(HealthDay News) — Patients with type 2 diabetes adhering to low-carbohydrate diets (LCDs) for 6 months may experience greater rates of diabetes remission, according to a review published online in The BMJ.

Joshua Z. Goldenberg, PhD, from Texas A&M University in College Station, and colleagues conducted a systematic review and meta-analysis to examine the efficacy and safety of LCDs and very LCDs (VLCDs) for people with type 2 diabetes. Data were included from 23 trials with 1357 participants.

The researchers found that compared with control diets, at 6 months, LCDs achieved higher rates of diabetes remission (defined as hemoglobin A1c [HbA1c] <6.5%; 57 vs 31%; risk difference, 0.32). When a remission definition of HbA1c <6.5% without medication was used, smaller, nonsignificant effect sizes were seen. Data on remission at 12 months were sparse, ranging from a small effect to a trivial increased risk for diabetes. At 6 months, there were large clinically important improvements in weight loss, triglycerides, and insulin sensitivity, which decreased at 12 months. VLCDs seemed less effective than less restrictive LCDs; this effect was explained by diet adherence. No significant difference was seen in quality of life at 6 months; however, a clinically important, but not statistically significant, worsening was seen at 12 months.

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“Clinicians might consider short term LCDs for management of type 2 diabetes, while actively monitoring and adjusting diabetes medication as needed,” the authors write.

One author disclosed financial ties to Texas A&M AgriLife Research.


Goldenberg JZ, Day A, Brinkworth GD, et al. Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data. BMJ 2021;372. doi:10.1136/bmj.m4743