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New Diabetes Guidelines Target Prevention

By Reporter Suzanne Rostler

TUESDAY October 17: DENVER (Reuters Health) —  As the number of Americans diagnosed with type 2 diabetes and the serious medical complications that can accompany the disorder continue to soar, a national nutrition organization will release an updated set of guidelines aimed at curbing the incidence of the sometimes fatal disease.

The new recommendations, which will be released in the coming months, were reviewed at the American Dietetic Association's (ADA) annual meeting, on Monday. The last set of guidelines was issued in 1994.

``Type 2 diabetics represent 90% of the 18 million Americans with diabetes,'' Christine A. Beebe, a registered dietitian, said. ``It is a huge problem in the US and around the world.''

Patients with type 2 diabetes do not respond to insulin, the hormone that under normal conditions clears the blood of sugar (glucose) after a meal and deposits it into cells to be used as energy. Over the long term, high blood glucose can lead to medical complications such as heart disease, kidney failure and blindness.

Family history is the number-one risk factor for type 2 diabetes. But even individuals at high risk can lower their chances of developing the condition by maintaining a healthy body weight, as obesity has been shown to substantially increase a person's risk. Indeed, a rise in the incidence of type 2 diabetes in America has coincided with a sharp increase in the number of people who are overweight and obese.

The ADA's nutrition recommendations for the first time will include strategies to prevent the disorder in addition to how to deal with it once a diagnosis has been made. The ADA will recommend that weight management through a low-fat diet and exercise can help a person respond to insulin. Whole grains and cereals might also lower the risk of developing the disorder, although more research in this area is needed.

Other recommendations include reducing calories, which can help people with diabetes maintain more stable blood glucose; restricting fat, which has been shown to lead to longer-term weight loss; consuming no more than 20% of calories from protein; and consuming less than 10% of total calories from saturated fat. Alcohol intake should be moderate--about one drink a day for women and two drinks for men.

There is also some evidence that fiber can help stabilize blood glucose, Beebe noted, adding that studies are not conclusive.

Research has not confirmed that timing meals and snacks leads to better blood sugar control, except when taking medications, she said.

According to the American Diabetes Association, type 2 diabetes is the seventh leading cause of death in the US.