Some people with type 2 diabetes who follow a low-carbohydrate diet may see improvements in their body’s ability to regulate blood sugar, even if they don’t lose excess weight, a new study has found.
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For the study, researchers randomly assigned 57 middle-aged adults with type 2 diabetes to either a low-carbohydrate diet (about 9 percent of calories from carbs) or a high-carbohydrate diet (about 55 percent of calories from carbs). Participants followed their assigned diets for 12 weeks, eating meals provided by the researchers. They also stopped taking any medication for type 2 diabetes during the study.
By the end of the study period, people on the low-carb diet saw more than twice as much improvement in how well cells in their pancreas called beta cells could produce, store, and release insulin in response to glucose, or sugars, according to findings published in the Journal of Clinical Endocrinology and Metabolism.
“Our research should not be interpreted to mean that a carbohydrate-restricted diet can replace medical therapy in those who need it, especially patients at risk of cardiovascular disease, heart failure, or chronic kidney disease,” says a study coauthor Marian Yurchishin, a nutrition researcher at the University of Alabama in Birmingham.
“However, a carbohydrate-restricted diet could serve as a complementary aspect of lifestyle therapy which could contribute to better glycemic control as a result of improved beta cell function, and potentially diminish the need for diabetes medications,” Yurchishin says.
Effectiveness of a Low-Carb Diet May Depend on Diabetes Severity
All study participants had relatively mild type 2 diabetes. They had been diagnosed less than a decade earlier, and had average so-called hemoglobin A1C (HbA1C) levels — which reflect average blood sugar levels over about three months — of 6.9 in the low-carb diet group and 6.7 in the high-carb diet group.
People are diagnosed with type 2 diabetes when A1C levels are 6.5 or higher. The goal for most people with this condition is to maintain A1C levels below 7.0, according to Cleveland Clinic.
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While study participants were able to discontinue medication and see improved beta cell function after following a low-carb diet, it’s possible that these results might only occur for people with milder cases and less advanced disease, Yurchishin says.
“Those with more long-standing type 2 diabetes may need to remain on certain medications depending on the recommendations of their primary care providers, but the findings of our study do support the notion that a carbohydrate-restricted diet could yield beneficial effects on beta cell function and could help patients achieve better glycemic control and reach HbA1C targets,” Yurchishin says.
Chances of Diabetes Remission Is Highly Variable
Even among people with milder cases of type 2 diabetes, not everyone will be able to achieve marked improvements in beta cell function over time without taking medication, says Binkai Liu, a nutrition researcher at the Harvard T.H. Chan School of Public Health in Boston who wasn’t involved in the new study.
“While some studies suggest that a low-carb diet can improve beta cell function and insulin sensitivity, the likelihood of achieving remission or managing type 2 diabetes without medication varies widely between individuals,” Liu says.
It depends on factors such as how long they have had diabetes and the extent of their remaining beta cell function, Liu notes. “Some people may see big improvements from eating a low-carb diet, but some may still need medication to keep their blood sugar under control,” Liu says.
A low carbohydrate diet can still be beneficial even when it doesn’t help lower blood sugar enough for people to discontinue medication to manage type 2 diabetes, says Sun H. Kim, MD, an associate professor of endocrinology, gerontology, and metabolism at Stanford University in California who wasn’t involved in the new study.
“Most everyone with type 2 diabetes will be able to get blood sugar improvement by lowering carbohydrate intake,” Dr. Kim says.
