|This article needs more medical references for verification or relies too heavily on primary sources. (June 2014)|
Diabetic diet refers to the diet that is recommended for people with diabetes mellitus. There is much controversy regarding what that diet should consist of. The diet most often recommended is high in dietary fiber, especially soluble fiber, but low in fat (especially saturated fat) and low in sugar. Recommendations of the fraction of total calories to be obtained from carbohydrate are generally in the range of 40 to 65%, but recommendations can vary as widely as from 16 to 75% . People with diabetes may be encouraged to reduce their intake of carbohydrates that have a high glycemic index (GI), although this is also controversial. (In cases of hypoglycemia, they are advised to have food or drink that can raise blood glucose quickly, such as lucozade, followed by a long-acting carbohydrate (such as rye bread) to prevent risk of further hypoglycemia.) However, others question the usefulness of the glycemic index and recommend high-GI foods like potatoes and rice. It has been claimed that oleic acid has a slight advantage over linoleic acid in reducing plasma glucose.
There has been long history of dietary treatment of diabetes mellitus – dietary treatment of diabetes mellitus was used in Egypt since 3,500 B.C., and was used in India by Sushruta and Charaka more than 2000 years ago. In the eighteenth century, John Rollo argued that calorie restriction in the diabetic diet could reduce glycosuria in diabetes. However, more modern history of the diabetic diet may begin with Frederick Madison Allen, who, in the days before insulin was discovered, recommended that people with diabetes ate only a low-calorie diet to prevent ketoacidosis from killing them. This was an approach which did not actually cure diabetes but merely extended life by a limited period. The first use of insulin by Frederick Banting in 1922 changed things, and at last allowed patients more flexibility in their eating.
In the 1950s, the American Diabetes Association, in conjunction with the U.S. Public Health Service, introduced the "exchange scheme". This allowed people to swap foods of similar nutritional value (e.g. carbohydrate) for another, so, for example, if wishing to have more than normal carbohydrates for dessert, one could cut back on potatoes in one's first course. The exchange scheme was revised in 1976, 1986 and 1995.
However, not all diabetes dietitians today recommend the exchange scheme. Instead, they are likely to recommend a typical healthy diet: one high in fiber, with a variety of fruit and vegetables, and low in both sugar and fat, especially saturated fat. A diet that is high in plant fibre was recommended by James Anderson (Anderson & Ward, 1979; cited in Murray & Pizzorno, 1990). This may be understood as continuation of the work of Denis Burkitt and Hugh Trowell on dietary fibre, which in turn, may be understood as a continuation of the work of Price (Murray & Pizzorno, 1990). It is still recommended that people with diabetes consume a diet that is high in dietary fiber.
In 1976, Nathan Pritikin opened a centre where patients were put on programme of diet and exercise (the Pritikin Program). This diet is high on carbohydrates and fibre, with fresh fruit, vegetables, and whole grains. A study at UCLA in 2005 showed that it brought dramatic improvement to a group of people with diabetes or pre-diabetes in only three weeks, so that about half no longer met the criteria for the disease.
On the other hand, in 1983, Richard K. Bernstein began treating people with diabetes and pre-diabetes successfully with a very low carbohydrate diet, avoiding fruit, added sugar, and starch. Both the Pritikin approach and the Bernstein approach prescribe exercise.
An approach that has been popular with some people with type one diabetes mellitus since 2000 is known as DAFNE (Dose Adjustment for Normal Eating). This approach involves estimating how much carbohydrates there will be in a meal and modifying the amount of insulin one injects before meal accordingly. An equivalent approach has for people with type two diabetes mellitus is known as DESMOND, which stands for Diabetes Education and Self-Management for On-Going and Newly Diagnosed (diabetes). DAFNE has its own newsletter and has received recommendation.
The American Diabetes Association in 1994 recommended that 60–70% of caloric intake should be in the form of carbohydrates. As mentioned above, this is controversial, with some researchers claiming that 40% or even less is better, while others claim benefits for a high-fiber, 75% carbohydrate diet.
An article summarizing the view of the American Diabetes Association contains the statement: "Sucrose-containing foods can be substituted for other carbohydrates in the meal plan or, if added to the meal plan, covered with insulin or other glucose-lowering medications. Care should be taken to avoid excess energy intake." Sucrose does not increase glycemia more than the same number of calories taken as starch. It is not recommended to use fructose as a sweetener. Benefits may be obtained by consumption of dietary fibre in conjunction with carbohydrate; as Francis (1987) points out, evidence suggests that carbohydrate consumed with dietary fiber will have a less major impact on glycemic rise than the same amount of carbohydrate consumed alone.
What has not generally been included in diabetic diet recommendations is the variation in effect from different carbohydrates. It has been recommended that carbohydrates eaten by people with diabetes should be complex carbohydrates.
Despite a common belief that table sugar contributes to the development of diabetes, it has medium (55–69) glycemic index that actually produces lower blood glucose levels than the same number of calories obtained from some other sources of carbohydrates. The Canadian Diabetes Association recommended that table sugar be included as part of the diabetes diet.
Some studies have suggested that adding vinegar to food may help to prevent carbohydrates putting up blood sugar too dramatically.
Richard K. Bernstein is critical of the standard American Diabetes Association diet plan. His plan includes very limited carbohydrate intake (30 grams per day) along with frequent blood glucose monitoring, regular strenuous muscle-building exercise, and, for people using insulin, frequent small insulin injections if needed. His treatment target is "near normal blood sugars" all the time.
Another critic of the ADA program is futurologist and transhumanist Ray Kurzweil, who together with Terry Grossman co-authored Fantastic Voyage: Live Long Enough to Live Forever (published 2004). They describe the ADA guidelines as "completely ineffective". Their observations are that the condition, particularly in its early stages can be controlled through a diet which has sharply reduced carbohydrate consumption. Their guidelines for patients with type 2 diabetes is a diet that includes a reduction of carbohydrates to one sixth of total caloric intake and elimination of high glycemic load carbohydrates. As someone who was previously diagnosed with diabetes but who no longer has symptoms of the disease, Kurzweil is a firm advocate of this approach. However, Kurzweil's prescription changed somewhat between his 1993 book The 10% Solution for a Healthy Life in which he recommended that only 10% of calories should come from fat, and Fantastic Voyage which recommends 25%.
Based on the evidence that the incidence of diabetes is lower in vegetarians, some studies have investigated vegan interventions. These studies have shown that a vegan diet may be effective in managing type 2 diabetes. Plant-based diets tend to be higher in fiber, which slows the rate sugar is absorbed into the bloodstream. Switching people with diabetes to a vegan diet lowered hemoglobin A1C and LDL levels. A vegan diet may improve blood filterability. Vegan diets may lower advanced glycation endproducts.Limited evidence suggests that reductions in iron stores increase insulin sensitivity. A vegan diet provides iron in its nonheme form, which is somewhat less absorbable than heme iron.
Diabetes U.K. state that diabetes should not prevent people from going vegetarian – in fact, it may be beneficial for people with diabetes to go vegetarian, as this will cut down on saturated fats. Recent evidence suggests that people with diabetes may benefit from as many as eight portions of fruit and vegetable a day.
Individuals with type 2 diabetes on a low-fat vegan diet or a diet following ADA guidelines improved glycemic control; however, the changes were greater in the vegan group.
Timing of meals
For people with diabetes, healthy eating is not simply a matter of "what one eats", but also when one eats. The question of how long before a meal one should inject insulin is asked in Sons ken, Fox and Judd (1998). The answer is that it depends upon the type of insulin one takes and whether it is long, medium or quick-acting insulin. If patients check their blood glucose at bedtime and find that it is low, for example below 6 millimoles per Liter (108 mg/dL), it is advisable that they take some long-acting carbohydrate before retiring to bed to prevent night-time hypoglycemia. Night sweats, headaches, restless sleep, and nightmares can be a sign of nocturnal hypoglycemia, and patients should consult their doctor for possible adjustments to their insulin routine if they find that this is the case. Counterintuitively, another possible sign of nocturnal hypoglycemia is morning hyperglycemia, which actually occurs in response to blood sugar getting too low at night. This is called the Somogyi Effect.
Special diabetes products
- They may be expensive,
- They may contain high levels of fat
- They may confer no special benefits to people who have diabetes.
It should also be noted that NICE, the National Institute for Health and Clinical Evidence (based in the United Kingdom), advises doctors and other health professionals to "Discourage the use of foods marketed specifically for people with diabetes".
Research has shown the Maitake mushroom (Grifola frondosa) has a hypoglycemic effect, and may be beneficial for the management of diabetes. The reason Maitake lowers blood sugar is because the mushroom naturally acts as an alpha glucosidase inhibitor. Other mushrooms like Reishi, Agaricus blazei, Agrocybe cylindracea and Cordyceps have been noted to lower blood sugar levels to a certain extent, although the mechanism is currently unknown.
Alcohol and drugs
Moderation is advised with regard to consuming alcohol and the use of some drugs. Alcohol inhibits glycogenesis in the liver and some drugs inhibit hunger symptoms. This, together with impaired judgment, memory and concentration caused by some drugs can lead to hypoglycemia. People with diabetes who take insulin or tablets such as sulphonylureas should not, therefore, ever consume alcohol on an empty stomach, but take some starchy food (such as bread or potato crisps) at the same time as consumption of alcohol.
G.I. Diet – lowering the glycemic index of one's diet can improve the control of diabetes. This includes avoidance of such foods as potatoes cooked in certain ways, and white bread, and instead favoring multi-grain and sourdough breads, legumes and whole grains—foods that are converted more slowly to glucose in the bloodstream.
Low Carb Diet – It has been suggested that the removal of carbohydrates from the diet and replacement with fatty foods such as nuts, seeds, meats, fish, oils, eggs, avocados, olives, and vegetables may help reverse diabetes. Fats would become the primary calorie source for the body, and complications due to insulin resistance would be minimized.
High fiber diet – It has been shown that a high fiber diet works better than the diet recommended by the American Diabetes Association in controlling diabetes, and may control blood sugar levels with the same efficacy as oral diabetes drugs.
Paleolithic diet – The Paleolithic diet has been shown to improve glucose tolerance in humans with diabetes type 2, humans with ischemic heart disease and glucose intolerance, and in healthy pigs.
- Diabetes management
- Diabetic diet (low-carb)
- Glycemic index
- Glycemic efficacy
- Low GI Diet
- Low-carbohydrate diet
- National Institutes of Health
- Lindeberg, Staffan (2010). Food and Western Disease: Health and Nutrition from an Evolutionary Perspective. Chichester, U.K.: Wiley-Blackwell. ISBN 1-4051-9771-4. OCLC 435728298.
- Sönsken, Peter; Fox, Charles; Judd, Sue (1998). Diabetes at Your Fingertips (Fourth ed.). London: Class Publishing. ISBN 1-872362-79-6. OCLC 41019837.
- Ramachandran, A.; Viswanathan, M. (1997). "Dietary management of diabetes mellitus in India and South Asia". In DeFronzo, Ralph A.; Alberti, K. G. M. M.; Zimmet, Paul. International textbook of diabetes mellitus. London: J. Wiley. pp. 773–7. ISBN 0-471-93930-7. OCLC 32628217.
- Bowling, Stella (1995). The Everyday Diabetic Cookbook. Grub Street Publishing. ISBN 1-898697-25-6.
- Govindi, A.; Myers, J. (1995) . Recipes for Health: Diabetes. Low fat, low sugar, carbohydrate counted recipes for the management of diabetes. London: Thorsons/Harper Collins. ISBN 0-7225-3139-7. OCLC 33280079.
- Murray, M. & Pizzorno, J. (1990). Encyclopaedia of Natural Medicine. London: Littlebrown and Company. ISBN 1-85605-498-5[verification needed]
- Francis, Dorothy Brenner (1987). Diets for sick children. London: Blackwell Scientific Publications. pp. 128–44. ISBN 0-632-00505-X. OCLC 18781984.
- Thomson, W.; Ireland, J. T.; Williamson, John (1980). Diabetes today: a handbook for the clinical team. New York: Springer. pp. 112–20. ISBN 0-8261-3491-2. OCLC 300560258.
- British Diabetic Association (November 2009). Festive Foods and Easy Entertaining. British Diabetic Association. ISBN 9781899288878.
- Katsilambros N, Liatis S, Makrilakis K (2006). "Critical Review of the International Guidelines: What Is Agreed upon – What Is Not?". Nestlé Nutrition Workshop Series: Clinical & Performance Program 11: 207–18; discussion 218. ISBN 3-8055-8095-9. PMID 16820742. doi:10.1159/000094453.
- John McDougall Glycemic Index – Not Ready for Prime Time, The McDougall Newsletter, July 2006.
- Segal-Isaacson CJ; Carello E; Wylie-Rosett J (October 2001). "Dietary fats and diabetes mellitus: is there a good fat?". Curr Diab Rep. NLM.NIH.gov 1 (2): 161–9. PMID 12643112. doi:10.1007/s11892-001-0029-3.
- Peterson, Amy Rachel; Karen Hanson Chalmers (1999). 16 Myths of a Diabetic Diet. Alexandria, VA: American Diabetes Association. p. 85. ISBN 1-58040-031-0.
- Trowell, Hugh C. & Burkett, Denis P. (1981). Western diseases: their emergence and prevention. Cambridge, MA: Harvard University Press. xiii–xvi. ISBN 0-674-95020-8.
- Frank W. Booth & Manu V. Chakravarthy (2006). "Physical activity and dietary intervention for chronic diseases: a quick fix after all?". J Appl Physiol 100 (5): 1439–1440. doi:10.1152/japplphysiol.01586.2005.
- Roberts CK, Won D, Pruthi S, Kurtovic S, Sindhu RK, Vaziri ND, and Barnard RJ. (2006). "Effect of a short-term diet and exercise intervention on oxidative stress, inflammation, MMP-9, and monocyte chemotactic activity in men with metabolic syndrome factors". J Appl Physiol 100 (5): 1657–1665. PMID 16357066. doi:10.1152/japplphysiol.01292.2005.
- Roberts, Christian., and Barnard, R. James (2005). "Effects of exercise and diet on chronic disease". Journal of Applied Physiology 98 (1): 3–30. PMID 15591300. doi:10.1152/japplphysiol.00852.2004.
- Shaoni Bhattacharya "Three-week diet curbs diabetes", New Scientist, 13 January 2006.
- "DAFNE Home".
- Garg A, Bantle JP, Henry RR et al. (May 1994). "Effects of varying carbohydrate content of diet in patients with non-insulin-dependent diabetes mellitus". JAMA 271 (18): 1421–8. PMID 7848401. doi:10.1001/jama.271.18.1421.
- Kiehm TG, Anderson JW, Ward K (1976). "Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men". The American Journal of Clinical Nutrition 29 (8): 895–9. PMID 941870.
- Bantle JP, Wylie-Rosett J, Albright AL et al. (2006). "Nutrition recommendations and interventions for diabetes—2006: a position statement of the American Diabetes Association". Diabetes Care 29 (9): 2140–57. PMID 16936169. doi:10.2337/dc06-9914.
- Sugar.ca[unreliable source?]
- Ann Wolters. "Effects Of Vinegar On Blood Sugar". livestrong.com.
- Nielsen JV, Joensson E (2006). "Low-carbohydrate diet in type 2 diabetes. Stable improvement of bodyweight and glycemic control during 22 months follow-up". Nutrition & Metabolism 3: 22. PMC 1526736. PMID 16774674. doi:10.1186/1743-7075-3-22.
- "Original Human 'Stone Age' Diet Is Good For People With Diabetes, Study Finds". ScienceDaily. 2007-06-28. Retrieved 2007-07-24.
- Bernstein, Richard K (2007). Dr Bernstein's Diabetes Solution. New York, NY: Little, Brown and Company. ISBN 978-0-316-16716-1.[page needed]
- Snowdon, D. A.; Phillips, R. L. (1985). "Does a vegetarian diet reduce the occurrence of diabetes?". American Journal of Public Health 75 (5): 507–512. PMC 1646264. PMID 3985239. doi:10.2105/AJPH.75.5.507.
- Jenkins DJ, Kendall CW, Marchie A et al. (2003). "Type 2 diabetes and the vegetarian diet". Am. J. Clin. Nutr. 78 (3 Suppl): 610S–616S. PMID 12936955.
- Nicholson AS, Sklar M, Barnard ND, Gore S, Sullivan R, Browning S (1999). "Toward improved management of NIDDM: A randomized, controlled, pilot intervention using a lowfat, vegetarian diet". Prev Med 29 (2): 87–91. PMID 10446033. doi:10.1006/pmed.1999.0529.
- Nicholson A (February 15, 2005). "Diabetes: Can a Vegan Diet Reverse Diabetes?". Physicians Committee for Responsible Medicine. Retrieved 2007-07-24.
- Barnard ND, Cohen J, Jenkins DJ et al. (2006). "A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes". Diabetes Care 29 (8): 1777–83. PMID 16873779. doi:10.2337/dc06-0606. Lay summary – News-Medical.Net (2006-08-08).
- McCarty, M. (2002). "Favorable impact of a vegan diet with exercise on hemorheology: implications for control of diabetic neuropathy". Medical Hypotheses 58 (6): 476–486. PMID 12323113. doi:10.1054/mehy.2001.1456.
- McCarty, M. (2005). "The low-AGE content of low-fat vegan diets could benefit diabetics – though concurrent taurine supplementation may be needed to minimize endogenous AGE production". Medical Hypotheses 64 (2): 394–398. PMID 15607576. doi:10.1016/j.mehy.2004.03.035.
- Ashley Henshaw (May 25, 2012). "Diabetes Nutrition Tips: 6 Foods You’ll Love". Retrieved January 7, 2013.
- "Diabetic foods – Joint statement on ‘diabetic foods’ from the Food Standards Agency and Diabetes UK". Positional statements. Diabetes UK. July 2002. Archived from the original on 2006-11-28. Retrieved 2006-10-22.
- NICE Clinical Guideline CG87 Type 2 diabetes: The management of type 2 diabetes. http://publications.nice.org.uk/type-2-diabetes-cg87
- Konno S, Tortorelis DG, Fullerton SA, Samadi AA, Hettiarachchi J, Tazaki H (2001). "A possible hypoglycaemic effect of maitake mushroom on Type 2 diabetic patients". Diabetic Medicine 18 (12): 1010. PMID 11903406. doi:10.1046/j.1464-5491.2001.00532-5.x.
- Hong L, Xun M, Wutong W (2007). "Anti-diabetic effect of an alpha-glucan from fruit body of maitake (Grifola frondosa) on KK-Ay mice". The Journal of Pharmacy and Pharmacology 59 (4): 575–82. PMID 17430642. doi:10.1211/jpp.59.4.0013.
- Kubo K, Aoki H, Nanba H (1994). "Anti-diabetic activity present in the fruit body of Grifola frondosa (Maitake). I". Biological & Pharmaceutical Bulletin 17 (8): 1106–10. PMID 7820117. doi:10.1248/bpb.17.1106.
- Lo HC, Hsu TH, Chen CY (2008). "Submerged culture mycelium and broth of Grifola frondosa improve glycemic responses in diabetic rats". The American Journal of Chinese Medicine 36 (2): 265–85. PMID 18457360. doi:10.1142/S0192415X0800576X.
- Manohar V, Talpur NA, Echard BW, Lieberman S, Preuss HG (2002). "Effects of a water-soluble extract of maitake mushroom on circulating glucose/insulin concentrations in KK mice". Diabetes, Obesity & Metabolism 4 (1): 43–8. PMID 11874441. doi:10.1046/j.1463-1326.2002.00180.x.
- Horio H, Ohtsuru M (2001). "Maitake (Grifola frondosa) improve glucose tolerance of experimental diabetic rats". Journal of Nutritional Science and Vitaminology 47 (1): 57–63. PMID 11349892. doi:10.3177/jnsv.47.57.
- Matsuur H, Asakawa C, Kurimoto M, Mizutani J (2002). "Alpha-glucosidase inhibitor from the seeds of balsam pear (Momordica charantia) and the fruit bodies of Grifola frondosa". Bioscience, Biotechnology, and Biochemistry 66 (7): 1576–8. PMID 12224646. doi:10.1271/bbb.66.1576.
- Zhang HN, Lin ZB (2004). "Hypoglycemic effect of Ganoderma lucidum polysaccharides". Acta Pharmacologica Sinica 25 (2): 191–5. PMID 14769208.
- Yang BK, Jung YS, Song CH (2007). "Hypoglycemic effects of Ganoderma applanatum and Collybia confluens exo-polymers in streptozotocin-induced diabetic rats". Phytotherapy Research 21 (11): 1066–9. PMID 17600864. doi:10.1002/ptr.2214.
- Liu Y, Fukuwatari Y, Okumura K et al. (2008). "Immunomodulating Activity of Agaricus brasiliensis KA21 in Mice and in Human Volunteers". Evidence-based Complementary and Alternative Medicine 5 (2): 205–219. PMC 2396466. PMID 18604247. doi:10.1093/ecam/nem016.
- Kim YW, Kim KH, Choi HJ, Lee DS (2005). "Anti-diabetic activity of beta-glucans and their enzymatically hydrolyzed oligosaccharides from Agaricus blazei". Biotechnology Letters 27 (7): 483–7. PMID 15928854. doi:10.1007/s10529-005-2225-8.
- Hsu CH, Liao YL, Lin SC, Hwang KC, Chou P (2007). "The mushroom Agaricus Blazei Murill in combination with metformin and gliclazide improves insulin resistance in type 2 diabetes: a randomized, double-blinded, and placebo-controlled clinical trial". Journal of Alternative and Complementary Medicine 13 (1): 97–102. PMID 17309383. doi:10.1089/acm.2006.6054.[unreliable medical source?]
- Fortes RC, Novaes MR, Recôva VL, Melo AL (2009). "Immunological, hematological, and glycemia effects of dietary supplementation with Agaricus sylvaticus on patients' colorectal cancer". Experimental Biology and Medicine 234 (1): 53–62. PMID 18997106. doi:10.3181/0806-RM-193.[unreliable medical source?]
- Kiho T, Sobue S, Ukai S (1994). "Structural features and hypoglycemic activities of two polysaccharides from a hot-water extract of Agrocybe cylindracea". Carbohydrate Research 251: 81–7. PMID 8149381. doi:10.1016/0008-6215(94)84277-9.
- Kiho T, Hui J, Yamane A, Ukai S (1993). "Polysaccharides in fungi. XXXII. Hypoglycemic activity and chemical properties of a polysaccharide from the cultural mycelium of Cordyceps sinensis". Biological & Pharmaceutical Bulletin 16 (12): 1291–3. PMID 8130781. doi:10.1248/bpb.16.1291.
- Kiho T, Yamane A, Hui J, Usui S, Ukai S (1996). "Polysaccharides in fungi. XXXVI. Hypoglycemic activity of a polysaccharide (CS-F30) from the cultural mycelium of Cordyceps sinensis and its effect on glucose metabolism in mouse liver". Biological & Pharmaceutical Bulletin 19 (2): 294–6. PMID 8850325. doi:10.1248/bpb.19.294.
- Zhao CS, Yin WT, Wang JY et al. (2002). "CordyMax Cs-4 improves glucose metabolism and increases insulin sensitivity in normal rats". Journal of Alternative and Complementary Medicine 8 (3): 309–14. PMID 12165188. doi:10.1089/10755530260127998.
- Lo HC, Tu ST, Lin KC, Lin SC (2004). "The anti-hyperglycemic activity of the fruiting body of Cordyceps in diabetic rats induced by nicotinamide and streptozotocin". Life Sciences 74 (23): 2897–908. PMID 15050427. doi:10.1016/j.lfs.2003.11.003.
- Li SP, Zhang GH, Zeng Q et al. (2006). "Hypoglycemic activity of polysaccharide, with antioxidation, isolated from cultured Cordyceps mycelia". Phytomedicine : International Journal of Phytotherapy and Phytopharmacology 13 (6): 428–33. PMID 16716913. doi:10.1016/j.phymed.2005.02.002.
- Brand-Miller, J.; Foster-Powell, K.; Nutr, M.; Brand-Miller, Janette (1999). "Diets with a low glycemic index: from theory to practice". Nutrition today 34 (2): 64–72. doi:10.1097/00017285-199903000-00002.
- Sheard, NF; Clark, NG; Brand-Miller, JC; Franz, MJ; Pi-Sunyer, FX; Mayer-Davis, E; Kulkarni, K; Geil, P (2004). "Dietary carbohydrate (amount and type) in the prevention and management of diabetes: a statement by the american diabetes association". Diabetes Care 27 (9): 2266–71. PMID 15333500. doi:10.2337/diacare.27.9.2266.
- Chandalia, M; Garg, A; Lutjohann, D; Von Bergmann, K; Grundy, SM; Brinkley, LJ (2000). "Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus". The New England Journal of Medicine 342 (19): 1392–8. PMID 10805824. doi:10.1056/NEJM200005113421903.
- Rodríguez-Morán, M; Guerrero-Romero, F; Lazcano-Burciaga, G (1998). "Lipid- and Glucose-Lowering Efficacy of Plantago Psyllium in Type II Diabetes". Journal of Diabetes and its Complications 12 (5): 273–8. PMID 9747644. doi:10.1016/S1056-8727(98)00003-8.
- Schwartz, SE; Levine, RA; Weinstock, RS; Petokas, S; Mills, CA; Thomas, FD (1988). "Sustained pectin ingestion: effect on gastric emptying and glucose tolerance in non-insulin-dependent diabetic patients". The American journal of clinical nutrition 48 (6): 1413–7. PMID 2849298.
- Jonsson T, Granfeldt Y, Ahren B, Branell UC, Palsson G, Hansson A, Lindeberg S (2009). "Beneficial effects of a paleolithic diet on cardiovascular risk factors in type 2 diabetes: A randomized cross-over pilot study". Cardiovascular Diabetology 8: 35–49. PMC 2724493. PMID 19604407. doi:10.1186/1475-2840-8-35.
- Lindeberg S, Jönsson T, Granfeldt Y, Borgstrand E, Soffman J, Sjöström K, Ahrén B (2007). "A Palaeolithic diet improves glucose tolerance more than a Mediterranean-like diet in individuals with ischaemic heart disease". Diabetologia 50 (9): 1795–807. PMID 17583796. doi:10.1007/s00125-007-0716-y.
- Jönsson T, Ahrén B, Pacini G, Sundler F, Wierup N, Steen S, Sjöberg T, Ugander M, Frostegård J, Göransson L, Lindeberg S (2006). "A Paleolithic diet confers higher insulin sensitivity, lower C-reactive protein and lower blood pressure than a cereal-based diet in domestic pigs". Nutrition & Metabolism 3 (39): 39. PMC 1635051. PMID 17081292. doi:10.1186/1743-7075-3-39.