Ophthalmologist Dr James Muecke and South Australian colleagues have reported 15 cases of people reversing their diabetic macular oedema (DMO) using only their diet.
The work – involving the University of Adelaide, Royal Adelaide Hospital, Adelaide Eye and Retina Centre and Sight For All – featured on an academic poster at the World Ophthalmology Congress in Vancouver, Canada, in August 2024.
Dr Muecke, the 2020 Australian of the Year, said while 15 patients had reversed their sight-threatening eye condition, they had also reversed their underlying metabolic dysfunction.
“I now have 15 patients who have reversed their type 2 diabetes related macular oedema utilising only therapeutic carbohydrate reduction. And there’s plenty more to come,” he said.
“As an ophthalmologist, I have a window into the human body and can see the damage being wrought by type 2 diabetes on our blood vessels. Loss of sight is the most feared complication of diabetes, but there are many other life-changing and life-threatening consequences. Most of these can be prevented and some can even be reversed with lifestyle management, primarily a change in diet.”
In the study, Dr Muecke et al wanted to explore the impact of low carbohydrate, healthy fat (LCHF) diets, such as the ketogenic diet, on type 2 diabetes and DMO.
They retrospectively analysed OCT scans of 15 DMO patients at a private metropolitan ophthalmology practice, none whom were undergoing anti-VEGF intravitreal injections (IVIs).
After being prescribed various LCHF diets to manage their disease, all patients had decreased intraretinal fluid (IRF) levels. Two eyes had stable disease with no improvement/worsening of IRL levels. Also, two patients had evidence of complete drying of the macula in at least one eye.
Interestingly, there was evidence of significant sensitivity to IRF levels regarding dietary compliance. In effect, IRF levels rebounded over periods of poor patient-reported dietary compliance.
Dr Muecke said the results showed “there needs to be more focus on this extraordinary opportunity in the training of doctors, dietitians and nutritionists”.
The researchers concluded that more research was required and that quantitative analysis of retina biomarkers and novel IRF volumetric studies will help to understand the role of LCHF diets on the retinal microenvironment.
“With the high burden of diabetic macular disease, adjunct therapies to help reduce IVI injection and appointment frequency are vital to improving ophthalmic system efficiency,” the study noted.
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