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

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URL: https://www.sciencedirect.com/science/article/pii/S0899900714003323?via%3Dihub

Journal: Nutrition

Publication Date: 01/2015

Summary: 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.

Key Takeaways

The diabetes epidemic is progressing uncontrolled by current medical and dietary management. Low-Carbohydrate ketogenic diets show significant improvement in the disease better than any recommendation currently on the table. With effective reduction in blood sugar, weight loss, and medication reduction, this should be the primary recommendation by physicians in the treatment of type 2 diabetes.

Why are Ketogenic Diets Not The First Line Recommendation for Diabetes?

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