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QUESTIONING THE BENEFITS OF HIGH-CARBOHYDRATE DIETS FOR DIABETICS.

The currently recommended diet for non-insulin- dependent diabetes mellitus (NIDDM) is high in carbohydrates (50 to 60 percent of the energy source) and relatively low in fats (30 percent of the energy source). This study compared the effects of two different diets on blood sugar and blood lipids; the diets were equal in terms of calories, simple carbohydrates, and fiber, but one was high in carbohydrates and the other was high in fats, especially monounsaturated fats.

Ten patients with NIDDM were given both diets at different times. Compared with the high-carbohydrate diet, the high-monounsaturated-fat diet led to lower levels of glucose, triglycerides, and very-low-density lipoprotein cholesterol, reduced insulin requirements, and higher levels of beneficial HDL cholesterol, without raising levels of LDL cholesterol.

This study and an accompanying editorial challenge the American Diabetes Association's recommendation of a high- carbohydrate diet. It remains to be seen whether this evidence will lead to a change in recommended diet therapy.

— ALK

Published in Journal Watch General Medicine October 4, 1988

Citation(s):

Reaven G M. Dietary therapy for non-insulin-dependent diabetes mellitus. N Engl J Med 1988 Sep 29 319 862-864.

• Medline abstract (Free)

Garg A; Bonanome A; Grundy S M; Zhang Z J; Unger R H. Comparison of a high-carbohydrate diet with a high- monounsaturated-fat diet in patients with non-insulin- dependent diabetes mellitus. N Engl J Med 1988 Sep 29 319 829-834.

• Medline abstract (Free)

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