American Diabetes Association Recommendations

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Diabetes is a complex metabolic disease. For the sake of this post, I have explained type II diabetes as simply as I could. I know genetics also play a part in a person’s risk for developing type II diabetes – that cannot be changed. A person’s behaviors can be changed, and that’s what I want to focus on in this post – particularly diet.

100% of the carbohydrates a person eats gets converted into glucose and the glucose enters the bloodstream within an hour or two after eating, elevating blood glucose levels. A small amount of the protein we eat will be converted into glucose, but is stored in the liver; therefore, has very little impact on blood glucose levels. Less than 10% of the fat we eat is turned into glucose, and it is absorbed slowly and does not cause an immediate rise in blood glucose levels.

When blood glucose levels rise, the pancreas releases insulin into the bloodstream to allow the glucose to move into the cells to be used for energy. Sometimes, cells don’t respond to the insulin and therefore cannot absorb glucose from the blood stream. The pancreas will have to secrete even more insulin in order to get the glucose from the bloodstream into the cell. This is called insulin resistance. This can take years, even decades to develop. The cause is not 100% known, but things they may cause it include: overweight & obesity, a diet heavy in carbohydrates, lack of physical activity or high stress levels. Eventually, the glucose will not be able to move from the bloodstream into the cells, despite the pancreas pumping out more insulin. This is type II diabetes.

So the American Diabetes Association just updated their recommendations. They acknowledge the evidence that diets with reduced carbohydrate intake work well to manage type II diabetes. But you can see in this snippet below that they are basically saying, “well we know it’s better when type II diabetics eat less carbohydrates, but it’s hard for them to make that behavior change…so we’re just gonna keep recommending that they eat a moderate amount of carbs, even though it’s not improving their health.”

Do you also interpret it this way or do you see them saying something else? Do you agree with that approach? Why do you think they won’t change the recommendations to reflect what current evidence shows?