A Low-Carb Diet Might Be Key for Combating Diabetes

Group medical visits (GMVs) in conjunction with weight management (WM) using a low-carb diet is effective at lowering blood sugar levels in type 2 diabetes patients, according to the findings of a study published in JAMA Internal Medicine.

In this study, researchers identified 263 participants (mean age, 60.7, 89.4% men, 54.4% black) via electronic medical records who all had type 2 diabetes, uncontrolled HbA_1c, and body mass index of 27 or higher. They randomized the participants into one of two groups: a GMV group (n = 136), in which they received counseling about diabetes-related topics with medication administered every 4 weeks for 16 weeks, then every 8 weeks; and a WM/GMV group (n = 127), where they received low-carbohydrate diet counseling with baseline medication reduction and subsequent medication optimization every 2 weeks for 16 weeks followed by an abbreviated GMV intervention every 8 weeks.

The key endpoints of this study included HbA_1c level, hypoglycemic events, diabetes medication effect score, and weight at 48 weeks, which was measured utilizing hierarchical generalized mixed models.

Subsequent to analysis, the results of the study showed that at 48 weeks, HbA_1c levels improved in both study groups (8.2% in the WM/GMV arm and 8.3% in the GMV arm; mean difference, −0.1%; 95% CI, −0.5% to 0.2%; upper 95% CI, <0.5% threshold; P = .44). The researchers observed that the WM/GMV arm had lower diabetes medication use (mean difference in medication effect score, −0.5; 95% CI, −0.6 to −0.3; P < .001) as well as augmented weight loss (mean difference, −3.7 kg; 95% CI, −5.5 to −1.9 kg; P < .001) juxtaposed to the GMV arm at 48 weeks. Moreover, the WM/GMV arm had approximately 50% fewer hypoglycemic events (incidence rate ratio, 0.49; 95% CI, 0.27 to 0.71; P < .001) over the duration of 48 weeks.

Group Medical Visits and Intensive Weight Management for Type 2 Diabetes https://t.co/hAbKqm84Px via @JAMAInternalMed pic.twitter.com/b837O1pPEi

— Dr. David L. Katz (@DrDavidKatz) November 5, 2019

The authors wrote in their conclusion that: “In GMVs for diabetes, addition of WM using a low-carbohydrate diet was noninferior for lowering HbA_1c levels compared with conventional medication management and showed advantages in other clinically important outcomes.”

More trial evidence that low carbohydrate approach is more powerful than drugs. https://t.co/YJ82NHpbP0

— Dr. Jason Fung (@drjasonfung) November 5, 2019

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