A role for low-carbohydrate diets in type 2 diabetes

The foreword to a report published by the Parliament of Western Australia (2019) states: ‘If there is one thing to take away from this report it is that type 2 diabetes can go into remission and it need not be a life-long progressive chronic illness. Some practitioners argue it is reversible.’

These aforementioned practitioners include Hallberg et al (2019), who note that before insulin's discovery in 1921, low-carbohydrate diets were commonly prescribed to treat diabetes. With the availability of exogenous insulin and the emergence of low-fat diets – which, axiomatically, are carbohydrate-enriched – the low-carbohydrate diet's goal of preventing raised blood glucose concentrations was supplanted by that of exerting blood glucose control through glycaemic control medication, including insulin (Hallberg et al, 2019).

The low-carbohydrate approach to diabetes is gaining traction. For example, a recent consensus report on nutrition therapy for people with diabetes or pre-diabetes stated that for certain people who are not meeting glycaemic targets, or where lowering anti-glycaemic medication is needed, reducing overall carbohydrate intake with low- or very low carbohydrate eating plans is a viable approach (Evert et al, 2019). In 2016, the World Health Organization's Global Report on Diabetes cited the Barbados Diabetes Reversal Study to determine the feasibility of reversing type 2 diabetes by incorporating a low-carbohydrate approach (WHO, 2016).