Even Merck sees the connection between dietary carbs and DM T2

http://www.merck.com/mmpe/sec12/ch158/ch158b.html

Diet adjusted to individual circumstances can help patients control
fluctuations in their glucose level and, for type 2 patients, lose
weight. In general, all diabetics need to be educated about a diet
that is low in saturated fat and cholesterol and contains moderate
amounts of carbohydrate, preferably from whole grain sources with
higher fiber content. Although dietary protein and fat contribute to
caloric intake (and thus, weight gain or loss), only carbohydrates
have a direct effect on blood glucose levels. A low-carbohydrate, high-
fat diet improves glucose control for some patients, but its long-term
safety is uncertain. Patients with type 1 DM should use carbohydrate
counting or the carbohydrate exchange system to match insulin dose to
carbohydrate intake and facilitate physiologic insulinreplacement.
“Counting” the amount of carbohydrate in the meal is used to calculate
the pre-meal insulin dose. In general, patients require 1 unit of
rapid-acting insulin for each 15 g of carbohydrate in a meal. This
approach requires detailed patient education and is most successful
when guided by an experienced diabetes dietician. Some experts advise
use of the glycemic index to delineate between rapid and slowly
metabolized carbohydrates, although others believe the index adds
little. Type 2 diabetics should restrict calories, eat regularly,
increase fiber intake, and limit intake of refined carbohydrates and
saturated fats. Some experts also recommend dietary protein
restriction to ≤ 0.8 g/kg/day to prevent progression of early
nephropathy (see Glomerular Diseases: Diabetic Nephropathy). Dietitian
consultation should complement physician counseling; the patient and
the person who prepares the patient's meals should both be present.
(See also the ADA Position Statement on Nutrition Principles and
Recommendations in Diabetes.)

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TC

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Relevant Pages

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