I’m not officially “diabetic” but my doctor says I am “prediabetic”. So some time back I got a blood glucose meter and tested myself for a while. Since then I have also started a very low-carb diet (call it Primal/Paleo or LCHF) and have lost a lot of weight. My HbA1C tests have showed I am still on the borderline, but my doctor says it shows “excellent control” (mine is 5.1%, non-diabetic will be 4.9% or less).
So I probably still have some level of insulin resistance, and will keep checking things. But, I am happy with the weight loss (70 pounds so far in the last 18 months) and I’m feeling great.
I found some links to suggest that the ADA still doesn’t “recommend” low-carb diets, but has admitted that they are useful for some people. Looks like the biggest concerns they have are “other side effects” (i.e. not having to do with diabetes) and “compliance” (meaning that users will not stick to the diet).
Progression of info from ADA:
2006: ADA: Low Carb Diet Helps Diabetics, but Still Not Recommended -- Patients Left On Their Own to Find Best Diet for Them
2007: Diabetes and Low-Carb Diets -- Guidelines May Be Changing Soon
2008: ADA approved low-carb diets for weight loss, but not blood glucose control.
2009: A Low-Carb Diet Shown to Reverse Type 2 Diabetes -- Study Proves Very Low Carb Diet is Effective (Not from ADA)
2011: Are carbs the enemy? (Diabetes Forecast Magazine)
The last one is a typical “mashup” magazine article that does a lot of quoting various experts, all of whom disagree, and doesn’t really show any facts. The ADA party line is still that “You can do it for weight loss if you wanbt but it’s not what we recommend for maintenance” - still quoting the conventional wisdom that “fat is bad, fat leads to heart disease” and “low-carb diets are a fad – people don’t stick to them.”
But, the official establishment (at least in US and UK) is that diabetics should continue to eat carbs, and should continue to chase them with added insulin and other medications.
Something has always struck me as fishy about this line of reasoning:
When you eat sugar or starch, your blood sugar level goes up
This triggers the production of insulin which in turn triggers your body’s cells to store the blood sugar (somewhere?)
When this happens too often, your cells get resistant to the insulin and don’t store the sugar
If you are insulin-resistant, or if you aren’t producing enough, the excess sugar makes you feel crappy
The body will take the sugar out through your urine, but it has to be dangerously high to trigger this
Therefore we want you to keep eating sugar and starch. (I’m sorry, what?)
Just keep track of how much you’re eating and spread it out over time, plus inject some insulin (Wait, didn’t you just say that starch and sugar started all this?)
By the way, we noticed you are fat, so eat less fat, because the word “fat” rhymes with “fat” so it must relate somehow (OK now you’re just making sh!t up, aren’t you)
The official stance of ADA and Diabetes UK is still that diabetic patients “should have the right to enjoy the same diet as everyone else” – they just need to closely monitor its effects on them and take the right meds.
The other thing that doesn’t quite ring true for me is the line about “you should have a balanced diet and have everything in moderation”. Sure, this sounds like good advice, but people fail to consider that today’s “low-fat” diet craze it itself quite new. These days the mainstream of doctors, nutritionists and media all say “Everything in moderation” but still they say *fat* is what needs to be moderated. I mean, it still sounds like “Everyone knows Fat is bad for you, well except ‘good fats’". Sure, low-carb diets are one extreme, but the standard US diet is also an extreme. Bacon and eggs are not new, bread is not new, but we are eating way more bread, and way less bacon/eggs/butter/oils than 50 or 100 years ago.
Seriously, low-fat diets and emphasis on low-fat foods was not heard of before 50 years ago, and has really taken off in the last 30 years. Has it helped the levels of obesity and diabetes in the US?
In general I don’t think doctors are recommending low-carb diets for people, mostly because “the evidence isn’t there yet”… But, in my case my doctor has been quite supportive of what I say I want to try. So, if you think it might work well for you also, check with your own doctor. I wouldn’t necessarily start with “Do you recommend low-carb diets” but instead start with “I’d like to try reducing my sugar and starch – what should I be aware of? And what should I watch out for?”