LCHF & Type 2 Diabetes
So what is my argument for LCHF in the setting of diabetes?
The case for LCHF in diabetes given by the opponents of LCHF, is that it is not significant or sustainable.
I would maintain that LCHF is a good strategy for improving or reversing diabetes and as a result, & those in which it is sustained, there may be both medical and financial benefit.
With this in mind, I continue to pursue the approach of LCHF in patients with diabetes, with the objective that any improvement is a good one.
I do not believe that randomised double-blind controlled trials are required to prove whether or not LCHF works in diabetes. If there is an improvement and it is sustainable then some improvement is better than none.
In addition, it may be possible to prevent escalation of treatment for a long time, if not indefinitely.
It is very clear to me that subject selection is critical to success of LCHF in diabetes. This is also true for any other patients & LCHF intervention.
There are those that will do well and there are those that will not do well. If motivated and finding the process relatively straightforward, patients do well. If patients have too many commitments or just find it all too difficult then they do not succeed.
I cannot see any harm in trying to improve things for many patients and do not regard the LCHF advice to be in any way harmful. Of course it is necessary to monitor patients in terms of lipid profile and diabetes control and at no time will safety be compromised.
What I have seen in the motivated patients is a fall in HbA1c, at times to within the normal range, with the ability to reduce and/or stop all diabetes medication. In the absence of end-organ damage as evidenced by photomonitoring, ACR or evidence of ischaemic or cerebrovascular disease, the patient can be returned non-diabetic status for as long as their HbA1c remains normal.
I wish to emphasise the fact that any improvement, if readily achievable must be a positive factor for patients.