There is now little evidence for the claim that a fat-reduced diet for weight reduction has any particular value beyond caloric counting [
10]. On the other hand, six randomised studies have shown that carbohydrate restriction with ad-libitum energy intake confers a significant benefit with regard to weight loss in obese persons [
11,
12,
13,
14,
15,
16]. The current study is consistent with these reports and suggests that high-starch, high-carbohydrate diets excessively stimulate appetite and disturb energy balance in patients with the metabolic syndrome and type 2 diabetes [
3]. A reduction of carbohydrates normalises the balance, reduces insulin concentrations and favours utilization of stored fat as fuel as well as significantly reducing insulin resistance [
3]. Considering the solid evidence for the negative effect of hyperglycemia on diabetes complications as well as cardiovascular disease the present high-carbohydrate dietary advice resulting in unnecessary hyperglycemia and insulin resistance seems difficult to support [
17,
18,
19] and for diabetes patients, current dietary recommendations seem to be a major part of their problem rather than being part of the solution. Carbohydrate restriction, however, reverses or neutralises all aspects of the metabolic syndrome [
20,
21].
Summary: A reduced carbohydrate diet is effective in motivated patients and can be recommended for overweight patients with type 2 diabetes. There has been no sign of a negative cardiovascular effect.