11 October 2010

What is the current ADA position?

Just when there is a glimmer or faint ray of hope, the American Diabetes Association has something like this. Granted the sidebar says August 2003, but the copyright is 2010. So I am wondering if this has been superseded or is still in force. My guess is that though not talked about, it still is as CDE's continue to refer to this, Doctors are still using this information.

The emphasis is on carbohydrates and more carbohydrates. They will not include the glycemic index or glycemic load as factors to help choose the right carbohydrates. Just that persons with diabetes must eat carbohydrates.

This is also disturbing to me. They (ADA) states “However, after reviewing the evidence, it was concluded that the total amount of available carbohydrate in meals or snacks is more important than the source (starch or sugar) or type (low or high GI) (A-level evidence), and although low-GI foods may reduce postprandial hyperglycemia, there was not sufficient evidence to recommend use of low-GI diets as a primary strategy in food/meal planning (B-level evidence).

Then when you compare the above information and full discussion with the 2010 position statement, which I referred to in my blog of May 26, 2010 which states - Check out Standards of Care section of the 2010 ADA Clinical Practice Recommendations. The updated carbohydrate recommendation starts on S25 (you will need to page down to this, as the reference starts on page S11) with the paragraph “Although numerous studies have attempted to identify the optimal mix of macronutrients for meal plans of people with diabetes....” This will now allow variation of carbohydrate consumption to fit the individual and not forcing a certain number of carbohydrates. The low fat regimen is still advocated.

I must wonder why if they have changed policies, do they continue to leave past information up and readily available for the public to view. It is no wonder that the medical community stays on the old publications if they don't like the new.

When policy changes, should not the ADA at least archive out of date material and clearly indicate that it has been superseded and list the URL for the current policy. When called out about this, they will always refer to the most current position statement, yet they will quote from prior position and related statements when it serves their purpose.

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