Good News In Diabetes Care - Count Carbs or Calories

< Jan. 02, 2008 > -- For the first time, the American Diabetes Association (ADA) is supporting the use of low-carbohydrate diets for people with diabetes who want to manage their weight.

People who have a New Year's resolution to lose weight in 2008, but are undecided about which weight-loss plan to follow, may want to discuss the ADA 's new Clinical Practice Recommendations with their physician.

The ADA estimates that more than 20 million children and adults are currently living with diabetes in the US. However, about one-third of those people have diabetes but have not been diagnosed.

New Guidelines for Low Carb Diets

The recommendations are intended to help physicians and their patients with diabetes prevention and management.

"The risks of overweight and obesity are well-known. We recognize that people are looking for realistic ways to lose weight," Ann Albright, president of health care and education for the ADA, says.

"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," adds Albright.

Before the release of the 2008 recommendations, the ADA did not support low-carbohydrate diets for diabetes management because of a lack of scientific evidence supporting their safety and effectiveness.

People on low-carb diets may replace calories from carbohydrate with fat or protein. If they do that, it is essential for them to have their lipid profiles (blood fats, including cholesterol and triglycerides) monitored.

High protein diets may also increase kidney problems. Hence, people who have kidney disease should talk with their physician about the appropriate amount of protein for them to eat and also be sure their physician is watching their kidney function tests.

Whatever the Diet, Stick to It

It is more important to stick with whatever diet you actually choose, rather than worrying about whether to count calories or carbs, according to the ADA.

The ADA also cites scientific evidence demonstrating that how well a person follows a diet is one of the biggest factors in whether they will succeed in losing weight.

The recommendations also support sustained, moderate weight loss and increased physical activity for people who are overweight, obese, living with diabetes, or are at risk for becoming diabetic.

Being overweight and physically inactive increases the risk of developing type 2 diabetes. These factors also may make treatment for type 1 and type 2 diabetes more challenging.

The 2008 recommendations state that all adults who are overweight and have an additional risk factor for diabetes, such as a family history of diabetes or are older should be tested for diabetes or prediabetes.

What is Prediabetes?

In prediabetes, blood glucose levels are higher than normal but not high enough to be defined as diabetes. However, many people with prediabetes develop type 2 diabetes within 10 years, states the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Prediabetes also increases the risk of heart disease and stroke. With a small amount of weight loss and moderate physical activity, people with prediabetes can delay or prevent type 2 diabetes.

Always consult your physician for more information.

How to Help Your Kids Avoid Type 2 Diabetes

Not so long ago, type 2 diabetes was also known as adult-onset diabetes. Now, the "adult-onset prefix "has been dropped because so many children are developing this condition.

Diabetes is a metabolic disorder that results when the body cannot make enough insulin or properly use it. Insulin is the hormone that helps convert glucose into energy the body can use.

"In the early 1990s, two to four percent of our patients were children with type 2 diabetes," says Dr. Francine R. Kaufman, a pediatric endocrinologist in Los Angeles. "Now, it may be up to 25 percent."

In general, those with type 2 diabetes have abnormally high levels of circulating glucose (blood sugar) because their pancreas either produces little insulin or their bodies are resistant to insulin that is produced. (Insulin  transports glucose into the body's cells.)

This resistance makes it difficult for the insulin to get glucose into the cells of the body. Like adults with type 2 diabetes, children with the condition are at increased risk for serious health problems such as heart disease, kidney disease, and blindness later in life.

Type 2 diabetes has an inherited component. Still, biology is not destiny.

"To get type 2 diabetes, you also have to have an environmental trigger," says Dr. Kaufman. "For most kids, that environmental trigger is obesity."

Weight gain, or fat, especially in the abdomen, increases the body's demand for insulin and interferes with the body's ability to use it properly.

"To prevent type 2 diabetes, help your children stay fit and avoid becoming overweight," says Dr. Kaufman. "Being of normal weight doesn't stress the pancreas as much, and exercise helps the body become more efficient at using glucose."

Helping kids stay lean and fit is a tall order, considering that twice as many children and adolescents are overweight or obese compared with 30 years ago, according to 2004 statistics from the Centers for Disease Control and Prevention (CDC.

"The problem is kids are bombarded with messages from television commercials to want junk food, to not understand what a portion size is, and to drink sugar-containing beverages like soda," says Dr. Kaufman.

"And many schools promote excess weight by allowing in-school vending machines and eliminating physical education classes. As a result, there's little opportunity for many children to get meaningful amounts of exercise."

Still, you can help your kids keep their weight in check. In fact, your encouragement and actions may be the only thing they have to counteract societal messages that promote weight gain.

"As a parent, you're your child's first teacher," says Sheah Rarback, R.D., a Miami child nutrition expert.

All told, your example carries a lot of importance, so make sure you practice what you preach. To get your kids into the exercise habit, for example, do what you want your kids to do rather than just urging them to go outside and play.

Participating as a family in lifestyle kinds of exercise, such as bike riding, hiking, walking, running, basketball, and tennis - fun activities that can carry over into adulthood - or even just playing in the park sends a strong message.

"Your kids will associate being active with fun times with the family. By virtue of your example and participation, exercise will become something they want to do," says Rarback.

Eat dinner together. Likewise, to expand your children's palates and help them learn to make healthy food choices, which, in turn, can help them avoid obesity, "make family meal time a priority at least a few times a week," says  Rarback.

Always consult your physician for more information.