In the spring of 1919, 11-year-old Elisabeth Hughes developed diabetes and often felt weak and tired due to dry mouth and drinking glass after glass of water.
Dr. F.M. Allen, then the nation’s foremost expert on diabetes, immediately gave Elizabeth “starvation therapy” – in addition to regular hunger strikes, she ate only lean meat, chicken, milk, a little fruit, a lot of fruit, and a lot of biscuits. In addition to regular hunger strikes, she usually eats only lean meat, chicken, milk, a little fruit, tasteless crackers, and vegetables that have been cooked several times to lose their sugar.
After a year of treatment, Elizabeth, who was 151 centimeters tall and 34 kilograms at the time of her illness, lost 24 kilograms and spent most of her time lying in bed reading or sewing.
In the summer of 1921, a 29-year-old surgeon, F.G. Banting, discovered insulin with the help of Professor J.J.R. Macleod, head of the Department of Physiology at the University of Toronto School of Medicine, and 21-year-old C.H. Best, a first-year master’s student, and it has since changed the lives of countless diabetics. Elizabeth is one of them.
Frederick Grant Banting
Source: Wikipedia
In August 1922, Elizabeth, teetering on the brink of death, was recommended by Dr. Arlen to receive insulin treatment from Dr. Banting and lived a healthy, normal life, marrying a young lawyer and having three children until she died of a sudden heart attack in 1981 at the age of 73.
In honor of Dr. Banting, who discovered insulin, the International Diabetes Federation celebrates his birthday, November 14, as World Diabetes Day, calling on the world to care for the needs of people with diabetes and to raise public awareness of the disease.
The International Diabetes Federation celebrates World Diabetes Day on his birthday, November 14, to raise awareness of the needs of people with diabetes.
“Starvation therapy” was the only treatment for diabetes in the early 21st century
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Although Dr. Banting discovered insulin in 1921, production of insulin began in June 1922, and mass production of insulin began in February 1923. In other words, in the early 20th century, the newly discovered insulin was difficult to obtain because of its limited availability.
So scholars advocated a very low-calorie diet (20% protein, 70% fat, 10% low-carb), known as the starvation diet, to control weight and achieve rapid reductions in urinary sugar levels in people with diabetes, which was considered at the time to be the only treatment for diabetes.
Robert Atkins
Source: Wikipedia
The concept of a low-carb diet was first introduced in 1972 by American physician Robert Atkins, whose Atkins diet consists of 4% carbohydrates, 64% fat, and 32% protein. The Atkins diet attracted widespread criticism from the mainstream medical community because it was so different from the mainstream diet and went against the widely accepted view that excess fat and protein were risk factors for disease. But Atkins was not discouraged, and he published another book in 1990 to update his views, and other physicians began to publish books expressing similar views.
After almost a century, the low-carb diet is making a comeback, and even gaining mainstream acceptance
In recent years, as research has increased, the call for a low-carbon-diet approach to diabetes has grown and even made a comeback. By the beginning of the 21st century, up to 18% of the US population was trying low-carbon diets.
In 2017, Virta Health, a US-based diabetes telehealth company that focuses on low-carbon-ketogenic diets, is treating people with diabetes by collecting patient data and giving remote dietary guidance. Meanwhile a clinical trial conducted by Virta Health in collaboration with Indiana University showed that patients treated with a low-carbon ketogenic diet had varying degrees of reduction in blood pressure, cholesterol, liver and kidney function indicators, and white blood cells.
And just this past October 4, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) jointly published a consensus report on diabetes that included low-carbon diets in adult diabetes management protocols for the first time.
The report states that there is no definitive ratio of carb, protein, and fat intake that is appropriate for all people with diabetes. The dietary regimen recommends using healthy foods, reducing harmful foods, catering to the patient’s preferences and metabolic needs, and building on healthy eating habits to ensure that it is feasible and sustainable. The recommended dietary regimen in the report includes a low-carbon diet.
So could a low-carb diet replace glucose medication or insulin and save people with diabetes?
Not really.
First, the long-term safety of low-carb diets is unknown. Although there are a number of cases and foreign studies that demonstrate the effectiveness of low-carbon diets in reducing weight, lowering glucose, and improving insulin resistance, especially in the first 3 to 6 months. However, this only shows the feasibility, better efficacy and safety of low-carbon diets in the short term. As for how a low-carbon-diet affects the body’s metabolic response and thus regulates the physiological responses in the body, the exact mechanism remains to be studied.
Also, maintaining a low-carb diet over time may have health consequences. A recent study published in The Lancet, a leading British medical journal, showed that after following more than 15,000 adults aged 45 to 64 in four U.S. communities for 25 years and regularly counting their recipes and health status, researchers found that people who consumed more carbohydrates or too few carbohydrates had a lower average life expectancy than those who consumed the right amount of carbohydrates. The average life expectancy of those who consumed too much or too little carbohydrate was lower (79, 83, and 82 years for the lower, moderate, and excess carbohydrate groups, respectively).
Even a study by scientists from Germany and the United States reported that unhealthy diets such as high-fat, high-sugar, low-fiber diets can make the body’s defenses more “aggressive” in the long term. The study found that an unhealthy diet led to an unexpected increase in the number of certain immune cells in the blood of mice, especially granulocytes and monocytes, which triggered an immune inflammatory response.
The bad news is that these inflammatory responses can accelerate the development of vascular disease or type 2 diabetes. And, because an unhealthy diet alters the way genetic information is packaged, it has long-term effects on the immune system’s response.
How do we get the low-carb diet right?
Low carb diets are indeed one of the options for treating obesity and managing diabetes. But if a person with diabetes is going to try a low-carb diet for diabetes, make sure you talk to your doctor and dietitian about it beforehand!
Patients should be carefully evaluated as to whether they are physically fit to use it, whether the severity of their condition and the degree of complications necessitate it, and whether the use is properly regulated; especially if they are on insulin injections or glucose-lowering medications. Because this type of diet will lower blood sugar, if improperly used, coupled with the hypoglycemic effect of drugs, may trigger serious hypoglycemia, which should not be ignored.
November 14 is the annual World Diabetes Day. The International Diabetes Federation (IDF) has chosen the theme for World Diabetes Day 2018-2019 as Families and Diabetes, calling attention to the important role of families in the prevention, management and care of diabetes.
To learn about diabetes and fight it together, Tencent Medical Dictionary works with millions of families with diabetes!