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ADA Recommendations Now Include Low Carbs

Feb 19, 2008

Laura Plunkett is glad that the American Diabetes Association has supported low-carbohydrate diets for people with diabetes who want to reduce their weight. But she is sorry that the have not endorsed the same diet for blood sugar control. In this weeks article she shares how low carbs worked at her house.

I felt relief when I read the newly-published 2008 ADA clinical practice recommendations. For the first time the American Diabetes Association has supported low-carbohydrate diets for people with diabetes who want to reduce their weight. I only wish they’d go a step further and endorse the same diet for blood sugar control.


Six years ago, when my son was diagnosed with juvenile diabetes, we came home from the hospital with a meal plan from the dietician full of his favorite foods: pancakes, grilled cheese, pasta, and juice. We were told Danny could eat what he wanted as long as we gave him insulin to cover the carbohydrates. I carefully measured, counted, and gave the prescribed amount of insulin. The problem was that it didn’t work. Before a meal, Danny might have had a blood sugar of 130 mg/dl, but two hours after eating macaroni and cheese, he’d be at 300 mg/dl, and two hours later, he’d have dropped to 50 mg/dl.

It was only after many painful months of this roller coaster ride that I began to suspect that, in part, food was the culprit. On a typical night, I’d serve a dinner with the prescribed 60-80 carbohydrates, and my husband and I would spend the rest of the night going back and forth to Danny’s room as his blood sugars fluctuated. It was clear that the injected insulin couldn’t keep up with his body’s too rapid conversion of food to sugar. White bread or pasta would spike his blood sugar levels before the insulin could kick in. Then the resulting food high would fade before the insulin finished working, and Danny would end up with low blood sugars.

My husband and I were exhausted and Danny was physically rundown. It was in this bleary and frazzled state that I started doing my own research about nutrition. I studied the glycemic index, whole foods nutrition, and low-carbohydrate diets. Slowly, I developed a set of goals that I introduced to my family. Let’s cut out white flour and white sugar. Let’s cut out ingredients with names we cannot pronounce, including artificial sweeteners and coloring. Let’s eat more fruits and vegetables, whole grains, and lean protein. Most importantly, let’s decrease our carbohydrates to 40 per meal.

It was not an easy sell, especially to Danny whose only edible vegetable at the time was a cucumber! The kids were seven and ten years old so we needed to start slowly. We went from white bread to oat bran bread to whole wheat bread and finally to sprouted whole wheat. We started with iceberg lettuce soaked in dressing before moving to green leaf, red leaf and, finally nutrient-rich spinach and kale. If Danny wanted pasta, I served a small amount with lots of vegetables and chicken on the side. We’d eat a slice or two of pizza with a large salad. We could see the results with our own eyes. Danny’s blood sugars held steady after meals and at the end of three months, his A1c had dropped two points. Life in our house improved noticeably for all of us; we had fewer colds and fevers and increased energy.

So, yes, I am happy to see that the ADA recommends a lower-carbohydrate diet for people who want to lose weight. And for those hard-working, conscientious parents who are wondering why their slender children’s blood sugar levels are still unfolding in peaks and valleys, I wish the ADA would recommended nutrient-rich, low-glycemic, low-carbohydrate food for everyone. In the meantime, I encourage people to see whether adjusting their diet in this direction works for them. With the help of a glucose meter, you can see food in action, measure its effect upon the body, and decide for yourself.

Laura Plunkett is a columnist for Diabetesincontrol.com and Diabetes Health magazine and author of the book, “The Challenge of Childhood Diabetes: Family Strategies for Raising a Healthy Child”. She recently spoke at the Juvenile Diabetes Symposium at the University of California, San Francisco. The Plunkett family has been featured in the Boston area on television, radio, and many local and national parenting magazines and newspapers. Laura currently speaks on the topic of “Raising Wholesome Children in a Fast-Food World: A Framework for Family Health” with her mother, Linda Weltner, and her daughter, Jessica. She had a thriving therapeutic private practice for 14 years with families, individuals and couples. Laura can be reached at lauramplunkett@challengeofdiabetes.com