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Br J Gen Pract. 2005 November 1; 55(520): 884.
PMCID: PMC1570767
Low carbohydrate diets for diabetes control
Katharine Morrison, Principal GP
Ballochmyle Medical Group, The Loan, Mauchline, Ayrshire KA5 6AJ E-mail: morrisons/at/ballochmyle.wanadoo.co.uk
Fleming, Cross and Barley1 are right to be concerned about the growing prevalence of type 2 diabetes in General Practice.
Despite the growing incidence of type 1 and 2 diabetes and the accelerating cost of the resources needed to monitor and treat these patients, we are obviously not succeeding in reducing either the number of people affected or the severity of the complications of these conditions.
Yet there is a simple, effective, low-cost strategy that is proven to work with diabetes: reduce the amount of sugar and starch in the diet.
This is backed up by rigorous scientific research and I have included a few of the more recent reviews concerning this subject below.24
On a more personal note, my son became diabetic 18 months ago. His HbAIC is 5.1 and his insulin requirements have not increased since stabilisation after diagnosis. His blood sugars are rarely out of the 4–7.8 range even after meals on a restricted carbohydrate diet. He rarely experiences hypoglycaemia and has had no severe events.
I have also encouraged my diabetic patients to try this way of eating for themselves. It is usual for patients with type 2 diabetes to experience a 2–3% drop in HbAIC after 3 months on a low carb diet. The impact on reducing complications and associated drug costs can be imagined.
The lower the carbohydrate consumed the less insulin is needed for type 1 diabetics and the less hard the pancreas has to work for type 2 diabetics. For example, insulin dependent diabetics can expect to half or third their insulin requirements. Less insulin injected results in more predictable blood sugars and less hypoglycaemia.
The medical establishment has been less than enthusiastic about adopting low carb diets. All of the usual gripes have been thoroughly debunked or can be dealt with by modifications to the diet. It is time to stop feeding patients a diet of junk science and start feeding them food that makes them well instead of sick.
You would think that Diabetes UK would be interested in promoting a diet that does all of these:
  • prolongs honeymoon phase in type 1 diabetics;
  • prolongs pancreatic function in type two diabetics;
  • promotes a healthy weight;
  • reduces need for insulin;
  • reduces need for oral hypoglycaemic drugs;
  • promotes high HDL and low triglycerides;
  • Reduces hypoglycaemia;
  • Reduces development of glucose intolerance to type two diabetes;
  • optimises glycaemic control including post prandial blood sugars.
Sadly, Diabetes UK does not.
If health professionals or patients want to learn more about this I can recommend Dr Bernstein's Diabetes solution.5 Dr Richard Bernstein became an insulin-dependent diabetic when he was 12 years old and continues to practice as a physician dedicated to diabetes management at the age of 67. He was the first patient to use a portable blood sugar monitor, and through careful self experimentation he managed to reverse most of his diabetic complications. He has developed a comprehensive educational course that turns normal patients into highly competent self carers with truly normal blood sugars round the clock.
How long can we as a profession afford to keep our heads in the sand regarding the benefits of low carb diets for diabetics?
REFERENCES
1. Fleming D, Cross K, Barley M. Recent changes in the prevalence of diseases presenting for health care. Br J Gen Pract. 2005;55:589–595. [PubMed]
2. Arora SK, McFarlane SI. The case for low carbohydrate diets in diabetes management. Nutr Metab (Lond). 2005;2:16. [PubMed]
3. Kennedy RL, Chokkalingam K, Farshchi HR. Nutrition in patients with type 2 diabetes: are low-carbohydrate diets effective, safe or desirable? Diabet Med. 2005;22(7):821–832. [PubMed]
4. McFarlane SI. Dietary recommendations for people with diabetes: time to reduce the carbohydrate loads. Endocrine Today. 2005;(Sept issue)
5. Bernstein RK. Dr Bernstein's diabetes solution: complete guide to achieving normal blood sugars. New York: Little, Brown and Company; 2004.

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