Can reducing carbs have a bigger impact than meds on type 2 diabetes patients?

Research published in the Journal of Clinical Endocrinology & Metabolism suggests that adults with type 2 diabetes may significantly improve their beta-cell function by adopting a low-carbohydrate diet. These improvements could help patients manage their diabetes more effectively and even discontinue medication in some cases, offering new hope for the 38 million Americans living with diabetes.

Type 2 diabetes, which accounts for more than 90% of diabetes cases, is largely driven by beta-cell dysfunction in combination with insulin resistance. Over time, the function of beta cells deteriorates in people with type 2 diabetes, particularly when their diets are high in carbohydrates, which are known to elevate blood sugar levels.

The study, led by Barbara Gower, Ph.D., of the University of Alabama at Birmingham, found that people with type 2 diabetes who reduced their carbohydrate intake saw notable improvements in beta-cell function compared to those on a high-carbohydrate diet. “This study shows people with type 2 diabetes on a low-carbohydrate diet can recover their beta-cells, an outcome that cannot be achieved with medication,” Gower said in a statement.

The 12-week study involved 57 white and Black adults with type 2 diabetes, half of whom followed a low-carbohydrate diet consisting of 9% carbohydrates and 65% fat, while the other half followed a high-carbohydrate diet with 55% carbohydrates and 20% fat. The participants’ beta-cell function and insulin secretion were measured both at the start of the study and at its conclusion.

Participants on the low-carbohydrate diet experienced significantly greater improvements in both acute and maximal beta-cell responses—2-fold and 22% greater, respectively, than those on the high-carbohydrate diet. Additionally, Black participants on the low-carbohydrate diet saw a remarkable 110% improvement in their acute beta-cell response, while White participants saw a 48% improvement in their maximal beta-cell response.

Although these findings suggest that carbohydrate restriction could be a powerful tool for improving beta-cell function, Gower cautioned that more research is needed to determine if it can lead to long-term remission of type 2 diabetes. Nonetheless, the study offers encouraging evidence that diet modification may be a more effective strategy than medication for some individuals with mild type 2 diabetes.

According to researchers, for physicians managing patients with type 2 diabetes, these findings underscore the potential benefits of recommending a low-carbohydrate diet, particularly in patients who are motivated to make lifestyle changes and may be able to reduce or eliminate their dependence on medication.