ketogenic diet even for a short time. You need to read a good book from a qualified nutritionist, not go by what unqualified people say on this site!!

  11. Hilda Glickman 14 January 2009 at 7:05 am #

    PS The natural fat in nuts, oily fish and fresh lean meat is needed by the body to make the myelin in nerve cells, steroid hormones, the cell membrane in cells in every part of our body. Again go and a course and learn some biochemistry.

  12. The other (non-dietician)Kate 16 January 2009 at 1:15 am #

    Oh hooray! – (and I mean that completely sincerely) Dr Schwarzbein another proper doc who has realised the truth about insulin and carbs.
    But why won’t people listen?
    There’s always some idiot who will come along and say ‘But you can’t do this diet, it is unhealthy – you MUST eat a balanced diet’ and swear by any number of trials and clinical results that they are right.

    I’m still reeling at the venom of Catherine Collins from last summer. So convinced that she was right and so rude to people to didn’t agree with the low-fat paradigm.

    The truth is so obvious. It really is two plus two logic. Eat carbohydrates and your blood sugars will rise.

    Don’t worry Hilda, if you read again, you will see that most people who commented agree with you and are highly critical of the raw-food movement (actually I think they are all barking mad, those who continue to live on it for years and who write such dreadful things about meat-eaters) and also who agree with you about carbs and insulin.
    Nigeepoo! You are the same famous Nigeepoo from the BBC dietboards are you not? Brave man, standing up to the low-fat comissars.

    Simona – if you do some more reading, you can find out about the Esquimo people who eat a very high fat diet and who are perfectly healthy. There was a BBC3 programme last year about at pair of identical twin doctors who went to live with them.
    Guess which twin had the best blood fats profile at the end of the experiment?
    kind regards,
    Kate

  13. simona 16 January 2009 at 5:54 am #

    Dr. Briffa talks about a recent study in which a “low-carb diet (less than 20 grams of carbohydrates a day)” was compared with a low GI diet. One has to do the maths, based on carb content. There is a small amount of fruit and a fair amount of vegetables that you can eat. For example you can have a look at these tables.
    http://www.second-opinions.co.uk/foods.html
    Nobody was talking about a low-fat diet.
    We’re just expressing different opinions, exchanging ideas based on our experience and knowledge. No need to despair.

  14. Hilda Glickman 17 January 2009 at 2:52 pm #

    But a healthy diet is not just about carbs versus fats. It is about getting all the nutrients you need such as vitamins, minerals, essential fats, but also antioxidants. One of the main problems with refined carbs such as white breads and pasta is that they are not only high in sarbs but loe in just about everything else you might need, especially things needed to process carbs such as chromium. Filling up kids with pasta is like feeding them with polyfilla.

  15. Sue 18 January 2009 at 3:38 am #

    Hilda, why should you not be on a ketogenic diet even for a short time?

  16. simona 20 January 2009 at 7:19 am #

    Hilda, I totally agree with what you said concerning a healthy diet. However, this post is about a diet that would help diabetics get off their meds.

  17. simona 20 January 2009 at 7:46 am #

    more about this study and other links related to the subject:
    http://www.medpagetoday.com/PrimaryCare/DietNutrition/12341
    see that the average carb consumption was 49 grams not under 20 and in the case of the low GI diet 149 grams.

    a ketogenic diet is linked generally with the risk of kidney stones, calcium excretion, see Wiki

  18. Sue 22 January 2009 at 5:39 am #

    “a ketogenic diet is linked generally with the risk of kidney stones, calcium excretion, see Wiki”

    No its not.

  19. Nigeepoo 29 January 2009 at 5:32 pm #

    The other (non-dietician)Kate says:
    “Nigeepoo! You are the same famous Nigeepoo from the BBC dietboards are you not? Brave man, standing up to the low-fat comissars.”

    I am that Nigeepoo. I think that “infamous” is more appropriate! Check out my Blog. Nige.

    To simona: Please read http//homepage.ntlworld.com/nigel.kinbrum/Long%20term%20effects%20of%20ketogenic%20diet%20in%20obese%20subjects%20with%20high%20cholesterol%20level.pdf

  20. Nigeepoo 29 January 2009 at 5:34 pm #

    Damn link didn’t work! There’s no preview mode.
    Try THIS

  21. Nigeepoo 29 January 2009 at 5:44 pm #

    Doh! I left the colon out! Sorry.
    3rd time lucky?

  22. Sue 31 January 2009 at 1:01 am #

    Thanks for that sudy.

  23. terry cantor 12 February 2009 at 9:28 pm #

    Hallo everybody.
    I have recently been diagnosed with Diabetes 2. I’m on 2 pills a day medication and eye drops for ‘Chronic glaucoma’. I’m 52.
    This low carb diet: Where can I get a good, simple-to -understand list of the stuff I can actually eat?
    There is so much differing opinion on all this, especially from the NHS medical people.
    Will it help the glaucoma?
    Thanks,
    Terry.

  24. Chris 17 March 2009 at 6:00 pm #

    Terry,
    I am T2db like yourself. I know that if you look for a simple explanation for the cause(s) of T2db then it is conspicuous by its’ absence from the places where you might most hope to find it. It is frustrating. Welcome to the club.
    There is wealth of advice and opinion and advice available to us and as you point out so much is contradictory.
    The first thing you must realise is that the way of the world is such that it suits certain peoples interests if we consumers are confused. The second thing you must realise is that suits the pharmaceutical industry to treat your condition on an ongoing basis. They would sooner continue to treat it than cure it.
    Thirdly, you will serve your own interests if you seek to add to your knowledge and forthly you should treat all new knowledge and advice with healthy scepticism. ( including this)

    You can and should adopt an attitude of taking responsibility for the management of your condition and you should share that responsibility with your GP. Never skip appointments.

    Without doubt, one thing that may improve your management of your condition is to lower the glycaemic load of your diet. So get down your library and seek out some books which explain GI and GL. Recommended authors are Jennie Brand-Miller, Nigel Denby and Rick Gallop. Really “Glycaemic Load” is not such a complicated concept and you can glean the important stuff from a general view.

    Much insight can be gained from Dr Briffas own book “The True You Diet” and the works of Barry Sears have been highly illuminating for me. I am not a fan of the ‘Dummies’ series.
    The discipline of Nutrition is a relatively young one and still clings to some outmoded notions so you may have to apply some free thinking of your own to arrive at a clear understanding.
    When you do it will likely make sense to you to reduce your dependency upon the starchy staples (wheat (and derivatives), potatoes (especially the ‘floury’ ones), and rice and additionally to control ones’ portions of animal protein to something no larger than would sit comfortably in the palm of your hand. To make up the calories you need you will have to eat lots of fresh fruits and vegetables. Boiled veg are fine, steamed often better, and raw often better still. Try to meet your daily calorie requirements evenly throughout the day. Give up sweetened beverages. Give up fruit juice – drink water; eat fruit.
    In effect it is a trade off between ‘energy density’ and ‘nutrient density’.
    Regular daily exercise will help enormously.
    If the bulk of what you eat could be sourced from a fishmonger, butcher and greengrocer then you would be on the right track.
    Sadly you have to forsake a little of what you may have come to regard as convenience. I concede it can be difficult; it is a challenge for me, however, with a little planning it is possible and the benefits are worth it. Bear in mind it is only in the last forty years that we have moved so far away from what I suggest so cast your mind back to your childhood.
    If you still have a thirst for knowledge after all this wise up on the ‘omega’ crisis. Dr Briffa touches upon this in ‘The True You Diet’ and after the read the nutritional boxes on the bottom of leading margarine brands.
    Finally, don’t forget to bookmark this page and let us know how you get on.
    Purely anecdotally on my part I find Alcohol very disruptive and also suggest that restricting caffeine is helpful.

  25. Hilda Glickman 5 April 2009 at 1:29 pm #

    Simona, The same diet that is needed for diabetics is needed for everyone. Refined sugar nad refined carbs should be out of the diet. Even if a person does not become diabetic they could start to get all sorts of other diseases on a high carb diet, But why is Dr Briffa not taking this to the Establishment (maybe he is). These are the people who need to hear it. Hilda Glickman

  26. Lisa 16 April 2009 at 12:57 am #

    Terry, I am not a diabetic but I come from a long blood line of them. I started the low carb almost 3 weeks ago. I see the difference in my face and my waist line already. It does work if you let it. I did this a year ago but stopped shortly after I started…(guy trouble).

    So now I am doing it for myself. I feel great….my midmorning/afternoon hunger attacks are gone and I don’t crave sugar.

    I wish my mother had practiced this. If she did, she would be here next week for her birthday. I am breaking that cycle. My mother’s sister now has it, my oldest sister has it and Im sure the others will too. Im not goin out like that.

  27. simona 18 May 2009 at 6:06 pm #

    Thanks Hilda and Nigepoo.

    I wish there was a way to monitor the new comments on older posts. Some other blogs have that function on the home page.

  28. Rachel 7 November 2010 at 2:16 am #

    I have just been to a medical herbalist who has advised me to go on a ketogenic diet – i am diabetic type II, have high blood pressure and high cholesterol and other meds. However, she also said to give up fruit as she says i am glucos intolerant – but other people say eating fruit is fine – I am confused – what would you advise? Thanks for your help.

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