Type 2 diabetes
Type 2 diabetes is a metabolic condition driven primarily by insulin resistance.
Randomised controlled trials and meta-analyses consistently show that therapeutic carbohydrate reduction improves glycaemic control, reduces insulin resistance, lowers HbA1c, and enables medication reduction or remission in many people with type 2 diabetes.
Compared with low-fat or calorie-restricted diets, low- and lower-carbohydrate approaches demonstrate superior outcomes for blood glucose control, triglycerides, and metabolic health markers, particularly over the medium to long term.
Position statement on metabolic health and Type 2 diabetes
The Australasian Metabolic Health Society endorses the 2018 position statement by Diabetes Australia on low-carb eating for people with type 2 diabetes.
Key messages from Diabetes Australia’s position statement
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Key evidence
Systematic review and meta-analysis of randomised controlled trials comparing low-carbohydrate diets with control diets in people with type 2 diabetes.
Goldenberg et al., BMJ (2021; updated analyses 2023)
Low-carbohydrate interventions were associated with greater rates of diabetes remission, improved HbA1c, and reductions in diabetes medications, particularly at 6 months.
Long-term randomised and non-randomised clinical trials of a carbohydrate-restricted, ketogenic intervention in adults with type 2 diabetes
Hallberg et al., Diabetes Therapy (2018, 2019, 2022)
Demonstrated sustained reductions in HbA1c, insulin resistance, body weight, and diabetes medication use over 2 to 5 years.
Systematic review of randomised trials comparing low-carbohydrate and low-fat diets in type 2 diabetes.
Snorgaard et al., BMJ Open (2017)
Low-carbohydrate diets showed greater improvements in glycaemic control and triglycerides, with no adverse effects on cardiovascular risk markers.
Updated systematic review of RCTs examining low-carbohydrate diets in type 2 diabetes.
Korsmo-Haugen et al., Nutrients (2024)
Found consistent improvements in glycaemic control, insulin sensitivity, and cardiometabolic risk factors compared with higher-carbohydrate dietary approaches.