The research was undertaken to determine if introduction of a low carbohydrate diet might be a useful option for type 2 diabetic patients who do not achieve glucose target levels despite conventional treatment.

The trial consisted of 28 people with Type 2 diabetes who were unable to achieve sufficient glucose control. The cohort comprised of 9 patients that were previously treated with diet alone and 19 that were treated with oral hypoglycemic drugs (although these were discontinued at the start of the trial). The patients were placed on a diet based on ideal body weight which comprised of 25% carbohydrate. After a mean of 8 weeks, they were then switched to a caloric equivalent diet, but composed of 55% carbohydrate.

Compared to the baseline diet, after 8 weeks of a 25% of daily energy in the form of carbohydrate diet, subjects showed significantly improved glycemia as evidenced by fasting blood glucose values and hemoglobin A1c levels. Those previously treated with oral hypoglycemic agents showed a significant decrease in weight and diastolic blood pressure despite the discontinuation of the oral agent. However, when they switched back to the so-called ‘healthy’ 55% carbohydrate diet, their glucose control worsened again and their haemoglobin A1c level rose significantly over the following 12 weeks.

Therefore, a low carbohydrate and calorie-restricted diet has beneficial short-term effects in subjects with type 2 who have failed either diet or sulfonylurea therapy which may obviate the necessity for insulin.

The objective of the study was to investigate the effects of a low-calorie diet on type 2 diabetes with the goal of remission within these patients.

Individuals aged 20–65 years were recruited who had been diagnosed with type 2 diabetes within the past 6 years, had a body-mass index of 27–45 kg/m² and were not taking insulin. The intervention comprised withdrawal of antidiabetic and antihypertensive drugs with total diet replacement (825–853 kcal/day formula diet for 3–5 months) with a stepped food reintroduction that lasted 2–8 weeks.

306 individuals were recruited from 49 intervention (n=23) and control (n=26) general practices; 149 participants per group comprised the intention-to-treat population. At 12 months, weight loss of 15 kg or more in 36 (24%) participants in the intervention group and no participants in the control group (p < 0•0001) was recorded. Diabetes remission was achieved in 68 (46%) participants in the intervention group and six (4%) participants in the control group.