0
Invited Commentary |

Moving Dietary Management of Diabetes Forward

Holly Kramer, MD, MPH1; Alex Chang, MD, MS2
[+] Author Affiliations
1Departments of Medicine and Public Health Sciences, Loyola University Chicago, Maywood, Illinois
2Department of Medicine, Johns Hopkins University, Baltimore, Maryland
JAMA Intern Med. 2013;173(18):1692-1693. doi:10.1001/jamainternmed.2013.8094.
Text Size: A A A
Published online

Extract

Type 2 diabetes mellitus is a nutritional disease with genetic and environmental cofactors. The goals of nutritional management of type 2 diabetes should include maintaining near-normal plasma glucose levels without risking hypoglycemia, controlling blood pressure and weight, and avoiding the complications of kidney and cardiovascular disease.

Unfortunately, dietary recommendations for individuals with type 2 diabetes have been quite varied and often contradictory over time. John Rollo, a surgeon general in the Royal Artillery of the British Army in 1797, first prescribed a diet composed mainly of animal products, particularly old, rancid meat, but no fruits and vegetables.1 Consequent improvement in glycosuria with this diet may have been due to weight loss itself rather than avoidance of carbohydrates. Severe carbohydrate and caloric restriction for type 2 diabetes management was endorsed by others, such as Frederick M. Allen, who introduced the “Allen Starvation Treatment” in 1914.2 This diet provided only 10 g/d of carbohydrates. Subsequent ketosis with this diet was managed by excessive water consumption and adding alkali or even alcohol to the diet.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();