REVIEW PAPER
The use of low-carbohydrate diet in type 2 diabetes – benefits and risks
 
More details
Hide details
1
Department of Physiology, Poznan University of Medical Sciences, Poland
 
2
Department of Chemistry and Clinical Biochemistry, Poznan University of Medical Sciences, Poland
 
3
Department and Clinic of Plastic, Reconstructive and Aesthetic Surgery, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland
 
 
Corresponding author
Łucja Czyżewska-Majchrzak   

Department of Physiology, Poznan University of Medical Sciences, Poland
 
 
Ann Agric Environ Med. 2014;21(2):320-326
 
KEYWORDS
ABSTRACT
The pharmacological treatment of type 2 diabetes is increasingly being supported by the recommendation of an appropriate diet. The purpose of this study is to identify the potential benefits and risks arising from the use of one of the modern models of low-carbohydrate diet in patients with type 2 diabetes. Research shows that diet can favourably affect the health of diabetic patients. It has been shown that diet affects positively the concentration of blood glucose, glycosylated haemoglobin, and also contributes to the reduction of insulin taken in the course of drug therapy. At the same time, short-term studies have demonstrated a positive relationship of nutrition with reduction in body weight, as well as favourable changes in lipid profile of HDL cholesterol and levels of triglyceride. Attention is also drawn to the negative health effects of a low-carbohydrate diet; these include an increased risk of mineral deficiency, hypovitaminosis and reduced intake of dietary fibres. This diet may be associated with very high levels of protein which, in turn, raises the risk of renal dysfunction and the appearance of irregularities in the water and electrolyte balance. The impact of changes in the skeletal system and the development of osteopenia and osteoporosis is also observed. Besides the positive impact of this model of diet on the lipid profile parameters, its use significantly increases the risk of adverse changes in other markers predisposing to atherosclerosis occurring in individuals with type 2 diabetes. In composing a nutrition model for diabetes patients, both the benefits and potential risks of a low-carbohydrate diet should therefore take into account. At the same time, it is important to individualize the diet used, based on the current state of health, used pharmacological treatments, as well as taking into account the individual characteristics of the patient.
REFERENCES (47)
1.
Tatoń J. Etiologia i patogeneza cukrzycy typu II. In: Tatoń J, Czech A (eds.). Diabetologia, Wydawnictwo Lekarskie PZWL, Warszawa 2001.p.151–164 (in Polish).
 
2.
Arathuzik GG, Goebel- Fabbri AE. Nutrition therapy and the management of obesity and diabetes: an update. Curr Diab Rep. 2011; 11(2): 106–110.
 
3.
Piłaciński S, Wierusz-Wysocka B. Kontrowersje wokół żywienia u chorych na cukrzycę, Diabetologia Praktyczna 2008; 9(1): 28–35 (in Polish).
 
4.
Całyniuk B, Grochowska-Niedworok E, Białek A, Czech N, Kukielczak A. Piramida żywienia – wczoraj i dziś, Probl Hig Epidemiol. 2011; 92(1): 20–24 (in Polish).
 
5.
Gertig H, Przysławski J. Bromatologia. Wydawnictwo Lekarskie PZWL 2007 (in Polish).
 
6.
Szewczyk A, Białek A, Kukielczak A, Czech N, Kokot T, Muc-Wierzgoń M, et al. Ocena sposobu żywienia osób chorujących na cukrzycę typu 1 i 2, Probl Hig Epidemiol. 2011; 92(2): 267–271 (in Polish).
 
7.
Worth J, Soran H. Is there a role for low carbohydrate diets in the management of type 2 diabetes? OJM. 2007; 100(10): 659–63.
 
8.
Wylie-Rosett J, Davis NJ. Low-Carbohydrate Diets:An Update on Current Research, Current Diabetes Reports 2009; 9: 396–404.
 
9.
Dyson PA. A review of low and reduced carbohydrate dietsand weight loss in type 2 diabetes, J Hum Nutr Diet. 2008; 21(6): 530–8.
 
10.
Westman EC, Yancy Jr WS, Mavropoulos JC, Marquart M, McDuffie JR. The effect of a low-carbohydrate, ketogenic diet versus alow-glycemic index diet on glycemic control in type 2 diabetes mellitus, Nutr Metab (Lond). 2008; 5: 36.
 
11.
Dytfeld J, Kujawska-Łuczak M, Pupek-Musialik D. Kontrowersje dotyczące stosowania diet niskowęglowodanowych, Diabetologia Doświadczalna i Kliniczna 2005; 5(5): 337–344 (in Polish).
 
12.
Ruxer J, Możdżan M, Loba J. Dieta Atkinsa a leczenie otyłości, Clin Exp Med. 2005; 14(5): 1027–1032 (in Polish).
 
13.
Boden G, Sargrad K, Homko C, Mozzoli M, Stein TP. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes. Ann. Intern. Med. 2005; 142: 403–411.
 
14.
Gutierrez M, Akhavan M, Jovanovic L, Peterson CM. Utility of a short-term 25% carbohydrate diet on improving glycemic control in type 2 diabetes mellitus. J Am Coll Nutr. 1998;17(6): 595–600.
 
15.
Nielsen J, Jonsson E. Low-carbohydrate diet in type 2 diabetes. Stable improvement of bodyweight and glycaemic control during 22 months follow-up. Nutr. Metab. 2006; 3: 22–27.
 
16.
Yancy WS Jr, Foy M, Chalecki AM, Vernon MC, Westman EC. A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutr. Metab. (Lond) 2005; 2: 34.
 
17.
Daly ME, Paisey R, Millward BA, Eccles C, Williams K, Hammersley S, McLeod KM, Gale T.J. Short-term effects of severe dietary carbohydrate restriction advice in Type 2 diabetes- a randomized controlled trial. Diabet Med. 2006; 23: 15–20.
 
18.
Daly ME, Piper J, Paisey R, Darby T, George L, Ball C, Vaezi A, Williams K, Gale TJ. Efficacy of carbohydrate restriction in obese Type 2 diabetes patients. Diabet Med. 2006; 23(2): 26.
 
19.
Robertson A, Broom I. Low-carbohydrate diets in the treatment of resistant overweight patients with Type 2 diabetes. Diabet Med 2002; 19: 24.
 
20.
Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, et al. Dr.P.H. for the Dietary Intervention Randomized Controlled Trial (DIRECT) group weight loss with a low-carbohydrate, mediterranean, or low-fat diet. N Engl J Med. 2008; 359: 229–234.
 
21.
Wheeler ML, Dunbar SA, Jaacks LM, Karmally W, Mayer-Davis EJ, Wylie-Rosett J, et al. Macronutrients, food groups, and eating patterns in the management of diabetes: A systematic review of the literature, 2010. Diabetes Care 2012; 35: 434–445.
 
22.
Volek JS, Sharman MJ. Cardiovascular and hormonal aspects of very-low-carbohydrate ketogenic diets. Obesity Research 2004; 12: 115–123.
 
23.
Kirk JK, Graves DE, Craven TE, Lipkin EW, Austin M, Margolis KL. Restricted-carbohydrate diets in patients with type 2 diabetes: a meta-analysis. J Am Diet Assoc. 2008; 108(1): 91–100.
 
24.
Nordmann AJ, Nordmann A, Briel M, Keller U, Yancy WS Jr, Brehm BJ, et al. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166(3): 285–293.
 
25.
Yancy WS Jr, Olsen MK, Guyton JR, Bakst RP, Westman EC. A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Ann. Intern.Med. 2004; 140: 769–777.
 
26.
Adam-Perrot A, Clifton P, Brouns F. Low-carbohydrate diets: nutritional and physiological aspects. Obesity Reviews 2006; 7: 49–58.
 
27.
Małecki MT. Otyłość – insulinooporność – cukrzyca typu 2, Kardiologia Polska 2006; 64: 10(6), 561–566 (in Polish).
 
28.
Masko EM, Thomas JA, Antonelli JA, Lloyd JC, Phillips TE, Poulton SH, et al. Low-carbohydrate diets and prostate cancer: how low is “low enough”? Cancer Prev Res (Phila). 2010; 3: 1124–1131.
 
29.
Nahleh Z. Breast cancer, obesity and hormonal imbalance: a worrisome trend. Expert Rev. Anticancer Ther. 2011; 11(6): 817–819.
 
30.
Bilsborough SA, Crowe TC. Low-carbohydrate diets: what are the potential short- and long-term health implications? Asia Pacific J Clin Nutr. 2003; 12(4): 396–404.
 
31.
Fenercioglu AK, Saler T, Genc E, Sabuncu H, Altuntas Y. The effects of polyphenol-containing antioxidants on oxidative stress and lipid peroxidation in Type 2 diabetes mellitus without complications. J Endocrinol Invest. 2010; 33: 118–124.
 
32.
Wood RJ, Fernandez ML, Sharman MJ, et al. Effects of a carbohydrate restricted diet with and without supplemental soluble fiber on plasma LDL-cholesterol and other clinical markers of cardiovascular risk. Metabolism 2007; 56: 58–67.
 
33.
Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, et al. Nutrition recommendations and interventions for diabetes – 2006: a position statement of the American Diabetes Association. Diabetes Care 2006; 29: 2140–2157.
 
34.
Czekalski S. Optymalizacja leczenia cukrzycowej choroby nerek. Przew Lek. 2009; 5: 41–46 (in Polish).
 
35.
Dansinger ML, Gleason JA, Griffith JL, Selker HP, Schaefer EJ. Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trial. The Journal of the American Medical Association 2005; 293 (1): 43–53.
 
36.
Carter JD, Vasey FB, Valeriano J. The effect of a low-carbohydrate diet on bone turnover. Osteoporos Int. 2006; 17: 1398–403.
 
37.
Reddy ST, Wang CY, Skhaee K, Brinkley L, Pak CY, Effect of low-carbohydrate-high-protein diets on acid-base balance, stone forming propensity and calcium metabolism. Am J Kidney Dis. 2002; 40: 265–274.
 
38.
Rylander R. High protein, low carbohydrate, and mineral balance. Am J Clin Nutr. 2011; 93: 1152–1156.
 
39.
Fleming RM. The effect of high-, moderate-, and low-fat diets on weight loss and cardiovascular disease risk factors. Prev Cardiol. 2002; 5: 110–118.
 
40.
Foster GD, Wyatt HR, Hill JO, et al. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003; 348: 2082–2090.
 
41.
Rankin JW, Turpyn AD. Low carbohydrate, high fat diet increases C-Reactive Protein during weight loss. J Am Coll Nutr. 2007; 26(2): 163–169.
 
42.
Bradley U, Spence M, Courtney CH, McKinley MC, Ennis CN, Mc Cance DR, McEneny J, Bell PM, Young IS, Hunter SJ. Low-fat versus low-carbohydrate weight reduction diets Effects on weight loss, insulin resistance, and cardiovascular risk: A randomized control trial. Diabetes 2009; 58(12): 2741–2748.
 
43.
de Koning L, Fung TT, Liao X, Chiuve SE, Rimm EB, Willett WC, et al. Low-carbohydrate diet scores and risk of type 2 diabetes in men. Am J Clin Nutr. 2011; 93(4): 844–850.
 
44.
Halton TL, Liu S, Manson AE, Hu FB. Low-carbohydrate-diet score and risk of type 2 diabetes in women. American Journal of Clinical Nutrition 2008; 87(2): 339–346.
 
45.
Trichopoulon A, Psaltopoulou T, Orfanos P, et al. Low carbohydrate-high-protein diet and long-term survival in a general population cohort. Eur J Clin Nutr. 2007; 61: 575–581.
 
46.
Lagion P, Sandin S, Weiderpass E, et.al. Low carbohydrate/high protein diet and mortality in a cohort of Swedish women. J Inter Med. 2007; 261: 366–374.
 
47.
Fung TT, van Dam RM, Hankinson SE, Stampfer M, Willett WC, Hu FB. Low carbohydrate-high-protein diet and long-term survival in a general population cohort. Ann Intern Med. 2010; 153: 289–298.
 
eISSN:1898-2263
ISSN:1232-1966
Journals System - logo
Scroll to top