Study Shows Ketogenic Diet May Reverse Type 2 Diabetes

If you’ve ever read about health on the internet, you’ve probably seen stories and ads claiming to reverse diabetes. Maybe you saw the article about juicing bitter gourds, or the one that suggests boiling cinnamon powder in water. And isn’t there one out there that suggests rubbing your pancreas with aloe vera twice a day? Maybe you’ve tried one of the above, but hopefully every time you’ve seen the words reverse diabetes, you quickly closed your browser’s tab. However, while there is definitely no way to reverse type 1 diabetes yet, a new study suggests type 2 diabetes really can be reversed (but not by pancreatic massage). Recently, a trial conducted by Stephen Phinney and Jeff Volek, of The Art and Science of Low Carb, showed the positive effects of a low-carbohydrate diet. Phinney and Volek have been low-carb advocates for some time, and you can see their other research here. This particular trial provides evidence that a low-carb diet can improve blood sugar levels and facilitate weight loss in adults with type 2 diabetes. In almost 60% of participants, medication was decreased or stopped altogether.

The study, conducted in Indiana in partnership with Indiana University Health, and published in the Journal of Medical Internet Research publications, looked at 262 people with type 2 diabetes who were also overweight. Each participant restricted their carbohydrate intake to 30 grams or less per day, and they increased fat and protein intake. This practice induces what is known as “nutritional ketosis” and is considered a ketogenic diet, forcing the body to burn fat for energy rather than carbohydrates.

According to Diabetes.co.uk, “Previous studies have shown that such ketogenic diets can improve insulin sensitivity and bring many other benefits. However, most studies done to date using them involved much smaller groups of people and often excluded those on insulin.”

Patients taking part in the low-carb trial were provided with “intensive nutrition and behavioral counseling, digital coaching and education platform, and physician-guided medication management,” according to the study.

The study lasted for ten weeks and participants changed their diets, but did not make any other changes to their lifestyle such as increasing physical activity. By the end of the study, the results noted that “HbA1c level was reduced by 1.0%, and the percentage of individuals with an HbA1c level of <6.5% increased to 56.1% [147 out of the 262].”

Almost 90% of the participants were taking at least one diabetes medication at the start of the trial. By the end of the trial 56.8% had reduced one or more diabetes medications or eliminated one altogether.

“In terms of weight loss,” Diabetes.co.uk reported “participants lost about 7.2 per cent of body mass. There were no reports of severe hypoglycemia during the time the study lasted for.”

The study was funded by Virta Health Corp, an “online specialty medical clinic that reverses diabetes without medications or surgery,” says their website. According to Virta, while most people with diabetes see their doctor every 6-12 months, their platform provides patients with continuous technology-enabled remote care from their physicians, as well as regular assistance from a health coach.                 

The need for a real way to reverse type 2 diabetes is more urgent than ever. According to Dr. Peter Attia, an advisor to – and an investor in – Virta Health, type 2 diabetes “costs Americans more than $300 billion per year: one of every three Medicare dollars is spent on type 2 diabetes, and one of every six healthcare dollars is spent on type 2 diabetes. At the individual level, patients and payers (employers and insurance companies) spend thousands of dollars (often more than $10,000) in annual expenses for medications and procedures with significant side effects, and much higher risk of developing cardiovascular disease, cancer, Alzheimer’s disease, blindness, amputation and kidney disease.”

As Attia explains, the traditional and unsuccessful approach to treating type 2 diabetes—which is clearly not working—is to “manage” this chronic condition with medications and the ever-ubiquitous “eat-less-avoid-fat-exercise-more” lifestyle interventions. At best, this approach only slows down the progression of the disease. Furthermore, many diabetes drugs have their own side effects and diabetes management has a dismal “reversal” rate of about 1%. To date, the only clinically proven practice that has been shown to reverse T2D has been bariatric surgery, which is costly and not without risk.

For many years, The American Diabetes Association recommended 45-60 grams of carbohydrate per meal for people with diabetes, but low-carbohydrate diets have become increasingly popular for people with both type 1 and type 2 diabetes.

Interestingly, in 2003, “the Diabetes UK nutritional guidelines for diabetes acknowledged that consuming over 50% of calories from carbohydrate wasn’t suitable for everyone and in 2011, the recommendations were further revised to state that there isn’t an ideal proportion of carbohydrate for optimal blood glucose control,” the Diabetes UK website says. The American Diabetes Association’s 2017 Standards of Medical Care seems to focus primarily on medication, caloric restriction and physical activity as means of preventing and treating type 2 diabetes. The Association still recommends whole grains and fruit as part of a healthy diet, and medical professionals generally still encourage a relatively high percentage of carbohydrates in people’s diets.

Phinney and Volek’s study may be the start of further examination into the positive impact of low-carb, high fat diets for people with diabetes. Perhaps the tide is turning and in the near future, we will see another change in medical advice from practitioners regarding diet for people with diabetes. Rather than recommending ample carbohydrates and avoiding fat, doctors may start prescribing a “reversal diet” to people diagnosed with type 2 diabetes.

Elizabeth Pfiester

Elizabeth Pfiester has lived with Type 1 diabetes for over 20 years. Early on, she found her passions of education and humanitarian work, which took her to the London, where she received a Master’s degree in International Development and Humanitarian Emergencies at the London School of Economics and Political Science. Elizabeth started www.t1international.com last year to create a space to easily navigate global diabetes resources, organizations, and existing literature about care, policy, and treatment in places where Type 1 diabetics are often forgotten. Since its inception, she has been conducting interviews and writing articles; she now has readers from over 80 countries.