Blindness is the most feared complication faced by people with type 2 diabetes and the one I deal with at work every day. Diabetes is now the leading cause of blindness among working-age adults in Australia.
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There are three proven methods for putting type 2 diabetes into remission: bariatric surgery, very low calorie diets and low-carbohydrate diets.
Bariatric surgery involves changes to the digestive system designed to limit caloric intake and promote weight loss. It can put type 2 diabetes into remission, but patients require lifelong dietary supplements to combat the accompanying nutritional deficiency. And it's a major abdominal procedure on a normal organ for what is in essence a dietary disease.
So, why not take a dietary approach to a dietary disease?
Very low calorie diets are 800 calorie per day starvation diets which require calorie counting and are quite simply not sustainable as they require a lifelong demand on willpower. They are also dependent on ultra-processed food-like substances which are designed to benefit the manufacturer and are the very antithesis of real food.
Low-carbohydrate diets are my pick. There have been more than 100 controlled clinical trials that show low-carbohydrate "real food" diets work to prevent type 2 or put it into remission.
There are no such trials to show that a wholly plant-based diet can put type 2 diabetes into remission. Low-carb diets are enjoyable, sustainable, nutritionally rich and avoid hunger and the need for calorie counting.
Ahead of the release late last year of the 2021-30 National Diabetes Strategy, I shared a database of low-carb diet studies with the expert advisory group working on the strategy, along with the plea "Should the opportunity for remission not be offered to every patient with type 2 diabetes?" I'm delighted that "remission" was included under one of the major goals of the strategy.
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Sadly, health practitioners have been band-aiding type 2 diabetes with medications that don't put type 2 into remission, don't extend life and can potentially hasten the devastating complications of this disease.
I worry that vested interests have not only shaped what we eat and driven chronic disease in our society, they've also shaped how we treat these diseases.
Eligible patients with type 2 diabetes should be given an opportunity to put their disease into remission, an opportunity that's free from vested interests.
Healthcare professionals must be given the opportunity to guide their patients through an effective and clinically proven dietary solution to their condition.
- Dr James Muecke is an Adelaide-based ophthalmologist and co-founder of the eye health charity Sight For All. He was Australian of the Year in 2020.