For people with type 2 diabetes (T2DM), losing excess weight can lead to lower blood glucose, triglyceride and cholesterol levels along with reduced blood pressure. Of the many low-carbohydrate diets, the Atkins Diet is among the most restrictive -- allowing only 20 grams of carbs per day in the first of its 4 phases, or 40 grams if you have less than 40 pounds to lose. Other daily calories come from fat and protein. Very-low-carbohydrate diets like Atkins trigger a metabolic state called ketosis, in which the body burns fat for energy instead of blood sugar, or glucose. Understanding the possible benefits and drawbacks of the Atkins Diet is important, especially if you have T2DM.
People with diabetes do lose weight with the Atkins Diet, but keeping the weight off in the long run is less certain. A study involving of 34 overweight or obese adults with T2DM or prediabetes published in the June 2014 in "PLoS One" showed that people on a very-low-carbohydrate diet similar to Atkins lost 5.5 percent of body weight in 3 months. These results were consistent with a prior 6-month study of 49 obese adults with T2DM published in the June 2008 "Nutrition and Metabolism," which was funded by the Robert C. Atkins Foundation. However, a November 2014 "Circulation: Cardiovascular Quality and Outcomes" review of 12 studies involving long-term weight loss with low-carb diets reported that much of the weight lost in the first 6 months on the Atkins Diet was regained at 1 year.
Blood Glucose Levels
The Atkins Diet has been consistently shown to lower blood glucose levels people with T2DM. This may be because weight loss itself leads to lower blood glucose levels. The virtual elimination of foods that would contribute to blood glucose due to the strict limitation of carbohydrates would also lower levels. In the "PLoS One" study, 44 percent of the study participants following an Atkins-like nutrition plan were able to stop taking one or more diabetes medications, compared to 11 percent of those following a medium-carbohydrate, calorie-restricted diet, as recommended by the American Diabetes Association (ADA). In the "Nutrition and Metabolism" study, people following an Atkins-like diet had greater reductions in blood glucose, compared to those on a low-glycemic-index, reduced-calorie diet. In addition, 95 percent of participants on the very-low-carbohydrate diet were able to stop taking diabetes medications, compared to 62 percent of those on the low-glycemic-index, reduced-calorie diet.
The high percentage of calories from fat on the Atkins Diet raises concerns that it could heighten cardiovascular disease risk, which is already increased in people with diabetes. However, the "PLoS One" study found that while the percentage of daily calories from fat increased due to the carbohydrate restriction among those on an Atkins-like diet, participants' total fat intake did not increase. With no increase in total fat intake, there was no increase in low-density lipoprotein, or "bad" cholesterol, among people on the Atkins-like diet. The "Nutrition and Metabolism" study similarly reported no significant increase in LDL among participants on the Atkins nutrition plan.
While these short-term studies indicate no apparent increased cardiovascular risk among people following an Atkins Diet, long-term studies are lacking. Additionally, a January 2005 "Diabetologia" study of 96 overweight women without diabetes but with insulin resistance -- a precursor to T2DM -- found that LDL rose by more than 10 percent in one-quarter of participants following an Atkins-like diet. The ADA notes that low-carb diets like Atkins may be effective for up to 1 year, but recommends monitoring blood fat levels.
The ADA does not recommend any specific diet and stresses that individualized nutrition plans should suit the individual. For some people with T2DM, the Atkins Diet may be a good weight-loss option. A May 2014 "European Journal of Clinical Nutrition" review article supports this notion, concluding that people with T2DM could benefit significantly from supervised, very-low-carbohydrate diets. However, people with T2DM should consult with their doctor or dietitian before changing their diet. If following the Atkins Diet, it's important to closely monitor both blood glucose and cholesterol levels. Whether following the Atkins Diet or another weight-loss plan, the change in diet and body weight may change your need for medication.