A recent case study in the Annals of Internal Medicine showed that diabetics who were started on a low carbohydrate Mediterranean diet delayed the need for medications geared towards diabetes. A Mediterranean Diet is a diet that is low in carbs and high in monusaturated fats. This diet seems to reduce cardiovascular risk factors and increases insulin sensitivity. Remember in med school when we were taught diet and exercise changes as the first treatment for hypertension, hypercholesterolemia and diabetes? I still think this is an excellent first line therapy. I tried it in my office and it is amazing what patients can achieve on their own and how they can change their lives without medication!