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tamarian
Thu, Dec-27-01, 21:02
Thursday December 27

New Dietary Guidelines for Diabetes Released

By Suzanne Rostler

NEW YORK (Reuters Health) - A diet that is low in fat, rich in fruits and vegetables and includes an occasional cookie or glass of wine can be as effective as some drugs when it comes to treating and preventing type 2 diabetes, the American Diabetes Association (ADA) said Thursday.

The updated nutrition guidelines, aimed at the estimated 16 million Americans with diabetes, reinforces the idea that it is the total amount of carbohydrates consumed in meals and snacks--not the source--that is the key to diabetes control.

Previously, it was believed that carbohydrates from cakes, cookies, pasta and potatoes caused dangerous spikes in blood glucose (sugar) levels.

It is true that these foods have a higher ``glycemic index,'' meaning they cause a faster rise in blood sugar compared with other carbohydrates such as whole wheat pasta or brown rice. But studies have not shown a significant benefit for low glycemic index diets over high glycemic index diets, the ADA states.

``We're still working on getting the message out about sugar and trying to explain that it's all foods they need to pay attention to, including fat and calories,'' Anne Daly, the ADA's president of Health Care and Education, said in an interview with Reuters Health.

For this reason, the guidelines do not support diets that focus on a food's potential to cause blood sugar to rise, which have not proven to be effective when it comes to controlling diabetes and may be difficult to maintain over the long term. Fad diets that severely restrict an entire category of food, such as low-carbohydrate, high-protein diets, have also not proven to be safe and effective over the long term. Not only are these diets potentially taxing to the kidneys of diabetic patients, the ADA notes; they also tend to be high in fat.

And high fat diets can increase the risk of heart and blood vessel disease, which is the most common complication of diabetes, Daly said.

The ADA advises patients to follow individualized eating plans designed by a dietitian. These plans should take into account a person's blood glucose, cholesterol level, blood pressure, weight and medical complications, in addition to lifestyle and food preferences.

Everyone, including people with diabetes, should eat fiber-rich foods such as whole grains, fruits, and vegetables because they contain vitamins, minerals and other beneficial nutrients, the ADA notes.

Protein from lean sources such as chicken and fish can account for up to 20% of a person's daily calorie intake, provided that his or her kidneys are functioning normally, and saturated fat and cholesterol should be limited, according to the ADA.

Men can consume up to two drinks a day, the ADA says, and women can enjoy one drink, defined as 12 ounces of beer, 5 ounces of wine or 1.5 ounces of hard liquor. Alcohol should be consumed with food and not used as a substitute, the group recommends.

The guidelines also emphasize weight loss and physical activity, which have been shown to improve insulin sensitivity and help control blood sugar in overweight people with type 2 diabetes. Excess body weight is a major risk factor for diabetes.

In the US, an estimated 61% of American adults currently meet the scientific definition of overweight or obesity, US Surgeon General Dr. David Satcher announced earlier this month.SOURCE: Diabetes Care 2002;25:202-212.

http://dailynews.yahoo.com/h/nm/20011227/hl/diabetes_1.html

alto
Thu, Dec-27-01, 21:06
I'm glad you posted this, Wa'il. This was on the evening news tonight. (I watched ABC.) They showed slices of thick, gooey chocolate cake and explained that "Good news! It is all right for diabetics to eat products with sugar as long as they controlled their insulin."

Natrushka
Thu, Dec-27-01, 21:55
Yes, I saw this too and when I went looking for it I found an article about how the FDA was looking at approving blood sugar lowering meds like Glucophage for type II diabetics so they could better manage their blood sugar. *sigh*

N

doreen T
Thu, Dec-27-01, 22:11
re- Glucophage (Metformin) ... at least it has the admirable effect of increasing insulin sensitivity, thereby reducing insulin levels overall. Unlike Glyburide and other sulfonurea drugs, which stimulate the pancreas to pump out more insulin ... with all its fat-storing/inhibition of fat-burning effects.

Glucophage coupled with a low-carb diet is the way to go for uncontrolled Type 2 diabetes, IMHO. Of course, I'm not a doctor or public healthologist ;)

Doreen

Clawed
Sat, Dec-29-01, 14:15
Originally posted by doreen T
re- Glucophage (Metformin) ... at least it has the admirable effect of increasing insulin sensitivity, thereby reducing insulin levels overall. Unlike Glyburide and other sulfonurea drugs, which stimulate the pancreas to pump out more insulin ... with all its fat-storing/inhibition of fat-burning effects.

Glucophage coupled with a low-carb diet is the way to go for uncontrolled Type 2 diabetes, IMHO. Of course, I'm not a doctor or public healthologist ;)

Doreen

I had problems with Glucophage (made me nauseous, and I never got used to it) when I was on it for a couple of weeks. I now take 8mg Avandia and 1 mg Amaryl. Even before I started dieting, it was working great and I suffered no side effects.

Now that I am losing some weight and having consistently good BGs when I test, I may be able to drop the Amaryl altogether. I'll discuss this possibility with my doctor in about a month.

Haven27
Sat, Jan-19-02, 17:07
When I see that the ADA is showing off cake for diabetics I think "it is about time!"

Everyone on this forum is whole heartedly convinced that LC is the way to go and are happy and willing to give up their carbs. More or less :-)

But there are millions of people in the US with diabetes and the ADA has the responsibility of making recomendations for ALL of them (and their overwhelming not-low carb doctors) not just the pro-low carb people.

For example, the millions of children with diabetes. My son was diagnosed a few days before kindergarten started. We got through all of elementary school with an average HA1c of about 7, simply because he was allowed to eat "like the other kids." I even wrote a piece for Diabetes Forecast on how being "like the other kids" allowed Shane to accept diabetes and not consider it his enemy or something that ruined his life. My main "thing" was that he be able to trick-or-treat at Halloween and eat his candy just the like his siblings (in moderation for all of them, btw) We never had a halloween (out of ten Halloweens and counting) where his blood sugar got above 150, and usually it was around 90.

It is a fact that people who are happy and able to accept their condition will cooperate and do better with their treatment than those who don't. For everyone here, being low carb is a way to feel great, be healthy and stay happy. For many diabetics, being happy is about eating their carbs.

And it IS possible for diabetics (at least for Type 1) to adjust their insulin to eat cake, if that is what is going to make them happy and get them through another day with good blood sugars. Especially with children, this is all you care about.

One of the biggest and most damaging problems my son has had is when people who are not diabetic - but who know he is - see him eating his allowed cake (or whatever) and they start to lecture him about what they think they know about his management system. Feeling like a "normal" person is VERY important to him, and these kinds of comments have undermined his self esteem and embarrased him.

Seeing the ADA say cake is okay not only might educate people who might otherwise be inclined to lecture, but also helps people who are newly diagnosed to see that their diagnosis isn't the end of the world. This is very important to their success and their acceptance of their disease and THAT is what leads to good blood sugars.

Low carb is a healther way of life for many, many people but it has to be a person's choice based on what will make them happiest (and thus, the most successful) - and is not universally even accepted as a good woe for type 1's by low carb doctors.

So saying cake is okay can have a positive effect for many diabetics. Just a tid bit of insight.

Kim

SusanKH
Mon, Apr-29-02, 15:28
Just throwing my 2 cents in....glucophage was extremely difficult for my body to get used to, but at the time it was the only diabetes medication I could take. I was allergic to the others. The side effects of glucophage (diarhea, gas, bloating, nausea, and lack of appetite) helped me lose 65 pounds. Now I take glucophage regularly without problems....but I agree that no one way is right for everyone....