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Diabetes Diet News

7 May 2009

Yet another trial that shows low-carb is better for diabetics

Haimoto H, Sasakabe T, Wakai K, Umegaki H. Effects of a low-carbohydrate diet on glycemic control in outpatients with severe type 2 diabetes. Nutrition & Metabolism 2009; 6:21


Published: 6 May 2009


We previously demonstrated that a loosely restricted 45%-carbohydrate diet led to greater reduction in hemoglobin A1c (HbA1c) compared to high-carbohydrate diets in outpatients with mild type 2 diabetes (mean HbA1c level: 7.4%) over 2 years.

To determine whether good glycemic control can be achieved with a 30%-carbohydrate diet in severe type 2 diabetes, 33 outpatients (15 males, 18 females, mean age: 59 yrs) with HbA1c levels of 9.0% or above were instructed to follow a low-carbohydrate diet (1852 kcal; %CHO:fat:protein = 30:44:20) for 6 months in an outpatient clinic and were followed to assess their HbA1c levels, body mass index and doses of antidiabetic drugs.

HbA1c levels decreased sharply from a baseline of 10.9 +/- 1.6% to 7.8 +/- 1.5% at 3 months and to 7.4 +/- 1.4% at 6 months. Body mass index decreased slightly from baseline (23.8 +/- 3.3) to 6 months (23.5 +/- 3.4).

Only two patients dropped out.

No adverse effects were observed except for mild constipation.

The number of patients on sulfonylureas decreased from 7 at baseline to 2 at 6 months. No patient required inpatient care or insulin therapy.

In summary, the 30%-carbohydrate diet over 6 months led to a remarkable reduction in HbA1c levels, even among outpatients with severe type 2 diabetes, without any insulin therapy, hospital care or increase in sulfonylureas. The effectiveness of the diet may be comparable to that of insulin therapy.

COMMENT: I have been preaching for over 20 years that diabetes is a disease of carbohydrate metabolism, and that type-2 diabetes can be cured with a low-carb, high-fat diet. By that I mean cutting calories from carbs to around 10% of calories and increasing calories from fats to 60% or more. Over that time, study after study has demonstrated that this protocol works and is safe.

The studies over this period started to reduce carbs and increase dietary fats only by small amounts, and we are still only at the stage in this study above of lowering carbs to 30% and increasing fats to 44%, so there is still some way to go. However, studies which have cut carbs to as low as 8% and raised fat intakes to over 60% have shown that this is entirely safe.[1]

It is possible that the American Diabetes Association and Diabetes UK will reverse their dietary guidelines and stop harming diabetics - but don't hold your breath. Without diabetics, how would they keep their jobs? Without diabetics, they would be redundant.


1. Sharman MJ, et al. A Ketogenic Diet Favorably Affects Serum Biomarkers for Cardiovascular Disease in Normal-Weight Men. J Nutr 2002; 132: 1879-1885

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Last updated 7 May 2009

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