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Low-carbohydrate diets better for diabetes patients

By Lilian AnekweLow-carbohydrate diets can improve glycaemic control and reduce hypoglycaemic events in patients with diabetes, a major new analysis reveals.The Cochrane review findings will fuel the long-running controversy over what dietary advice GPs should give to patients with diabetes, and challenge the traditional belief that a low-fat, high-carb diet is best.Patients on a diet of foods with a low glycaemic index – including foods extremely low in carbohydrates such as lentils, beans and oats – had an HbA1c level 0.5% lower than controls.There were also significantly fewer episodes of hypoglycaemia in patients on a low-GI diet, with a reduction of 0.8 episodes per patient per month achieved in one trial. The review, which collated data from 11 randomised trials in 402 patients, confirms a shift in the evidence in recent years, with a number of recent studies suggesting a low-carb diet could offer long-term benefits, including sustained weight loss with no significant effect on glycaemia or lipid levels.It has been seized on by critics of traditional low-fat diets, advocated to offset the increased risk in coronary heart disease seen in patients with diabetes.Professor Chris Powell, head of endocrinology at the University of Sydney and lead researcher, said: ‘The decrease of 0.5% HbA1c is clinically significant and is similar to decreases achieved through medications for newly diagnosed type 2 diabetes, and improvements of this size have been associated with a significant reduction in the risk of microvascular complications.'Dr Malcolm Kendrick, a GP in Macclesfield who advocates a high-fat, low carbohydrate diet in patients with diabetes, said the study's conclusions should encourage GPs to reject the conventional wisdom.‘The reality is that over the years, and around the world we have killed literally millions of diabetics by advising them to eat a high-carb diet and avoid fats.‘Only now is it being recognised that previous advice was and remains useless, dangerous and scientifically illiterate. The authors of this Cochrane review should be applauded for taking the fist step on a path that will, inevitably, result in the destruction of the nonsense.‘The Pope is Catholic, bears shit in woods, and diabetics should try to eat low GI diets - because it might help with their underlying problems with insulin resistance.'BOX: A shift in the evidence – how low-carb diets rose to prominence • December 06 – Patients on a low carbohydrate diet lost 6.9kg over three months, with no significant effect on glycaemia or lipid levels (International Diabetes Federation conference)
• January 09 – High-fat, low-carbohydrate diet reduced HbA1c by an average of 1.8% in 532 patients with type 1 diabetes (American Journal of Clinical Nutrition 2009;89:518-524
• January 09 – Cochrane review finds low glycaemic index diets improves glycaemic control without compromising hypoglycaemic events (Cochrane Database of Systematic Reviews, Issue 1)
Diabetes: reports backs controversial diet Diabetes: reports backs controversial diet

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Readers' comments (1)

  • Diabetes is an inability to process carbohydrates. Why would type 2 diabetics benefit from eating carbs. Every type 2 diabetic should find their personal dietary limit for carbohydrate processing and stay at or below it.

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