Telemedicine and low-carb diet slashes diabetes meds and drives lasting remission

A groundbreaking five-year study has shown that a low-carbohydrate diet, combined with continuous remote care, can help people with type 2 diabetes (T2D) achieve long-term remission and significantly reduce their reliance on medication.

The study, published in Diabetes Research and Clinical Practice, evaluated a telemedicine intervention that helped participants follow a very low-carbohydrate diet to reach nutritional ketosis. Over the five years, participants experienced notable health improvements, including weight loss, better cardiometabolic health, and reduced inflammation, all while significantly decreasing their use of diabetes medications.

Key Findings

The intervention demonstrated high retention rates and substantial health benefits over the five-year period:

• Cardiovascular improvements: A 17.4% increase in HDL cholesterol (“good” cholesterol) and an 18.4% decrease in triglycerides contributed to improved heart health.
• Inflammation reduction: Markers like high-sensitivity C-reactive protein (hs-CRP) dropped by 43.6%, reducing inflammation-related health risks.
• Diabetes remission: After five years, 20% of participants achieved remission, with 32.5% maintaining glycated hemoglobin (HbA1c) levels below 6.5% without medications or only using metformin.
• Weight management: Over 61% of participants lost at least 5% of their body weight, and nearly 40% maintained a 10% weight loss over five years.

Background

Type 2 diabetes has traditionally been seen as a progressive, chronic condition. However, this study provides evidence that specific interventions, such as nutritional ketosis, can reverse diabetes, leading to remission and a reduction in glucose-lowering medications. Among those who achieved remission at two years, 57.6% remained in remission at the five-year mark.

Remote Care Model

The intervention was delivered entirely online through an app, offering participants nutrition counseling and medication management without in-person visits. The app helped participants adhere to a restricted carbohydrate diet (less than 30 grams daily), track weight and blood sugar levels, and access a peer support community. The remote care model proved effective in managing diabetes while minimizing the need for frequent medical appointments.

Reduced Medication Use

One of the most striking findings was the reduction in medication use. Over 46% of medication changes were complete eliminations, and nearly 60% when excluding metformin. The study showed a significant decrease in the need for glucose-lowering drugs, with the use of diabetes medications dropping from 85.2% to 71.3%.

Conclusions

This five-year study highlights the effectiveness of a carbohydrate-restricted diet paired with continuous remote care in achieving sustained diabetes remission and reducing medication use. The long-term improvements in blood sugar levels, weight management, and cardiovascular health suggest that this approach could offer a powerful alternative for managing type 2 diabetes. Additionally, the flexibility of remote care and peer support was key to maintaining high retention and long-term success.