The following article from Diabetes Care linked below claims “High-carbohydrate, high-fiber (HCF) diets have beneficial therapeutic effects for selected patients with diabetes mellitus.”
This is typical ADA baloney, but I must admit at first glance it appeared as though the findings of this study may have supported the use of high carbohydrate diets in the treatment of diabetics. It took me all of five minutes to figure out the flaws of this study, their findings, and conclusions.
The study findings have been presented in a way by the above referenced article from Diabetes Care a publication of the ADA that obscures the fact that dietary carbohydrate raises blood sugar and claims adding dietary carbohydrate fosters blood sugar control and reduces insulin requirements. The abstract notes an improvement of blood sugars, and lipid profiles for those studied and a decrease in insulin requirements when the percentage of total caloric intake of carbohydrate increases from 43% to 70% and that these improvements were maintained by adhering to a diet that contains 55% to 60% carbohydrate.
What the authors don’t tell you is the 43% carbohydrate diets were not observed they were likely based on reports of what the patient had been eating prior to hospitalization or worse yet on generalizations based on large population data. The patients were likely eating more total calories before hospitalization but in any event was likely not accurately determined. It also does not disclose the caloric content of any of the diets.
These ommissions and faulty assumptions whether intentional or not challenge the universal validity of this study. If the patients had been getting 43% of carbohydrate from a 2500 calorie a day diet and only 1600 calories a day on the 70% carbohydrate diet, total carbohydrate consumption would increase by only 5% from the pre-hospitalization diet vs. the hospital diet. A corresponding decrease in protein consumption from 156 grams of protein a day to 60 grams of protein a day would account for the decrease in insulin and other blood sugar lowering medication requirements. If 3000 calories a day with 43% derived from carbohydrate were consumed on the pre-hospitalization diet then the total amount of carbohydrate on the HCF diet consumed by the patients in the trial while hospitalized would have actually decreased if the HCF diet consisted of 1600 calories. This along with the reduction in protein consumed, even if protein as a percentage of total calories decreased as it often does on carbohydrate restricted diets would certainly account for the reduction in insulin and other blood sugar lowering medication requirements.
If the amount of calories in the maintenance diet increased to 2000 and the decreased percentage of calories derived from carbohydrate were replaced with calories derived from protein, the total amount of insulin or other blood sugar lowering medications would remain constant as the absolute amount of carbohydrate would change very little while the total amount of protein may only increase slightly having a statistically insignificant effect. This is what likely occurred.
This study only shows that eating less, if the baseline diet is assumed to be mixed, reduces requirements for blood sugar lowering medications and improves blood sugar control. Duh. The study didn’t compare the effects of high carbohydrate fiber diets vs. high fat protein diets that were equal in total calories. The pharmaceutical companies won’t fund a study that shows their dangerous drugs like sulfonyloreas are not necessary or that industrial doses of safe and effective drugs like insulin confer no benefit. The ADA won’t fund them either because their mendicant pleas for money to fund research for a pharmacological or surgical cure would lose their urgency and appeal if people knew that treatments for diabetes already exist which normalize blood sugar through dietary means and the use of medication currently on the market.