Intended for healthcare professionals

Rapid response to:

Endgames Case Review

A patient request for some “deprescribing”

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4023 (Published 03 August 2015) Cite this as: BMJ 2015;351:h4023

Rapid Response:

Re: A patient request for some “deprescribing”

As a registered dietitian and certified diabetes educator, I have witnessed the dramatic improvements in health experienced by patients who adopt a low-carbohydrate diet. From declines in A1c to reduction in hypoglycemic events to improved energy levels and ability to more easily maintain a healthful body weight, carbohydrate restriction results in profound benefits for people with type 1 and type 2 diabetes.

The current low-fat recommendations espoused by many dietitians and other health care professionals often result in elevated postprandial blood glucose levels that require ever-increasing dosages of insulin and/or oral diabetes medication in order to achieve mediocre control (A1c of less than 7%r). These recommendations also encourage snacking as a result of hunger within 2-3 hours of eating meal.

On the other hand, eating nutrient-dense, low-carbohydrate foods not only allows people to achieve normal blood glucose levels (A1c less than 5.7%) while minimizing mealtime insulin dosage requirements (or in the case of Type 2 diabetes, discontinuation or lowering of diabetes medication) but also increases satiety, leads to a less atherogenic lipid profile (particularly in those with metabolic syndrome), simplifies meal planning, and improves overall wellness and quality of life.

Competing interests: No competing interests

31 August 2015
Franziska Spritzler
Registered Dietitian
19051 Goldenwest Street, Suite 446, Huntington Beach, CA 92648