Carbohydrate restriction for diabetes: rediscovering centuries-old wisdom

Reduced-carbohydrate diets have been used to treat diabetes for more than a century. After the discovery of insulin, high-carbohydrate diets became the mainstay of MNT for diabetes, not because of demonstrated superiority for long-term outcomes, but because insulin could ameliorate the acute metabolic effects of carbohydrate consumption. With new understanding of the importance of controlling postprandial hyperglycemia, mitigating glycemic variability, and ameliorating metabolic syndrome, carbohydrate restriction has gained renewed attention. Preliminary research suggests that this dietary approach might transform clinical management and perhaps normalize HbA1c for many people with diabetes, at substantially reduced treatment costs.