A low-carbohydrate, low-energy dietary intervention in primary care for patients with type 2 diabetes: a randomised feasibility trial.

Type 2 diabetes is a lifelong condition in which a person’s blood sugar levels are too high. It affects 1 in 16 people in the UK, and causes almost 15% of adult deaths worldwide. If it isn’t controlled, it can lead to blindness, kidney failure, and heart disease. We know that what we eat affects our blood sugar levels, and that changing our diets and losing weight can both help to control diabetes. However, it is not clear what the best advice is to help people achieve this goal.

Committed clinicians have shown that, in selected patients, low-carbohydrate, low-energy diets can transform the lives of people with type 2 diabetes, reducing the need for medications, improving quality of life and reducing costs for the NHS. However, we don’t know whether this will work for everyone with diabetes, and whether this diet can be managed without intensive help from specialists.

We aim to investigate whether it is possible for GPs and practice nurses to support people with type 2 diabetes to change their diet. First to reduce their energy intake to around 800 calories per day for 8 weeks (mostly by cutting out carbohydrates, found in foods like cakes and biscuits but also bread, pasta, rice and potatoes), and second to gradually increase their energy intake while still severely restricting the amount of carbohydrate. We will measure how well the advice is delivered and how successful people are in following the programme over a 3 month period. The findings from this early stage testing will help to refine the programme before we progress to a full scale study, to investigate whether this diet can improve blood sugar control more effectively than the standard dietary advice for people with diabetes.