The effect of a low-carbohydrate, high-protein diet on type 2 diabetes Original paper

A large number of studies have investigated the effects of diets with low amounts of carbohydrates and typically higher amounts of protein, often reporting beneficial effects on markers of glycemic control among people with type 2 diabetes.^[1] Does such a diet likewise result in a lesser need for blood sugar–lowering medications?

The 6-month randomized controlled trial examined the effect of a low-carbohydrate, high-protein (LCHP) diet on 134 people with type 2 diabetes with an average age of 51. Participants were randomly assigned to follow an LCHP, with an expected calorie distribution of 14% carbohydrates, 28% protein, and 58% fat, or a low-fat (LF) diet, with an expected distribution of 53% carbohydrates, 17% protein, and 30% fat.

The primary outcomes were body weight and markers of glycemic control: fasting blood sugar, postprandial glucose (taken after a meal), and hemoglobin A1C (HbA1c). Secondary outcomes were the medication effect score (MES; a composite score based on the amount of diabetes medication used) and individual changes in lipid-lowering and blood pressure–lowering medications. The majority of participants (78.5%) took oral antiglycemic medication.

Body weight decreased in the LCHP diet compared with the LF diet (−4.1 vs. −1.0 kilograms), and all 3 markers of glycemic control improved to a greater extent in the LCHP group compared with the LF diet.

Compared with the LF diet, the LCHP group experienced a decrease in their antiglycemic MES (−1.1 vs. 0), and a higher number of participants saw a decrease in their MES score (80% vs. 34.4% of participants). In addition, more participants on the LCHP diet than in the LF group increased their use of lipid-lowering medications (8.3% vs. 0%), and fewer decreased their use of those medications (0 vs. 11.5%).