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To the Editor:
Re “The Old-Fashioned Way to Treat Diabetes,” by Sarah Hallberg and Osama Hamdy (Sunday Review, Sept. 11):
The writers cite a study that recommends a daily intake of 20 grams of carbohydrates, an extremely low-carb intake for anyone. Maintaining such a diet requires excluding major food groups, including fruit, grains and starchy vegetables, and can contribute to nutritional deficiencies.
The American Diabetes Association does not recommend any specific diet for people with diabetes. The best nutrition plan for patients is one that they can realistically achieve, given their life and circumstances. The association’s nutrition therapy goals and recommendations are based on the latest scientific research, and are reviewed and updated every year within our Standards of Care.
The first-line treatment recommendation for Type 2 diabetes is built on a comprehensive medical evaluation to meet the individual needs of each patient. The foundations of care include self-management education, nutrition, counseling, physical activity, psychosocial care and possibly medication.
Diabetes is a complex and lifelong disease that requires personalized care from an integrated team of multiple medical providers, and the care plan will evolve throughout each patient’s lifetime as his or her health changes and additional needs emerge.
The American Diabetes Association recommends metabolic surgery only as an option for some patients who meet specific medical criteria, including patients with severe obesity.
ROBERT E. RATNER
Chief Scientific and Medical Officer
American Diabetes Association
Alexandria, Va.
A version of this letter appears in print on September 21, 2016, on page A26 of the New York edition with the headline: Advice on Diabetes. Today's Paper|Subscribe
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