Fifty years ago, patients with diabetes managed their diets according to the conventional wisdom of the time. But the accepted theory didn't add up for Charles Read, MD, a UI pediatrician who had devoted considerable time and effort to understanding insulin, diet, and blood glucose.
Read developed his own nutritional approach to diabetes care that he called the "constant carbohydrate diet," and though it did not become a household phrase, the diet now is a widely adopted model for patient care.
When Read earned his medical degree from McGill University in 1943, the so-called "exchange diet" was the nutritional standard for patients with diabetes. This required patients to match the carbohydrate, fat, and protein content of each type of food in order to have variety in their diets.
But these "triple exchanges," Read wrote recently in the International Journal of Pediatric Endocrinology, were difficult for patients—or their parents—to manage; moreover, he wrote, the theory "made little sense to me."
Read had little direct experience with patients with diabetes when he reported for his first faculty appointment at the University of Manitoba in Winnipeg in 1951. Thus, he explained recently, "I was empty and didn't have anything to unlearn. Not knowing anything, I came up with this diet."
Insulin has little role in breaking down fat, Read reasoned, and his experience showed that patients' protein intake typically was "remarkably" stable from day to day. That left carbohydrates as the main variable determining the body's insulin need.
Read's diet focused on maintaining consistency from day to day in each meals' carbohydrate content. Patients could manage their diets much more easily with the aid of a carbohydrate guide.
Dietitians and doctors alike were slow to change their practices. After joining the UI faculty in 1954, Read advocated tirelessly for many years to his colleagues and counterparts, who helped spread knowledge of the constant carbohydrate diet's success.
Today, most practitioners and mainstream organizations, such as the American Diabetes Association, recognize the primacy of carbohydrates in regulating the body's need for insulin.
"They don't all call it the constant carbohydrate diet," said Eva Tsalikian, MD, director of the UI's pediatric endocrinology and diabetes division, "but they practice pretty much what Dr. Read recommended." |
