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作者认为沿用已久的简单限制糖尿病患者摄取碳水化合物的饮食方案缺乏科学依据。在亚洲和非洲,由于经济方面的原因,依赖胰岛素维持的糖尿病患者仍以碳水化合物为主食,但并未见因此使病情加重。目前已有令人信服的依据证实,糖尿病患者摄取能量的60～80％可由含碳水化合物的食物供给,并可同时减少外源性胰岛素的用量。作者认为,糖尿病患者适应摄取碳水化合物之机制可能为胰岛素受体和受体结合后的活性发生变化,增加胰岛素受体结合后活性可提高胰岛素外周敏感性及增加糖酵解途径的酶类的活性。胰岛素不足时,糖尿病患者不会发生这一改变。若胰岛素补充得当,则对碳水化合物的摄取可与非糖尿病患者相同。所有营养物质均能转化为葡萄糖,认为每天只能供给10g碳水化合物的糖尿病饮食方案是没有生理学根据的。目前的生理学研究表明,调节能量摄入对于控制糖尿病更有营养学意义,由于强调摄取低碳水化
The authors argue that there is a lack of scientific justification for the well-established diet regimen for carbohydrate intake in patients with limited diabetes. In Asia and Africa, people with diabetes who rely on insulin for maintenance are still predominantly carbs for economic reasons, but nothing has worsened their condition. At present, there is a convincing evidence that 60-80% of the energy consumed by diabetic patients can be supplied by carbohydrate-containing foods and at the same time, the amount of exogenous insulin can be reduced. The authors believe that diabetic patients may adapt to carbohydrate intake mechanism of insulin receptor and receptor binding activity changes, increase insulin receptor binding activity can increase insulin peripheral sensitivity and increase the activity of glycolytic enzymes . Insulin deficiency, this change will not occur in diabetic patients. If insulin is properly supplemented, carbohydrate intake can be the same as in nondiabetic patients. All nutrients can be converted to glucose, consider the daily diet can only provide 10g of carbohydrate diet program is not physiologically based. Current physiological studies have shown that the regulation of energy intake is more nutritious for the control of diabetes, due to the emphasis on low-carbohydrate intake