Next Article in Journal
Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective
Next Article in Special Issue
Type 2 Diabetes Mellitus in Class II and III Obesity: Prevalence, Associated Factors, and Correlation between Glycemic Parameters and Body Mass Index
Previous Article in Journal
Evaluation of an Alimentary Education Intervention on School Canteen Waste at a Primary School in Bari, Italy
Previous Article in Special Issue
Effects of Nigella Sativa on Type-2 Diabetes Mellitus: A Systematic Review
Review

Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice

1
HRB Clinical Research Facility, National University of Ireland, H91YR71 Galway, Ireland
2
The Norwood Surgery, Southport PR9 7EG, UK
3
Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, H91YR71 Galway, Ireland
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(7), 2557; https://doi.org/10.3390/ijerph17072557
Received: 2 March 2020 / Revised: 6 April 2020 / Accepted: 7 April 2020 / Published: 8 April 2020
(This article belongs to the Special Issue Research into Obesity and Diabetes Prevention and Effectiveness)
Low-carbohydrate diets are increasingly used to help patients with obesity and type 2 diabetes. We sought to provide an overview of the evidence for this treatment approach, considering the epidemiology and pathophysiology of obesity and diabetes in terms of carbohydrate excess. We describe the mechanistic basis for the clinical benefits associated with nutritional ketosis and identify areas of practice where the evidence base could be improved. We summarize the key principles which inform our approach to treating patients with low-carbohydrate diets. The scientific controversy relating to these diets is real but is consistent with the known challenges of any dietary interventions and also the limitations of nutritional epidemiology. Secondly, notwithstanding any controversy, international guidelines now recognize the validity and endorse the use of these diets as a therapeutic nutritional approach, in appropriate patients. Thirdly, we have found that early de-prescription of diabetes medications is essential, in particular insulin, sulphonylureas, and sodium-glucose cotransporter (SGLT2) inhibitors. Fourthly, we encourage patients to eat ad libitum to satiety, rather than calorie counting per se. Furthermore, we monitor cardiovascular risk factors frequently, as with all patients with obesity or diabetes, but we do not necessarily consider an increase in low-density lipoprotein (LDL)-cholesterol as an absolute indication to stop these diets, as this is usually related to large LDL particles, which are not associated with increased cardiovascular risk. In the absence of large randomized controlled trials with cardiovascular and other hard endpoints, adopting a low-carbohydrate diet is a legitimate and potentially effective treatment option for patients with diabetes or obesity. View Full-Text
Keywords: low-carbohydrate diets; diabetes remission; lifestyle modification; obesity treatment; type 2 diabetes low-carbohydrate diets; diabetes remission; lifestyle modification; obesity treatment; type 2 diabetes
Show Figures

Figure 1

MDPI and ACS Style

Kelly, T.; Unwin, D.; Finucane, F. Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice. Int. J. Environ. Res. Public Health 2020, 17, 2557. https://doi.org/10.3390/ijerph17072557

AMA Style

Kelly T, Unwin D, Finucane F. Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice. International Journal of Environmental Research and Public Health. 2020; 17(7):2557. https://doi.org/10.3390/ijerph17072557

Chicago/Turabian Style

Kelly, Tara, David Unwin, and Francis Finucane. 2020. "Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes: A Review from Clinicians Using the Approach in Practice" International Journal of Environmental Research and Public Health 17, no. 7: 2557. https://doi.org/10.3390/ijerph17072557

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop