ADA & Low Carb Diabetes Treatment

science
#1

Did you see that the ADA just included low carb in the list of potential dietary treatments for diabetes? We’re winning.

(KCKO, KCFO 🥥) #2

Here is a link to the research with no pay wall:

(Eric - The patient needs to be patient!) #3

Some day in the future there will be a gold rush to keto foods, supplements and misinformation on how to be keto. We have to help the world around us understand how to do keto simply.

(KCKO, KCFO 🥥) #4

This mentions low carb Mediterranean diet by name (p12), no keto mentions.
Three trials of a Mediterranean
eating pattern reported modest weight
loss and improved glycemic control
(66–68). In one of these, people with
new-onset diabetes assigned to a lowcarbohydrate
Mediterranean eating pattern
were 37% less likely to require
glucose-lowering medications over 4
years compared with patients assigned
to a low-fat diet (HR 0.63 [95% CI 0.51,
0.86]). A meta-analysis of RCTs in patients
with type 2 diabetes showed that
the Mediterranean eating pattern reduced
HbA1c more than control diets
(mean difference 23.3 mmol/mol, 95%
CI 25.1, 21.5 mmol/mol [20.30%, 95% CI
20.46%, 20.14%]) (69). Low-carbohydrate,
low glycemic index, and high-protein diets,
and the Dietary Approaches to Stop Hypertension
(DASH) diet all improve glycemic
control, but the effect of the Mediterranean
eating pattern appears to be the
greatest (70–72). Low-carbohydrate diets
(,26% of total energy) produce substantial
reductions in HbA1c at 3 months (25.2
mmol/mol, 95% CI 27.8, 22.5 mmol/mol
[20.47%, 95% CI 20.71%, 20.23%]) and
6 months (4.0 mmol/mol, 95% CI 26.8,
21.0 mmol/mol [20.36%, 95% CI 20.62%,
20.09%]), with diminishing effects at 12
and 24 months; no benefit of moderate
carbohydrate restriction (26–45%) was
observed (73). Vegetarian eating patterns
have been shown to lower HbA1c,
but not fasting glucose, compared with
nonvegetarian ones (74). Very recent trials
of different eating patterns in type 2
diabetes have typically also included
weight reduction, hindering firm conclusions
regarding the distinct contribution
of dietary quality.

But on p. 18, it goes back to corp. profits recommendation of food replacements. Like you can live your whole life getting your nutrition from a can or packaged products, UGH
The most effective nonsurgical strategies
for weight reduction involve food
substitution and intensive, sustained
counseling (e.g., 12–26 individual counseling
sessions over 6–12 months).
Among adults with type 2 diabetes,
meal replacement (825–853 kcal/day
[3,450–3,570 kJ/day] formula diet for
3–5 months) followed by gradual reintroduction
of food and intensive counseling
resulted in 9-kg placebo-adjusted
weight loss at 1 year and high rates of
diabetes remission (46% vs. 4%; odds
ratio [OR] 19.7 [95% CI 7.8, 49.8]) compared
with best usual practice (75). In
terms of intensive behavioral interventions,
the Action for Health in Diabetes
(Look AHEAD) trial (76) randomized
5,145 overweight or obese patients
with type 2 diabetes to an intensive
lifestyle program that promoted energy
restriction, incorporating meal replacements
to induce and sustain weight loss,
along with increased physical activity
compared with standard diabetes education
and support in the control group.
After 9.6 years, weight loss was greater
in the intervention group (8.6% vs. 0.7%
at 1 year; 6.0% vs. 3.5% at study end;
both P , 0.05). HbA1c also fell in the
intervention group despite less use of
glucose-lowering medications. Cardiovascular
event rates were not reduced,
but there were numerous other benefits.
In a 12-month trial, 563 adults with
type 2 diabetes who were randomized
to Weight Watchers compared with standard
care had a 2.1% net weight loss
(24.0% vs. 21.9%; P , 0.001), a 5.3
mmol/mol (23.5 vs. 11.8 mmol/mol;
P 5 0.020) net absolute improvement in
HbA1c (0.48% [20.32% vs. 10.16%]), and
a greater reduction in use of glucoselowering
medications (226% vs. 112%;
P , 0.001) (77). Similar programs have
resulted in a net 3-kg weight loss over
12–18 months (78–80).

And my “favorite” recommendation in this paper has to be this piece of shit advice.
Consensus recommendation
All overweight and obese patients
with diabetes should be advised of
the health benefits of weight loss
and encouraged to engage in a
program of intensive lifestyle management,
which may include food
substitution.

(Keto Victory) #5

The ADA is a slow-moving, stubborn dinosaur, and it is apparently not yet willing to deliver a simple, unambiguous recommendation to avoid carbs. (For example, “Sugar and starch are bad for T2Ds, so we recommend substituting fat for net carbs.”)

Instead we get wordy double-talk that recharacterizes a plain, low-carb diet as “Medical Nutrition Therapy.” :thinking:

(Michelle isaacson) #6

You are :100: on this! Every time I get into Facebook an ass pops up about Keto and to spend :moneybag: money to learn! Everything I know was free…this forum is invaluable! The free podcasts (2KetoDudes) also invaluable!
Ketoaide is $0.30 per serving! No special club or subscription needed! Just a great community!!

:smiley::heart::avocado:

(Running from stupidity) #7

I predict that day will be in September 2018.

#8

Nailed it! That’s amazing.
Now, when are they going to start charging more for the fattier cuts of beef?

(Running from stupidity) #9

The day you move down here that will happen for you, trust me on this :slight_smile:

#10

figures

(Running from stupidity) #11

EVERYTHING down here is more expensive.

OTOH, we pay a living wage, so, you know…

#swingsandroundabouts