Friday, June 09, 2006

Low-Carb Research Featured at ADA 66th Scientific Sessions

Today the American Diabetes Association opens the 66th Scientific Sessions in Washington, DC with some intriguing presentations. Unlike previous years, I'm not able to attend this year's sessions, but am carefully following the program line-up and hope to write about as much of the latest research findings as possible in the days to follow.

Today two presentations of interest are found in the session, Conundrum - A Diverse Mix of Approaches to Nutrition and Diabetes Education, scheduled for 4:15PM.

In the first, Efficacy and Safety of Carbohydrate Restriction Diets in Obese Type 2 Diabetes, researchers evaluated the efficacy and safety of carbohydrate restricted diets compared with the conventional prescribed dietary approach for those with type II diabetes. They conclude "Carbohydrate restriction is an effective means of weight loss in type 2 diabetes over 6mths, associated with reduced waist circumference. Furthermore it was not associated with any deleterious effect on glycaemic control, other risk factors or renal safety over a 6mth period."

Within this study group, there were two statistically significant findings between the diets - weight loss and reduction of waist circumference. In all other measures, the differences did not reach significance, but were greater in those following the low-carb diet.In the second study, A Randomized, Controlled Trial of a Low-Glycemic Index vs. a Low-Carbohydrate, Ketogenic Diet for Type 2 Diabetes, researchers evaluated differences between a very low-carb diet (ketogenic) and a low glycemic index diet (good carb). Again, the better approach was a low-carb diet. The researchers conclude, "Both lifestyle interventions led to medication reduction, weight loss, and improved glycemic control, but the LCKD led to a greater reduction in HgbA1c after 3 months."

It's important to note that 79% of those assigned the low-carb diet either reduced or eliminated their medications within the three month trial. This is a finding consistent with numerous other studies evaluating a low-carb diet - reduction or elimination of medication in a relatively short period of time.

In previous years similar findings such as these have been presented at the annual Scientific Sessions. Yet, they remain ignored by the ADA and those considered "expert" in the management and treatment of diabetes within the organization. I personally find this dismissal of evidence not only contrary to the standards of evidence-based medicine, but also a major breach of trust between the leading diabetes organization, healthcare professionals on the frontlines of an epidemic of diabetes and the public.

I've previously written some scathing words here about the ADA:

I remain of the opinion that the ADA must accept the evidence as it stands - evidence that for decades has found the dietary recommendation they advance is inferior to other approaches - specifically carbohydrate restricted diets. Millions of people in the United States - MILLIONS - are already living with type II diabetes, millions more are already pre-diabetic. If the ADA does not rethink their standards of care, I fear that number will only continue to rise in both our youth and adults in the United States.

I've said it before, and I'll say it again - we have the evidence, we have the hard data, we have thousands already off diabetic medication following a low-carb diet...when will we accept it and finally take an evidence-based approach and actually run with it to reverse this epidemic?

When will the ADA be held accountable to the millions already diagnoised with diabetes and the millions more on the road to diabetes?

1 comment:

  1. It's been 3 months since you posted this, and I see no comments here... saddening AND maddening!

    CDA (Canadian Diabetes Association) pretty much trails along behind the ADA, putting policy/position papers before evidence-based medicine and recommendations.

    What are the possibilities of getting this info and commentary to and feedback directly from the front line? The "diabetes educators" and nurse-practitioners and nutritionists and MDs (GPs as well as Endos)?!

    Does it happen? I fear it does not...