Low-carbohydrate diets for the treatment of obesity and type 2 diabetes

Curr Opin Clin Nutr Metab Care. 2018 Jul;21(4):308-312. doi: 10.1097/MCO.0000000000000470.


Purpose of review: Summarize the physiological effects of low-carbohydrate diets as they relate to weight loss, glycemic control, and metabolic health.

Recent findings: Low-carbohydrate diets are at least as effective for weight loss as other diets, but claims about increased energy expenditure and preferential loss of body fat are unsubstantiated. Glycemic control and hyperinsulinemia are improved by low-carbohydrate diets, but insulin sensitivity and glucose-stimulated insulin secretion may be impaired, especially in the absence of weight loss. Fasting lipid parameters are generally improved, but such improvements may depend on the quality of dietary fat and the carbohydrates they replaced. Postprandial hyperlipemia is a potential concern given the high fat content typical of low-carbohydrate diets.

Summary: Low-carbohydrate diets have several potential benefits for treatment of obesity and type 2 diabetes, but more research is required to better understand their long-term consequences as well as the variable effects on the endocrine control of glucose, lipids, and metabolism.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diet, Carbohydrate-Restricted* / adverse effects
  • Dietary Carbohydrates / administration & dosage*
  • Dietary Carbohydrates / metabolism
  • Dietary Carbohydrates / pharmacology
  • Dietary Fats / administration & dosage
  • Dietary Fats / metabolism
  • Fasting
  • Humans
  • Hyperinsulinism / diet therapy
  • Hyperlipidemias / etiology
  • Insulin / metabolism*
  • Insulin Resistance
  • Lipids / blood*
  • Obesity / diet therapy*
  • Obesity / metabolism
  • Postprandial Period
  • Weight Loss


  • Blood Glucose
  • Dietary Carbohydrates
  • Dietary Fats
  • Insulin
  • Lipids