Today NICE proudly announced that it have come up with a really good idea on how to help manage the diabetes crises in the UK and is proposing that we extend bariatric surgery. Well that is about as imaginative as a cold shower. To be fair Mark Baker did say that the first solution must be diet and exercise but didn’t go on to comment why that had failed so miserably. Of course the journalist on the BBC didn’t ask that question so why would Mark Baker bother to raise this whole issue?

And it is this lack on intellectual engagement by journalists and doctors (other than those like Aseem Mulholtra and a few others) into the issue of diet and exercise which confounds me. If something is not working, and the message of diet and exercise, which has been out there loudly for over 15 years, is not working, you have to ask why and accept that you may need to change your position.

There are numerous reasons why the current message of diet and exercise cannot overcome the current obesity and diabetes challenge and whilst many want to blame the lazy British public, the reality is that this solution is  NOT WORKING. Period. So when something is not working and it hasn’t been working for 15 years do you keep doing it again and again or do you do something different. As Einstein says – madness is doing the same thing again and again but expecting a different outcome.

And is the answer paying for more bariatric operations or is there another alternative? When you look at diabetes it is hard to believe that most intelligent people would not think that the obvious diet to recommend to a sufferer is a low starch low sugar diet rather than bariatric surgery.

So for all the SACN members and all the dieticians busy telling those with diabetics to eat more low fat starch let us just remind ourselves again what diabetes is.

The term “diabetes mellitus” describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both. The effects of diabetes mellitus include long–term damage, dysfunction and failure of various organs (WHO 1999). 

The following is from ‘Biochemistry’ by Berg, Tymoczko & Stryer:

“The hallmark of type2 diabetes is insulin resistance. The beta cells of the pancreas secrete normal or even greater-than-normal amounts of insulin, but the tissues do not respond to the hormone despite the fact that the insulin receptor is functional”

And then let us remind ourselves of the foods that trigger the release of insulin…starch ( yes even the brown stuff) and sugar.  And so diabetes is a condition that will be aggravated by the intake of sugar and starch. Can humans live without sugar and starch? Yes they can. So why tell them to base their diet on these foods?

So I have this really novel idea…We suggest  an alternative to the low fat, low calorie option currently recommended by the BDA and the NHS. We suggest a low sugar low starch diet. Risks nil – likely positive outcome high and I have attached a reference to a recent study which support this view. ( Desperate GPs trying to find a way of helping their patients notwithstanding the BDA.)

It will be cheaper than £15,000 per OP and may prove itself to be a very effective way of managing diabetes without a waiting list of a doctor’s referral.

low carbohydrate diet to achieve weight loss and improve HbA1c in type two diabetes …Unwin Practical Diabetes VOL 31 NO2