I received this Q&A response from Diabetes UK today in relation to the SACN report which you may find helpful:
Douglas Twenefour, Deputy Head of Care at Diabetes UK, said:
“The role of carbohydrate foods in someone's diet – and in particular, the effect low carb diets can have in diabetes – has been debated over recent years.
“This new report gives a clear and objective review of current evidence on lower carb diets in adults with type 2 diabetes and, more importantly, how they could be used in practice. And currently, the evidence shows that these diets areeffective for people with type 2 diabetes in the short term, but no more effective than other diets longer term.
“The best advice for anyone looking to make lifestyle changes is to find a diet that works best for them and that they can stick to, and to approach any change in a safe and sustainable way.
“It is important that people considering a lower carb option do so with the support of their healthcare team, so that any impact on diabetes management or medications can be closely monitored.”
1. What is this report about?
This is the final report from the government’s Scientific Advisory Committee on Nutrition (SACN). The group reviewed the evidence for lower carb diets compared to current UK government advice for adults with type 2 diabetes.
The report does not apply to people with type 1 or any other type of diabetes, children or people without diabetes.
2. Who else was involved in the work
SACN’s remit is to provide advice to the UK governments on the UK general population based on its assessment of the scientific evidence. Since the Committee does not usually make recommendations relating to specific health conditionssuch as diabetes, a joint working group (WG) was put together for this work.
The joint working group included experts from SACN, Diabetes UK, the British Association of Dietitians (BDA), the Royal College of GPs (RCGP), the Association of British Clinical Diabetologists (ABCD) and the Royal College of Physicians. The group also included an adult with type 2 diabetes (nominated by Diabetes UK). NHS England, NICE, Department of Health and Social Care and government representatives from Northern Ireland, Scotland and Wales were also invited as observers.
3. What was Diabetes UK’s role in putting the report together?
Diabetes UK nominated two experts Douglas Twenefour, Deputy Head of Care at Diabetes UK and Prof Nita Forouhi to the working group. We also nominated a patient representative. Dougie co-chaired the working group.
4. What are the key findings from the report?
The key findings were:
• Overall, the evidence suggests beneficial effects of lower carb diets for HbA1c, fasting blood glucose and triglycerides in the shorter term (i.e. less than 12months) but these are unclear in the longer term (more than 12 months).
• No differences were observed between higher and lower carb diets on total cholesterol, LDL cholesterol and HDL cholesterol either in the shorter term or longer term.
• No differences were observed between higher and lower carbohydrate diets on body weight in the longer term
• Lower carb diets led to reduction in diabetes medications.
5. What is Diabetes UK’s position on low carb?
Diabetes UK’s current position is that low-carb diets are an option for some people with type 2 diabetes. It can be safe and effective in the short term in managing weight, and can also help people with type 2 in managing their blood sugar levels, as well as reducing their risk of heart disease and stroke.
But as there’s no consistent evidence to say that a low-carb diet is better than other diets in the long term, we can’t recommend it as the only approach for everyone with diabetes. We would therefore encourage people to find a healthy diet that works best for them and can be sustained in the long term.
6. What is different in the report compared to Diabetes UK’s position on low carb diets?
In broad terms, the findings of this report are similar to Diabetes UK’s current position which is that low carb diets seem to be more effective in the short term but not in the longer term when compared to higher carb diets.
• The SACN report focused purely on adults with type 2diabetes. Our position statement includes some evidence on low carb diets for people with type 1 diabetes: ourconclusion is that although there is some published information and reported cases of people with type 1 benefiting from low carb diets, the evidence is limited so we cannot recommend it.
• children - our conclusion is that low carb diets should not be recommended to children because there is some evidence that it can negatively affect their growth
7. Does the publication of the report mean Diabetes UK’s position needs changing?
Diabetes UK will make a decision on our position based on the final report including the recommendations.
8. What does this mean to people who want to follow a low carb diet?
For people with type 2 diabetes, we are still saying low carb diets are an option, and we encourage people to speak to their healthcare team so that they can receive the support they need to follow this diet safely and effectively. This support may include reviewing their medications and checking their blood glucose levels more regularly.
As there is a lack of strong evidence on safety and effectiveness regarding low carb diets for adults with type 1 diabetes, we cannot recommend it. However, we know that some people with type 1 have benefited from following a low carb diet. We would want healthcare professionals to support those who still want to follow this diet by referring them to a dietitian and helping them manage their insulin to minimise the risk of hypos.
9. What info do we have on low carb diets?
We have meal plans to help people follow a low carb diet
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/meal-plans-/low-carb
Our position statement is found here
https://www.diabetes.org.uk/resources-s3/2017-09/low-carb-diets-position-statement-May-2017.pdf
Our dietary advice explained
https://www.diabetes.org.uk/guide-t...ietary-advice-explained/your-queries-answered
