Patients with Type-2 diabetes who follow a strict low carbohydrate diet for six months may experience greater rates of remission compared with other recommended diets without adverse effects, a new study suggests.

Most benefits diminished at 12 months, but say doctors might consider short-term strict low carbohydrate diets for managing Type-2 diabetes, while actively monitoring and adjusting diabetes medication as needed, the researchers, including Joshua Z. Goldenberg from Texas A&M University, said.

“Future long term, well designed, calorie controlled randomised trials are needed to determine the effects of LCD on sustained weight loss and remission of diabetes, as well as cardiovascular mortality and major morbidity,” the researchers said.

A low-carb diet is a diet that restricts carbohydrates, such as those found in sugary foods, pasta and bread. It is high in protein, fat and healthy vegetables.

Type-2 diabetes is the most common form of diabetes worldwide and diet is recognised as an essential part of treatment. But uncertainty remains about which diet to choose and previous studies have reported mixed results.

For the study, published in The BMJ journal, the team assessed the effectiveness and safety of low carbohydrate diets (LCDs) and very low carbohydrate diets (VLCDs) for people with Type-2 diabetes, compared with (mostly low fat) control diets based on analysis from 23 randomised trials involving 1,357 participants.

LCDs were defined as less than 26 per cent daily calories from carbohydrates and VLCDs were defined as less than 10 per cent daily calories from carbohydrates for at least 12 weeks in adults (average age 47 to 67 years) with Type-2 diabetes.

Based on low to moderate certainty evidence, the researchers found that patients on LCDs achieved higher diabetes remission rates at six months compared with patients on control diets, without adverse events.

LCDs also increased weight loss, reduced medication use, and improved body fat (triglyceride) concentrations at six months.

However, most of these benefits diminished at 12 months, a finding consistent with previous reviews, and some evidence showed worsening of quality of life and cholesterol levels at 12 months, the team said.