"Let food be thy medicine and medicine be thy food"
-Hippocrates
Diabetes has been called "carbohydrate intolerance," meaning that people who suffer from diabetes have difficulty properly processing carbohydrates. This idea is gradually being validated by a growing body of research demonstrating the beneficial effects of a low-carb diet.
There is still a lot more research to be done, but there is currently a substantial amount of data with irrefutable evidence indicating that people who follow a low-carb diet have a good chance of putting diabetes into remission.
Carbohydrates are the primary substrate that is converted to sugar, which then enters the bloodstream. Eating fewer carbohydrates automatically means that there is less sugar being produced, and thus less need for insulin. This means that both type 1 and type 2 diabetes can potentially benefit from reducing carbohydrate intake.
A 2021 study found that people with type 2 diabetes who followed a very low-carb diet (defined as less than 50g of carbs per day) saw significant improvement in their blood sugar levels and, in some cases, were able to maintain normal blood sugar levels without medications.
In addition to blood sugar control achieved with a low-carb diet, there are also metabolic and cardiovascular benefits, which we will discuss at another time.
Another therapeutic method for managing diabetes is intermittent fasting. It is not exactly a diet but rather involves skipping certain meal times. Fasting gives your body a break from processing food and allows it to manage insulin levels more effectively. During periods of fasting, insulin levels drop, and the body starts to use stored fat to produce energy.
A 2019 study in Cell Metabolism showed that people with prediabetes or type 2 diabetes who followed a time-restricted eating window (typically 8–10 hours) experienced improved insulin sensitivity and lower blood sugar levels. In another review, intermittent fasting was found effective in lowering HbA1c levels in people with type 2 diabetes.
Plant-based diets emphasize foods rich in fiber, which slow digestion and keep blood sugar stable over extended periods, thereby improving insulin sensitivity. Many people have also successfully reversed type 2 diabetes on a plant-based diet.
For many people, the answer is YES. While there is no guaranteed cure, the right diet can reduce the impact of diabetes to the point where blood sugar levels can be controlled without medication.
One of the largest studies on diabetes remission is the DIRECT study, conducted in 2018, which demonstrated that a very low-calorie diet could help people achieve remission within a year. It was a resounding success and is now the basis for the Diabetes Remission Programme in the National Health Service of the UK.
It must be acknowledged that following a diet can be restrictive, and most people are reluctant to make this change. Many people report losing weight and achieving blood sugar control on a diet but then returning to previous habits when they are unable to sustain it.
Therefore, it’s important to consider the sustainability of any diet you choose. While managing blood sugar is essential, you want to make lifestyle choices that you can maintain over the long term.
If you have diabetes, you should be properly monitored and cared for by your primary care provider. Do not begin a diet without the supervision of a healthcare professional. The best way to engage with dietary changes is by regularly monitoring your blood sugar. Some medications may not interact well with certain diets and can expose you to potentially dangerous side effects.
Your health is your responsibility. Learning how to use diet to regulate your blood sugar could be one of the most important steps you take to avoid complications from diabetes. Finally, remember: "Let food be thy medicine and medicine be thy food."
