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Nitya Kalyani Kumar,1 Jennifer D Merrill,2 Scott Carlson,1 Jashalynn German,1 William S Yancy Jr3 1Division of Endocrinology, Diabetes, & Metabolism, Duke University, Durham, NC, USA; 2Division of Endocrinology, Diabetes, & Metabolism, Ohio State University, Columbus, OH, USA; 3Duke Lifestyle and Weight Management Center and Division of General Medicine, Duke University, Durham, NC, USACorrespondence: Nitya Kalyani Kumar, 30 Duke Medicine Circle Clinic 1A, Durham, NC, 27710, USA, Email nitya.kumar@duke.eduAbstract: Evidence suggests that low carbohydrate (< 130 g/day of carbohydrate) (LCD) and very low carbohydrate, ketogenic diets (typically < 50 g/day of carbohydrate) (VLCKD) can be effective tools for managing diabetes given their beneficial effects on weight loss and glycemic control. VLCKD also result in favorable lipid profile changes. However, these beneficial effects can be limited by poor dietary adherence. Cultural, religious, and economic barriers pose unique challenges to achieving nutritional compliance with LCD and VLCKD. We review the various methods for assessing adherence in clinical studies and obstacles posed, as well as potential solutions to these challenges.Keywords: low carbohydrate diet, ketogenic diet, adherence, type 2 diabetes |
