Diet AnD Diabetes
In diabetes, the cells of the body cannot get the sugar they need. Glucose, a simple sugar, is the body’s main fuel. It is present in the blood, but in diabetics it cannot get into the cells where it is needed. When diabetes starts in childhood (insulin-dependent diabetes), it is due to an in adequate supply of insulin, the hormone which ushers sugar into the cells of the body. Without insulin, the cell membranes keep sugar out. This form of diabetes is also called Type I or childhood-onset diabetes. When diabetes begins in adulthood (non-insulin-dependent diabetes), it is not due to an inadequate supply of insulin. There is plenty of insulin in the bloodstream, but the cells do not respond readily to it. Sugar cannot easily get into the cells, and it backs up in the bloodstream. This form is also called Type II or adult-onset diabetes. In the short run, diabetics may experience episodes of labored breathing, vomiting, and dehydration. In the long run, diabetics are at risk for heart disease, kidney problems, disorders of vision, and other difficulties.
The old approach to diabetes was to focus on eliminating refined sugars and foods that turned into sugars—starches, breads, fruits, etc.—from the diet. The rationale was based on the fact that diabetics’ urine contains sugar. Unfortunately, with all of the complex carbohydrates eliminated, fat and protein are all that is left in the diet.
The new approach focuses more attention on fat. Fat is a problem for diabetics. The more fat there is in the diet, the harder time insulin has in getting sugar into the cell. Exactly why this occurs is not clear. But what is clear is that minimizing fat intake and reducing body fat help insulin do its job much better. Modern diabetic treatment programs drastically reduce meats, high-fat dairy products, and oils. At the same time, they increase grains, legumes, and vegetables. One study found that 21 of 23 patients on oral medications and 13 of 17 patients on insulin were able to get off of their medications after 26 days on a near-vegetarian diet and exercise program.1 During two- and three-year follow-ups, most diabetics treated with this regimen have retained their gains.2 The dietary changes are simple, but profound, and they work. Low-fat, vegetarian diets are ideal for diabetics.
There is a second essential component to managing diabetes. Through regular exercise, the need for insulin injections can often be reduced, and oral medications often become unnecessary. This holds true not only for people with non-insulin-dependent diabetes, but also to some extent for those with insulin-dependent diabetes. Exercising muscles have a voracious appetite for fuel. When an individual is engaged in regular aerobic exercise, the sugar is able to enter the cells without the need for as much, or perhaps any, insulin.
While people with non-insulin-dependent diabetes can often eliminate medications when their weight is reduced and foods and exercise are better controlled, those with insulin-dependence will always need a source of insulin. The cause of insulin-dependent diabetes remains elusive. Several recent studies have implicated cow’s milk consumption as a possible contributor.3,4 When milk consumption patterns were examined across various nations, there was a very strong correlation with the incidence of insulin-dependent diabetes. It may be that milk proteins cause an autoimmune reaction in which the body mistakenly attacks its own insulin-producing cells. Even so, a good diet and regular exercise can minimize the amount of insulin these diabetics require. This is especially important given their tendency toward complications, heart disease, and other blood vessel problems that are much more common in diabetics. So it is doubly important to keep fit and to keep dietary fat to a minimum.
Diabetics are shortchanged by the diet most doctors give them. The typical American Diabetes Association (ADA) diet is still high in fat. The ADA diet limits the amount of butter, eggs, and so forth, but it contains about 300 milligrams of cholesterol per day and about 30 percent fat.
This fact sheet is not intended as a comprehensive program for diabetes. If you have diabetes, consult your doctor and tailor a program for your needs. But it is important to recognize that, for many, diabetes is a disease that need never occur. In most cases, diabetics can manage their disease much better with a food plan that gets most of its calories from complex carbohydrates while minimizing fats. At the same time, regular, vigorous exercise helps insulin work optimally.
1. Brand JC, Snow BJ, Nabhan GP, Truswell AS. Plasma glucose and insulin responses to traditional Pima Indian meals. Am J Clin Nutr 1990; 51(3):416-20.
2. Barnard RJ, Massey MR, Cherny S, O’Brien LT, Pritikin N. Long-term use of a high-complex-carbohydrate, high-fiber, low-fat diet and exercise in the treatment of NIDDM patients, Diabetes Care 1983;6(3):268-73.
3. Scott FW. Cow milk and insulin-dependent diabetes mellitus: is there a relationship? Am J Clin Nutr 1990;51:489-91.
4. Karjalainen J, Martin JM, Knip M, et al. A bovine albumin peptide as a possible trigger of insulin-dependent diabetes mellitus. N Engl J Med 1992;327:302-7.