Nutrition for diabetics

[FracturedRabbit]

This consensus report on Nutrition Therapy for Adults With Diabetes or Pre-diabetes has just been published by the American Diabetes Association. A consensus report gathers and summarises data from relevant research papers, in this case more than 300 of them.

 

http://care.diabetesjournals.org/content/42/5/731

 

It's a long read, but the summarised recommended eating patterns are:

 

• A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes.

• Until the evidence surrounding comparative benefits of different eating patterns in specific individuals strengthens, health care providers should focus on the key factors that are common among the patterns:

  • ○ Emphasize nonstarchy vegetables.

  • ○ Minimize added sugars and refined grains.

  • ○ Choose whole foods over highly processed foods to the extent possible.

• Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.

• For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic medications is a priority, reducing overall carbohydrate intake with low- or very low-carbohydrate eating plans is a viable approach.

[Kohsamida]

The trouble with this report, and the major issue I have with the sponsor of the report (the American Diabetes Association) is that their goal, and the message of this report  is to help people live with diabetes—not to get over it all together. The fact is, adult onset diabetes is far from incurable, even though the mainstream medical establishment would have you believe otherwise. I don't mean to come off sounding like a conspiracist but the sad fact is that Big Pharma (injectable insulin and metformin) and the processed food industry (highly refined foods containing high fructose corn syrup stripped of natural fats and fiber and deceptively labelled as "low fat") make billions of dollars per year in profits, and spend a lot of that money in powerful lobbying efforts and sponsoring biased research studies to sway public opinion and the medical establishment to be in favor of their products. 

 

There is an epidemic of biased-based research today, and unfortunately that is what this "consensus report" really is.  Very little discussion in this report addresses the underlying cause of diabetes which is insulin resistance.  In fact the term "insulin resistance" is only mentioned two times in this entire 60 page report.  The two most likely dietary culprits involved in causing insulin resistance, namely refined sugar, and highly processed foods are only mentioned three times, and minimized in importance.  The ADA's view on Diabetes-type 2 (and thus, most medical professionals) is that Diabetes-2 is a chronic disease that is not reversible.  Scientific research in the last few years shows that the exact opposite is true! Yet the myth persists.  Why?  Because it is profitable to the powerful medical, pharmaceutical and processed food industries.  

 

Sadly, there is no money in healthy eating (well, except the millions you and our government could save on medical care). Both medical professionals and drug companies will justify their costly medications with spurious rationales like, “Patients won’t make lifestyle changes to lose weight, so we’re doing them a favor by providing medications as an option.”  The truth is, Diabetes-2 is preventable, and it is reversible in early stages and THAT should be the real message promoted by the ADA and the medical establishment! 

 

Unfortunately, the ADA and most medical professionals do not address the underlying cause of Diabetes-2.  They are merely treating the symptoms, and this report is really only about minimizing symptoms.  It's analogous to putting a band-aid on an infected wound.  Diabetics who follow ADA recommendations will not find themselves improving much, and they sure won’t have a complete reversal of the disease which is entirely possible in the early stages (prediabetes). They’ll take the prescribed meds and follow palliative dietary guidelines, which may help stabilize their blood sugar, giving them the very false impression that all is well.  Meanwhile, the disease process—caused largely by dietary lifestyle—continues unchecked.

 

 

 

[FracturedRabbit]

Compared to previous recommendations, I thought this one was on the right track. No, they don't mention insulin resistance, because 95% (99%?) of people have no idea what that is.

 

But, minimising sugar and refined grains and "reducing overall carbohydrate intake with low- or very low-carbohydrate eating plans is a viable approach" is a real step forward and will tackle insulin resistance if adopted. There are very few positive messages coming from the nutrition industry, I thought this was one of them.

[stephenterry]

Exactly. 

[Kohsamida]

1 hour ago, FracturedRabbit said:

Compared to previous recommendations, I thought this one was on the right track. No, they don't mention insulin resistance, because 95% (99%?) of people have no idea what that is.

 

But, minimising sugar and refined grains and "reducing overall carbohydrate intake with low- or very low-carbohydrate eating plans is a viable approach" is a real step forward and will tackle insulin resistance if adopted. There are very few positive messages coming from the nutrition industry, I thought this was one of them.

Yes I agree it is better than the ADA has done in the past but still it amounts to nothing but "faint praise" of the current scientific understanding of Diabetes-2, and the ADA is still delivering the message that Diabetes type 2 is a chronic condition that requires treatment with pharmaceutical drugs when in fact science is increasingly showing that the cause is nutrition-based, and lifestyle changes can indeed reverse the course if action is taken early enough.

 

The ADA's position is that the cause of Diabetes type 2 is high blood sugar when in fact this is only a symptom, not a cause.  In order to lower blood sugar, ADA has increasingly and more aggressively advocated measures such as prescription drugs instead of lifestyle modification.  In other words, they are advocating prescription medications in order to treat a symptom, not the actual cause.

 

Furthermore, since 2001 when they first coined the term "pre-diabetes", they have continuingly been redefining the term so as to include greater and greater percentages of the population that should be considered to fit the definition, and thus be on prescription medications. 

 

 

Many international scientific experts flatly reject the ADA's position and find their actions quite alarming!

 

It's very clear that the pharmaceutical companies are the primary beneficiary of this!  Science Magazine did an expose story in which they found that the ADA and its "experts" who promote aggressive treatment of prediabetes regularly accept large amounts of funding from diabetes drugmakers. 

 

So far, no drugs have been approved specifically for prediabetes, meaning that doctors are limited to prescribing diabetes drugs or other medications "off label" to treat the condition. But drug companies are testing dozens of drugs aimed at prediabetes in hopes of tapping a potential worldwide market of hundreds of millions of people.

 

Personally I find this all very troubling since most people are under the impression that organizations such as the American Diabetes Association are trusted source of information for consumers, when in fact they seem to exist as carefully disguised marketing agents for pharmaceutical companies.

 

Very few medical professionals are willing to think "out of the box".  Instead, they just blindly accept the ADA guidelines when dealing with patients.  Fortunately there are a few that do otherwise and do in fact advocate nutritional & lifestyle change instead of just reaching for a prescription pad. 

 

I think it's only prudent that the patient do the same thing, and research the actual facts themselves and make up their own minds rather than just accept Diabetes type 2 as a chronic condition and face the prospect of being on prescription medications for the rest of their lives that only provide a false sense of well-being while the disease progresses unchecked.