Just Read: Lifestyle Management, Standards of Medical Care in Diabetes 2019, American Diabetes Association (behavior, a little less strange – low carbohydrate eating now included)

I had noted previously that non-adherence to the latest evidence around nutrition has resulted in strange behavior on the part of nationally respected organizations, who do things like endorse sugar sweetened cereals and pure fruit juice, or advise the consumption of high amounts of dietary carbohydrate in the setting of dietary carbohydrate intolerance. Some of this may be related to visible conflicts of interest.

I recently read the 2019 Standards of Medical Care in Diabetes and see there has been a change in approach, which I’m calling a little less strange, and quite welcome. I clipped the relevant pages in the slide above, and what they contain are:

The statement:

For people with type 2 diabetes or prediabetes, low-carbohydrate eating plans show potential to improve glycemia and lipid outcomes for up to 1 yearAmerican Diabetes Association. Standards of Medical Care in Diabetes 2019. Diabetes Care [Internet]. 2019 Jan 1 [cited 2019 Mar 31];42(Supplement 1).

As well as

• Studies by Saslow, et al and Hallberg, et al, referenced for the first time
• Relaxation of the sodium restriction for people with diabetes
• Relaxation of the fat restriction for people with diabetes

And also

• Visible, declared conflicts of interest on the part of the authors

This is a very significant change.

The People we Went to Medical School to Serve are now Leaders in Controlling their own Health and Life Destiny

Also worth noting, the current CEO of the American Diabetes Association is the first CEO to have diabetes herself. I find that both remarkable and impressive. It’s also evidence that the people we went to medical school to serve are leading in controlling their own health and life destiny. I like that, and I like being in a century where this is happening 🙂 .

See: “5 Things I Wish Someone Told Me When I First Became CEO of The ADA”, With Tracey Brown

References

• American Diabetes Association. Standards of Medical Care in Diabetes 2019. Diabetes Care [Internet]. 2019 Jan 1 [cited 2019 Mar 31];42(Supplement 1).
• McKenzie AL, Hallberg SJ, Creighton BC, Volk BM, Link TM, Abner MK, et al. A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes. JMIR Diabetes [Internet]. 2017 Mar 7 [cited 2017 Mar 13];2(1):e5. Available from: http://diabetes.jmir.org/2017/1/e5/
• Saslow LR, Daubenmier JJ, Moskowitz JT, Kim S, Murphy EJ, Phinney SD, et al. Twelve-month outcomes of a randomized trial of a moderate-carbohydrate versus very low-carbohydrate diet in overweight adults with type 2 diabetes mellitus or prediabetes. Nutr Diabetes [Internet]. 2017 Dec 21;7(12):304. Available from: http://www.nature.com/articles/s41387-017-0006-9