May 11, 2016

Type 2 diabetes is dramatically increasing and it seems that treatment options fail dismally. The standard advice to ‘eat less and exercise more’ doesn’t work for most people, and in the case of diabetes it’s not the best treatment.

Type 2 diabetes is a lifestyle disease. Some people are more pre-disposed than others to develop it, but it can be avoided by following a healthy lifestyle. Where an unhealthy lifestyle made people develop the disease, then adopting a healthy lifestyle can help undo the damage.

Most people with Type 2 diabetes are currently, or will eventually be, medicated. The medication helps, but does not stop the progression of the disease, which can lead to limb amputations, renal failure, and blindness. With that sort of prognosis, surely people would prefer prevention rather than ineffective treatment?

Channel 7s Sunday Night featured a segment where three people with Type 2 diabetes prepare to adopt different dietary strategies to treat their condition. One person will follow a low carb healthy fat (LCHF) diet, the second a very low calorie (800 cal/day) diet, and the third a low-GI diet under the guidance of a dietitian.

While interesting, it’s hardly a research study and it’s good to know that channel 7 is not portraying it as such. One subject per group, short term, and no control group mean that any results are just interesting, not evidence. As part of a TV program, it seems fair to assume that there will be some sensationalising, and the relative successes and failures of each participant (and dietary strategy) are likely to be exaggerated.

What is great about Channel 7s work is that the spotlight is being shone on diet as an approach to treating – even reversing – Type 2 diabetes.

Too many people get their diagnosis and then try to follow their doctor’s recommendations. These recommendations rarely include specific dietary advice, only the generalised Australian Healthy Eating Guidelines that do not apply specifically to anyone with a health condition.

This, of course, is not the fault of doctors. Medical schools focus on disease and treatment, not prevention or reversal. They do not focus on nutrition: indeed, some medical students receive no nutrition education, others only a single lecture. Doctors are not qualified or confident in giving nutrition advice.

According to the law of the instrument, Abraham Maslow said in 1966, “I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.” Doctors learn how to treat and medicate disease and this is the tool they have at their disposal.

This is not to say that people should ignore their doctor, of course. It is saying that in some cases the doctor is not the only source of information or treatment. If Type 2 diabetes is in your family, it will be interesting to see what the Sunday Night brings.