When patients are diagnosed with type 2 diabetes, clinicians stress lifestyle modifications—and especially diet—as the first and best intervention. Often, they recommend diets endorsed by the American Diabetes Association.
A previous study suggested that a very low-carbohydrate ketogenic diet augmented with more physical activity, adequate sleep, positive attitude, and consistent mindfulness helped overweight people with type 2 diabetes or prediabetes improve glycemic control and lose weight. Clinicians delivered this intervention in person. Lack of time, flexibility, transportation, social support, and/or financial resources were significant barriers for some individuals.
The researchers, a team from the University of Michigan who conducted the previous study, wondered if an online intervention would deliver comparable results to online diet support based on the American Diabetes Associations’ conventional, low-fat “Create Your Plate” diet. The findings were published in the Journal of Medical Internet Research.
The researchers enrolled a small number of patients with diabetes and body mass index ≥25 to use either a ketogenic diet or the plate method. The ketogenic diet is a high-fat, adequate-protein, low-carbohydrate diet that has been used primarily to treat refractory epilepsy in children. It forces the body to burn fats rather than carbohydrates. The researchers delivered interventions online, and followed participants for 32 weeks.
At 32 weeks, participants who followed the low carbohydrate ketogenic diet reduced their HbA1c by approximately 0.8%. Participants in the control (plate) arm reduced their HbA1c by approximately 0.3%. More than half of participants who followed the ketogenic diet lowered their HbA1C to less than 6.5%. No control group participants reached that goal.
Weight was also greater among ketogenic diet participants, who reported average weight loss of 12.7 kg. Participants in the control group lost an average of 3 kg.
Participants in the program were taking no medication or metformin only.
The researchers reported that online delivery of very low-carbohydrate ketogenic diet and lifestyle recommendations could help patients with diabetes across the country lose weight and improve their health.