Calorie-counting: Is there a better way of dieting for patients with type 2 diabetes?

This study compared the traditional diabetic diet (TDD) with a low-carbohydrate diet (LCD) for patients with poorly controlled type 2 diabetes (T2D). They found that the LCD resulted in better blood glucose (sugar) control and reduced need for diabetic medications compared to the TDD.

The traditional diabetic diet (TDD) relies on calorie-counting. This diet has often been recommended for patients with T2D with poor control. It involves a carbohydrate intake of 50-60% daily. However, there is evidence that a low-carbohydrate diet (LCD) may be more effective for managing diabetes. Low carbohydrate diets involve reduced intake of glucose. This means eating less carbohydrate-based foods such as bread and pasta, and more proteins and fats such as meat, dairy, and vegetables. The effects of TDD compared to a LCD on blood glucose control and blood cholesterol levels in patients with T2D are still not clear.

85 patients with T2D and poor glucose control were recruited for this study. Poor control was defined as an Hba1c blood level higher than 7.5%. Participants were divided into two groups. One group followed the TDD and the other group followed the LCD. Participants in the LCD group were limited to less than 90 g of carbohydrates per day and were taught to consume this as 6 small portions. 

Participants were followed up for 18 months. They were monitored to see how well their blood sugars were controlled and for any changes in their medications. Participants were given a medication effect score (MES) which measured how much medication they needed to control their blood glucose and whether it changed over time.

Patients in the LCD group had better blood glucose control than those in the TDD group after 18 months. There was a a reduction in HbA1c of -1.6% in the LCD group compared to -1.0% in the TDD group. The LCD group also required less medication to control their diabetes after 18 months. They had a reduction in MES of -0.42 compared to -0.05 in the TDD group. 

Patients in the LCD group also lost significantly more weight compared to the TDD group. Patients in the LCD group lost an average of 2.7 kg compared to an average of 0.7 kg in the TDD group. Also, patients in the LCD group lost an average of 5.7 cm from their waists compared to 1.9 cm in the TDD group. 

Patients in the LCD group also had lower blood pressure compared to the TDD group. At the end of the follow-up, the LCD group had reduced their blood pressure by an average of 8.3 mmHg. On the other hand, the TDD group had an average blood pressure higher by 1.6 mmHg.

This study showed that a low carbohydrate diet results in better blood glucose control and a reduced need for medication after 18 months, compared to a traditional diabetic diet.

This study had a small patient population. More studies are needed to confirm these findings.

Speak to your physician to see if you would benefit from a low-carbohydrate diet.