The number of individuals with type 2 diabetes continues to increase at an alarming rate. The prevalence of type 2 diabetes has doubled over the past 30 years, and is predicted to more than double by the year 2030. There are estimated to be 170 million people worldwide with type 2 diabetes. The World Health Organization is predicting that there will be 360 million people with type 2 diabetes by 2030 if current trends continue. Type 2 diabetes is strongly associated with obesity and even modest weight loss, by dieting or by bariatric surgery, can prevent the progression of prediabetes to full blown diabetes. Low carbohydrate ketogenic diets have been shown to allow for weight loss in obese individuals. We have previously discussed the finding that diabetes can be reversed with a very low calorie diet. Low carbohydrate ketogenic diets have also recently been shown to improve diabetes in obese individuals.
Researchers, led by Dr. Hussein Dashti from Kuwait University, have found that low carbohydrate ketogenic diets are better than low calorie diets for the control and improvement of diabetes in obese individuals. The results of their study were published in the journal Nutrition. The researchers recruited 363 overweight and obese study participants for a 24 week diet intervention trial using a low calorie diet or a low carbohydrate ketogenic diet. One hundred and two of the study participants had type 2 diabetes. Body weight, body mass index, changes in waist circumference, blood glucose level, changes in hemoglobin and glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, uric acid, urea and creatinine were assessed before and at 4 week intervals during the diet interventions. The researchers found that body weight, body mass index, levels of blood glucose, totalcholesterol, low-density lipoprotein cholesterol, and triglycerides were decreased by both diets, but were more significantly decreased by the low carbohydrate ketogenic diet.
The authors wrote, “In the present 6-months’ dietary intervention, the [low carb ketogenic diet] resulted in a significant improvement of glycemia, as measuredby the fasting glucose and HbA1c levels in patients with type 2 diabetes. More importantly, this improvement was observed after some antidiabetic medications had been decreased to half in the [low carb ketogenic diet] group. The present data showed that the participantsin the two dietary programs exhibited decreases in body weight”.
The authors cautioned, “Until we learn more about using [low carb ketogenic diets], the medical monitoring for hypoglycemia, dehydration, and electrolyte abnormalities is imperative in patients taking antidiabetic or diuretic medications”.
The authors concluded, “…the [low carb ketogenic diet] had significant positive effects on body weight, waist measurement, serum triacylglycerols, and glycemic control in participants with type 2 diabetes. Most impressively, there was an improvement in HbA1c despite the small sample and short duration of follow-up, and this improvement in glycemic control occurred after the antidiabetic medications had been decreased substantially in participants using the [low carb ketogenic diet] program”.
This study provides evidence that low carbohydrate ketogenic diets help to low blood glucose levels in diabetes and also improves many other metabolic parameters. These diets can be particularly helpful for individuals who are obese and have type 2 diabetes because both weight loss and diabetes control can be accomplished. These diets will become increasingly important in the future because the worldwide rate of type 2 diabetes is expected to continue to increase at an alarming rate. Dietary interventions should be the primary focus in the treatment of type 2 diabetes, while medications should be prescribed only after dietary efforts have failed.
Talib A. Hussain el al. “Effect of low-calorie versus low-carbohydrate ketogenic diet in type 2 diabetes” Nutrition Volume 28, Issue 10, Pages 1016-1021, October 2012 http://dx.doi.org/10.1016/j.nut.2012.01.016