Diagnosed With Diabetes? 4 Tips for a Low-Carb Diabetes Diet

We teach biochemistry and nutrition to medical students at SUNY Downstate Medical Center. Among the things we teach is the point made in the article that (regardless of what somebody at the Mayo Clinic may say): “low-carb diets...have been touted for weight loss. Promoters of these diets contend that if carbs increase blood sugar and insulin levels and lead to weight gain, then limiting carbs should lower blood sugar and insulin levels, in turn leading to weight loss.”

More important for people with diabetes, we show medical students the data that carbohydrate restriction lowers blood glucose and stabilizes insulin fluctuations, dramatically lowers triglycerides and raises HDL(good cholesterol). Most significantly, low-carb diets reduce the need for medication. Consider the first tip in the article:

“1. Talk with your doctor or dietitian about how much insulin "covers" a particular amount of carbs.... For each meal, add all carbs in the food you plan to eat. Then take enough insulin to process that amount of carbohydrate.”

This is perhaps the strangest recommendation of any in medicine: encouraging something that will make a disease worse so that you can “cover” it with drugs.

During the course, a student asked: “why is the American Diabetes Association (ADA) opposed to low carbohydrate diets?” I quoted the 2008 guidelines which say something analogous to the article: “limit consumption of carb-heavy foods like bread, rice, starchy vegetables, grains, and fruit—but not avoid them altogether because some of these foods contain vitamins.” Why not avoid them altogether? The non-starchy vegetables recommended by low-carb diets provide more vitamins than rice and starchy vegetables. In any case, does Ann Albright think that taking a vitamin pill is in the same ballpark as injecting insulin?

Information on why carbohydrate restriction is beneficial is available without subscription at http://www.nutritionandmetabolism.com/content/pdf/1743-7075-5-9.pdf The paper is written by 24 clinicians and scientists, including directors of endocrine centers. It was rejected out of hand by Diabetes Care, one of the ADA publications. Also worth reading is Eric Westman’s commentary that deaths in the large diabetes ACCORD trial might have been avoided if carbohydrate restriction rather than intensive drug therapy were used. He concludes “At the end of our clinic day, we go home thinking, ‘The clinical improvements are so large and obvious, why don't other doctors understand?’ Carbohydrate-restriction is easily grasped by patients: because carbohydrates in the diet raise the blood glucose, and as diabetes is defined by high blood glucose, it makes sense to lower the carbohydrate in the diet….we have been able to taper patients off as much as 150 units of insulin per day in 8 days, with marked improvement in glycemic control-even normalization of glycemic parameters.”

Richard Feinman, Professor of Biochemistry.

Richard Feinman of NY 1:54PM March 22, 2009