Every day 100s of pieces of diabetes-related research are published and disseminated through cyberspace. In most cases they vary from the ludicrously irrelevant to mildly interesting but in very rare circumstances there is something potentially revolutionary. I just read a study that falls into the latter category for diabetes management.
A recently published study* of 800 non-diabetic people fitted with CGM found that
“Surprisingly, the foods that raise blood sugar levels differ dramatically from person to person.”
“…the scientists found that different people responded very differently to both simple and complex meals. For example, a large number of the participants’ blood sugar levels rose sharply after they consumed a standardized glucose meal, but in many others, blood glucose levels rose sharply after they ate white bread, but not after glucose. “ http://www.sciencedaily.com/releases/2015/11/151119143445.htm
So this study shows that the science we’ve been taught about carb counting and the GI factor does not hold true in individuals. Let that sink in for a moment. Those handy books with their carb count and GI factor and those alogorithms based on averages….they don’t work. We have been taught that white bread has a GI factor very similar to glucose and yet here are many people with very different response to glucose than white bread.
One woman had huge spikes from eating tomatoes. I’m almost certain that if a diabetic took a food diary and bsl record/CGM output to a health care professional that showed highs after eating tomatoes, the HCP would think she was a “non-compliant liar”. Why wouldn’t they when everyone “knows” tomatoes are low-carb and low GI?
What’s particularly exciting about the study is that the researchers were able to do a follow-up study in which they designed personalised “good” and “bad” diets for participants . These diets obviously varied for each person but the good diets kept sugars stable while the “bad” diets showed spikes. What’s even more exciting from a diabetes perspective is that the researchers were able to use the data from individuals to predict their personalised bsl response.
This is huge! You’d think the endos, the DEs, the dietitians and Diabetes organisations like ADA, IDF (who are telling us all to eat a healthy diet) would be abuzz. If this study can be replicated and holds true for people with diabetes (either type 1 and/or type 2) this would revolutionise diabetes education. Standardised advice and algorithms cannot be relied upon. Studies that show average results for groups of people can’t be applied to individuals. This is particularly heartening to me, who tried to follow a low-carb diet only to find that it made me insulin resistant. I suspect that I might have inherited the genes of my ancestors who thrived on a diet consisting almost entirely of potatoes, so I am genetically programmed for carbs. So a study that shows that the average reduction in insulin needs for a group on LCHF is greater than those on a moderate carb, low fat diet does NOT mean that a LCHF diet is best for everyone in achieving a reduction in insulin needs.
So my questions for the 1000s of HCPs working in diabetes, the 1000s of researchers, the professional associations of dietitians, Endos, DEs and the diabetes organisations like American Diabetes Association and Diabetes Australia who bang on ad nauseum about “diet”
*Who is going to fund the replication of this study in people with diabetes?
*Pending the urgent resolution of whether this information holds true in people with diabetes, when will you amend your diet advice?
*Dietitians and DEs, will you amend your practice to gather the data necessary for each individual and then devise a personalised diet for each person rather than the standard dissemination of information.
*Diabetes organisations will you lobby and advocate for the resources necessary to gather the data and create individualised diets for optimising blood sugar stability?
Will this study just fade into oblivion whilst people continue to be handed generalised dietary information that is potentially harmful and certainly won’t achieve optimal control of diabetes?
*The quotes are from the above linked Science Daily Journal, the original article is available here: Personalized Nutrition by Prediction of Glycemic Responses. Cell, 2015; 163 (5): 1079 DOI: 10.1016/j.cell.2015.11.001