ADA Guidance No Longer Bars Low-Carb Diets

▸ Continuous glucose monitoring might be a supplemental tool to self-monitoring of blood glucose for selected patients with type 1 diabetes, especially those with hypoglycemic unawareness.

▸ More information in the hypoglycemia section about prevention and hypoglycemia unawareness, with the recommendation that patients who have hypoglycemic unawareness or episodes of severe hypoglycemia raise their glycemic targets to strictly avoid hypoglycemia for at least several weeks, with the aim of partially reversing the unawareness and reducing the risk of further episodes.

▸ The reduction of the number of treatment recommendations for hypertension and blood pressure control to emphasize use of ACE inhibitors or angiotensin receptor blockers.

▸ Fewer recommendations in the dyslipidemia/lipid management section to emphasize the use of statins for most patients, along with new language stating that if patients don't reach specified targets on maximal tolerated statin therapy, an LDL cholesterol reduction of about 40% from baseline is an alternative goal. Triglyceride levels of less than 150 mg/dL and HDL cholesterol levels greater than 40 mg/dL in men and more than 50 mg/dL in women are desirable, though “cholesterol-targeted statin therapy remains the preferred strategy.”

'This is notan endorsementof lifelongmarked carbohydrate restriction.' DR. STONE