Review of ADA’s Complete Guide to Diabetes

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A while back I was sent an advanced copy of the American Diabetes Association’s Fifth Edition of the Complete Guide to Diabetes which comes out this June.  I also got to ask the Chief Scientific and Medical Officer, Dr. David M Kendall a few questions.  Read on for the review and Dr. Kendall’s answers.

This four-hundred-some page manual provides the most updated info on:

  • Preventing Complications
  • Managing Blood Glucose Levels
  • Handling Emergencies
  • Using a Meter
  • Insulin Pumps
  • Nutrition
  • Exercise
  • Sexuality
  • Coping
  • Family Life
  • Travel
  • Pregnancy
  • And more

I found this book to be the kind of reference book I’d want at home for those times when I need to look something up.  It’s less overwhelming than searching on the internet, although I search there, too for additional information and other opinions.  I’d also expect this book to be purchased by health care providers.  If every general practitioner read this book, we’d have a lot less friction with these folks.  They’d have a very good general understanding of diabetes and the tools it takes to manage blood sugars.

There are helpful discussions in the book which are important to bring up-such as, “Is intensive management right for you?”  and “Choosing a diabetes care provider”.  There is a lot of guidance on these and many other subjects which I found valuable.  I enjoyed the long chapter on insulin and was surprised to learn a few things.

I know a book cannot possibly cover everything in the world of diabetes as it’s such a complicated disease.  One thing that an updated book might have included is information on blood ketone strips.  Only the urine ketone strips were mentioned and the blood ketone strips pick up on trace amounts of ketones before the urine ones do.  Also, the book states there are more than 10 different forms of diabetes. I couldn’t help but wish some of the more unknown forms had been touched upon or discussed. I suppose we serve the masses.

Also, there wasn’t enough information, in my opinion, having to do with guiding a person through their food choices depending on what their blood sugars are.  I suppose this has more to do with the fact that we haven’t come to a consensus about how to change one’s meal supposing blood sugar is elevated.  For example, for a type 1 diabetic, if blood sugar is high before a meal, should one give insulin and wait until blood sugar is lowered before eating?  Or should one go ahead and eat a low carb meal?  Or neither?  This seems to be up to debate and different for each and every one of us depending on our preferences.  It is my experience however, that my lowered A1c’s were achieved only when I began waiting for blood sugar to lower into range before eating.  (Not something that can always be done with children, I know)  I would expect a newly diagnosed to find guidance on this topic rather useful.  For a type 2 diabetic, I would personally encourage them to cut back on grains if it elevated their blood sugars.  Yet, there is that debate going on as well.  Is it healthy to omit carbs?  I think the answer is it depends on who you are.  I think it’s important to remember that some people feel rather good eating low carb and others don’t.  I know for a fact though, that no one does well or feels well with elevated blood sugars.  So if something like lowering carbohydrates helps blood sugars, I see it as a win over carbs not being the ideal fuel-because high blood sugars do more damage. 

The ADA keeps their alliance to the food pyramid as a general guide for all.  And overall it promotes what I would as well.  I just think the relationship between blood sugars and carbohydrates deserves extra attention. 

I asked the ADA’s Chief Scientific & Medical Officer Dr. David M. Kendall about why low carb eating was not discussed or mentioned in the book (it is my understanding that low or lower carb diets help many with diabetes out there) and I also asked him why eggs were not recommended in the healthy eating section of the book.  His reply:

“There are so many pieces that make up the best individual plan for living with diabetes, and the Complete Guide to Diabetes tries to touch upon all of them in some way in these 500 pages: from medications and meal plans to insurance coverage and travel tips. For anyone looking for more in depth information, the Association has even more resources available at 800-DIABETES or diabetes.org.”

I can understand the confusion surrounding how we should eat, especially considering it varies due to personal preference and how our bodies feel with certain foods.  So, I asked Dr. Kendall what he considered to be the most impactful lifestyle change someone with type 2 diabetes can make.  He said:

“Research shows that being physically active (at least 30 minutes a day 5 days a week, everything from walking to more vigorous aerobic exercise) and losing weight and/or maintaining a healthy weight can help prevent or delay diabetes complications.”

That’s good news!

I mentioned how people with diabetes are viewed as an economic burden and seen as unwilling to take care of themselves-a great injustice.  Dr. Kendall and the ADA’s statement to that was this: 

“Diabetes is a chronic disease that requires long term attention to limit the impact on a patient’s health and ultimately on our health system. Neither type 1 nor type 2 diabetes develop as the result of an individual’s own “actions” – very simply no one should be “blamed” for their diabetes. Both genetics and a number of environmental triggers (many are poorly understood) give rise to a risk for diabetes. Diabetes does not develop from simply eating “too much sugar” nor is obesity – a major risk factor for type 2 diabetes – the sole fault of an individual who may develop type 2 diabetes. Just like diabetes risk, the risk for overweight and obesity are the result of genetic and environmental factors. While much can be done in hopes of limiting some of this risk, knowing your risk and taking steps to stay healthy, active and lose a modest amount of weight can be helpful in preventing and treating diabetes. If someone feels that they are being discriminated against at work or at school, they can contact the American Diabetes Association at 800-DIABETES to find help”

The reason I’d recommend this book to any person with diabetes is that I’ve found that having all the basics laid out in front of me in an easy to search and read format helps tie loose ends together.  It helps that the second we have a question regarding our diabetes, we instantly have a resource to go to.  I also recognize that although much of the info in this book doesn’t apply to me right now, it doesn’t mean it won’t in the future.  Having a heads up and being aware of things such as medications that can help insulin resistance and knowing the symptoms of diabetes related complications may be crucial to our well being.

As always, my stance is this:  Knowledge is power.  Being informed is a lifesaver.  It’s not always easy or convenient, but having a reference at our fingertips backed by the ADA is a pretty good start.

If I could, the first people I’d hand this book to would be the newly diagnosed.  This book, chapter by chapter, eases a person into the world of diabetes management very gently and I think that is important.

Kudos to the ADA for mentioning the support that can be found online in blogs and message boards. For their next edition, I hope they’ll call it by it’s unofficial title, the Diabetes Online Community.

If you want the book, get it at the ADA’s site or at Amazon.

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