Dietary treatment of diabetes mellitus in the pre-insulin era (1914-1922).
ABSTRACT Before the discovery of insulin, one of the most common dietary treatments of diabetes mellitus was a high-fat, low-carbohydrate diet. A review of Frederick M. Allen's case histories shows that a 70% fat, 8% carbohydrate diet could eliminate glycosuria among hospitalized patients. A reconsideration of the role of the high-fat, low-carbohydrate diet for the treatment of diabetes mellitus is in order.
SourceAvailable from: Wendy K Pogozelski[Show abstract] [Hide abstract]
ABSTRACT: The inability of current recommendations to control the epidemic of diabetes, the specific failure of the prevailing low-fat diets to improve obesity, cardiovascular risk, or general health and the persistent reports of some serious side effects of commonly prescribed diabetic medications, in combination with the continued success of low-carbohydrate diets in the treatment of diabetes and metabolic syndrome without significant side effects, point to the need for a reappraisal of dietary guidelines. The benefits of carbohydrate restriction in diabetes are immediate and well documented. Concerns about the efficacy and safety are long term and conjectural rather than data driven. Dietary carbohydrate restriction reliably reduces high blood glucose, does not require weight loss (although is still best for weight loss), and leads to the reduction or elimination of medication. It has never shown side effects comparable with those seen in many drugs. Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1. They represent the best-documented, least controversial results. The insistence on long-term randomized controlled trials as the only kind of data that will be accepted is without precedent in science. The seriousness of diabetes requires that we evaluate all of the evidence that is available. The 12 points are sufficiently compelling that we feel that the burden of proof rests with those who are opposed. (C) 2015 The Authors. Published by Elsevier Inc.Nutrition 07/2014; 31(1). DOI:10.1016/j.nut.2014.06.011 · 3.05 Impact Factor
Article: Insulin: moments in history[Show abstract] [Hide abstract]
ABSTRACT: The isolation of insulin by Banting and Best in 1922 was a historic event of life-saving importance. Thousands of individuals doomed to die of type I diabetes were saved. The inspiring story of insulin continued to grow and evolve with the development of PZI, NPH, and lente insulins. The advent of production of human insulin from recombinant DNA brought an end to the extraction of insulin from animal pancreas. Modification of the amino acid sequences of insulin led to new forms of fast-acting insulin, such as lispro, aspart, and glulisine, and to long-acting insulins like glargine and detemir. The technology of insulin pumps advanced from large, cumbersome equipment to present-day devices no bigger than a hand calculator. The accuracy of implantable glucose sensors improved progressively, culminating in the approval of devices that will soon exert reliable feedback control of insulin pumps. Transplantation of the pancreas offers a cure for type I diabetes, and the development of islet cell transplantation continues. It is now appreciated that islet cells regenerate in the normal pancreas, and islet cell neogenesis agents have been identified and may eventually contribute to the reversal of diabetes. Drug Dev Res 69:95–100, 2008. ©2008 Wiley-Liss, Inc.Drug Development Research 05/2008; 69(3):95 - 100. DOI:10.1002/ddr.20232 · 0.73 Impact Factor
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ABSTRACT: Research on the role of behavior change as an efficacious intervention for adults with type 2 diabetes is evolving. Searching PubMed and Ovid Medline, we identified and reviewed primarily randomized controlled trials from 2010 to 2013 of adults managing type 2 diabetes without insulin. All studies are evaluated in terms of the rigor of their design and their impact on glycosylated hemoglobin. The most efficacious interventions appear to be low-carbohydrate/glycemic load diets, combined aerobic and resistance training, and self-monitoring of blood glucose, which educates patients about the impact of their food selections and physical activity on their blood glucose.Current Diabetes Reports 09/2013; DOI:10.1007/s11892-013-0423-7 · 3.38 Impact Factor