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Low Carb Diets Approved for Use in Treatment of Type-2 Diabetes
Akshay Naik 16 October 2018
Life
On 4 October 2018, a new joint position statement was released by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) which included approval of low carbohydrate diets for use in the management of type-2 diabetes in adults. It essentially indicates that ADA and EASD now recognise low-carb diet as a safe and effective method to manage type-2 diabetes in adults. 
 
The statement that was published online said that the new recommendations were based on a systematic evaluation of the literature since 2014. In other words, the approval for use of low-carb diets is based on current research. Lifestyle management, medication and obesity management are just a few of the therapeutic options endorsed by both the medical associations. They also suggest that an individual programme of medical nutrition therapy (MNT) should be offered to all patients.
 
MNT, as explained in the statement, is made up of an education component and a support component to enable patients to adopt healthy eating patterns with the goal of managing blood glucose and cardiovascular risk factors. The ultimate goal is to reduce risk for diabetes-related complications while still maintaining the pleasure of eating. This is essentially achieved through two basic dimensions of MNT - diet quality and energy restriction. The statement goes on to say that “there is no single ratio of carbohydrate, proteins and fat intake that is optimal for every person with type 2 diabetes.” It suggests several good options for treatment, with professional guidelines that recommend individually selected eating patterns, emphasising foods with health benefits, minimising harmful foods and accommodating patient preference as well metabolic needs.
 
According to the statement, Mediterranean diets, dietary approaches to stop hypertension (DASH) diets, low-carb diets and vegetarian diets are all considered effective ways of managing symptoms of type-2 diabetes. The statement also noted that “low carbohydrate diets (less than 26% of total energy) produce substantial reductions in HbA1C at 3 months and 6 months with diminishing effects at 12 and 24 months.” HbA1C is a form of haemoglobin that is measured primarily to identify the three-month average plasma glucose concentration. The joint statement also mentioned that moderate carbohydrate restriction was of no benefit. 
 
ADA and EASD further acknowledged that there are several different types of low-carb diets and, more specifically, a low carb Mediterranean diet helps in reducing the requirement of medication over a period of four years. It is stated that “people with new-onset diabetes assigned to a low carbohydrate Mediterranean eating pattern were 37% likely to require glucose-lowering medications overfour years compared with patients assigned to a low-fat diet.” 
 
It is important to note that the primary physiological actions depend on which particular diet is followed. Among the advantages of following a particular diet, listed by ADA and EASD, is the fact that dietary changes are inexpensive and have no side-effects. However, there are disadvantages listed as well wherein maintaining a particular diet in adults requires instruction, motivation and lifelong behaviour change and may pose some social barriers. 
 
Overall, this announcement comes as a relief for dieticians and health professionals across the world, as some clarity has, finally, been provided on the benefit of low-carb diets compared to the numerous other diets that are being followed by people these days. 
 
Comments
Abdul Salim Pottengal
7 years ago
Good information. Thanks. A lot of people in Kerala and Tamilnadu are following this (LCHF and Paleo) diets
Reply
Anand Vaidya
7 years ago
What people should be eating is whole foods such as pulses, brown rice, bananas and completely skipping processed junk and meats and dairy. It is clearly demonstrated that T2 diabetes is an insulin resistance problem within cells caused by excessive intramyocellular lipids (or fat globules inside cells) and not carbs per se. Eating high quality carbs such as sweet potatoes, green leafies, beans, vegetables and berries can cure T2D in the long term etc. Do visit https://www.masteringdiabetes.org/ created by two T1 Diabetics to help other diabetics for a wealth of knowledge, one of the creators is a PhD in Nutrition, btw.
Reply
Anand Vaidya
Replied to Anand Vaidya comment 7 years ago
It would be interesting to know the opinion of Dr B.M.Hegde on this recommendation...
Reply
Mohan Krishnan
7 years ago
Most of traditional Indian diets consumed by people with type 2 diabetes in India is Vegetarian, High Carb High Fibre diet. May be they should add more deals and pulses and soya to their diet.
Reply
Reji Thankachan
7 years ago
LCHF diet is very common.
Reply
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