Low-carb diet may benefit beta-cell function in patients with type 2 diabetes
Click Here to Manage Email Alerts
Key takeaways:
- A restricted-carbohydrate diet enabled patients with type 2 diabetes to recover beta-cell function in the short term.
- The effect was greater for white patients than Black patients.
Patients with type 2 diabetes on a carbohydrate-restricted diet showed recovery in beta-cell function, researchers reported in The Journal of Clinical Endocrinology & Metabolism.
“Beta-cell failure is responsible for the development of type 2 diabetes. In particular, the loss of first-phase insulin secretion in early type 2 diabetes is a key determinant in disease outcomes,” Marian Yurchishin, MS, a PhD student at the University of Alabama at Birmingham, told Healio. “However, no conventional drug therapy for type 2 diabetes exists that can restore the first-phase beta-cell response. We aimed to investigate if a carbohydrate-restricted diet could be a feasible approach to improve beta-cell function in the context of a short-term study.”
The researchers conducted a study of 57 patients with type 2 diabetes not using insulin to determine the effect of diet on beta-cell response to glucose. The patients stopped all diabetes medications 1 to 2 weeks before baseline and were randomly assigned to a eucaloric carbohydrate-restricted diet (approximately 9% energy from carbohydrate and 65% energy from fat; mean age, 53 years; five men and 22 women; 17 Black and 10 white) or a eucaloric higher-carbohydrate diet (approximately 55% energy from carbohydrate and 20% energy from fat; mean age, 55 years; eight men and 22 women; 20 Black and 10 white).
At 12 weeks, acute C-peptide response was twofold greater in patients assigned the carbohydrate-restricted diet compared with those assigned the higher-carbohydrate diet (P < .01), the researchers found.
In addition, maximal C-peptide response was 22% greater in the carbohydrate-restricted diet group compared with the higher-carbohydrate diet group at 12 weeks (P < .05), they found.
“One process thought to lead to beta-cell failure is their loss of glucose sensing and glucose responsiveness, which is thought to result from the beta cells’ chronic exposure to glucose (eg, ‘glucose toxicity’),” Yurchishin told Healio. “Removal of this exposure via a carbohydrate-restricted diet may therefore allow beta cells to repair their secretory mechanisms, but more research is needed to identify the specific mechanisms behind this effect.”
Maximal C-peptide response was 48% greater with the carbohydrate-restricted diet in white patients (P < .01), but the difference between the groups was not significant in Black patients (P for interaction < .05), according to the researchers.
“Research supports the contention that the pathophysiology of type 2 diabetes can differ among races based on genetic factors and environmental interactions that affect beta-cell function,” Yurchishin told Healio. “For example, type 2 diabetes onset in African Americans may be less related to obesity and insulin resistance than it is in European Americans and depend on alterations in beta-cell function to a larger degree. While sociocultural factors do influence type 2 diabetes risk, other studies have also shown that there are inherent biological differences in the mechanisms that lead to beta-cell failure between races that warrant further investigation. Our research seeks to identify such differences as an effort to better understand and address the racial disparity in type 2 diabetes risk.”
An oral glucose tolerance test determined that the effect on the disposition index was 32% greater with the carbohydrate-restricted diet (P < .05), Yurchishin and colleagues wrote.
“Treatment of type 2 diabetes optimally involves lifestyle interventions featuring healthy meal patterns in conjunction with medical therapy,” Yurchishin told Healio. “Our research should not be interpreted to mean that a carbohydrate-restricted diet can replace medical therapy in those who need it, especially patients at risk of cardiovascular disease, heart failure or chronic kidney disease (ie, indications for GLP-1 receptor agonists or SGLT2 inhibitors), or when medications are needed to achieve HbA1c targets. However, a carbohydrate-restricted diet could be considered as a component of lifestyle therapy, which could contribute to better glycemic control as a consequence of improved beta-cell function. The data also highlight the benefits of a carbohydrate-restricted diet on beta-cell function in the absence of weight loss and the fact that African Americans experience a much greater increase in insulin secretion than European Americans.”
Reference:
- People with type 2 diabetes who eat low-carb may be able to discontinue medication. https://medicalxpress.com/news/2024-10-people-diabetes-carb-discontinue-medication.html. Published Oct. 22, 2024. Accessed Oct. 22, 2024.
For more information:
Marian Yurchishin, MS, can be reached at myurchis@uab.edu.
Collapse
Click Here to Manage Email Alerts