Low-carb diet within a year of diagnosis offers 'window' for diabetes remission, GP study shows

There is a 12-month  ‘window of opportunity’ for remission from diabetes following diagnosis though adopting a low carbohydrate diet, a study in general practice has suggested.

Analysis of data from a GP practice in Southport found that half of the 186 patients who chose to manage their type 2 diabetes through a low carbohydrate diet achieved remission, leading to prescribing savings of £68,353 a year on diabetes drugs by 2022 compared with neighbouring practices.

NHS figures from last summer show that diabetes drugs make up 13% of prescriptions spending in England, at a cost of £1.25bn.

In the practice, which routinely offered carbohydrate diet and weight loss advice for type 2 diabetes, 39% of patients were willing to try the approach.

In those who had diabetes for less than a year, 77% achieved remission, the practice reported from records between 2013 and 2021.

For patients who had the condition for more than 15 years, remission was 20%, the team from the Norwood Surgery in Southport reported in BMJ Nutrition, Prevention and Health.

Over an average of 33 months, there was a mean weight loss of 10kg and median HbA1c fell from 63mmol/mol to 46, the audit showed.

The level of support provided by the practice depended on the patient they said but averaged at three consultations a year as well as optional group sessions held every six weeks.

Patients were also given educational resources including a diet sheet and computer-generated graphs of metrics such as weight and HbA1c were provided so patients could see their progress.

Dr David Unwin, GP and lead researcher who has also written the RCGP e-learning module on type 2 diabetes and the glycaemic index, said those newly diagnosed would need three or four appointments a year – maybe less for those with pre-diabetes – and group meetings had made offering support more affordable for the practice.

The team concluded: ‘The remission rate drops after that first year, suggesting that those leaving it longer are missing an important window of opportunity’ and added that practices should focus on metabolic age (duration of diabetes) rather than chronological age of patients who might particularly benefit.

A version of this article was initially published by our sister publications Pulse and Nursing in Practice.