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Senior Citizen Health & Medicine
Best Diet Selection Changes in Latest Diabetes
Treatment Guidelines by ADA
Notable change in the Medical Nutrition Therapy
section dealing with weight loss
 Dec. 28, 2007 - The American Diabetes Association
(ADA) today issued its annual Clinical Practice Recommendations to help
health care providers treat people with diabetes using the most current
evidence available. This year, one notable change occurs in the Medical
Nutrition Therapy section dealing with weight loss.
Until now, the ADA
did not recommend low carbohydrate diets because of lack of sufficient
scientific evidence supporting their safety and effectiveness.
The 2008 Recommendations include a statement
recognizing the increasing evidence that weight-loss plans that restrict
carbohydrate or fat calorie intake are equally effective for reducing
weight in the short term (up to one year).
The “Standards of Medical Care in Diabetes—2008”
document reviews the growing evidence for the effectiveness of either
approach to weight loss.
In addition, there is now evidence that the most
important determinant of weight loss is not the composition of the diet,
but whether the person can stick with it, and that some individuals are
more likely to adhere to a low carbohydrate diet while others may find a
low fat calorie-restricted diet easier to follow.
As it has in the past, the ADA continues to
emphasize the importance of sustained, moderate weight loss and
increased physical activity for people who are overweight or obese and
at risk for diabetes or living with diabetes.
“The risks of overweight and obesity are well
known. We recognize that people are looking for realistic ways to lose
weight,” said Ann Albright, PhD, RD, President, Health Care & Education,
American Diabetes Association.
“The evidence is clear that both low-carbohydrate
and low-fat calorie restricted diets result in similar weight loss at
one year. We’re not endorsing either of these weight-loss plans over any
other method of losing weight. What we want health care providers to
know is that it’s important for patients to choose a plan that works for
them, and that the health care team support their patients’ weight loss
efforts and provide appropriate monitoring of patients’ health.”
Because people following low carbohydrate diets may
replace calories from carbohydrate with fat or protein, the
recommendations also include monitoring the lipid profile (blood fats,
including cholesterol and triglycerides) of patients on such diets. High
protein diets may also worsen kidney problems. Therefore, it is also
recommended that patients with kidney disease be counseled about
appropriate intake of protein and that their kidney functions be
monitored carefully.
“Short-term weight loss is beneficial, but what is
most important for health is keeping the weight off long-term,” said
Albright. “We also want to continue to emphasize the importance of
regular physical activity, both to aid weight loss from
calorie-restricted diets, and also for the positive health gains
associated with exercise that are independent of weight loss.”
Being overweight or obese and inactive are major
contributing factors to the onset of type 2 diabetes. Overweight and
obesity also complicate the treatment of diabetes (both type 1 and type
2) and can contribute to the development of other health problems, such
as heart disease and cancer. In the United States, rates of type 2
diabetes in adults and children have risen dramatically in recent years,
along with the national epidemic of obesity.
This year’s revisions also include:
• Recommendations that adults who are overweight or obese and have one
or more diabetes risk factor be tested for pre-diabetes and diabetes
• New treatment guidelines for older adults
• Recommendations for preparing and maintaining disaster kits for
diabetes self-management
• Structural changes to make the documents more “user-friendly,”
incorporating an Executive Summary, screening recommendations and
diagnostic cut-point tables, along with general treatment information.
For more information about the ADA’s 2008 Clinical
Practice Recommendations, which are published as a supplement to the
January issue of Diabetes Care, please visit diabetes.org. Diabetes
Care, published by the American Diabetes Association, is the leading
peer-reviewed journal of clinical research into the nation’s fifth
leading cause of death by disease. Diabetes also is a leading cause of
heart disease and stroke, as well as the leading cause of adult
blindness, kidney failure, and non-traumatic amputations. For more
information about diabetes, visit the American Diabetes Association Web
site diabetes.org or call 1-800-DIABETES (1-800-342-2383).
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Controversy over Diabetes
Drug - Avandia
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major chronic disease among senior citizens, is found in
about 1 out of 5
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Diabetes Drugs to Strengthen Warning of Heart
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