Tuesday, June 12, 2012

Insights from the American Diabetes Association

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 I am a few days late for my weekly posting. I was really busy attending the 72nd Scientific Sessions of the American Diabetes Association (ADA). This year the meetings were held in  Philadelphia. I know Philadelphia is not exactly a top destination spot.

But regardless of the city where the ADA is held, I find these meetings to always be intellectually exciting and engaging. Enthusiastic attendees share a passion for preventing and treating diabetes. Attendees spend most of their waking hours during these meetings sitting down in air-conditioned rooms listening to presentations on the latest research. There are opportunities to network and discuss.  There is a substantial international attendance. And over 17,000 people attend. But unfortunately, relatively few endocrinologists that I know attend. That's a shame because there is much to learn here.

But every year I attend the ADA I have to deal with two challenges. One is avoiding a sore bottom from sitting so much. I am not used to sitting for hours at a time. This year taking the stairs and a short run at the end of each day helped me deal with this prolonged inactivity.

The other challenge is deciding which sessions to attend. There are multiple presentations held at the same time. It is often very difficult to decide which one to go to. This year I focused on nutrition, weight, behavioral issues and medications. I still missed out on a lot. Sure you can buy a recording of the entire meeting which is said to include all presentations but when I've done that in the past I never seem to find the time to view it.

I do find it helpful to write down key points from the meetings. 
And here are a just few insights from the ADA:

Any physical activity is better than none. Walking for 5 minutes every hour that you are sitting can significantly help in managing your blood glucose. The risk of diabetes does increase as we get older but that is because we become more inactive. Those who remain physically active as they age will reduce their risk of diabetes.

All exercise is helpful: muscle toning, so called resistance exercise, as well as aerobic exercise is important. And don't forget flexibility or stretching and balance training. Wow, balance training.

It's common for patients to not take medication as prescribed. This is called non-adherence. There are two types of non-adherence: intentional and non-intentional. We have better tools to detect non-adherence but we all need to understand more about non-adherence. It's no surprise that those who have higher non-adherence do worse. If you do not take your medication for diabetes your sugars run higher. If you miss your blood pressure pills, your blood pressure is not well controlled.

Most studies show that a higher protein intake reduces appetite. But that's when the protein is in solid form. Liquid protein as in protein shakes have less satiating effect. Some studies support a “protein leverage hypothesis”: we eat more until we get enough protein. And in the U.S., as most Americans have gained weight, over a 40 year period ending in 2000, there was an increase in average carbohydrate and fat intake per person but no increase in protein. Interesting!

But there is a lot more to food intake than just appetite.
Often we eat when we’re not hungry. We are fortunate though to have better medications for diabetes that reduce appetite and that do not cause low blood sugar. See my recent post.

I will share more insights from the ADA soon.
Tomorrow it’s back to work to implement some of what I’ve  learned.


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