Diet and Diabetes

Alan R. Gaby, MD
JAMA. 1981;246(12):1302. doi:10.1001/jama.1981.03320120014014.
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To the Editor.—  In his discussion of dietary management of insulindependent diabetes mellitus (1981; 245:1771), James R. Sowers, MD, neglects an important point. Accumulating evidence indicates that diets high in fiber and complex carbohydrates improve diabetic control, as manifested by reduction in glycosuria, decrease in postprandial and fasting blood glucose levels, beneficial changes in lipoprotein patterns, and reduction in insulin requirements.1-5While maintaining an ideal body weight is an appropriate dietary goal for diabetics, it is certainly not the only goal. The benefits previously noted usually occurred without changes in body weight. The improved control is more likely related to the slow absorption of high-fiber foods, particularly legumes.It is no longer adequate to consider diabetic diets simply in terms of their proportion of fat, carbohydrate, and protein. Individual foods affect glucose metabolism in ways that cannot be explained by their macronutrient concentrations. Evidence indicates that diabetics should increase


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