The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog ran from 2006 to 2016 and was intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Low-carbohydrate, ketogenic diet in diabetes

     Does a low carbohydrate, keotgenic diet result in improved diabetes control in overweight people with type 2 diabetes mellitus?

    Researchers from Duke University Medical Center in Durham, North Carolina compared a low-carbohydrate, ketogenic diet to a low-glycemic, reduced-calorie diet.

    First, the details.

    • 84 obese people with type 2 diabetes were randomly assigned to a diet for 24 weeks.
      • A low-carbohydrate, ketogenic diet (less than 20 grams of carbs daily)
      • A low-glycemic, reduced-calorie diet (500 kcal/day less than needed for weight maintenance).
    • Both groups participated in group meetings and received nutritional supplementation and exercise recommendations.
    • The main outcome was blood sugar control, measured by hemoglobin A1c.
      • The A1c test shows the average amount of sugar in the blood over the last 3 months.
      • Ketogenic diets are high fat, adequate protein, and low in carbohydrates.

    And, the results.

    • Both treatments improvemed A1c, fasting blood sugar levels, fasting insulin, and weight loss.
    • The low-carb ketogenic diet group had significantly greater improvements in A1c, body weight, and HDL (good) cholesterol vs the low glycemic diet.
    • Diabetes medications were reduced or eliminated in 95% of low-carb group vs. 62% with the low glycemic diet.

    The bottom line?
    Both diets led to better diabetes control, less need for anti-diabetic drugs, and weight loss over 24 weeks. However, the low-carb, ketogenic diet was most effective.

    The greater effect of the low-carb ketogenic diet appeared to be due to the lower carbohydrate intake,” concluded the authors, “because statistical significance remained after adjustment for weight loss.

    Long-term compliance is a problem with any diet. This is particularly true with the ketogenic diet. In 1 study, only 50% of children receiving the ketogenic diet remained on the diet after 1 year.

    Similarly, in this study, 45% of those on the low-carb, ketogenic diet dropped out compared to 37% in the low-glycemic, reduced-calorie diet group.

    With so many lifestyle changes required of people with diabetes, are the added benefits of a low-carb ketogenic diet — which are considerable — worth the effort? And at what point in treatment should patients be introduced to it?

    1/7/09 20:42 JR

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