17 December 2010

Dietitians May Play Key Role In Diabetes Management

I know that I may offend a few registered dietitians, but I would prefer using the word dietitian. And also I want to emphasize they should be trained in diabetes nutrition. Too many are not and are therefore useless to those of us with diabetes. There are some excellent dietitians that are very knowledgeable about diabetes and they deserve the respect and status from us.

The American Dietetic Association (ADA – different from Diabetes ADA) in their December issue of the Journal of the American Dietetic Association reviews the evidence and nutrition practice presented in the ADA Nutrition Practice Guidelines for Type 1 and Type 2.

The summary of the recommendations are:
  1. Consistency in day-to-day carbohydrate intake for persons with type 2 diabetes
  2. Adjusting insulin dose to match carbohydrate intake for persons with type 1 diabetes
  3. Focusing on total carbohydrate intake rather than the type of carbohydrate
  4. Cardio protective nutrition interventions
  5. Weight management strategies
  6. Regular physical activity
  7. Use of self glucose monitoring data to determine if goals are being met
I would have to ask some questions, but the basic ideas are excellent if they can be varied to fit each individual. The one point that I must disagree with is the third point above. Total carbohydrate intake being more important that the type of carbohydrate is unhealthy. Many people with diabetes know this. Why can't those that we depend on for nutritional guidance understand this?

Oh, yes, we have the American Diabetes Association to thank for this piece of stupidity, along with the American Medical Association. It seems that they do not understand the difference between good nutritional carbohydrates and poor non-nutritional carbohydrates. I cannot accept their – a carbohydrate, is a carbohydrate, is a carbohydrate mantra.

You may read the article here.

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