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Vegan/vegetarian[edit]
Based on the evidence that well planned vegan diets can be lower in unhealthy processed foods than the standard American diet, some studies have investigated vegan interventions as a possible treatment for Type 2 Diabetes. 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. Additionally, simple carboydrates, abundant in processed foods, which are often not vegan, have the potential to elevate HbA1c levels more than other healthier foods. In multiple clinical trials, participants who were placed on a vegan diet experienced a greater reduction in their Hemoglobin A1c levels than those who followed the diet recommended but the ADA. The American Diabetes Association has released a statement declaring a vegan diet to be a healthful option for all ages. In the ADA's 2018 Standards of Medical Care in Diabetes, a vegan diet was even included as a treatment option. Diabetes UK agrees, and has stated 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.

In one meta analysis done in 2017, the authors agreed on the possibility of a vegetarian diet having preventative effects on Type 2 Diabetes development, however, they concluded that more research on this field needs to be conducted. Another meta analysis that included twelve cohort studies concluded that red meat consumption is associated with an increased risk of Type 2 diabetes. A third meta analysis done in 2013 that compared a variety of different diet's effects on health concluded that a plant  based diet high in whole foods, and with limited processed foods can be beneficial for the treatment and prevention of Type 2 Diabetes.

Although this treatment method is not without controversy, there have been multiple highly publicized supporters. Dr. Neal Barnard, who appeared in the documentary Forks over Knives, has been a vocal proponent of a vegan diet as a Type 2 Diabetes treatment method. Another well know vegan physician and nutrition expert, is Dr. Michael Gregor. He is the author of the book How Not to Die, which emphasizes the importance of diet in health.

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Effects of a Vegan Diet on Type 2 Diabetes
A vegan diet, characterized by its avoidance of all animal derived products has been recommended as a healthy diet for all age groups, that may provide health benefits, and even aid in the treatment and prevention of some diseases. For those with Type 2 Diabetes, diet plays an integral role in the management and treatment of their disease. Some argue that eating a vegan diet is an effective way to manage diabetes with less specific restriction than by following the diet recommended by the American Diabetes Association (ADA). Although the adoption of a vegan diet may not eliminate the many facets of the treatment of Type 2 Diabetes, it may be a more effective way to alter an individual's diet in a cost effective way. An example of a well balanced vegan breakfast, with many vitamins and fiber.

Current Treatment
Current treatment of Type 2 Diabetes includes a combination of blood sugar monitoring, regular excersise and healthy eating, and in some cases insulin injections or other diabetes medications. The diet guidelines currently recommended by the ADA includes less than 300mg of cholesterol per day, less than 10% of calories from trans fat, less than 2300 mg of sodium, more than 25 g of fiber, and 1550-1650 calories. The ADA also recommends eating fish two times per week, and poultry without the skin as ways to incorporate protein. The ADA does concede that limiting red meat intake, due to its relatively higher levels of saturated fat is a way to improve a person with Type 2 Diabetes' diet.

Proponents of a Vegan Diet
Dr. Neal Barnard, who appeared in the documentary Forks over Knives, has been a vocal proponent of a vegan diet as a Type 2 Diabetes treatment method. Dr. Angie Sadeghi, a self proclaimed vegan herself, has been a strong supporter of the use of a vegan diet to improve health. Another well know vegan physician and nutrition expert, is Dr. Michael Gregor. He is the author of the book How Not to Die, which emphasizes the importance of diet in health. Dr. Mauricio Gonzalez, a plant based physician who caters to a Spanish speaking audience, has also proclaimed that a plant based diet can prevent diabetes. In 2009, the ADA released a statement that an appropriately planned vegan diet is healthy through all stages of life, and can proved some health benefits.

Opponents of a Vegan Diet
Some physicians, including Dr. Mercola, advise against the use of a vegan diet. Arguments include nutrient difficentcies, including vitamin B12, and humanity's history of eating animal products. Nutritionist Michelle Strong has also critiqued the vegan diet, noting concerns about protein levels and overconsumption of grain products as possible drawbacks of a vegan diet.

Scientific Rationale
An individual with Type 2 Diabetes in unable to adequelty control their blood glucose levels. The HbA1c level is a good measure of how much control an individual has over their diabetes, as it indicates how much sugar has bound to the red blood cells in that individual over the previous three months. A vegan diet has been shown to lower HbA1c levels more than the diet recommended by the American Diabetes Association in multiple clinical trials. A Lower HbA1c in those who follow a vegan diet means that they had less excess sugar that had to bind to their red blood cells. Simple carboydrates, abundant in processed foods, which are often not vegan, have the potential to elevate HbA1c levels more than other healthier foods. A decrease in the intake of Calcium and vitamin B12 has been a major side effect of this kind of diet.

Current Research
In 2006, a randomized clinical trial was performed by Barnard, N D et al on the effects of a vegan diet on Type 2 Diabetes. This study conducted with 99 participants over 22 weeks, found that those who followed a vegan diet experienced a greater drop in their HbA1c levels than those who followed the diet recommended by the ADA. Another study in 2008 Barnard, N D et al conducted a similar study over a 74 week interval, that also concluded that the group that followed a vegan diet expressed a greater drop in the average HbA1c levels. One clinical trial preformed in Korea in 2016 with 93 participants, also concluded that those who followed a vegan diet for 12 weeks, had a larger reduction in HbA1c levels that the control subjects who followed a diet recommended by he Korean Diabetics Association. A meta analysis has also been preformed in 2013, which concluded that a vegan diet lead to lower HbA1c levels, and weight loss.

Future Research
Many researchers agree that more studies need to conducted in this subject. Clinical trials over longer periods of time have yet to be conducted. Studies with larger sample sizes, and with different levels of severity of Type 2 Diabetes should also be preformed. Marco Springmann performed one study that predicted that the US would save up to 208.2 billion dollars by 2050 in direct healthcare savings if the entire US population became vegan. Many researchers agree that a vegan diet can be less expensive than a traditional American diet, but major research has yet to be done on the implications of a vegan diet as a treatment method on the entirety of the financial cost of being afflicted with Type 2 Diabetes.

See Also

Vegan Nutrition

The Vegan Society

Diabetic Diet