Moderate Low-Carb Diet Just as Effective as Insulin Shots in Type 2 Diabetes

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Mount Fuji

A low-carbohydrate diet is just as effective as insulin shots for people with severe type 2 diabetes, according to research recently announced by Japanese investigators.

Thirty-three uncontrolled Japanese type 2 diabetics, similar numbers of men and women, were placed on a low-carbohydrate diet for six months.  The diet provided 30% of energy from carbs, 44% fat, and 20% protein.  [By point of reference, the average American derives 55–60% of energy from carbs.]  Average caloric intake was 1,852/day.  [I’m not sure what provided the other 6% of calories – I suspect distilled liquor.]  Average body mass index was 24  and did not change during the six months.  The only adverse effect was mild constipation.  Two people dropped out of the study before completion.  Seven participants were on sulfonylurea drug therapy.

Protein and fat intake were unlimited.  They were given a list of high-carbohydrate foods to avoid (see reference).

Results

Hemoglobin A1c, a standard test of diabetes control, fell from10.9% to 7.8% at three months and 7.4% at six months.  Five of the seven patients on sulfonylurea were able to stop the drug.  No patient required insulin therapy or hospitalization. 

Comments

The low drop-out rate may be a testament to the palatability of this low-carb way of eating.

Japanese diabetes may not be exactly the same disease as American or European diabetes.  For instance, Japanese diabetics are not as overweight.  Only 3% of the Japanese population is obese (body mass index over 30), compared to 30% of the U.S. population. 

The degree of carbohydrate restriction in this study is not nearly as severe as with the Ketogenic Mediterranean Diet.  Yet the improvement in hemoglobin A1c was dramatic after just three months.

Being aware of genetic and other influences on disease, I’m always wary about generalizing research results from one race or ethnic group to others.  When it comes to the efficacy of low-carb eating in people with type 2 diabetes, however, we’ve seen similar results already in white and black Americans. 

Steve Parker, M.D. 

Reference:  Haimoto, Hajime, et al.  Effects of a low-carbohydrate diet on glycemic control in outpatients with severe type 2 diabetesNutrition and Metabolism, 6:21   doi:10.1186/1743-7075-6-21

2 Comments

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2 responses to “Moderate Low-Carb Diet Just as Effective as Insulin Shots in Type 2 Diabetes

  1. That’s not a trivial decrease in A1c. It’ll be interesting to see how/if that translates into protection from either micro- or macrovascular disease hard endpoints, especially compared to pharmacotherapy.

  2. My impression is that many diabetic drugs gain FDA approval for just a 0.3% absolute decrease in HgbA1c, assuming the drug is otherwise safe.

    -Steve