January 16, 2019
Elizabeth Mayer-Davis, PhD, Cary C. Boshamer Distinguished Professor of nutrition and medicine at the UNC Gillings School of Global Public Health, is senior author of an article that recognizes low-carbohydrate diets as a potentially suitable strategy in the management of Type 2 diabetes.
“Low-carbohydrate diets in Type 2 diabetes” was published online Jan. 15 in the journal The Lancet Diabetes and Endocrinology.
Though an increasingly popular point of discussion in both the scientific community and the public, low-carbohydrate diets also can be confusing and controversial when it comes to nutrition and health outcomes. The American Diabetes Association’s guidelines recognize the evolving scientific evidence related to low-carbohydrate diets and emphasize individual nutritional counseling based on patients’ dietary goals and health profiles.
There is growing, reliable evidence that restricting carbohydrates as part of a nutritionally sound diet can benefit individuals with Type 2 diabetes and improve health outcomes for these individuals. Recent studies have shown short-term effectiveness of low-carbohydrate diets for improving Hemoglobin A1C (HbA1c) tests, which measure the average blood glucose levels in an individual for the previous two to three months. In these studies, greater HbA1c reductions were associated with greater carbohydrate restrictions.
However, no significant difference was observed in HbA1c improvements between low-carbohydrate and high-carbohydrate diets after one year. This difference in improvements could be attributed to early weight loss associated with low-carbohydrate diets, which would show greater improvement, or a patient’s lack of adherence to the low-carbohydrate diet long-term, which would slow improvement.
Mayer-Davis said these findings do not necessarily refute the long-term benefit of low-carbohydrate diets, as studies also reported a reduced need for diabetes medications in participants who consumed the low-carbohydrate diet.
“For some individuals with Type 2 diabetes, a low carbohydrate diet may be helpful to improve their blood sugar control and cardiovascular disease risk factors, and may allow them to cut back on their diabetes medications,” she said.
Mayer-Davis’s article addresses Type 2 diabetes, but even less is known about how low-carbohydrate diets might benefit individuals with Type 1 diabetes, in which day-to-day blood sugar management is particularly challenging. Mayer-Davis is now conducting a study funded by the National Institutes of Health (NIH) to learn how a low-carbohydrate diet compares to other approaches for weight management and blood sugar control in young adults with Type 1 diabetes.
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