You may know that the Atkins Diet is an ultra-low carb diet. It is one of several low-carb ketogenic diets. The glucocorticoid hormones released on a low carb diet trick the body into a constant gluconeogenic state. While the liver can produce enough glucose for brain and heart cells, the rest of the cells in our bodies switch to burning fats, hence the weight loss. Discredited some years ago, the Atkins Diet (and similar ones e.g., South Beach) is now back in favor. Some folks on these diets restrict their intake of carbohydrates so much that they can develop “acetone breath”! Nevertheless, low carb diets are important in the control of diabetes. In older folks, type 2 (adult-onset) diabetics can control their disease with a low carb diet and a drug called metformin, which blocks gluconeogenesis and therefore prevents glucose synthesis from gluconeogenic substrates, at the same time stimulating cellular receptors to take up available glucose. For more details on the mechanism of metformin action, check out Hundal RS et al. [(2000) Mechanism by Which Metformin Reduces Glucose Production in Type 2 Diabetes. Diabetes 49 (12): 2063–9]. Given the prevalence of obesity and type 2 diabetes in the U.S., it’s likely that someone you know is taking metformin or other similar medication!
158 Gluconeogenesis & the Atkins Diet