"The inability of current recommendations to control the epidemic of diabetes, the specific failure
of the prevailing low-fat diets to improve obesity, cardiovascular risk or general health and the
persistent reports of some serious side effects of commonly prescribed diabetic medications, in
combination with the continued success of low-carbohydrate diets in the treatment of diabetes
and metabolic syndrome without significant side effects, point to the need for a reappraisal of
The benefits of carbohydrate restriction in diabetes are immediate and well-documented.
Concerns about the efficacy and safety are long-term and conjectural rather than data-driven.
Dietary carbohydrate restriction reliably reduces high blood glucose, does not require weight loss
(although is still best for weight loss) and leads to the reduction or elimination of medication and
has never shown side effects comparable to those seen in many drugs.
Here we present 12 points of evidence supporting the use of low-carbohydrate diets as the first
approach to treating type 2 diabetes and as the most effective adjunct to pharmacology in type 1.
They represent the best-documented, least controversial results. The insistence on long-term
random-controlled trials as the only kind of data that will be accepted is without precedent in
science. The seriousness of diabetes requires that we evaluate all of the evidence that is
available. The 12 points are sufficiently compelling that we feel that the burden of proof rests
with those who are opposed."
Feinman RD, Pogozelski WK, Astrup A, et al, Dietary Carbohydrate restriction as the first approach in diabetes
management. Critical review and evidence base, Nutrition (2014), doi: 10.1016/j.nut.2014.06.011.