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.
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.