Dietary carbohydrate restriction as the first approach in diabetesmanagement: Critical review and evidence base

((SOMEONE POSTED THIS SOMETIME BACK. I AM USING IT AGAIN FOR THE BENEFIT OF ALL. 

I WOULD LIKE TO THANK THE PERSON THOUGH I DONT RECALL WHO IT WAS..))

The inability of current recommendations to control the epidemic of diabetes, the specific failure of

the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the

persistent reports of some serious side effects of commonly prescribed diabetic medications, in

combination with the continued success of low-carbohydrate diets in the treatment of diabetes

and metabolic syndrome without significant side effects, point to the need for a reappraisal of

dietary guidelines. The benefits of carbohydrate restriction in diabetes are immediate and well

documented. Concerns about the efficacy and safety are long term and conjectural rather than data

driven. Dietary carbohydrate restriction reliably reduces high blood glucose, does not require

weight loss (although is still best for weight loss), and leads to the reduction or elimination of

medication. It has never shown side effects comparable with those seen in many drugs. Here we

present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to

treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They

represent the best-documented, least controversial results. The insistence on long-term randomized

controlled trials as the only kind of data that will be accepted is without precedent in science.

The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12

points are sufficiently compelling that we feel that the burden of proof rests with those who are

opposed.

2015 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND

license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

12 Points of evidence

Point 1. Hyperglycemia is the most salient feature of diabetes.

Dietary carbohydrate restriction has the greatest effect on

decreasing blood glucose levels

Point 2. During the epidemics of obesity and type 2 diabetes,

caloric increases have been due almost entirely to increased

carbohydrates

Point 3. Benefits of dietary carbohydrate restriction do not require

weight loss

Point 4. Although weight loss is not required for benefit, no

dietary intervention is better than carbohydrate restriction for

weight loss

Point 5. Adherence to low-carbohydrate diets in people with type

2 diabetes is at least as good as adherence to any other dietary

interventions and is frequently significantly better.

Point 6. Replacement of carbohydrate with protein is generally

beneficial

Point 7. Dietary total and saturated fat do not correlate with risk

for cardiovascular disease

Point 8. Plasma saturated fatty acids are controlled by dietary

carbohydrate more than by dietary lipids

Point 9. The best predictor of microvascular and, to a lesser extent,

macrovascular complications in patients with type 2 diabetes, is

glycemic control (HbA1c)

Point 10. Dietary carbohydrate restriction is the most effective

method (other than starvation) of reducing serum TGs and

increasing high-density lipoprotein

Point 11. Patients with type 2 diabetes on carbohydrate-restricted

diets reduce and frequently eliminate medication. People with

type 1 usually require lower insulin

Point 12. Intensive glucose lowering by dietary carbohydrate

restriction has no side effects comparable to the effects of

intensive pharmacologic treatment

THOUGH THIS DOES NOT SPEAK ON LCHF WHICH I FOLLOW BUT THIS HOLDS THE CARBS AS A CULPRIT WHICH THE DRS STILL RECOMMEND TO THE EXTENT TO 60% OF A DIABETIC DIET.

THIS ALSO CLEARS THE FEAR OF DIETARY FATS WHICH WE USUALLY HAVE. 

THE CULPRIT OF INCREASED SERUM FATS IS DUE TO HIGH CARBS / SUGAR INTAKE. 

12 Replies

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  • AS a Type 2 diabetic for last nearly 28 years, I can vouch for the  above 12 points. I have been following carb restricted diet mostly replacing qwith protein or fat,  my lipid and triglycerides are also well under control. For substantially longtime i.e. nearly 12 years I managed without medicines and about 5 years on very less medicines.However  thereafter medicines gradually increased. At present juncture after 28 years I  now find it  difficult even  after carbohydrate restricted diet to  maintain sugar levels within normal limits with almost full quote of medicines and perhaps  I may have to shift  to insulin

  • If we continue to believe that only carbohydrate controls sugar , we are living in Fools para-dine. Please feel free to discuss that High Blood Sugar/Glucose is indication of Low Cholesterol in particular HDL.

    The Carbohydrate which we had been taking for years, cannot suddenly become poison.

    I am not here insisting on my point of view. I expect people to think differently.

  • Rsridhar

    We used to have brown rice that too the Kanji taken out. 

    Now we have white rice that too pressure cooked

    All starches in. Also sugar in all ready stuff have increased and used by us. 

    Activity decreased 

    Hence we are prone to diabetes 

    Now that we got it dietary restrictions of carbs works 

    If u feel otherwise that continue the ADA recommended diet and keep increasing the medicine doses 

    It's upto you. 

    No compulsion to follow the above 

  • rsreedhar can you please clarify what is the diabetic diet  which including  carb / protein/fat ratio. ADA WHO or any  guidelines is prescribed only for  healthy persons  not for diabetic persons.

     Even Doctor  cannot say anything about this they simply says the  same guidelines

      But by restricting  some carb quantity   my blood sugar level  comes normal  and  as non diabetic range since from last july   I have tested it july 2015 and  also my diet and blood test report as

                   healthunlocked.com/diabetes...

    healthunlocked.com/diabetes...

     please share your  suggestion a regarding carb/protein/fat how much quantity may be consumed by the  diabetic person .  This may help all the members of the  forum., since this forum have  ADAWHO guideline followers and also LW/LWMDR and also LCHF followers

     

  • The Diet mentioned by you seems to be alright. Just tell me what is it you need from me?

    Please avoid at any cost Sunflower Oil, Corn Oil, Soyabeans, Oats etc.

    Avoid second coffee you mentioned.

    Let us not entangle ourselves. Let us follows what suits us. India has been HEAVEN. Let others follow us.

  • Whatever snacks you are taking, please see that let it be home made in Groundnut Oil. Please do not buy from market and consume these.

  • Seen your comment But you cannot mention diabetic person how much quantity of carb protein and  fat consumed daily and how much calorie he may required as general

  • Ratio is 60% Fats 20% carbs and 20% proteins 

    No calorie watching 

    My caloric intake now is bigger than earlier 

    And no wt gain 

    After the initial loss it's stable now 

  • Generally A plate of meal might contain, 40% of Carbohydrate, 25% of Protein, 25% of Fats and 10% of green leaves and vegetables. Here important fact is that all should available at a time to the body. Otherwise we may not get intended changes in our profile.

    Our Lipid profile is just what we eat.

  • Earlier We had the habit of eating SWEETS made out of Ghee and Sugar. But incidentally never experienced the advent of Diabetes. Now sometimes we take sweets made out of refined oil or HEART HEALTHY Oils, definitely not with GHEE. This is what is first major deviation happening.

    In fact Cholesterol and Sugar are getting balanced like a seesaw. High sugar is indication of low Cholesterol. 

  • Exactly 

  • Few days ago on world health day govt. Of Maharashtra published one as for diabetes...it clearly mentions and stress the benefits of carb restriction for diabetics.

    Further it is seen that cause of T2 is mainly increases insulin resistance. This is also accepted fact.

    Insulin resistance will go on increasing with presences of more and more inslulin. In order to check this situation... It is utmost important to restrict carbs immediately.

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