As a person with a back ground in science I have been confused by many posts stating “Low Carb”, “No Carb” and “High Fat”.
It is probably the most common comment that I hear from diabetics and people with heart disease. That is they receive confusing messages from those who should know better.
I myself have experienced this, not only from would be experts but from members of the medical profession who should know better.
My dentist often tries to tell me to eat soft foods low in fibre, as he is drilling and filling my teeth at the time I am in no position to argue.
Recently I sat through a talk from a surgeon who clearly was not familiar with the special dietary needs of diabetics, suggesting Jellies etc.
No wonder that people get confused. I think, that if we put ourselves forward as “experts”, at least we can be consistent with our advice and ensure that we are not confused by the terms that we use.
I guess as a person with a scientific mind I had to investigate this further. Here are the results of my research.
From Wikipedia, the free encyclopaedia
”A carbohydrate is a biological molecule consisting of carbon (C), hydrogen (H) and oxygen (O) atoms, usually with a hydrogen: oxygen atom ratio of 2:1 (as in water); in other words, with the empirical formula Cm(H2O)n (where m could be different from n). Some exceptions exist; for example, deoxyribose, a sugar component of DNA, has the empirical formula C5H10O4. Carbohydrates are technically hydrates of carbon; structurally it is more accurate to view them as polyhydroxy aldehydes and ketones.”
“The term is most common in biochemistry, where it is a synonym of saccharide, a group that includes sugars, starch, and cellulose. The saccharides are divided into four chemical groups: monosaccharides, disaccharides, oligosaccharides, and polysaccharides. In general, the monosaccharides and disaccharides, which are smaller (lower molecular weight) carbohydrates, are commonly referred to as sugars.”
“Carbohydrates perform numerous roles in living organisms. Polysaccharides serve for the storage of energy (e.g., starch and glycogen) and as structural components (e.g., cellulose in plants and chitin in arthropods). The 5-carbon monosaccharide ribose is an important component of coenzymes (e.g., ATP, FAD and NAD) and the backbone of the genetic molecule known as RNA. The related deoxyribose is a component of DNA. “
“In food science and in many informal contexts, the term carbohydrate often means any food that is particularly rich in the complex carbohydrate starch (such as cereals, bread and pasta) or simple carbohydrates, such as sugar (found in candy, jams, and desserts).”
Why A No Carb diet Will Not Work
Carbohydrates are important:-
“Lack of dietary fiber – indigestible carbohydrates which are not a source of energy –; inadequate intake can lead to significant increases in mortality.” Though Wikipedia does not elaborate. Fibre is important in digestion and control of both sugar and cholesterol. Soluble fibre, found in Oat, Okra and many other carbohydrate foods are helpful in that the line the intestines and slow the absorptions of sugars and can reduce the sugar spikes that can occur after meals.
Further “following a diet consisting of very low amounts of daily carbohydrate for several days will usually result in higher levels of blood ketone bodies than an isocaloric diet with similar protein content. This relatively high level of ketone bodies is commonly known as ketosis and is very often confused with the potentially fatal condition often seen in type 1 diabetics known as diabetic ketoacidosis. Somebody suffering ketoacidosis will have much higher levels of blood ketone bodies along with high blood sugar, dehydration and electrolyte imbalance.”
This is not very desirable for diabetics.
Why the Confusion
“Nutritionists often refer to carbohydrates as either simple or complex. However, the exact distinction between these groups can be ambiguous. The term complex carbohydrate was first used in the U.S. Senate Select Committee on Nutrition and Human Needs publication Dietary Goals for the United States (1977) where it was intended to distinguish sugars from other carbohydrates (which were perceived to be nutritionally superior). However, the report put “fruit, vegetables and whole-grains” in the complex carbohydrate column, despite the fact that these may contain sugars as well as polysaccharides. This confusion persists as today some nutritionists use the term complex carbohydrate to refer to any sort of digestible saccharide present in a whole food, where fiber, vitamins and minerals are also found (as opposed to processed carbohydrates, which provide energy but few other nutrients). The standard usage, however, is to classify carbohydrates chemically: simple if they are sugars (monosaccharides and disaccharides) and complex if they are polysaccharides (or oligosaccharides).
In any case, the simple vs. complex chemical distinction has little value for determining the nutritional quality of carbohydrates. Some simple carbohydrates (e.g. fructose) raise blood glucose slowly, while some complex carbohydrates (starches), especially if processed, raise blood sugar rapidly. The speed of digestion is determined by a variety of factors including which other nutrients are consumed with the carbohydrate, how the food is prepared, individual differences in metabolism, and the chemistry of the carbohydrate.
Even though these complex carbohydrates are not very digestible, they represent an important dietary element for humans, called dietary fiber. Fiber enhances digestion, among other benefits.””
So what these confused people really mean when they say Low Carb is Low Sugar, and no Carb means no Sugar.
I have no problem with low sugar or no sugar so why don’t we say that, it is simple and not confusing and consistent with science.
What we probably need is a list of Good Carbs Bad Carbs, this has been done by brighter minds than mine and can be found at:-
So What the Experts Say
Carbohydrate (Dietitians Association of Australia)
Carbohydrate is an important nutrient found in many foods. Carbohydrate containing foods include breads, breakfast cereal, rice, pasta, noodles, fruit, potato and starchy vegetables, corn, dried beans and lentils, sugar, milk and yoghurt.
Carbohydrate is an important source of energy for the body. Many carbohydrate-containing foods are high in dietary fibre and are healthy food choices. Try to eat carbohydrate-containing foods in every meal to provide the body with energy throughout the day.
The rate at which carbohydrate-containing foods are digested varies greatly. Carbohydrate containing foods that are digested slowly and therefore provide a longer lasting release of energy are those with a low glycaemic index or GI.A great deal of misleading information exists about carbohydrate. Many fad diets suggest carbohydrate-containing foods be eliminated in order to lose weight. This is far from the truth.
There is strong evidence that a diet high in whole grains is associated with lower body mass index, smaller waist circumference, and reduced risk of overweight. Research shows that significant weight loss is achievable with energy-controlled diets that are high in cereals and legumes.
Carbohydrate-containing foods are generally low in saturated fat, low in energy (kilojoules) and high in fibre, and are an important inclusion in any weight-loss plan.
Carbohydrate foods like breads and cereals are also fuel to the probiotic (helpful) bacteria in our gut and are essential for a healthy digestive tract.
For good health, eat a variety of low GI, high fibre carbohydrate-containing foods each day. Examples include:
- Fresh, canned or dried fruit
- Rice, bread, quinoa and pasta (preferably brown/whole grain varieties)
- Low fat milk and yoghurt
- Whole grain breakfast cereals
- Legumes such as beans, chickpeas and lentils
An Accredited Practising Dietitian (APD) can provide expert advice on the best type and amount of carbohydrate to be included in your diet.
Carbohydrates and sugars (The Heart Foundation)
Many people think of rice, potatoes and pasta as ‘carbs’ but that’s only a few examples of the huge range of foods that contain carbohydrates. All fruit and vegetables, all breads and grain (cereals) products, sugar and sugary foods contain carbohydrates.
Choosing the healthier carbohydrates is common sense. Fresh fruit and veggies, wholegrain breads, wholegrain cereals and pastas are all healthy foods and form part of a healthy eating pattern.
Not all carbohydrates are equal
Some grain (cereal) foods, which contain carbohydrates, have high amounts of added saturated fat, added sugar, added salt and not much fibre, vitamins or minerals. These include most cakes, muffins, pies, pastries and biscuits. These foods should be limited – choose only sometimes and in small amounts.
Why choose wholegrains?
Wholegrain cereals include all the parts of the natural grain. They contain more fibre and other nutrients than white or refined starchy foods. That means they retain all of their nutrients including dietary fibre, B vitamins, vitamin E and the healthier fats.
Choosing wholegrain options also helps to keep your digestive system healthy.
Carbohydrates are made of long chains of simple sugars. Thus sugar is a type of carbohydrate, needed by our body for energy. It may be called different names e.g. sucrose, glucose, high fructose corn syrup, maltose, dextrose, raw sugar, cane sugar, malt extract and molasses.
Sugar in food and drinks can be naturally occurring, for example in fruit and dairy products, or added during processing, for example in confectionary, cakes, biscuits and sauces. Some healthy, core foods contain added sugars for flavour or food technology reasons, for example in flavoured yoghurt and some breakfast cereals.
What’s the evidence around sugar?
The Australian Government’s NHMRC (National Health and Medical Research Council) recently reviewed all available evidence to update the Australian Dietary Guidelines and concluded that sugar as an individual nutrient was important in relation to dental caries, and sugary drinks can increase the risk of weight gain in adults and children.
Where do we get most of our sugar from?
The majority of ‘added’ sugar in the Australia diet comes from discretionary foods such as cakes, biscuits, pastries and sugary drinks. It is sensible to reduce the consumption of these discretionary foods which are a source of excess added sugar and energy. The Heart Foundation recommends that these foods are limited in a heart healthy diet.
According to the 2011/12 National Nutrition Survey, the top five sources of total sugar in the Australian diet are:
- Fruit products and dishes
- Cereal based products and dishes – including sweet biscuits, cakes, muffins*
- Soft drinks, flavoured mineral waters, electrolyte, fortified and energy drinks*
- Sugar products and dishes*
- Dairy products and dishes
* denotes added sugar, as opposed to naturally occurring sugar
What the Heart Foundation recommends
The Heart Foundation recommends that a heart healthy diet is one that is plant-based and includes a wide variety of fruit, vegetables, legumes and wholegrains which are good quality sources of carbohydrates.
The Heart Foundation recommends limiting ‘extra’ or ‘sometimes’ foods that are high in sugar such as sugar sweetened soft drinks, sports drinks, fruit drinks, cordials, confectionery, sweet biscuits and cakes, etc.
Limiting excess energy (kilojoules) intake, in the form of added sugar and sugary drinks, can help to achieve or maintain a healthy weight, which is an important risk factor for heart disease.
What can I do?
Choose a variety of foods from the five food groups, and limit foods like cakes, confectionary, biscuits and sugary drinks. See our healthy eating tips for more information.
Consider the whole food when considering added sugar. Added sugar in milk or yoghurt may help to increase intake, particularly in children and teenagers – which is important as milk and yoghurt are nutritious foods essential to the diets of growing kids. However, products like sugary drinks which have a lot of added sugar and provide no nutritional benefit to the diet are not a good choice.
What is the Heart Foundation doing?
The Heart Foundation, in partnership with the Cancer Council Victoria and Diabetes Australia is raising awareness about the health consequences of drinking sugary drinks. Visit Rethink Sugary Drink to find our more.
The Heart Foundation, through the Tick Program, encourages manufacturers to reformulate products to reduce portion size and total energy (kilojoules), along with salt, trans fat and saturated fat. In 2015, the Tick Program will introduce sugar criteria specifically to some food categories which contribute added sugar to the Australian diet.
Thinking of trying a low carb diet?
Thinking of trying a low carb diet? While they can produce fast results, there are potential long term risks, especially as saturated fat often takes the place of carbohydrate. We believe low carb diets are unnecessarily restrictive and can leave you missing out on important vitamins and minerals. Low GI diets strike a happy medium between low fat and low carb diets – you can enjoy your carbs, just quality ones!
Let’s be blunt: I have never seen diabetes on a death certificate. What I have seen is Heart, Vascular or Kidney disease. Modern medical thinking blame fat and sugar for most of these diseases.
So Why High Fat.
A Swedish scientist was studying Omega-3 fats and why it was good for us. As a side discovery he found that fat lined the digestive system and this slowed the absorption of sugars. (NB I have read the original research paper but somehow lost it during my research, if anyone can provide me with the original link I will include it in this blog.)
Remember that soluble fibre found in oats and okra and many other foods, works in a similar manor and has been discussed earlier.
Somehow the confused has extended this to all fats.
Many diabetics have found that fats, especially Omega-6 fats, effect their blood sugar levels as much, if not more than sugar. I have to admit that I am one of these and I discovered early in my diabetic life that by cutting out Omega-6 fats helped in controlling my blood sugars.
Experts say today that the modern diet has contributed to an increase in diabetes and heart disease in many western societies.
Further tom reinforce this pont:-
“Researchers found that mice who were fed a high-fat diet had brain changes that were associated with anxious symptoms – and that the beneficial effects of an antidepressant were canceled out while the mice were eating this way.
The findings suggest that metabolic conditions like diabetes could be considered a predictor of treatment resistance when it comes to alleviating depression or anxiety.
A healthy diet has an Omega-3: Omega-6 ratio of 1:3 – 1:4, modern western diets is usually 1:20 to even 1:40.
So try a diet high in Omega-3, in fact that is what our Swedish friend recommends:-
“Try to radically lower omega-6 fat intake by limiting vegetable fats to well below 10 grams a day. Then balance that number with omega-3 fats from a variety of sources including fatty fish, pastured meat, and high-quality, stabilized fish oil.”
How can this be achieved?
I have done extensive research in this area. The results can be found in the following blogs:-
About the Australian Dietary Guidelines
The Australian Dietary Guidelines give advice on eating for health and wellbeing. They’re called dietary guidelines because it’s your usual diet that influences your health. Based on the latest scientific evidence, they describe the best approach to eating for a long and healthy life.
What are the Australian Dietary Guidelines?
The Australian Dietary Guidelines have information about the types and amounts of foods, food groups and dietary patterns that aim to:
- promote health and wellbeing;
- reduce the risk of diet-related conditions, such as high cholesterol, high blood pressure and obesity; and
- reduce the risk of chronic diseases such as type 2 diabetes, cardiovascular disease and some types of cancers.
The Australian Dietary Guidelines are for use by health professionals, policy makers, educators, food manufacturers, food retailers and researchers, so they can find ways to help Australians eat healthy diets.
The Australian Dietary Guidelines apply to all healthy Australians, as well as those with common health conditions such as being overweight. They do not apply to people who need special dietary advice for a medical condition, or to the frail elderly.
The Australian Dietary Guidelines (the Guidelines) provide up-to-date advice about the amount and kinds of foods that we need to eat for health and wellbeing. The recommendations are based on scientific evidence, developed after looking at good quality research.
By following the dietary patterns recommended in the Guidelines, we will get enough of the nutrients essential for good health and also help reduce our risk of chronic health problems such as heart disease, type 2 diabetes, some cancers and obesity.
How to order Australian Dietary Guidelines publications
The following products are available in print form, at no cost, via National Mailing and Marketing. To place an order:
- Review the Australian Dietary Guidelines – ordering catalogue (PDF, 4MB)
- Take note of the reference code attached to each product.
- Contact National Mailing and Marketing on email@example.com or 02 6269 1080 to place an order.
Note: products marked with an asterisk (*) after the reference code are now not orderable. No back orders are being taken.
Summary media release information
Australia is facing an obesity epidemic. The scientific evidence suggests that one of the contributing issues is the replacement of healthy, nutritious food with energy dense food with minimal nutritional value in Australian dietary patterns.
Health professionals working with people trying to achieve a healthy diet now have access to updated scientific evidence about the best dietary patterns for Australians of all ages.
“To achieve and maintain a healthy weight, Australians need to balance physical activity with amounts of nutritious foods and drinks that meet energy needs. We all need to limit energy rich nutrient poor ‘junk foods’ that are high in saturated fat, added salt or sugar,” NHMRC CEO Professor Warwick Anderson said.
A stringent review of around 55,000 scientific publications shows that the scientific evidence has strengthened about the link between diet and health.
Launch of the Australian Dietary Guidelines and the Infant Feeding Guidelines
In short, the guidelines are:
- To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious foods to meet your needs.
By the way, we will have additional help on our website and for doctors and dieticians about what this means for different ages of people.
- Enjoy a wide range of nutritious foods from these five food groups
- Plenty of vegetables
- Grains, such as cereals, breads, rice and pasta, preferably wholegrain
- Lean meats and poultry, fish, eggs, nuts and seeds, tofu
- Milk, yoghurt and cheese products (mostly reduced fat so to keep within daily kilojoule range)
And drink plenty of water.
- Limit intake of foods containing saturated fat, added salt, added sugars and alcohol .
- You know what these foods that are high in saturated fat are! And if you don’t, it’s on the label!
- And it’s theaddedsalt and added sugars that need to be limited.
- NHMRC has additional guidelines on alcohol in our Australian Alcohol Guidelines for low risk drinking.
- Encourage, support and promote breast feeding for babies
- And, care for your food; prepare and store it safely.
Low carbohydrate, high fat diets for diabetes
A word on saturated fats
In ‘Low Carb, High Fat’ diets, a variety of fats have also been suggested as replacements for carbohydrate foods. Some LCHF diets promote foods like coconut oil and animal fats (such as lard and butter), often suggesting these are more ‘natural’ sources of fat. DAA believes this is misleading.
All fats are rich in energy (kilojoules) – containing twice the amount of kilojoules as either protein or carbohydrate – so if eaten in large amounts, can make weight control more difficult. The Australian Dietary Guidelines recommend Australians limit intake of foods high in saturated fat.
Foods high in saturated fat include:
- Many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks
- Butter, cream, cooking margarine, coconut and palm oil.
High Fat Diet Could Lead to Depression, Anxiety
High blood sugar and increased body weight due to a high-fat diet could lead to symptoms of depression and anxiety, according to new research.
Researchers found that mice who were fed a high-fat diet had brain changes that were associated with anxious symptoms – and that the beneficial effects of an antidepressant were canceled out while the mice were eating this way.
The findings suggest that metabolic conditions like diabetes could be considered a predictor of treatment resistance when it comes to alleviating depression or anxiety.
Diabetics: Watch your diet
The research may also have implications for diabetics who adhere to a low-carb diet for weight management or insulin control, as this typically means more high-fat foods (meats, cheeses, etc.) are consumed in the absence of carbohydrate-rich foods.
A study published earlier this year in Biological Psychiatry found that high-fat diets can impair brain health, partially by disrupting the gastrointestinal tract.
In the currently study, taking the mice off a high-fat diet, researchers found, completely reversed their anxious symptoms.
“The results set the tone for future investigations on potential mechanisms that may link metabolic and psychiatric disorders,” a press release on the studystated.
I HAVE TYPE 2 DIABETES. HOW MUCH CARBOHYDRATE SHOULD I AIM FOR EACH DAY? I HAVE READ THAT VERY LOW CARB DIETS MAKE IT EASIER TO MANAGE BLOOD SUGAR. ARE THERE ANY PROBLEMS WITH THEM?
How much carbohydrate a day? This depends on many things including your body size, age, gender, plus how active you are, your food preferences, food culture and family background. And on the amount and type of diabetes medication you are taking.
In the past 20 years, diabetes organisations around the world have recommended that people with diabetes aim to consume 45–60% of their energy intake from carbs. However, ongoing research suggests that there’s quite a range of eating patterns that can help people with diabetes manage their blood glucose levels in the short to medium term.
People with diabetes consuming lower carbohydrate/higher protein, low GI, Mediterranean vegetarian, and vegan diets for at least six months will lower their HbA1c by 0.12 to 0.47 percentage points with the low carb diet providing the 0.12% reduction and the Mediterranean diet the 0.47% reduction. We don’t really know what happens after that as we don’t have any very long-term (> 2 years) studies at this stage.
By very low I assume you mean the kick start phase of diets such as Atkins. A recent CSIRO study found that both high carbohydrate and very low carbohydrate (around 75 grams per day) diets produced improvements in diabetes control. But without enough carbohydrate in your diet you may experience in the short term: muscle fatigue, causing even gentle exercise to be an exceptional effort; insufficient fibre intake and therefore constipation; headaches and tiredness due to low blood glucose levels; bad breath due to the breakdown products of fat (ketones); negative mood.
A real concern with low carb diets is the potential for adverse cardiovascular outcomes. High saturated fat intake is usually part and parcel of a very low carb diet. Even a single meal high in saturated fat can have an adverse effect on blood vessels by inhibiting vasodilation, the normal increase in the diameter of blood vessels that occurs after a meal. A short-term and long-term effect of most low carb diets includes an increase in LDL cholesterol. Compounding this, there may be a low intake of miconutrients that are protective against disease. For this reason, a vitamin and mineral supplement is an essential accompaniment to most low carb diets.
To ensure that blood glucose levels can be maintained between meals, your body draws on the glucose stored in the liver; that form of glucose is called glycogen. Supplies of glycogen are strictly limited and must be replenished from meal to meal. If your diet is low in carbohydrate, your glycogen stores will be low and easily depleted.
The take-home? For most people diabetes is a lifelong condition. What matters is that you adopt a healthy eating pattern that you enjoy, that helps you manage your diabetes and that you can live with for the rest of your days. Food after all is one of life’s great pleasures to enjoy with family and friends. Talk over your options with your diabetes dietitian, as within wide limits there is flexibility in the macronutrient proportions that are considered healthy.
Professor Jennie Brand-Miller (AM, PhD, FAIFST, FNSA, MAICD) is an internationally recognised authority on carbohydrates and the glycemic index with over 250 scientific publications. She holds a Personal Chair in Human Nutrition in the Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders and Charles Perkins Centre at the University of Sydney. She is the co-author of many books for the consumer on the glycemic index and health.
Dietary Fat Acutely Increases Glucose Concentrations and Insulin Requirements in Patients With Type 1 Diabetes
CONCLUSIONS This evidence that dietary fat increases glucose levels and insulin requirements highlights the limitations of the current carbohydrate-based approach to bolus dose calculation. These findings point to the need for alternative insulin dosing algorithms for higher-fat meals and suggest that dietary fat intake is an important nutritional consideration for glycemic control in individuals with type 1 diabetes.
Current guidelines for the intensive treatment of type 1 diabetes focus exclusively on carbohydrate counting for mealtime bolus calculation (1,2). This carbohydrate-based approach to insulin dose calculation assumes that carbohydrate is the only dietary macronutrient that affects glucose levels and insulin requirements.
I have hung around these groups for several years. The problem is they do not blindly follow they are brainwashed by confused people who put themselves as experts. Here are some of the studies they quote. Note in all cases they compare 2 bad fats which conclude that Sat fat is the best. In the first they compare Tran and sat fat. I will not argue that Tran fat is bad. It is fact what causes the confusion between Margarine and butter. In the US they make margarine from Tran fats (This is the stuff that they developed as turkey food and it killed the turkeys. In most countries Margarine is made from unsaturated fats (vegetables oils Omega 6 and 3). Anyway you should not be using either as they are used to add moisture to a sandwich. Once you stop using them you do not miss them.
Trans fats, but NOT saturated fats, are the problem
Saturated fats are not associated with an increased risk of death, heart disease, stroke, or type 2 diabetes, finds a Canadian study published in The British Medical Journal (BMJ)this week. However, the findings show that trans fats are associated with greater risk of death and coronary heart disease.
The study confirms previous suggestions that industrially produced trans fats might increase the risk of coronary heart disease and calls for a careful review of dietary guidelines for these nutrients.
Saturated Fats are Essential – Here’s Why
Despite conventional wisdom, saturated fat is essential to staying healthy and actually lowers our risk of disease (including those of the heart). The 3 saturated fats we consume most have beneficial impacts on cardiovascular risk factors, as they assist in conversions to essential fatty acids in the liver, and in raising HDL (good) cholesterol.
Saturated fats not so bad after all, say leading Australian scientists
Two of Australia’s leading academics in nutritional health have taken a swipe at the current orthodoxy concerning which fats are health or unhealthy.
Professor Andrew Sinclair of Deakin University and Professor Robert Gibson from the University of Adelaide, were two of the speakers at a recent food industry symposium hosted in Melbourne in April 2016.
Professor Sinclair explained the new research which strongly suggests saturated fats are not as bad as the health warnings say.
Benefits of switch from saturated fat to corn oil for longer life challenged
Replacing saturated fats in the diet with unsaturated corn oil fails to reduce the risk of death, according to a finding from a large randomized trial in the U.S. that went mysteriously unpublished for decades despite its implications for nutrition recommendations.
The “diet-heart hypothesis” predicts that replacing saturated fat with vegetable oil rich in linoleic acid will lower cholesterol levels in the blood and reduce cardiovascular events and deaths. Despite years of claims that unsaturated fats like corn oil are healthier, at the time the findings of a gold-standard randomized controlled trial weren’t fully published.
Now Christopher Ramsden at the U.S. National Institutes of Health in Bethesda, Md., and his team have analyzed data from the Minnesota coronary experiment. It was a blinded randomized trial that occurred 45 years ago on 9,423 men and women from state mental hospitals and a nursing home in Minnesota.
The participants were followed for up to 4½ years and fed either corn oil rich in unsaturated omega-6 fatty acid or a diet high in saturated fat from meat, butter and shortening as a control.
In diabetic children, ED visits are risk markers for ketoacidosis
NEW YORK (Reuters Health) – In children with type 1 diabetes, recent and repeated emergency department (ED) visits are among indicators of impending diabetic ketoacidosis (DKA), according to California-based researchers.
As Dr. Stephanie S. Crossen told Reuters Health by email, “Our finding that visits to emergency departments are associated with an almost four times higher odds of DKA hospitalization within the subsequent two weeks suggests a time period during which patients are at elevated risk, and provides a potential trigger and target for case management interventions.”
“In identifying this and other patterns of health care use that are associated with preventable DKA,” she added, “our analysis also has the potential to improve type 1 diabetes management at a system level by focusing limited resources on the right patients at the right times.”
As reported online May 20 in Pediatrics, Dr. Crossen and colleagues at Stanford School of Medicine reviewed data from 2009 to 2012 on more than 5,200 such children. All had been enrolled for at least a year in a program for low-income children with chronic disease.