Carbohydrate-Restricted Diets for Type 2 Diabetic Patients

For six months, researchers from the University of Southern Denmark in Odense, Denmark, randomly assigned 165 people with type 2 diabetes to either a low carbohydrate, high-fat diet or a high carbohydrate, high-fat diets diet. Participants in both groups were asked to consume the same number of calories, equal to their energy expenditure. Participants on the low carbohydrate diet were asked to get no more than 20% of their calories from carbohydrates but could get 50-60% of their calories from fat and 20-30% from protein.

Patients on the low-fat diet were instructed to consume approximately half of their calories as carbohydrates, with the remainder evenly divided between fats and proteins. The authors discovered that people on the low carbohydrate diet reduced HbA1c by 0.59 percent more than those on the low-fat diet, and they also lost 3.8 kg more weight than those on the low-fat diet.

Low-carbohydrate dieters also lost more body fat and had a smaller waist circumference. At 6 months, both groups had higher high-density lipoprotein cholesterol and reduced triglycerides. However, changes were not sustained three months following the intervention, implying that dietary adjustments must be maintained over time to be effective. The high fat intake in the low-carbohydrate group did not affect the liver: there was no difference in the amount of liver fat or inflammation between the two groups, according to the researchers.

In another community-based cohort of type 2 diabetes, the low-carbohydrate, high-fat diet was associated with superior A1C level reduction, greater weight loss, and significantly more patients discontinuing or reducing anti-hyperglycemic therapies, suggesting that the low-carbohydrate, high-fat diet may be a metabolically favorable option in the dietary management of type 2 diabetes (2^✔ ✔Trusted Source
Effects of the low carbohydrate, high fat diet on glycemic control and body weight in patients with type 2 diabetes: experience from a community-based cohort

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Is a Low-Carbohydrate, High-Fat Diet Recommended for Preventing Obesity and Diabetes?

According to the scientific literature, controlled diet studies (many weeks to two years) with low carbohydrate, high-fat diets in people with obesity and diabetes do elicit good effects on weight reduction, blood glucose, and insulin, as well as some less desired effects (increase low-density lipoprotein cholesterol, decrease vascular reactivity).

Compliance with ketogenic, low carbohydrate, high-fat diets tends to be low, and after a while, many people seemed to migrate to greater intakes in the 130-160 g/day range. As a result, aiming for 100-150 g/day may be more feasible.

There is a scarcity of evidence to support the long-term efficacy, safety, and health advantages of low-carbohydrate, high-fat diets. Any recommendation should be evaluated in this context.

People with type 2 diabetes or borderline diabetes should limit their daily intake of fast-digesting carbohydrates (sugars, syrups, potatoes, white rice, white bread, etc.). It is also recommended that when transitioning to a higher-fat diet, people choose foods high in unsaturated fatty acids.

Lifestyle therapies, combined with a carbohydrate-rich diet, result in long-term prevention of type 2 diabetes progression and are widely regarded as safe in those at high risk of developing the disease.

Any diet that causes overweight or diabetic people to eat less food and expend less energy will result in weight loss, which will lead to favorable metabolic and functional changes.

Because of the complexity of the potential mechanisms, their interactions, and the lack of data from well-controlled long-term studies (> 2 years), a general public evidence-based recommendation to support ketogenic, low carbohydrate, high fat, and low carbohydrate, high-fat diets as a preventive measure to help reduce the risk of type 2 diabetes appears premature. The role of long-term high-fat consumption paired with reduced carbohydrate consumption requires more research before broad suggestions can be made (3^✔ ✔Trusted Source
Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable?

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Limitations of Dieting Among Diabetic Patients

Firstly, the scientific debate around these diets is real, but it is consistent with the inherent constraints of any dietary intervention as well as the limitations of nutritional epidemiology.

Secondly, despite any disagreements, international standards now recognize and support the use of these diets as a therapeutic nutritional approach in eligible patients.

Thirdly, we discovered that early prescription of diabetic drugs is critical, particularly insulin, sulphonylureas, and sodium-glucose co-transporter (SGLT2) inhibitors.

Fourthly, rather than calorie counting, patients should be encouraged to consume until satiation.

Furthermore, as with other patients with obesity or diabetes, we closely evaluate cardiovascular risk factors, but an increase in low-density lipoprotein (LDL) cholesterol is not always an unambiguous indication to discontinue these diets (4^✔ ✔Trusted Source
Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice

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Over the last few decades, the frequency of coupled obesity and diabetes has risen rapidly. Although medical and surgical weight management are variables in their effectiveness in combating this epidemic, it is critical to complement these strategies with low-carbohydrate, high-fat, calorie-unrestricted diets along with appropriate macro-nutrient composition to induce weight loss, improve glycemic control, and improve cardiovascular risk factors.

References :

1. Effect of Calorie-Unrestricted Low-Carbohydrate, High-Fat Diet Versus High-Carbohydrate, Low-Fat Diet on Type 2 Diabetes and Nonalcoholic Fatty Liver Disease : A Randomized Controlled Trial – (https://pubmed.ncbi.nlm.nih.gov/36508737/)
2. Effects of the low carbohydrate, high fat diet on glycemic control and body weight in patients with type 2 diabetes: experience from a community-based cohort – (https://pubmed.ncbi.nlm.nih.gov/32193200/)
3. Overweight and diabetes prevention: is a low-carbohydrate-high-fat diet recommendable? – (https://pubmed.ncbi.nlm.nih.gov/29541907/)
4. Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice – (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177487/)

Source: Medindia