Hot topics for type 2 diabetes – low carb diets and remission
All Australians are encouraged to eat a wide variety of foods that support good health. These include whole fruits and vegetables, wholegrains, dairy foods, nuts and seeds, legumes, seafood, lean meats, and eggs.
At the same time, intake of highly processed foods should be limited. This includes items such as sugary drinks, chips, cakes, biscuits, pastries, and lollies.
When it comes to type 2 diabetes, the most effective management strategies are those developed in consultation with your diabetes healthcare team and guided by the best available evidence. There is no “one-size-fits-all” approach to living well with diabetes.
Everyone is different, and how each person chooses to manage their type 2 diabetes - including their approach to eating, medication, and physical activity - will vary.
You may have recently heard about low-carbohydrate diets or the possibility of diabetes remission. These topics are gaining attention and are often discussed as part of diabetes management.
Should I follow a low carbohydrate diet if I have type 2 diabetes?
A low carb diet is defined as consuming less than 130g carbohydrates daily.
Research suggests that lower carb eating, in the short term, can be beneficial in the management of type 2 diabetes. As well as improving blood glucose levels, lower carb eating can help with body weight management and reduced heart disease risk factors, such as raised cholesterol and blood pressure. However, the same research suggests that the benefits of low carb eating are no longer evident after 12 months. This type of eating can also be very difficult to maintain longer term.
Low carb eating is not recommended for children, pregnant or breastfeeding women, or people with certain medical conditions or histories. So, make sure you consult with your dietitian and diabetes healthcare team before considering changing your diet.
You can read Diabetes Australia’s low carb eating position statement here.
Low carb eating may be useful for the management of type 2 diabetes, but should not be confused with the structured, low-energy diet typically required if attempting diabetes remission.
Type 2 diabetes remission
Type 2 diabetes ‘remission’ refers to a sustained improvement in blood glucose, where HbA1c levels remain below 6.5% (48mmol/mol) for at least 3 months, without the use of glucose-lowering medications.
Let’s be clear though – this doesn’t mean that type 2 diabetes is cured or reversed. Underlying glucose intolerance or cardiovascular risks may persist, and over time, glucose levels may return to type 2 diabetes diagnosis levels.
How can I achieve remission?
For some people with type 2 diabetes, remission has been possible through dietary and physical activity changes, or by bariatric surgery. Research suggests that it’s more likely for people who;
- Were diagnosed with type 2 diabetes less than 5 years ago
- Had lower HbA1c levels when attempting remission
- Don’t require insulin therapy.
Remission may not be possible for everyone. Body weight changes may not be the key to remission for some. And for others, it may not be desirable to stop taking glucose-lowering medications as the benefits extend beyond the management of blood glucose levels.
It’s important to remember that if you don’t achieve or sustain remission, this doesn’t mean you have ‘failed’. The health benefits of a reduction in HbA1c are still significant.
If you’re thinking about type 2 diabetes remission, it’s important to talk about this with your diabetes healthcare team before making any changes to your diet, lifestyle or medication.
You can read Diabetes Australia’s type 2 diabetes remission statement here.
