[Diabetes-talk] excellent article

[Bill Lewis]

Hello Llynn and Mike,

While most people want science findings to be written in stone, it keeps 
changing as new data is examined, leading to new conclusions or hypotheses.

I recall about ten years ago, when the A.D.A. was recommending the 
importance os keeping our glucose numbers as close to 100-80 as possible. 
Then, long-term research showed that people do much better with glucose 
ranges of 110[140.  Then A1C norms moved from 5-5.5 to 6-7.  And food 
choices changed from measuring calories, fat, calories, and the amount of 
food in a cup[[one-third to one-half.  Now the experts say we can eat 
whatever we like, so long as we keep the portion sizes down to total a 
maximum number of calories, and such.l

My, that's what I love about science!  It actually looks for new ways of 
looking at the world.  Right on!

Bill




-----Original Message----- 
From: Mike Freeman
Sent: Saturday, June 16, 2012 10:06 PM
To: 'Lynn Baillif' ; 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] excellent article

Hi, Lynn.

I'm afraid that on this one, we shall have to amicably agree to disagree. To
me, the article at

http://www.healthcentral.com/diabetes/c/17/27575/brain-fuel-myth

is more convincing than the traditional way of thinking. But then I'm going
at this from the point of view of a physicist who thinks that most research
on human beings is somewhere between difficult and impossible to carry out
with scientific rigor.

If nothing else, list participants will have two different points of view
and, as always with diabetics, will have to make their own judgments. (grin)

Mike


-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Lynn Baillif
Sent: Saturday, June 16, 2012 7:11 PM
To: diabetes list
Subject: [Diabetes-talk] excellent article

Mike,

Interesting blog.  I have a couple comments.  First, don't hate on us
dietitians.  As a profession, we work hard to provide quality nutrition care
using our background in the hard sciences and nutrition science.  We follow
nutrition practice guidelines that are compiled by panels of experts based
on current scientific data.  The most recent guidelines for nutrition
management in diabetes are found within the 2012 Guidelines for Medical
Management of Diabetes published in the January 2012 issue of Diabetes
Care.  Here is a link to the full text.
http://care.diabetesjournals.org/content/35/Supplement_1/S11.full
The section on medical nutrition therapy is quite a ways down the article.

As for the specific question of should a person with diabetes consume
starch/sugar (carbohydrates) at every meal, I make the following points.
First, the current recommendation is that the majority of calories in the
diet come from carbohydrates- preferrably from whole grains, fruits,
vegetables and dairy.  Carbs are the preferred food source of the
body (biochemically speaking) and adequate carbs from a variety of sources
is needed for adequate micronutrients.   Secondly, depending on the type of
diabetes you have and the type of medication you are on, spreading carbs
throughout the day may help maintain blood sugar levels.  If you are on some
medications, eating too little carb will cause blood sugar to drop.  Or, for
some folks with type 2, the liver releases too much glucose from storage
when inadequate carbs are eaten.  So, eating too few carbs can cause the
blood sugar to rise in this situation.  On the other hand, if you take fast
acting insulin with your meals and adjust your dose based on the carbs you
eat- you could eat few carbs at the meal without affecting your blood
sugar.  But the question arises, was it a well balanced meal?

In conclusion, should people with diabetes have carbs at every meal? It
depends.  But, I caution against the belief that carbs should be cut out
totally in order to control blood sugar.  As usual, moderation is the key.
And, indivualization of meal planning is key.
Lynn
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