July 21, 2003
Meal Planning, Food and Diet
Question from Jacksonville, Florida, USA:
Anyone with diabetes who has tried a lower glycemic, lower carb diet knows it improves blood sugars. I have had type 1 diabetes for 15 years with A1cs of 4.5-5.5% for all of those 15 years. The only way to accomplish normalizing blood sugars 95% of the time is eating this way most of the time, and I have no complications. My five year old son, who also has type 1 diabetes (for two years) eats lower glycemic index foods, and his A1x is 4.5-5.9%.
The FDA Food Guide Pyramid seems to be in question lately with all the low-glycemic, low carb diets around. The past information about excess protein in the diet can cause kidney disease in someone with diabetes with normal kidney function is also in question. Is the Food Guide Pyramid for someone with diabetes going to change? It seem that doctors do not talk about this way of eating for people trying to control blood sugars.
There is on-going discussion on the lower glycemic index, lower carb diet for those with diabetes, and there may be some modifications in new guidelines. Keep in mind that the recommendations are population-based, and this may not be the best for each individual.
I think the bottom line is if the hemoglobin A1c is normal, there are no kidney or cardiovascular complications, and the person is happy with their diet and not feeling that they are “missing out on life”, then do not change anything.
Additional comments from Dr. Stuart Brink:
There are some new research studies about food that suggest there are alternatives to the standard Food Guide Pyramid being used. It’s likely this will be re-evaluated but exactly when is not so clear.
You should consult with your physician and health care team, of course, although it sounds like what you and your son are doing is working well.
Good science is based upon good research and what is now called evidence-based medicine. Good science also acknowledges new information as it becomes available and updates recommendations as appropriate. This applies to diabetes recommendations as well.