The American Diabetes Association has relaxed its previous restrictions on foods high in sugar. The Association's new recommendations emphasize the importance of total carbohydrate intake instead of controlling high-sugar foods.

Under these guidelines, a person with diabetes can indulge in an occasional dessert or drink moderate amount amounts of alcohol -- so long as they are taken into account in the daily carbohydrate tally. People who do this should measure their blood glucose levels two hours after having the snack or drink, to make sure they have enough insulin to handle the glucose. If not, they should increase their dose of insulin or other diabetes medication to keep glucose levels from surging.

The change reflects research that has shown that sugary foods do not boost blood sugar more than other carbohydrates, as was previously believed. In other words, a carbohydrate is a carbohydrate, whether it comes from starch, fiber, or sugar.

Otherwise, the recommendations are not much different from those in the previous edition, released in 1994.

The guidelines list these goals of medical nutrition therapy:

• Attain and maintain optimal metabolic outcomes, including:
  • Blood glucose levels in the normal range, or as close to normal as is safely possible, to prevent or reduce the risk for complications.
  • A lipid profile that reduces the risk for vascular disease.
  • Blood pressure levels that reduce the risk for vascular disease.
• Prevent and treat the chronic complications of diabetes, including obesity, lipid disorders, cardiovascular disease, hypertension and kidney disease.
• Improve health through healthy food choices and physical activity.
• Address individual nutritional needs, taking into consideration personal and cultural preferences and lifestyle while respecting the individual's wishes and willingness to change.

Next week, we'll look at some specific carbohydrate recommendations based on the new guidelines.

Related information: Lifestyle - Diet | Nutrition channel

Source:  ADA. Evidence-based nutritional principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care, January 2002;25:202.