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Back to the Future for Diabetes
Technology can take us only so far—and it often doesn’t address the fundamental problem behind diabetes
Until one hundred years ago, carbohydrate restriction was the mainstay of treatment for diabetes, capable of alleviating the symptoms in adults with what we now call type 2 diabetes and prolonging the life of children with type 1 diabetes.
The discovery in 1921 of insulin, a life-saving hormone for people with type 1 diabetes, transformed treatment. Insulin allowed anyone with diabetes to eat carbohydrates without experiencing acute symptoms such as excessive urination and dehydration caused by high levels of the blood sugar glucose.
Today, technology, not diet, dominates diabetes management, including new “designer” insulins and sophisticated devices to monitor blood glucose levels. But despite remarkable advances, diabetes continues to extract a huge toll on patients and public health, with economic costs in the US nearly $1 billion a day (see note at bottom on the egregious price of insulin).
In a special issue of The Journal of Clinical Investigation earlier this year, my colleagues and I argue that to improve health outcomes and reduce costs, the future of diabetes lies in a centuries-old approach: a low-carbohydrate diet.
