This 2014 pilot study examined whether a low-carbohydrate diet could improve metabolic health in a general practice setting. Nineteen patients with type 2 diabetes or pre-diabetes were advised to eliminate sugar and sharply reduce foods such as bread, pasta, rice, and potatoes while eating protein, vegetables, and fats according to hunger rather than deliberately restricting calories.

Eighteen of the 19 patients completed the eight-month intervention, and all 18 lost weight. Average HbA1c fell from 51 to 40 mmol/mol, with 16 of 18 participants returning to normal blood glucose control by the end of the study. Blood pressure, waist circumference, liver enzymes, and cholesterol also improved significantly, and several patients were able to discontinue medications entirely. Many participants also reported reduced hunger and improved energy levels.

The study was small and lacked a control group, but provides real-world evidence that carbohydrate restriction—without intentional calorie restriction—can be a practical and effective tool for improving glycemic control and reversing markers of metabolic disease.

https://wchh.onlinelibrary.wiley.com/doi/10.1002/pdi.1835