And more than 50% of participants had sustained remission for three months.
Addressing type 2 diabetes generally involves a mix of lifestyle changes and medication. But a new study found that more than half of patients were able to better manage their blood glucose (or blood sugar) by going on a low-carb diet.
The study, which was published in BMJ Nutrition, Prevention & Health, analyzed data from 186 patients with type 2 diabetes over eight years. Those patients opted to go on a low-carb diet (no more than 130 g of carbs a day) and were given advice by doctors during routine visits on how to follow and maintain a low-carb diet. Patients self-reported their meals and also had the option of attending group sessions to help them choose and prep low-carb foods.
Overall, researchers found that patients who followed a low-carb diet lost about 22 lbs. on average. About 97% of the patients who followed a low-carb diet had a big drop in their A1C levels (a blood test that indicates blood glucose average over three months) during follow-up periods, and 51% of patients (94 people) had sustained remission for three months, meaning their blood sugar levels were below the range for a diagnosis of diabetes (an A1C below 6.5).
The researchers also discovered that 77% of patients who went on a low-carb diet within a year after being diagnosed with type 2 diabetes were able to achieve remission. This, they wrote in the study’s conclusion, “represents an important window of opportunity for achieving drug-free remission of diabetes.”
It’s important to note that this study has its limitations, though. Namely, that there was no control group of general treatment, and patients’ family history and other conditions that might affect insulin resistance were not noted.
This isn’t the first time a low-carb diet has been linked to better diabetes management. A meta-analysis published in BMJ in 2021 also found that patients who followed a low-carb diet for six months had higher rates of diabetes remission than those who didn’t alter their diet.
But why might a low-carb diet help with diabetes management, and how can you know if this is right for you? Here’s the deal.
To understand how carbs may play a role in diabetes management, it’s important to cover how carbohydrates work in the body. When you eat or drink carbs, your body breaks them down into glucose (a form of sugar), according to the American Diabetes Association (ADA). That raises the level of glucose in your blood, aka your blood sugar, and your body uses that for fuel. Your pancreas needs to release something called insulin to help your cells absorb that glucose, the ADA explains.
With prediabetes and type 2 diabetes, carbs are broken down into glucose but your pancreas doesn’t make enough insulin to help your cells absorb the glucose, per the ADA. As a result, your blood sugar goes up and that can lead to symptoms like feeling tired, having more infections than usual, peeing a lot, and feeling very thirsty.
The goal of diabetes management is glycemic control, which is keeping blood sugar levels within a certain range, explains Jessica Cording, R.D., a nutritionist and author of The Little Book of Game Changers.
As for going low-carb, Cording says that “there is something to the idea that following a low-carb diet can support stable blood sugar.” She adds, “By default, you’re having more of your calories from protein and fat, which slows the digestive process and keeps your blood sugar more stable.”
Keri Gans, R.D., a New York City-based nutritionist and the author of The Small Change Diet, agrees. “If an individual is consuming less carbohydrates at meal time, it may be easier to maintain glycemic control,” she says, since the body’s slower insulin production doesn’t need to tackle more carbohydrates.
There is a range of possible treatments for type 2 diabetes, and it largely involves a mix of lifestyle changes and medication, Cording says. Treatment for type 2 diabetes generally includes the following, according to the Mayo Clinic:
“Diet is critical, as it determines how glucose is absorbed,” says Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. But, he says “If dietary control is not sufficient, then medication are required.” And there is no shame in that.
Dr. Buettner says that the goal is to keep your blood glucose within a certain range “and, if that requires medications, then that’s what we need.” Still, he says, “watching your diet, eating lots of vegetables, and avoiding white starches and sugar can have major benefits which, in general, is under-appreciated.”
It depends. The ADA makes it clear that people with diabetes should be aware of their carb intake, but that a good balance is important. The organization urges people to choose carbs that are nutrient-dense, i.e. rich in fiber, vitamins and minerals, and low in added sugars, sodium, and unhealthy fats. The ADA specifically recommends that people with type 2 diabetes eat mostly whole, unprocessed, non-starchy vegetables, like lettuce, cucumbers, broccoli, and tomatoes, while having some whole, minimally-processed carbohydrates like apples, blueberries, and sweet potatoes. Highly processed, refined carbs like soda, juice, and cakes should be limited, per the ADA.
But, Cording points out, “The appropriate amount of carbohydrates differs from person to person.” Meaning, the right amount of carbs to help you manage your blood sugar could be very different from someone else’s. “Every person is different and every person’s diabetes experience is different,” Cording says.
If you have diabetes, Cording recommends against just switching to a low-carb diet to see what happens, particularly if you’re on medication to help manage your type 2 diabetes. If you dramatically alter the number of carbs you take in and don’t adjust your medication, you could end up having hypoglycemia, or blood sugar that’s too low, she points out.
Ultimately, if you have prediabetes or are type 2 diabetic and are interested in trying a low-carb diet, Cording suggests speaking to your doctor first. They should be able to help guide you on next steps.
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