Nutrition

Type 2 diabetes: Can a low-carb diet work better than drugs?

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A low-carb diet can help improve insulin sensitivity by boosting beta cell activity, recent research suggests. Image credit: Ellie Baygulov/Stocksy.
  • Beta cells are pancreatic cells responsible for producing and releasing insulin, a hormone that helps regulate blood sugar levels.
  • A recent study shows that adults with type 2 diabetes can improve their beta cell function by eating a low-carbohydrate diet.
  • Experts are concerned about the sustainability of low-carb diets but offer tips for success and other, evidence-based ways to improve beta cell function.

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

People with type 2 diabetes have a weak response of beta cells to blood sugar. This may be caused by excessive consumption of carbohydrates.

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

Almost One in 10 Americans has diabeteswith 90–95% of these cases being type 2, making it one of the most common and preventable chronic diseases in the United States.

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

This approach may help them manage the condition more effectively and possibly eliminate the need for medication.

This randomized controlled trial included 57 black and white adult men and women ages 35 to 65 with “mild” type 2 diabetes.

Participants had received their diagnosis of type 2 diabetes within the previous 10 years and were being treated with diet or medication but not using insulin.

The researchers had the participants stop using their medications a week or two before the baseline test. Then, they assigned the participants to one of two diets for 12 weeks:

  • a reduced carbohydrate diet with about 9% carbohydrates and 65% fat.
  • a high carbohydrate diet with about 55% carbohydrates and 20% fat.

They wanted to see if a low carb diet could improve beta cell response to glucose compared to a high carb diet.

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

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

During the dietary intervention, two participants from the high carb group and one from the low carb group resumed their metformin medication, and their information was included in the results.

After 12 weeks, researchers observed significant improvements in beta cell function and insulin release among participants on a low-carb diet compared to those on a high-carb diet. .

In particular, they found that people who ate a low-carb diet had an improvement in initial (fast) and large beta cell responses that were twice and 22% greater, respectively, compared to those on a high-carb diet.

The results of the oral glucose tolerance test showed that after 12 weeks, the low-carb diet improved the effect of insulin on blood sugar levels by 32%.

Among all groups, Black adults following a low-carbohydrate diet showed a 110% greater improvement in beta-cell activation than those on a high-carbohydrate diet . This effect was not observed in white adults.

In contrast, white adults had a 48% greater improvement in beta cell response than those on the high-carbohydrate diet, a difference not seen in black adults. .

The authors of the study suggest that the different responses to dietary interventions seen between ethnic groups may be due to natural differences in beta cell function.

Black adults may show a higher immediate insulin response to glucose compared to white adults, even though their levels of insulin sensitivity are similar.

They decided that “with that warning [carbohydrate restriction] it may be difficult for some patients, such a diet may allow less patients [type 2 diabetes] to stop using medication and enjoy eating foods and snacks that meet their energy needs while improving beta cell function, an effect that cannot be achieved with medication.”

The study found that insulin sensitivity, or how well the body uses insulin, did not change significantly with dietary interventions. Thus, it is unlikely that changes in insulin sensitivity were the reason for the improvement in the response of beta cells to a low carbohydrate diet.

In other words, the enhanced beta cell response may be due to something other than changes in insulin sensitivity.

More research is needed, though Medical News Today spoke with Thomas M. Holland, MD, MS, physician-scientist and assistant professor at the RUSH Center for Healthy Aging, RUSH University, College of Health Sciences, who was not involved in the study, to gain a better understanding of what Can a low carb diet improve beta cell function.

“Carbohydrate-restricted diets can improve [pancreatic] Beta cell function in people with type 2 diabetes is impaired by reducing the pressure of beta cells to produce insulin. This improvement may be due to a reduction in blood glucose (from carbohydrates), which reduces the need for beta cells to produce insulin, potentially reversing beta cell dysfunction. caused by sugar poisoning.”

“While this benefit is most evident in people with diabetes, it can still help people with prediabetes. [with an HbA1c of about 5.7%-6.4%] or even those with advanced diabetes, although the level of improvement may vary from person to person,” added Holland.

Holland emphasized that “a carbohydrate-rich diet can help control type 2 diabetes, but adherence, especially in older people, can be difficult.”

To make a low-carb diet sustainable, she recommends:

  • including carb modification while prioritizing whole, unprocessed or minimally processed foods that are high in fiber and nutrients.
  • adding variety and making food more delicious
  • monitoring blood sugar levels regularly, especially when adjusting or reducing medications under the guidance of a healthcare provider
  • consultation with a health care provider is to ensure that the diet meets the individual’s health needs.

“It’s still ketogenic [very low carbohydrate] diets can work well if followed correctly, under the guidance of a dietitian or doctor, the main concern is the potential for side effects when reinstating carbohydrates,” Holland warned.

He explained that these reversible effects can cause “significant weight gain and stress on beta cells to ensure proper insulin production,” which can lead to negative health outcomes.

MNT also spoke toSheri Gaw, RDN, CDCES, a registered dietitian, certified diabetes care and education specialist, and owner of The Plant Strong Dietitian, was also not involved in the study.

He also advises choosing high-fiber, low-carb foods to make it easier to eat low-carb foods, as “fiber helps slow down digestion.” food and increase satiety.”

He recommends foods such as:

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