Rethinking the Triad of Diabetes Management in the New Millennium

Historically, few individuals developed what is now known as type 2 diabetes, because a sedentary lifestyle and access to calories in excess of daily requirements was an unimaginable luxury for all but a few. When insulin-requiring diabetes did occur, it was extremely rare. For centuries, the only therapeutic options were dietary management and the promotion of physical activity. However, these strategies were usually short-lived.Author Michael Bliss, in his book, The Discovery of Insulin , describes in detail many of the early diets used to treat diabetes.1 One, known as the Allen Starvation Diet, was prescribed for the treatment of diabetes from 1910 to 1921.2 The goal of this diet was to extend life for several months to years.The nutritional strategies of this “starvation” approach are outlined in alarming detail in the 1921 4th edition of the book, The Allen (Starvation) Treatment of Diabetes with a Series of Graduated Diets. 2 The book, co-written by a dietitian, included the following starvation procedure: fasting the affected individual until glucosuria cleared, then initiating the consumption of moderate quantities of protein and fat with only small amounts of carbohydrate. The starvation diet also suggested the inclusion of 1.5 oz of whiskey. The alcohol provided additional calories as well as helped to make patients more comfortable as they were starving. The book then provided a series of maintenance diets that could be used after the starvation phase had reduced glucosuria. The book's …