It's a wonder no one has tried to have Mary Vernon's medical license revoked.

  Since 1999, the 52-year-old family doctor has been treating diabetic patients in Lawrence, Kansas, with an approach that was abandoned by most physicians in the 1930s. Worse, this Depression-era remedy is the opposite of the current guidelines established by the American Diabetes Association, a nonprofit organization that spent nearly $51 million on research in 2005, and so should know a thing or two about how to handle diabetes.

  There's no question that Dr. Vernon is trouble -- but for whom? Not her patients, that's for certain. They just won't stay sick. People walk into her office afflicted with type-2 diabetes and, by every objective medical measurement, walk out cured. There's $51 million that says that isn't supposed to happen, not in a clinic in Kansas, and definitely not as a result of cleaning out the refrigerator.

  "My first line of treatment is to have patients remove carbohydrates from their diets," explains Dr. Vernon, a petite, energetic mother of two who also serves as the president of the American Society of Bariatric Physicians. "This is often all it takes to reverse their symptoms, so that they no longer require medication."

That's it?

  That's it -- a simple strategy, but one that's  controversial. If Dr. Vernon and a growing cadre of researchers are correct about carbohydrates, we may be looking at an epic case of ignorance on the part of the medical community. That, however, pales next to the implications for the American Diabetes Association, namely that the very organization dedicated to conquering diabetes is rejecting what could be the closest thing we have to a cure.

A Diabetic Epidemic

  Although not an infectious disease, diabetes seems to be spreading like one. Since 1980, its prevalence in the United States has risen by 47 percent, a trend that's expected to take a space-shuttle trajectory in the next decade. That's because nearly half of American men today either have the condition or are on the verge of developing it, according to a new report from the National Institutes of Health. And the consequences are considerable: Diabetes is the primary cause of cardiovascular disease, slashing a man's life span by an average of 13 years. Dodge early death and you could still end up impotent, blind, in kidney failure, or, most likely, minus a foot. (A gangrenous limb or digit is amputated every 6 minutes in the United States.)

  "This is a 'grab your muskets, fellas, the wolves are at the door' scenario," says David Katz, M.D., an associate professor of public health at Yale University school of medicine. "What once was 'adult-onset' diabetes -- a condition mostly of overweight, sedentary, middle-aged adults -- is now an epidemic in children under the age of 10."

  So what exactly is diabetes? In freshman-biology terms, it's a disease of the hormone insulin. Secreted by your pancreas, insulin moves glucose -- the form of sugar your body uses for energy -- from your bloodstream into your cells. Problems arise, however, when, often due to excessive weight gain, your cells start to become resistant to the effects of insulin. (It knocks, no one answers.) As a result, more insulin is required to dispose of the same amount of glucose. (The knock becomes a loud banging.) This condition, called insulin resistance, is the first stage of type-2 diabetes.

  As insulin resistance worsens over time, your pancreas has to pump out enormous amounts of insulin to force glucose into your cells. (Hey, let's use a sledgehammer!) Eventually, your pancreas has trouble keeping up, leaving you with chronic high blood sugar, a.k.a. hyperglycemia -- the defining marker of diabetes and the root cause of the calamities that arise from it. Alas, it only gets worse from here: If the resistance continues to mount, some of the insulin-producing beta cells inside your pancreas can "burn out" and stop working altogether. (In type-1 diabetes, an autoimmune disorder destroys most or all of the beta cells.) Once beta cells burn out, you're looking at a lifetime of daily insulin injections.

Or not, if you believe Dr. Vernon.

  Unlike protein, fat, and fiber -- which have little if any impact on blood sugar -- carbohydrates such as starch and sugar are quickly broken down into glucose during digestion, which is then absorbed into your bloodstream. The more you eat, the higher and faster your blood sugar rises. Therefore, if you have diabetes, it would make sense to control your blood sugar by limiting your carbohydrate intake. Another benefit of consuming fewer carbs is that you often end up consuming fewer calories, and that can help lower weight, which, in turn, reduces insulin resistance.

  By contrast, the American Diabetes Association suggests that people with diabetes build their diets around bread. Okay, not just bread. In explaining the foundation of its Diabetes Food Pyramid, the ADA Web site -- the public face of the organization -- states, "This means you should eat more servings of grains, beans, and starchy vegetables than of any of the other foods." And while high-fiber whole grains are emphasized, a slice of whole-wheat bread is still more than 80 percent starch.

  Granted, sweets are at the pinnacle of the pyramid, though so are "fats" and "oils," which makes it appear that the ADA's main focus isn't on high blood sugar at all but rather on a different affliction.

  "Long-term, what you're really concerned about is heart disease," says Marion Franz, R.D., a member of an 11-person team of experts who coauthored the ADA's 2006 nutrition recommendations. "It's the major cause of death for people with diabetes." In other words, they use food as a weapon against a complication of diabetes, rather than diabetes itself.

  When it comes to controlling blood sugar, the ADA seems to push drugs as hard as diet. An ADA position statement published in August 2006 advises that people newly diagnosed with type-2 diabetes immediately commence taking metformin, an oral medication that slows the body's internal production of glucose, helping to lower blood-sugar levels. With total sales of metformin having neared $1.1 billion in 2005, according to IMS Health, this recent recommendation must have brought a big smile to big pharma -- and a look of utter disbelief to the faces of the ADA's critics.

  "They're contradicting themselves," says Richard Feinman, Ph.D., director of the Nutrition & Metabolism Society and a professor of biochemistry at SUNY Downstate medical center, in New York City. "They want diabetics to take medication to lower their blood sugar, but recommend a diet that has the opposite effect."

  At least the ADA's recommendations are pointing in the same direction in the case of overweight people with diabetes -- pop metformin, but also cut calories and add exercise to reduce insulin resistance. What's odd here, however, is that they don't advise giving the lifestyle component a chance to work before reaching for the pill bottle.

  "Metformin is insurance for people who aren't following their diet and exercise plan," explains John Buse, M.D., Ph.D., president-elect of medicine and science for the ADA.

  The message to insulin-resistant America: We don't think you're going to help yourself, so here, take this.

Eliminate Foods that Raise Blood Sugar

When Brian Llong awoke covered in his own blood, he knew it was time to see a doctor. The boil that had been festering on his right thigh for 2 months had finally ruptured. On the recommendation of a friend, the 30-year-old business owner made an appointment with a local doctor. Luckily, her name was Mary Vernon.

  "As soon as I saw the type of boil Brian had, it was obvious to me that he had diabetes," recalls Dr. Vernon, explaining that lingering boils -- along with cuts and scrapes that don't heal -- are one of the few outward signs of diabetes. A glucose test provided the necessary confirmation: Long's blood sugar was 360 milligrams per deciliter, almost four times higher than normal.

  Dr. Vernon instructed Long to adopt a low-carbohydrate, high-fat diet instead of the ADA's well-established dietary guidelines. His condition reversed -- and fast. In just 3 months, he was no longer diabetic. And this was without ever taking a single dose of metformin or injecting insulin.

  "My treatment didn't seem like a treatment," says Long. "All I had to do was change my eating habits."

  This turnaround may have amazed Long, but Dr. Vernon is more matter-of-fact about the remedy and the results. "I believe in addressing the cause, not the symptoms," she says. "That's why I first eliminate the foods that raise blood sugar. It's only logical."

  So logical, in fact, that Elliott Proctor Joslin, M.D., a Harvard- and Yale-educated physician, used it more than a century ago. According to carefully documented patient logs he kept from 1893 to 1916, Dr. Joslin successfully treated dozens of diabetic patients -- including his own mother -- using a diet made up of 70 percent fat and just 10 percent carbohydrates.

  Then, in 1921, a Canadian scientist named Frederick Banting found that by injecting diabetic dogs with insulin, he could lower their blood sugar back to normal. Soon after, insulin therapy made the leap from these hyperglycemic hounds to human beings. By the 1940s, insulin was in widespread use, and low-carbohydrate diets were on the decline. Dr. Joslin was later labeled a medical reactionary.

  "Instead of advising people with diabetes to first restrict carbohydrates, physicians simply started prescribing enough insulin to accommodate patients' carbohydrate intake," says Dr. Vernon, who some 60 years later is trying to pick up where Dr. Joslin left off and reeducate academics and physicians by sharing her observational evidence. In published, retrospective reviews of her patients' medical charts, Dr. Vernon has documented the beneficial effects of a low-carbohydrate, high-fat diet for more than 60 people who had diabetes or were at high risk of developing the disease.

  Of course, in the world of medicine, the experience of one doctor carries little scientific weight compared with experimental studies conducted under controlled conditions. That's why, in 2003, researchers at Duke University set out to test Dr. Vernon's findings in a laboratory setting. The results of their 16-week study: 17 out of the 21 diabetic patients who participated were able to significantly reduce their medication or discontinue it altogether.

  "When you cut out carbohydrates, reducing insulin and other diabetes medications isn't just a benefit, it's a necessity," says William Yancy, Ph.D., lead author of the Duke study. "Otherwise, blood-sugar levels would drop too low."