Monday January 4 2000

Low-carbohydrate diet helps diabetics

NEW YORK, Jan 04 (Reuters Health) -- A low-carbohydrate, calorie-restricted diet can help people with type 2 diabetes get their blood sugar under control when standard dietary changes and drug treatment have failed, according to California researchers. At least in the short run, the diet may help patients avoid having to take insulin to control their disease.

After 8 weeks on a diet with 25% of calories from carbohydrates, type 2 diabetics had a significant improvement in blood sugar levels compared to those seen with a diet with 55% of calories from carbohydrates, the authors report in the December issue of the Journal of the American College of Nutrition.

Of the 28 patients in the study, 9 were treated with a standard diet containing 55% carbohydrates, and 19 with sulfonylurea agents, but none of the subjects were able to achieve target glucose levels with those therapies, according to Dr. Lois Jovanovic and colleagues at Sansum Medical Research Foundation in Santa Barbara, California.

After 8 weeks on the 25% diet, the subjects had a drop in hemoglobin A1c, a marker for blood sugar control. When placed on the 55% carbohydrate diet for another 12 weeks, hemoglobin A1c increased, a marker of worsening blood sugar control.

Patients who had previously taken sulfonylurea drugs also lost weight while on the 25% diet, but the benefits of the diet were not dependent on this loss, according to the report.

The benefit of insulin treatment in type 2 diabetes is controversial and the data ``suggest that dietary therapy may sustain remission for an interim and allow the reintroduction of oral hypoglycemic therapy in the event that low-carbohydrate diet therapy alone is not successful,'' the authors note.

SOURCE: Journal of the American College of Nutrition 1998;17:595-600.