The CulinaryRx blogger at MedPageToday asked two physicians what diet modifications they’d recommend for a 41-year-old man with prediabetes. (To read the article you may need to do a free sign-up.)
The moderator asked his experts twice whether carbohydrate restriction is important, and never got a straight answer. These experts must not think it’s important since they push legumes, lentils, fruits, and whole grains. Dr. Nadeau said he believes there is no specific diet for folks with diabetes. I almost fell off my chair when I read one comment recommending cookies and sweets, because they’re traditional. They also recommend low glycemic load, nuts, higher protein consumption, vegetables, and “good oils” like olive oil (ghee not mentioned).
Read this blog post for prior comments that include advice from possible clinicians.
I’m confident that Dr. Ronesh Sinha in Silicon Valley, California, would disagree with the advice of MedPageToday’s experts. Dr. Sinha would likely recommend limiting digestible carbohydrates to 50–150 grams/day as the most important dietary step. (I plan on a review of Dr. Sinha’s book here within a few months.)
I’m still looking for clinical studies of various diets for South Asians (aka Indian Asians) with prediabetes and diabetes.
Steve Parker, M.D.
Diabetic Mediterranean Diet 
The transcript reads like the fable of the Blind Men and the Elephant. How can physicians who treat diabetics on a daily basis be so clueless as to the cause of impaired glucose tolerance in anyone, whether South Asian or not ???
About the only logical thing said was Dr. Puma’s statement “And in fact both of you suggested proteins and carbohydrates at breakfast for the blueberries and the protein powder leaving out the good oils which are important both for absorption of specific vital nutrients to reduce inflammation as Dan indicates as well as to improve satiety and of course to not release insulin. Having fat in the diet – fat is really the only noninsulin-releasing macronutrient.” The other two suggested canola oil (and olive oil, to be fair) in response–canola is a highly inflammatory processed seed oil!
It’s terrifying to think that patients put themselves in the hands of these doctors.
Jan, I share all of your concerns.