Can low-carb diets be more effective than medications?

• Beta cells are pancreatic cells responsible for the production and release of insulin, a hormone that controls blood sugar levels.
• A recent study indicates that adults with mild type 2 diabetes can improve their beta cell function by following a low-carb diet.
• Experts worry about the sustainability of the low-carb diet, but offer tips for success and alternative, evidence-based ways to improve beta cell function.

Beta cells are specialized cells in the pancreas that produce and release the hormone insulinwhich helps regulate blood sugar levels.

People with type 2 diabetes has a weakened response of the beta cells to blood sugar levels. This may be partly caused by excessive carbohydrate consumption.

The combination of beta cell failure and insulin resistance stimulates the development and progression of type 2 diabetes.

About one in ten Americans has diabeteswith 90-95% of these cases being type 2, making it one of the most common and largely preventable chronic diseases in the United States.

Now, a new study suggests that following a low-carb diet could improve beta cell function in adults with mild type 2 diabetes.

This approach can help them manage the condition more effectively and potentially eliminate the need for medication.

This randomized controlled trial included 57 black and white adult men and women aged 35 to 65 years with ‘mild’ type 2 diabetes.

Participants were diagnosed with type 2 diabetes within the past 10 years and were treated with diet or medications, but did not use insulin.

Researchers had participants stop taking their medication one or two weeks before the baseline measurement. They then had the participants follow one of two diets for twelve weeks:

• a low-carb diet with approximately 9% carbohydrates and 65% fat
• a high-carb diet with approximately 55% carbohydrates and 20% fat.

They wanted to see if a low-carb diet would improve participants’ beta cell response to sugar (glucose) compared to a high-carb diet.

Both diets were designed by a registered dietitian to be “eucaloric,” meaning the diets provided the number of calories each participant needed to maintain their body weight.

The study provided participants with daily meals, detailed meal plan instructions, and weekly meetings with the registered dietitian.

During the dietary intervention, two participants from the high-carb group and one from the low-carb group resumed their diet metformin medications, and their data were included in the results.

After twelve weeks, the researchers observed significant improvements in beta cell function and insulin release in participants on the low-carb diet compared to those on the higher-carb diet.

Specifically, they found that individuals who followed a low-carb diet experienced improvements in their eating habits iinitial (fast) and maximal beta cell responses that were twofold and 22% greater, respectively, compared to those on a high-carbohydrate diet.

The results of the oral glucose tolerance test showed that the low-carbohydrate diet improved the effect of insulin on blood sugar levels by 32% after twelve weeks.

Among all groups, black adults who followed a low-carb diet showed a 110% greater improvement in rapid beta cell response than those who followed a high-carb diet. This effect was not observed in white adults.

Conversely, white adults experienced a 48% greater improvement in maximum beta cell response than those on a high-carb diet, a difference not seen in black adults.

The study authors propose that the varying responses to the dietary intervention observed between breeds may be partly due to biological differences in beta cell function.

Black adults may exhibit a higher immediate insulin response to glucose than white adults, even if their levels of insulin sensitivity are equivalent.

They concluded that “with the caveat that (carbohydrate restriction) may be difficult for some patients, such a diet may allow patients with mild diabetes (type 2 diabetes) to discontinue medications and enjoy meals and snacks that meet their energy needs meet while improving beta levels. cell function, a result that cannot be achieved with medication.”

The study showed that insulin sensitivityor how effectively the body uses insulin did not change much with the dietary interventions. Thus, it is unlikely that changes in insulin sensitivity were the reason for the improvements in beta cell responses specific to the low-carb diet.

In other words, the improved beta cell responses were likely due to something other than changes in insulin sensitivity.

More research is needed, but Medical news today spoke to Thomas M. Holland, MD, MSa physician-scientist and assistant professor at the RUSH Institute for Healthy Aging, RUSH University, College of Health Sciences, who was not involved in the study, to better understand how a low-carb diet might improve beta cell function .

“A low-carb diet can improve (pancreatic) beta islet cell function in people with mild type 2 diabetes by reducing the pressure on the beta cells to produce insulin. This improvement is likely due to less glucose (from carbohydrates) entering the bloodstream, which reduces the demand on beta cells for insulin secretion, potentially reversing some of the beta cell dysfunction caused by glucose toxicity.”

“Although this benefit is more pronounced in people with mild diabetes, it can still help people with prediabetes (with an HbA1c of about 5.7%-6.4%) or even people with more advanced diabetes, although the degree of improvement may differ from person to person. ,” Holland added.

Holland emphasized that “a low-carb diet may be beneficial for the treatment of type 2 diabetes, but adherence, especially among older adults, can be a challenge.”

To make a low-carb diet more sustainable, he recommended:

• flexibility in carbohydrate intake, prioritizing whole, unprocessed, or minimally processed foods rich in fiber and nutrients
• adding variety and making the diet enjoyable
• checking blood sugar levels regularly, especially when adjusting or reducing medications under the guidance of a healthcare provider
• consultation with a healthcare provider should ensure that the diet meets individual health needs.

“While a ketogenic (very low-carb) diet can be effective when followed correctly, under the guidance of a dietitian or physician, a major concern is the potential for rebound effects when reintroducing carbohydrates,” Holland warned.

He explained that these rebound effects can cause “substantial weight gain and pressure on beta islet cells to ensure adequate insulin production,” which can lead to negative health outcomes.

MNT also talked toSheri Gaw, RDN, CDCESregistered dietitian, certified diabetes care and education specialist, and owner of De Plant Sterke Dietitist, who was also not involved in the study.