`Low Carb Mediterranean Diet Results in Higher Rate of Remission in Type 2 Diabetes - Olive Oil Times
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Low Carb Mediterranean Diet Results in Higher Rate of Remission in Type 2 Diabetes

By Jedha Dening
Feb. 8, 2016 10:16 UTC

Type 2 dia­betes is a seri­ous health con­di­tion that com­monly results in health decline and an increas­ing need for med­ica­tion. However, some stud­ies indi­cate that dietary inter­ven­tion can, in fact, not only delay the need for med­ica­tion but can result in a higher rate of com­plete remis­sion of dia­betes.

Moreover, a dietary inter­ven­tion replac­ing car­bo­hy­drate for fat, par­tic­u­larly healthy monoun­sat­u­rated fat such as olive oil, appears to pro­vide greater over­all ben­e­fits com­pared to low-fat diets.

In a 4‑year ran­dom­ized con­trol trial pub­lished in the Annals of Internal Medicine, 2009, Esposito and Colleagues com­pared the effects of a low-car­bo­hy­drate Mediterranean diet (LCMD) (less than 50 per­cent car­bo­hy­drate) to a typ­i­cal low-fat diet (LF) (less than 30 per­cent fat) on the need for anti­hy­per­glycemic med­ica­tion in patients with newly diag­nosed type 2 dia­betes.

The trial fol­lowed 215 over­weight par­tic­i­pants with newly diag­nosed type 2 dia­betes who had never been treated with anti­hy­per­glycemic drugs and had HbA1c lev­els less than 11 per­cent. Primary out­comes included the start of anti­hy­per­glycemic drug ther­apy, defined by a pro­to­col as indi­cated for fol­low-up HbA1c level greater than 7 per­cent. Secondary out­comes included changes in weight, glycemic con­trol, and coro­nary risk fac­tors.

After 4 years, only 44 per­cent of patients in the LCMD group required med­ica­tion com­pared to 70 per­cent in the LF group, LCMD reduced HbA1c by 2 per­cent com­pared to LF 1.6 per­cent, there was higher reduc­tion in serum triglyc­erides in the LCMD group (23.4 mg/dl com­pared to 12.6 mg/dl in the LF group), and HDL cho­les­terol increased in the LCMD group only, by 1.8 mg/dl.

In 2014, an 8.1‑year fol­low-up of the orig­i­nal study was pub­lished in Diabetes Care to assess the long-term effects of the dietary inter­ven­tions on pri­mary and sec­ondary out­comes.

After the 8.1‑year fol­low-up, there was a 2‑year dif­fer­ence for the aver­age time period par­tic­i­pants required med­ica­tion (LCMD 8.1 years, LF 6.1 years). Remission was obtained and sus­tained at a sig­nif­i­cantly higher rate in the LCMD group.

Overall the LCMD proved best for achiev­ing a com­plete remis­sion in type 2 dia­betes, with 9.7 per­cent expe­ri­enc­ing at least a 3‑year remis­sion com­pared to only 2 per­cent in the LF group, a 5.7 per­cent remis­sion for 4 years com­pared to zero per­cent in the LF group, and a 2.9 per­cent remis­sion for 5 years com­pared to zero per­cent in the LF group.

After con­duct­ing the 8.1‑year fol­low-up study, the authors con­cluded that:

“In patients with newly diag­nosed type 2 dia­betes, an LCMD resulted in a greater reduc­tion of HbA1c lev­els, a higher rate of dia­betes remis­sion, and delayed need for dia­betes med­ica­tion com­pared with a low-fat diet.”

Further to this, Esposito and Colleagues pub­lished a detailed sys­tem­atic review of all meta-analy­sis and ran­dom­ized tri­als that com­pared a Mediterranean diet with a con­trol diet on the treat­ment of type 2 dia­betes. Published in the British Medical Journal, 2015, the study eval­u­ated 2,824, con­clud­ing that:

“The Mediterranean diet was asso­ci­ated with bet­ter glycemic con­trol and car­dio­vas­cu­lar risk fac­tors than con­trol diets, includ­ing a lower fat diet, sug­gest­ing that it is suit­able for the over­all man­age­ment of type 2 dia­betes.”

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