Dietary advice in the management of diabetes mellitus - history and current practice

Blades, Mabel; Morgan, Jane; Dickerson, J. W. T.

doi:10.1177/146642409711700303

Cited by 21 publications

(15 citation statements)

References 14 publications

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“…Carbohydrates are the major insulin secretagogues [47] and glycemic control in diabetic subjects is greatly influenced by dietary carbohydrate content. In fact, before the discovery of insulin, dietary carbohydrate restriction was the recommended treatment for diabetes management [48].…”

Section: Low Carbohydrate Diet and Glycemic Controlmentioning

confidence: 99%

The case for low carbohydrate diets in diabetes management

Arora

McFarlane

2005

Nutr Metab (Lond)

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A low fat, high carbohydrate diet in combination with regular exercise is the traditional recommendation for treating diabetes. Compliance with these lifestyle modifications is less than satisfactory, however, and a high carbohydrate diet raises postprandial plasma glucose and insulin secretion, thereby increasing risk of CVD, hypertension, dyslipidemia, obesity and diabetes. Moreover, the current epidemic of diabetes and obesity has been, over the past three decades, accompanied by a significant decrease in fat consumption and an increase in carbohydrate consumption. This apparent failure of the traditional diet, from a public health point of view, indicates that alternative dietary approaches are needed. Because carbohydrate is the major secretagogue of insulin, some form of carbohydrate restriction is a prima facie candidate for dietary control of diabetes. Evidence from various randomized controlled trials in recent years has convinced us that such diets are safe and effective, at least in short-term. These data show low carbohydrate diets to be comparable or better than traditional low fat high carbohydrate diets for weight reduction, improvement in the dyslipidemia of diabetes and metabolic syndrome as well as control of blood pressure, postprandial glycemia and insulin secretion. Furthermore, the ability of low carbohydrate diets to reduce triglycerides and to increase HDL is of particular importance. Resistance to such strategies has been due, in part, to equating it with the popular Atkins diet. However, there are many variations and room for individual physician planning. Some form of low carbohydrate diet, in combination with exercise, is a viable option for patients with diabetes. However, the extreme reduction of carbohydrate of popular diets (<30 g/day) cannot be recommended for a diabetic population at this time without further study. On the other hand, the dire objections continually raised in the literature appear to have very little scientific basis. Whereas it is traditional to say that more work needs to be done, the same is true of the assumed standard low fat diets which have an ambiguous record at best. We see current trends in the national dietary recommendations as a positive sign and an appropriate move in the right direction.

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Section: Low Carbohydrate Diet and Glycemic Controlmentioning

confidence: 99%

The case for low carbohydrate diets in diabetes management

Arora

McFarlane

2005

Nutr Metab (Lond)

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“…The earliest reference to dietary fat intake and diabetes dates back to one of the oldest existing medical documents, the ancient Egyptian Papyrus Ebers, which were written around 1500 BC, approximately 1000 years before the birth of Hippocrates. The Papyrus Ebers recommended a low fat, high carbohydrate diet consisting of wheat, grapes, honey, sweet berries, and beer [2], and a similar diet was recommended by the Cappadocian physician Aretoeus in the second century AD [3]. Although there was no universal diet for treating diabetes, the emphasis had shifted to controlling glycosuria with Thomas Willis, a 17th century English physician who severely restricted calories and presumably fat to control glycosuria [2].…”

Section: History Of Dietary Fat Intake Recommendations and Diabetesmentioning

confidence: 98%

“…In the late 18th century, John Rollo, a surgeon general in the English army treated diabetes with a moderately high fat and relatively low carbohydrate diet that emphasized moderate portions of rancid meats and fat for lunch and dinner, based on the idea that diabetes was caused by a malfunctioning stomach and that rancid meats spared the stomach digestive work, presumably because bacterial action had "predigested" them [2]. However, by the end of the 19th century, portions were further reduced to cut calories in order to better control glycosuria [3].…”

Section: History Of Dietary Fat Intake Recommendations and Diabetesmentioning

confidence: 99%

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Dietary fats and diabetes mellitus: Is there a good fat?

2001

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As knowledge of the fatty acid functions has increased, so has the complexity of making dietary fat recommendations to people with type 2 diabetes. Oleic acid seems to offer a slight advantage over linoleic acid in reducing plasma glucose, insulin levels, total cholesterol, low-density lipoproteins (LDLs), and triglycerides, but may also have atherogenic properties through another mechanism. A diet containing a higher proportion of polyunsaturated fatty acids (PUFAs) may require a concomitant increase in antioxidant intake because PUFAs oxidize easily and are then converted to oxidized LDL, which is more atherogenic. In addition to raising total and LDL cholesterol, long chain saturated free fatty acids may interact with plasma glucose to increase insulin secretion. Omega-3 fatty acids decrease triglycerides and reduce the risk of fatal cardiac arrhythmias. Glycemic control does not appear to be adversely affected by omega-3 fatty acids at amounts of up to 3 g/d.

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“…In addition, reducing elevated blood lipids levels has been shown to lower the incidence of acute coronary events in other at-risk populations. Research have shown that before the advent of insulin therapy in the early 20 th century, medical nutrition therapy (MNT) was the only form of therapy for DM [6].…”

Section: Introductionmentioning

confidence: 99%