Lower Carb Eating

Reduce glucose variability, decrease hunger, decrease cravings for sugar and fast carbs, decrease insulin requirements

Background

The CDC reports that 85.2% of people with type 2 diabetes are overweight or obese. Insulin works to stimulate lipid uptake and storage and to inhibit lipid breakdown, promoting fat stores in the body and leading to weight gain. When cells absorb too much glucose, the body converts this into fat. Reducing carbohydrate intake leads to a reduction in insulin circulating in the body, which can lead to weight loss and a reduction of insulin resistance and could result in reversing a patient’s type 2 diabetes.MCT2D is incorporating lower carbohydrate eating patterns coupled with continuous glucose monitoring devices to provide real time feedback to patients about their food choices. These diets reduce glucose variability, decrease hunger, decrease cravings for sugar and fast carbs, decrease insulin requirements, and lead to weight loss.

The Action to Control Cardiovascular Risk in Diabetes ACCORD Trial, a study of ~10,000 adults with type 2 diabetes, finds significantly more weight gain in the intensive glycemia arm of the trial compared with the standard arm (3.0 ± 7.0 vs. 0.3 ± 6.3 kg). Initiation of TZD and/or insulin therapy was the most important medication-related factor associated with weight gain.

Fonseca et al. (2013) “Determinants of Weight Gain in the Action to Control Cardiovascular Risk in Diabetes Trial.” Diabetes Care. doi: 10.2337/dc12-1391

Time course of weight gain in the ACCORD trial by treatment allocation.

Type 2 Diabetes results in part from the accumulation of fat in the liver and pancreas. This effect of exogenous insulin is not surprising, as we know that insulin is an anabolic hormone that promotes fat storage.

In fact, T2DM is characterized by hyperinsulinemia and visceral fat.

Carb reduction offers an opportunity to break this cycle by treating hyperinsulinemia as an underlying cause of T2DM.

Lim, Hollingsworth et al.(2011). Diabetologia. doi: 10.1007/s00125-011-2204-7

CHANGE STARTS WITH NUTRITION

“
I thought I was trying! I spent most of my day trying to manage my diabetes. Constantly trying not to eat but always eating it seemed like. And fighting my portions. It was constant.
”

— Frankie

Hear how Frankie’s life changed when he embarked on a new approach to managing his type 2 diabetes:

GUIDELINES

Low and very low carbohydrate diets are supported by guidelines from the 2021 American Diabetes Association Standards of Medical Care in Diabetes:

“For individuals with type 2 diabetes not meeting glycemic targets or for whom reducing glucose-lowering drugs is a priority, reducing overall carbohydrate intake with a low- or very low-carbohydrate eating pattern is a viable option.”

PUBLISHED RESULTS

See the evidence

Keto: One clinic enrolled 28 overweight patients with T2D and had them complete a 16-week keto diet intervention. HbA1C decreased by 16% from baseline, mean body weight decreased 6.6%, and diabetes medications were reduced or discontinued in 17 of 21 patients. (Yancy et.al, Nutrition Metab, 2005. doi: 10.1186/1743-7075-2-34).

Low Carb vs. High Carb: A study comparing a low carb and a high carb diet for 125 patients with T2D found that completion rates, weight reduction, and HbA1C reductions, improved similarly for both groups but the low carb diet group had greater improvements in lipid profile, blood glucose stability, and reduction in diabetes medication requirements. (Tay et al, Clinical Nutrition, 2015. doi: 10.3945/ajcn.115.112581).

Insulin: 185 patients with T2D participated in a 12-month trial of low carb diets found that 86% of those who completed the 12 months were able to reduce or discontinue insulin, with 70.6% discontinuing insulin completely. (Wolver et al, Frontiers in Nutrition, 2021. doi: 10.3389/fnut.2021.690855)

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Support for The Michigan Collaborative for Type 2 Diabetes (MCT2D) is provided by Blue Cross and Blue Shield of Michigan as part of the BCBSM Value Partnerships program.

Although Blue Cross Blue Shield of Michigan and MCT2D work collaboratively, the opinions, beliefs and viewpoints expressed by the author do not necessarily reflect the opinions, beliefs and viewpoints of BCBSM or any of its employees.