Diabetes Canada Deems Low Carb and Very Low Carb Diet Safe

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Introduction

Diabetes Canada has just released a new Position Statement acknowledging that a low carb and very low carb (keto) diet is both safe and effective for adults with diabetes.

Reflecting back on their 2018 Clinical Practice Guidelines, Diabetes Canada clarified that it was not their intention to restrict the choice of individuals with diabetes to follow dietary patterns with carbohydrate intake below the consensus recommendation of 45-60% energy, nor to discourage health-care practitioners from providing low-carb dietary support to those who want it. Several consistent themes have emerged internationally—specifically that low carbohydrate diets (<130g/day) and very low carbohydrate diets (<50g/day) can be safe and effective for managing weight and lowering HbA1C in people with type 2 diabetes over the short term.

Summary of the Evidence – Type 2 Diabetes

A review of the evidence found that a low carbohydrate diet may be effective for weight loss and improved blood sugar control, including a reduction in the need for anti-hyperglycemic therapies. Diabetes Canada notes that while other dietary approaches may be effective for weight loss, they have not achieved this while also reducing the need for medication—a “meaningful outcome.” Furthermore, very low-carbohydrate diets may be superior to higher carbohydrate diets for improving blood sugar control and body weight in the short term (up to 12 months).

Summary of the Evidence – Type 1 Diabetes

For those living with type 1 diabetes, significant improvements such as lower HbA1C, reduced insulin requirements, and less blood sugar variability have been reported by individuals following these patterns. In the absence of clear generalized trial evidence, Diabetes Canada concludes that health-care providers should work as partners with patients, recognizing that diverse approaches are required to address the complex challenges of diabetes and obesity.

Cautions and Safety

Diabetes Canada advises that insulin and/or sulphonylurea doses may need to be reduced or discontinued to avoid hypoglycemia. They also warn that SGLT2 inhibitors may increase the risk of diabetic ketoacidosis in individuals following low-carbohydrate diets, necessitating careful clinical monitoring.

Diabetes Canada’s Five Recommendations

  1. Support healthy eating patterns consistent with individual values and goals.
  2. Consider healthy low-carb or very-low-carb diets as a pattern for weight loss and improved blood sugar control.
  3. Support patients by adjusting medications and ensuring adequate intake of fibre and nutrients.
  4. Educate patients on the risk of diabetic ketoacidosis while using SGLT2 inhibitors.
  5. Seek support from a Registered Dietitian who can help create an enjoyable and sustainable plan.

Final Thoughts

As a Dietitian who has been helping individuals safely follow these patterns for several years, I am delighted that Diabetes Canada shares the consensus of other international groups. These diets are safe and effective tools for achieving much better blood sugar control and weight loss.

More Info?

If you would like more information about how I can help you get started on a low-carbohydrate or very low-carbohydrate diet, you can learn about me and the Comprehensive Dietary Package that I offer.

To your good health!

Joy

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References

  1. Diabetes Canada. Diabetes Canada Position Statement on Low Carbohydrate Diets for Adults with Diabetes: A Rapid Review. Canadian Journal of Diabetes. 2020 Jun;44(4):295-299. [https://doi.org/10.1016/j.jcjd.2020.04.001]
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