Research Papers

Diabetes prevalence

Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., Colagiuri, S., Guariguata, L., Motala, A.A., Ogurtsova, K. and Shaw, J.E., 2019

Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice, 157, p.107843.

Health New Zealand. Te Whatu Ora (n.d.).

Virtual Diabetes Register (2024) Retrieved May 19, 2024

Zimmet, P.Z., 2017

Diabetes and its drivers: the largest epidemic in human history? Clinical diabetes and endocrinology, 3, pp.1-8.

General practice / Clinical audits - Effectiveness

Cupit, C. and Redman, E., 2021

Supporting people to implement a reduced carbohydrate diet: a qualitative study in family practice. BMJ Nutrition, Prevention & Health, 4(1), p.226.

Firman, C.H., Mellor, D.D., Unwin, D. et al

Does a Ketogenic Diet Have a Place Within Diabetes Clinical Practice? Review of Current Evidence and Controversies. Diabetes Ther 15, 77–97 (2024).

Glandt, M., Ailon, N. Y., Berger, S., & Unwin, D. (2024)

Use of a very low carbohydrate diet for prediabetes and type 2 diabetes: An audit. Journal of Metabolic Health, 1(1).

Hawkins, M.A., Zinn, C. and Delon, C., 2023

The application of carbohydrate-reduction in general practice: A medical audit. Journal of Metabolic Health, 6(1), p.11.

Iwasaki K. Low carbohydrate diet rescued severe type 2 diabetes patient from insulin injection, a case report

J Family Med Prim Care. 2021 Jan;10(1):550- 551. doi: 10.4103/jfmpc.jfmpc_1798_20. Epub 2021 Jan 30. PMID: 34017786; PMCID: PMC8132770.

Kelly T, Unwin D, Finucane F. Low-Carbohydrate Diets in the Management of Obesity and Type 2 Diabetes

A Review from Clinicians Using the Approach in Practice. International Journal of Environmental Research and Public Health. 2020;17(7):2557. doi:10.3390/ijerph17072557

Mark Cucuzzella, Adele Hite, Kaitlyn Patterson, Laura Saslow & Rory Heath

A clinician’s guide to inpatient lowcarbohydrate diets for remission of type 2 diabetes: toward a standard of care protocol

Unwin, D., Delon, C., Unwin, J., Tobin, S. and Taylor, R., 2023

What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss. BMJ Nutrition, Prevention & Health, 6(1), p.46.

Unwin, D., Khalid, A.A., Unwin, J., Crocombe, D., Delon, C., Martyn, K., Golubic, R. and Ray, S., 2020

Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: a secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years. BMJ nutrition, prevention & health, 3(2), p.285.

Clinical controlled trials

Amy L. McKenziea, Shaminie J. Athinarayananb, Michelle R. Van Tieghem, Brittanie M. Volk, Caroline G.P. Roberts, Rebecca N. Adams, Jeff S. Volek, Stephen D. Phinney, Sarah J. Hallberg; 2024:

5-Year effects of a novel continuous remote care model with carbohydrate-restricted nutrition therapy including nutritional ketosis in type 2 diabetes: An extension study

Athinarayanan, S.J., Vantieghem, M., McKenzie, A.L., Hallberg, S., Roberts, C.G., Volk, B.M., Adams, R.N., Ratner, R.E., Volek, J. and Phinney, S., 2022.

832-P: Five-Year weight and glycemic outcomes following a very-low-carbohydrate intervention including nutritional ketosis in patients with type 2 diabetes. Diabetes, 71(Supplement_1).

Hallberg, S.J., McKenzie, A.L., Williams, P.T., Bhanpuri, N.H., Peters, A.L., Campbell, W.W., Hazbun, T.L., Volk, B.M., McCarter, J.P., Phinney, S.D. and Volek, J.S., 2018.

Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study. Diabetes Therapy, 9(2), pp.583-612.

Han, Y. et al. (2021) ‘A Low-Carbohydrate Diet Realizes Medication Withdrawal:

A Possible Opportunity for Effective Glycemic Control’, Frontiers in Endocrinology, 12. doi:10.3389/fendo.2021.779636.

Moriconi E, Camajani E, Fabbri A, Lenzi A, Caprio M. Very-Low-Calorie Ketogenic Diet as a Safe and Valuable Tool for Long-Term Glycemic

Management in Patients with Obesity and Type 2 Diabetes. Nutrients. 2021;13(3):758. doi:10.3390/nu13030758

Karkee A, Singh S, Shrestha PK, Shakya NS, Shrestha S, Niroula S. Effect of Dietary Intervention Using Low-Carbohydrate Diet to Manage Newly Diagnosed

Type 2 Diabetes Mellitus in TUTH Hospital, Nepal. Nepalese Medical Journal. 2021;4(1):419-423. doi:10.3126/nmj.v4i1.34710

Ahmed SR, Bellamkonda S, Zilbermint M, Wang J, Kalyani RR.

Effects of the low carbohydrate, high fat diet on glycemic control and body weight in patients with type 2 diabetes: experience from a community-based cohort. BMJ Open Diabetes Res Care. 2020;8(1). doi:10.1136/bmjdrc-2019-000980

Chen C-Y, Huang W-S, Chen H-C, et al.

Effect of a 90 g/day low-carbohydrate diet on glycaemic control, small, dense low-density lipoprotein and carotid intima-media thickness in type 2 diabetic patients: An 18-month randomised controlled trial. PLOS ONE. 2020;15(10):e0240158. doi:10.1371/journal.pone.0240158

Laza-Cagigas R, Chan S, Sumner D, Rampal T.

Effects and feasibility of a prehabilitation programme incorporating a low-carbohydrate, high-fat dietary approach in patients with type 2 diabetes: A retrospective study. Diabetes Metab Syndr. 2020;14(3):257-263. doi:10.1016/j.dsx.2020.03.010

McKenzie A, Athinarayanan S, Adams R, Volek J, Phinney S, Hallberg S. SUN-LB113 A

Continuous Remote Care Intervention Utilizing Carbohydrate Restriction Including Nutritional Ketosis Improves Markers of Metabolic Risk and Reduces Diabetes Medication Use in Patients With Type 2 Diabetes Over 3.5 Years. J Endocr Soc. 2020;4(Supplement_1). doi:10.1210/jendso/bvaa046.2302 (5 Year Data https://doi.org/10.2337/db22-832-P )

Thomsen MN, Skytte MJ, Astrup A, et al.

The clinical effects of a carbohydrate-reduced high-protein diet on glycaemic variability in metformin-treated patients with type 2 diabetes mellitus: A randomised controlled study. Clinical Nutrition ESPEN. Published online August 1, 2020. doi:10.1016/j.clnesp.2020.07.002

Athinarayanan SJ, Adams RN, Hallberg SJ, et al.

Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial. Front Endocrinol. 2019;10. doi:10.3389/fendo.2019.00348

Govers E, Otten A, Schuiling B, Bouwman W, Visscher T.

Effectiveness of the 6 × 6 Dieet® in Obese DMT2 Patients Effectiveness of a Very Low Carbohydrate Ketogenic Diet Compared to a Low Carbohydrate and Energy-Restricted Diet in Overweight/Obese Type 2 Diabetes Patients. September 2019. doi:10.16966/2380-548X.158

Romano L, Marchetti M, Gualtieri P, et al.

Effects of a Personalized VLCKD on Body Composition and Resting Energy Expenditure in the Reversal of Diabetes to Prevent Complications. Nutrients. 2019;11(7):1526. doi:10.3390/nu11071526

Taylor PJ, Thompson CH, Luscombe-Marsh ND, Wycherley TP, Wittert G,

Brinkworth GD. Efficacy of Real-Time Continuous Glucose Monitoring to Improve Effects of a Prescriptive Lifestyle Intervention in Type 2 Diabetes: A Pilot Study. Diabetes Ther. 2019;10(2):509-522. doi:10.1007/s13300-019-0572-z

Tay J, Thompson CH, Luscombe-Marsh ND, et al.

Effects of an energy-restricted low-carbohydrate, high unsaturated fat/low saturated fat diet versus a high-carbohydrate, low-fat diet in type 2 diabetes: A 2-year randomized clinical trial. Diabetes Obes Metab. 2018;20(4):858-871. doi:10.1111/dom.13164

Saslow LR, Daubenmier JJ, Moskowitz JT, et al.

Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. Nutr Diabetes. 2017;7(12):304. doi:10.1038/s41387-017-0006-9

Reviews / meta-analyses

Wheatley, S.D., Deakin, T.A., Arjomandkhah, N.C., Hollinrake, P.B. and Reeves, T.E., 2021.

Low carbohydrate dietary approaches for people with type 2 diabetes—a narrative review. Frontiers in Nutrition, 8, p.415

Snorgaard, O., Poulsen, G.M., Andersen, H.K. and Astrup, A., 2017. 

Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes. BMJ Open Diabetes Research and are, 5(1), p.e000354.

Jayedi, A., Zeraattalab-Motlagh, S., Jabbarzadeh, B., Hosseini, Y., Jibril, A. T., Shahinfar, H., Mirrafiei, A., Hosseini, F., & Shab-Bidar, S. (2022).

Dose-dependent beffect of carbohydrate restriction for type 2 diabetes management: A systematic review and dose-response meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition, 116(1), 40–56.

Apekey, T.A. et al. (2022)

‘Comparison of the Effectiveness of Low Carbohydrate Versus Low Fat Diets, in Type 2 Diabetes: Systematic Review and Meta-Analysis of Randomized Controlled Trials’, Nutrients, 14(20), p. 4391.

Li S, Ding L, Xiao X. 

Comparing the Efficacy and Safety of Low-Carbohydrate Diets with Low-Fat Diets for Type 2 Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. International Journal of Endocrinology. 2021;2021:e8521756. doi:10.1155/2021/8521756

Churuangsuk, C. et al. (2021)

‘Diets for weight management in adults with type 2 diabetes: an umbrella review of published meta-analyses and systematic review of trials of diets for diabetes remission’, Diabetologia. doi:10.1007/s00125-021-05577-2

Goldenberg JZ, Day A, Brinkworth GD, et al.

Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data. BMJ. 2021;372:m4743. doi:10.1136/bmj.m4743

Yuan X, Wang J, Yang S, et al.

Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis. Nutrition & Diabetes. 2020;10(1):1-8. doi:10.1038/s41387-020-00142-z

Meng Y, Bai H, Wang S, Li Z, Wang Q, Chen L. 

Efficacy of low carbohydrate diet for type 2 diabetes mellitus management: A systematic review and meta-analysis of randomized controlled trials. Diabetes Research and Clinical Practice. 2017;131:124- 131. doi:10.1016/j.diabres.2017.07.006

Snorgaard O, Poulsen GM, Andersen HK, Astrup A. 

Systematic review and meta- analysis of dietary carbohydrate restriction in patients with type 2 diabetes. BMJ Open Diabetes Res Care. 2017;5(1):e000354. doi:10.1136/bmjdrc-2016-000354

Ajala O, English P, Pinkney J. 

Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr. 2013;97(3):505-516. doi:10.3945/ajcn.112.042457

Feinman RD, Pogozelski WK, Astrup A, et al.

Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base. Nutrition. 2015;31(1):1-13. doi:10.1016/j.nut.2014.06.011

Lipids

Statin Therapy is not warranted for a person with high LDL cholesterol on low carb diet

Purpose of review Although there is an extensive literature on the efficacy of the low carbohydrate diet (LCD) for weight loss and in the management of type 2 diabetes, concerns have been raised that the LCD may increase cardiovascular disease (CVD) risk by increasing the level of low-density lipoprotein cholesterol

Are mental health benefits of the keto diet accompanied by increased risk of cardiovascular disease?

Ketogenic (very low carbohydrate) diets have well-established, as well as potential, benefits in the treatment of neurological disorders.

Saturated Fat is Not the Main Issue

Let’s bust the myth of its role in heart disease

Pork Scratchings Cheese and Kaimoana

A general practitioner’s commentary on low carbohydrate, healthy fat eating

Other Research

Zinn, C., Rush, A. and Johnson, R., 2018.

Assessing the nutrient intake of a low-carbohydrate, high-fat (LCHF) diet: a hypothetical case study design. BMJ open, 8(2), p.e018846

Lenferna De La Motte, K., Campbell, J.L., and Zinn, C., 2024.

Exploring consumption of ultra-processed foods and diet quality in the context of popular low carbohydrate and plant-based dietary approaches. Food Science & Nutrition, 12(10), p.e4496.

Crofts, C., 2024. Beyond Blood Sugar.

Pharmac proposes widening access to medicine used in the treatment of chronic heart failure. WholeNZ, November 2024.