Including low carb weight loss counselling helped people with type 2 diabetes reduce weight, use less medication and reduce hypoglycemia in a randomised research trial.

The finding comes from a 48-week study carried out by researchers at the Duke Diet & Fitness Center in Durham, North Carolina. The study involved 263 participants who were veterans with type 2 diabetes.

The participants were predominantly male (89%), with an average age of 61 years old and average HbA1c levels of 76 mmol/mol (9.1%) at the start of the study.

The study involved two groups. Both groups attended group medical visits which enabled them to receive education, self-management skills training and help with managing medication. One of the groups were given low carbohydrate diet counselling and had their medication reduced. This group had medical visits to ensure their medication was correctly optimised on the low carb diet.

The results at 48 weeks showed greater weight loss in those in the low carb weight loss counselling group. Participants lost nearly 4kg more on average than the other group. The low carb group had lower use of medication and experienced 50% fewer episodes of hypoglycemia.

HbA1c levels were similar between the groups after 48 weeks. However, it should be noted that the low carb group were taking less medication and were experiencing less hypoglycemia which will have conferred an appearance of advantage, in terms of HbA1c, to the non-low carb group.

Lead author and director of the Duke Diet & Fitness Center, Dr William Yancy, said: “Intensive weight management using a low carbohydrate diet can be as effective for glycemic improvement as medication intensification.

“We know that lifestyle changes can be difficult to maintain, but this study shows that group meetings can be an efficient and effective strategy that helps patients sustain these improvements.”

The findings are published in the JAMA Internal Medicine journal.

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