"BMJ" Short-term low-carb diet can directly alleviate type 2 diabetes

In a study published in the international journal BMJ, scientists from Texas A&M University and other institutions found that people who strictly adhered to a low-carb diet for up to 6 months had type 2 diabetes compared to the recommended diet.

Most of the benefits diminished after 12 months, but the researchers said clinicians could consider using a short-term, low-carb diet to manage type 2 diabetes while actively monitoring and adjusting patients' diabetes medications

Type 2 diabetes is the most common form of diabetes in the global population, and diet is recommended as part of treatment; however, researchers are currently unsure which diet to choose for the best results, as previous research results have been mixed

To address this evidence gap, in this study, researchers evaluated the efficacy and safety of low-carbohydrate diets (LCDs) and very low-carbohydrate diets (VLCDs) in patients with type 2 diabetes; a total of 23 randomized trials were analyzed.

Among adults with type 2 diabetes (average age 47 to 67 years), LCDs were defined as less than 26% of daily carbohydrate calories and VLCDs were defined as less than 10% of daily carbohydrate calories

The researchers also assessed participants' health at 6 and 12 months, including diabetes remission (lower blood sugar levels with or without diabetes medication), weight loss, adverse health events and health-related quality of life

Although the design and quality of these clinical trials varied, the researchers took this into account in their analysis; based on low-to-moderate-certainty evidence, the researchers found that the use of LCDs compared with control patients on a controlled diet Patients on the diet had higher rates of diabetes remission without adverse events after 6 months

For example, those who followed the LCDs dietary pattern had a 32% absolute risk reduction in diabetes remission at 6 months, or 28 per 100 follow-up cases, based on 8 moderate-certainty evidence involving 264 participants

At 6 months, LCDs also increased weight loss, decreased medication use, and improved triglyceride levels

Many of the benefits began to diminish after 12 months, the researchers said, consistent with previous studies that showed patients had less improvement in quality of life and cholesterol levels after 12 months

In this study, the researchers used a very robust method to improve the precision and overall certainty of effect estimates, while they also acknowledged limitations such as the debate on diabetes remission and the long-term efficacy and safety of LCD monitors.

Our findings are based on moderate to low-certainty evidence

In the future, long-term, well-designed randomized trials of caloric control are needed to determine the effects of LCDs on sustained weight loss, diabetes remission, cardiovascular mortality, and major morbidity, the researchers said

Joshua Z Goldenberg, Andrew Day, Grant D Brinkworth, et al.