The American Diabetes Association misses the mark… again (sigh)


The American Diabetes Association (ADA) released its updated position statement for the evaluation and management of youth-onset type 2 diabetes. And it once again demonstrated it has blinders on when it comes to lifestyle interventions to treat and prevent type 2 diabetes. The ADA lays the blame solely on obesity, suggesting kids simply need to eat less and move more to treat their diabetes.

American Diabetes Association: The evaluation and management of youth-onset type 2 diabetes

Where have we heard this before? Oh yeah, in the ADA’s position statement on type 2 diabetes for adults. But then we had trials from David Ludwig showing us that all calories are not the same. Then came studies showing a low-carb diet was effective for reversing type 2 diabetes, with the most impressive study showing a reversal of type 2 diabetes in over 60% of subjects, with 94% reducing or eliminating their need for insulin.

To its credit, the ADA has added a brief mention of low-carb, high-fat diets for treating adults with type 2 diabetes, and the current position statement on kids mentions the need to limit sugar-sweetened beverages. But that doesn’t change the fact that this guideline is stuck in the antiquated “calories-in, calories-out” model — a model where drug therapy is first line treatment.

There isn’t a single mention of a low-carb diet.

Unfortunately, this cannot be taken lightly. As the guideline recognizes, kids with type 2 diabetes have a more aggressive course than adults, with a faster rate of beta cell deterioration, poorer response to medications, and earlier complications resulting in significant morbidity and mortality. This is a disease that needs comprehensive and aggressive treatment. Why wouldn’t they mention low-carb diets?

Some, such as Dr. Robert Lustig, would argue it’s due to Big Pharma’s monetary influence on the ADA. For the sake of all our kids and the future of this world, I hope that is not the case. I hope that continued education of pediatric endocrinologists as to the power of a low-carb diet will someday soon turn the tide away from “calories-in, calories-out” and toward an understanding of the power of carbohydrate restriction in reversing type 2 diabetes.


New major study: A calorie is not a calorie

Cutting calories won’t solve your weight issues – do this instead

Is low carb the best treatment for reversing diabetes?

Does caloric restriction cause weight loss? Not according to science!

Low carb


  1. David
    Youth onset type 2? Adult onset type2? These people disgust me. I'm a type 1adult onset and I didn't do anything to deserve this. For 40 years now I have put a lot of effort in to controlling my blood sugars. Type 2's are quite literally eating themselves to death and enjoying, too much so, all the sweet and high carb junk that they self indulge themselves with. They deserve what they get. They are spoiled and don't deserve help. The ADA ought to give its funding to the JDRF and help in the research to find a cure for what really is a disease. An opinion....for what it's worth.
  2. My
    Wow David. How uncompassionate of you. You would not want someone to judge you as a t1, so don't judge the t2s. There are so many who work equally hard to control their blood sugar. (I am proud to work with these many). There are amazing t2 triathlon racers, professional cycalists and other athletes. I don't think you are a nice person to call them "spoiled" or not deserving of help.
    Get off your horse.
  3. Joan
    I too am deeply troubled by David's comments, though he is just saying aloud what many mistakenly think. Having struggled with my weight for years I can tell you with certainty that some persons brains signal them to eat at a much much higher rate than others do. I had to say no to eating many times within any given hour, even if I had just eaten and my stomach felt distended. It wasn't until I had a doctor who let me try Victoza (even though I was not yet T2) that I saw how the rest of the world lived. It was so much less distracting! Then when I went LCHF my appetite reduced even more. Now I can go without Victoza as long as I stay away from carbs and eat plenty of fat.

    Some of us have bodies (appetite regulation systems) that constantly scream for food on low fat diets. It kind of feels like an obsessive-compulsive disorder, and it is certainly as distracting OCD. So actually I think I had phenomenal self control under the circumstances!
    Watch the Netflix series called This Is US for a little insight into how hard some children and adults find it to manage their weight. It is a sad disorder because in addition to all the health problems, you face constant stigma; society says it's your fault. I evidenced great self-discipline in many other areas of my life (PhD, tenure, publications, art, well raised children) but the drive to eat was always a demon in my mind. Imagine not being able to NOT think about eating. I finally fell apart from all my drive and had to just accept my obesity. LCHF is the first diet I have been on in years, and I tried it to help with another medical condition.
    So please David, take a second look. You will meet some wonderful people who simply have a physical disorder...just like you.

  4. Jane
    What a nasty, unsympathetic and rather ignorant comment, David. Many of us have a lifetime struggle with our weight which has nothing to do with over-eating or a healthy diet. Such a judgmental attitude may well backfire on you when you need help.
  5. Larry
    Is the ADA the only organization for diabetics. If they are it might be a good time to start a new organization to displace them.
  6. Keto-Paula
    Well well seem to have made friends here. I am not as disgusted or upset with David because (to quote a line from the movie THE HELP) "you can't help the hopeless". David is one of those Narcisstic types who cannot relate or empathize with anyone other than himself. I, on the other hand, am grateful for this Diet Doctor platform because it has educated all of us to the science and diversification of how various carbohydrates, insulin, or resistance, and gut bacteria, or the lack thereof, contributes to the development of inflammation in various organs which in turn lead to various diseases, and morbid obesity. There is another epidemic in this world, and that is the lack of education and tolerance for those who happen to be obese and have diabetes. This discrimination is not limited to just social interaction, but it is a Hollywood/media/television/social media discriminating cancer that needs to be corrected. Thankfully television has picked up on the success of a Ketogenic/low carb diet and brought awareness to the unaware, whether it is well received or not. The info is out there and many suffers have found freedom from obesity, diseases and discrimination. Thumbs up diet Doctor, I am fast becoming one of the success stories.

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