Atkins and Diabetes: What Low-Carb Eating Can and Cannot Do
The old version of this post said that the Atkins diet can help you “stay off the road to diabetes” and that high-carbohydrate diets caused the obesity epidemic. It also described the body’s response to carbohydrates in a way that was both garbled and oversimplified. Diabetes is a serious medical condition, so I have replaced those claims with what major health organizations say about low-carb eating and diabetes.
What causes type 2 diabetes?
According to the National Institute of Diabetes and Digestive and Kidney Diseases, type 2 diabetes is caused by several factors, including overweight and obesity, not being physically active, insulin resistance and genes. You are more likely to develop it if you are 45 or older, have a family history of diabetes, are overweight, or have prediabetes or had gestational diabetes. Symptoms often develop slowly and can include increased thirst and urination, tiredness, blurred vision and sores that do not heal. The old post’s statement that high-carbohydrate diets are the cause of the obesity epidemic is too simple, because many factors are involved.
What does insulin resistance mean?
Insulin helps move sugar from your blood into your cells. In insulin resistance, the cells respond less well, so the body needs more insulin to do the same job. The old post described the pancreas releasing “20 times more insulin” than needed and a chain reaction involving adrenaline. I could not find a source for those details, so I have taken them out. The key point is that being overweight and inactive makes cells less responsive, and losing weight and exercising can improve this.
Is low-carb eating a recognized option for type 2 diabetes?
Yes, for some people. The American Diabetes Association’s 2019 consensus report on nutrition therapy says that for select adults with type 2 diabetes who are not meeting blood sugar targets, or for whom reducing diabetes medicines is a priority, reducing overall carbohydrate intake with low or very low-carbohydrate eating plans is a viable approach. One meta-analysis cited in that report found larger A1C benefits for very low-carb plans at 3 and 6 months, but not at 12 and 24 months. So low-carb eating can help in the short term, and the benefits are less clear over years. Atkins itself recommends its 20-gram plan for people with prediabetes or type 2 diabetes, but that is the company’s advice, not a medical guideline.
What are the risks?
The main risk is low blood sugar. The ADA report says that a very low-carb plan can cause fluid loss and quickly lower blood glucose, so people should speak to a knowledgeable practitioner at the start to prevent dehydration and to reduce insulin and other drugs that can cause hypoglycemia. The ADA’s Standards of Care also say that these plans are not recommended for people who are pregnant or breastfeeding, who have kidney disease, or who have or are at risk of disordered eating, and that they should be used with caution in people taking SGLT2 inhibitors because of the risk of ketoacidosis. In other words, if you take medicine for diabetes, do not start Atkins on your own.
Does Atkins prevent diabetes?
I could not find good evidence that the Atkins diet prevents diabetes. NIDDK lists overweight and physical inactivity among the causes, so keeping a healthy weight and staying active are sensible steps for everyone. The old post said that studies show low-carb diets “can help” with pre-diabetes. The ADA report is about adults who already have type 2 diabetes. For prevention, speak to your doctor about your own risk, have your blood sugar tested, and choose an eating plan you can keep up for years. Our post on Atkins and ketosis explains how ketone strips work, and how Atkins handles cravings and low-carb swaps show practical ways to cut sugar and refined carbohydrates.
What should you do next?
If you have diabetes or prediabetes and are interested in low-carb eating, ask your doctor or a registered dietitian first, and ask what to monitor. Whatever plan you follow, include vegetables, protein and healthy fats, and stay active. If you are looking for gentle movement, our guide to yoga and diabetes: how to start safely covers the basics.