Diabetes

BMJ: Practices Should Be Able to Keep Money Saved from Putting Patients on a Low-Carbohydrate Diet

Doctor using a blood glucose meter

When people with diabetes start a low-carb diet, their need of medications often immediately plummets.

How could we encourage this? How about letting practices keep the money saved, effectively incentivizing health professionals for helping their patients improve and get off drugs?

Dr. David Unwin suggests this great idea in the British Medical Journal.

The article

GPs who advise patients on the benefits of a low carbohydrate diet to manage type 2 diabetes should be entitled to keep all or part of any resulting savings in their drugs bill, an independent forum of MPs and peers has heard.

David Unwin, a GP in Southport made the proposal on 28 March at the All Party Parliamentary Food and Health Forum. The forum is conducting a hearing on diabetes and diet, chaired by the Labour peer and former London GP Nicolas Rea.

Unwin said that his practice’s spending on type 2 diabetes drugs (excluding insulin) was £4194 (€4940; $5260) less per 1000 patients than the average of £7385 per 1000 patients across the clinical commissioning group area

He said that the main advice at his practice was to consume a diet with a low glycaemic index. “As well as cutting out sugar, this involves reducing intake of starchy carbohydrates such as bread, rice, and potatoes. These digest down into glucose that people with type 2 diabetes can no longer metabolise. So, by having toast and cornflakes with a glass of apple juice for breakfast, they are in effect having sugar with their sugar with their sugar,’ said Unwin.

He recently published research showing popular high carbohydrate food in terms of teaspoons of sugar as calculated from the glycaemic index (table 1⇓).2 He told the forum, “If only doctors could be made aware of the difference this information could make to dietary choices. We have eaten our way into this epidemic of type 2 diabetes, and a low carb diet is a possible way of eating our way out again.”

Lord Rea welcomed the proposal. “If your results could be rolled out across the UK, it would save many millions of pounds,” he said. “A low carb diet also offers a much needed additional method of managing this major disease entity that brings mortality forward many years along with complications that significantly reduce quality of life.”

Read the full article here:

BMJ: Practices should be able to keep money saved from putting patients on low carbohydrate diet, GP says

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