Re: Times article diet, diabetes)CDE vs RD MNT

[Guest guest]

Hi All, The problem that I have heard from my Diabetic patients is that the CDE,

who was not an RD, gave them a sheet of paper with a Diet on it. No, referal

was made to a RD or a RD CDE. The " Diabetic Medical Nutrition Therapy vs

Nutrition " is a real problem in the world of Diabetic treatment. Plus, the

Nutrition info from the Non RD CDE is lacking even the basic nutrition needs of

the Diabetic and in many cases miss information or poor nutrition is given to

the Diabetic patient. ADA has great side by side information on " Diabetic

Nutrition vs Diabetic Medical Nutrition Therapy " MNT vs. Nutrition Education

(08/09/2006)

http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/nutrition_363_ENU_HTML.htm I

opened the Emory Diabetic Unit at Dunwoody Hospital in Metro Atlanta in 1983.

Back in the day, all Diabetics were under the care of an Endocrinologist who had

a RD and a RN. Today, the Family Docs, General Practice Docs and the Internal

Medicine Docs want to keep their Diabetic patients as long as they can until

they become so Brittle that these Docs have to make a referral to the

Endocrinologist and the Surgeon, who starts cutting off the Diabeitc's toes one

at a time and this is the time when the RD gets to do Medical Nutrition

Therapy...when the patients are having post-tramatic stress. Well, the wake-up

call for all the primary care doctors would be to refer to the RD for Medical

Nutrition Therapy so they may keep their Diabetic patients in their practice

($$$$) and keep the Diabetic Healthy..duh! I just started working with a

Diabetic Medical Supplier who also wants to help the Primary Care Docs out by

working with me to include MNT. This is a plus for the CDE also because the RD

may send the Patient back to the CDE for training needs which only a RD would

notice while doing the patients MNT Assesment.

Thanks, Weaver MS RD LD Medical Nutrition

www.linkedin.com/pub/6/833/688 www.mdrdtherapy.com

Senior Account Executive America's Business Benefit Association

Non Profit Organization Provides Help to Business www.ABBAplans.com

Insurance Producers of America Agency www.ipa-america.com/products.aspx

Rated EXCELLENT by www.AMBEST.com Over 30 YEARS Longevity $1.3 BILLION in Assets

Healthcare www.phcs.com www.mygreatwest.com

10% Premium Reduction on Health Savings Account Set Up

www.treas.gov/offices/public-affairs/hsa/

2300 Lakeview Parkway 7th Floor Alpharetta, GA 30004

Affordable Health/Dental Insurance For Individual Business Owners &

Self-Employeed!

Access To NATIONAL GROUP Benefits

24 Hour WorldWide & On The Job Coverage

You May Not Be Singled Out For Rate Increase Or Cancellation

Unique Plans Help Satisfy Deductible & Disability

Get a Free Quote Today!

Re: FYI (Ny Times article on diet, diabetes)

I was expecting a lot of debate or discussion on this NY Times article.

Did I miss it? When you read this article, " ...kept their blood sugar

under better control when they ate foods like beans and

nuts...scientists describe these foods as having a low glycemic index, "

don't you get the impression that the difference was significant?

My co-worker returned from August 2008 AADE conference with the bottom

line from discussions there that there was " no significant improvement "

at least in A1c —-(I don't remember any mention of improvement to HDL

Cholesterol — that is encouraging.

Anyone irked by the title, " Recommended diet for diabetics may need

changing. " Somehow, I believe I have not been alone (on this list

serve) in highly recommending (for like the past 50 years) " foods like

beans and nuts... " AND whole grains. Gee, Mediterranean Diet

anybody?

Robin Rhoades

Hartford

>>> " Kalman " 12/19/2008 9:10 AM

>>>

December 19, 2008

Recommended Diet for Diabetics May Need Changing, Study Suggests

By RONI CARYN RABIN

People with Type 2 diabetes

<http://health.nytimes.com/health/guides/disease/type-2-diabetes/overvie

w.html?inline=nyt-classifier> on a high-fiber

<http://health.nytimes.com/health/guides/nutrition/fiber/overview.html?i

nline=nyt-classifier> diet

<http://health.nytimes.com/health/guides/specialtopic/food-guide-pyramid

/overview.html?inline=nyt-classifier> kept their blood sugar under

better control when they ate foods like beans and nuts instead of the

recommended whole-grain diet, researchers have found.

Beans and nuts are among foods that only modestly increase blood

glucose

levels; scientists describe these foods as having a low glycemic

index.

The new study, which lasted six months, is one of the largest and

longest to assess the impact of foods with a low-glycemic index,

researchers said.

Participants on the low-glycemic diet also saw significant

improvements

in cholesterol

<http://health.nytimes.com/health/guides/nutrition/cholesterol/overview.

html?inline=nyt-classifier> after six months, with increases in HDL

<http://health.nytimes.com/health/guides/test/hdl/overview.html?inline=n

yt-classifier> , the so-called " good " cholesterol associated with a

reduced risk of heart disease, the study found.

" That's an important issue today, because there's a double whammy for

people who are diabetic, " said Dr. J. A. , lead author of

the report and a professor of nutritional sciences at the University

of

Toronto. " If they're men, they have twice the risk of heart disease,

and

if they're women, they have four times the risk. If you can hit the

heart disease to which they're particularly vulnerable, you may have

something useful. "

" Pharmaceuticals used to control Type 2 diabetes have not shown the

expected benefits in terms of reducing cardiovascular disease, " he

added.

The study was published on Tuesday in the Journal of the American

Medical Association.

Some 210 patients with Type 2 diabetes were randomly assigned to a

low-glycemic diet or a high-cereal, high-fiber diet.

The high-cereal high fiber diet emphasized " brown foods " such as

whole-grain bread and breakfast cereal, brown rice and potatoes with

the

skin on. The low-glycemic diet included beans, peas, lentils, pasta,

quickly boiled rice and certain breads, like pumpernickel and rye, as

well as oatmeal and oat bran cereals.

Both diets are low in saturated fat

<http://health.nytimes.com/health/guides/nutrition/fat/overview.html?inl

ine=nyt-classifier> and trans fat

<http://topics.nytimes.com/top/reference/timestopics/subjects/t/trans_fa

tty_acids/index.html?inline=nyt-classifier> . Both groups were told to

limit their consumption of white flour and to eat five servings of

vegetables and three servings of fruit each day.

Participants on the low-glycemic diet saw their hemoglobin

<http://health.nytimes.com/health/guides/test/hemoglobin/overview.html?i

nline=nyt-classifier> A1C

<http://health.nytimes.com/health/guides/test/hba1c/overview.html?inline

=nyt-classifier> levels - a measure of blood glucose levels over

recent

months - reduced slightly, by 0.5 percent on average, but experienced

significant improvements in HDL, which increased by 1.7 milligrams per

deciliter of blood on average. Those on the high-cereal diet saw

smaller

reductions in hemoglobin A1C and slight drops in HDL.

Dietitians who work with people who have Type 2 diabetes said earlier

studies had not demonstrated the benefits of low-glycemic index foods

as

clearly as this report.

" We've been telling people to eat whole grains for a long time, " said

Emmy Suhl, a nutrition and diabetes

<http://health.nytimes.com/health/guides/disease/diabetes/overview.html?

inline=nyt-classifier> educator at the Joslin Diabetes Center in

Boston. " What this study shows is that it's not enough to have whole

grains. It's these very specific low-glycemic carbohydrates

<http://health.nytimes.com/health/guides/nutrition/carbohydrates/overvie

w.html?inline=nyt-classifier> that do a much better job. "

But, she said, following such a diet is complicated, since the

glycemic

index of a food can change depending on how it is prepared and served.

" People tell us again and again that diet is the hardest part of

diabetes management, " she added.

S. Kalman PhD, RD, CCRC, FACN

Miami Research Associates

Director, Nutrition & Applied Clinical Research

6141 Sunset Drive #301

Miami, FL. 33143

(fax)

www.miamiresearch.com <http://www.miamiresearch.com>

[Guest guest]

Agreed. A close friend went to a CDE that works in her docs office because her

insurance covers doc visit. She brought the info to me because she was so

confused and wasn't sure what she received nor what to do. As her close friend,

I have spent time reviewing and going over basic info this person didn't

discuss. The main point my friend had was she didn't know what to eat! I have

encouraged her to go back o this person and insist that she spend time on what

she needs to eat and how to make that happen- not just a sheet of paper with

groups of items to eat and how many servings of pro/cho/fat.

I hear this more and more about not giving clients what to eat not just how.

This is a basic premis that must be communicated in order to be successful.

Thank you,

Nodvin

Re: Times article diet, diabetes)CDE vs RD MNT

Hi All, The problem that I have heard from my Diabetic patients is that the CDE,

who was not an RD, gave them a sheet of paper with a Diet on it. No, referal

was made to a RD or a RD CDE. The " Diabetic Medical Nutrition Therapy vs

Nutrition " is a real problem in the world of Diabetic treatment. Plus, the

Nutrition info from the Non RD CDE is lacking even the basic nutrition needs of

the Diabetic and in many cases miss information or poor nutrition is given to

the Diabetic patient. ADA has great side by side information on " Diabetic

Nutrition vs Diabetic Medical Nutrition Therapy " MNT vs. Nutrition Education

(08/09/2006)

http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/nutrition_363_ENU_HTML.htm I

opened the Emory Diabetic Unit at Dunwoody Hospital in Metro Atlanta in 1983.

Back in the day, all Diabetics were under the care of an Endocrinologist who had

a RD and a RN. Today, the Family Docs, General Practice Docs and the Internal

Medicine Docs want to keep their Diabetic patients as long as they can until

they become so Brittle that these Docs have to make a referral to the

Endocrinologist and the Surgeon, who starts cutting off the Diabeitc's toes one

at a time and this is the time when the RD gets to do Medical Nutrition

Therapy...when the patients are having post-tramatic stress. Well, the wake-up

call for all the primary care doctors would be to refer to the RD for Medical

Nutrition Therapy so they may keep their Diabetic patients in their practice

($$$$) and keep the Diabetic Healthy..duh! I just started working with a

Diabetic Medical Supplier who also wants to help the Primary Care Docs out by

working with me to include MNT. This is a plus for the CDE also because the RD

may send the Patient back to the CDE for training needs which only a RD would

notice while doing the patients MNT Assesment.

Thanks, Weaver MS RD LD Medical Nutrition

www.linkedin.com/pub/6/833/688 www.mdrdtherapy.com

Senior Account Executive America's Business Benefit Association

Non Profit Organization Provides Help to Business www.ABBAplans.com

Insurance Producers of America Agency www.ipa-america.com/products.aspx

Rated EXCELLENT by www.AMBEST.com Over 30 YEARS Longevity $1.3 BILLION in Assets

Healthcare www.phcs.com www.mygreatwest.com

10% Premium Reduction on Health Savings Account Set Up

www.treas.gov/offices/public-affairs/hsa/

2300 Lakeview Parkway 7th Floor Alpharetta, GA 30004

Affordable Health/Dental Insurance For Individual Business Owners &

Self-Employeed!

Access To NATIONAL GROUP Benefits

24 Hour WorldWide & On The Job Coverage

You May Not Be Singled Out For Rate Increase Or Cancellation

Unique Plans Help Satisfy Deductible & Disability

Get a Free Quote Today!

Re: FYI (Ny Times article on diet, diabetes)

I was expecting a lot of debate or discussion on this NY Times article.

Did I miss it? When you read this article, " ...kept their blood sugar

under better control when they ate foods like beans and

nuts...scientists describe these foods as having a low glycemic index, "

don't you get the impression that the difference was significant?

My co-worker returned from August 2008 AADE conference with the bottom

line from discussions there that there was " no significant improvement "

at least in A1c —-(I don't remember any mention of improvement to HDL

Cholesterol — that is encouraging.

Anyone irked by the title, " Recommended diet for diabetics may need

changing. " Somehow, I believe I have not been alone (on this list

serve) in highly recommending (for like the past 50 years) " foods like

beans and nuts... " AND whole grains. Gee, Mediterranean Diet

anybody?

Robin Rhoades

Hartford

>>> " Kalman " 12/19/2008 9:10 AM

>>>

December 19, 2008

Recommended Diet for Diabetics May Need Changing, Study Suggests

By RONI CARYN RABIN

People with Type 2 diabetes

<http://health.nytimes.com/health/guides/disease/type-2-diabetes/overvie

w.html?inline=nyt-classifier> on a high-fiber

<http://health.nytimes.com/health/guides/nutrition/fiber/overview.html?i

nline=nyt-classifier> diet

<http://health.nytimes.com/health/guides/specialtopic/food-guide-pyramid

/overview.html?inline=nyt-classifier> kept their blood sugar under

better control when they ate foods like beans and nuts instead of the

recommended whole-grain diet, researchers have found.

Beans and nuts are among foods that only modestly increase blood

glucose

levels; scientists describe these foods as having a low glycemic

index.

The new study, which lasted six months, is one of the largest and

longest to assess the impact of foods with a low-glycemic index,

researchers said.

Participants on the low-glycemic diet also saw significant

improvements

in cholesterol

<http://health.nytimes.com/health/guides/nutrition/cholesterol/overview.

html?inline=nyt-classifier> after six months, with increases in HDL

<http://health.nytimes.com/health/guides/test/hdl/overview.html?inline=n

yt-classifier> , the so-called " good " cholesterol associated with a

reduced risk of heart disease, the study found.

" That's an important issue today, because there's a double whammy for

people who are diabetic, " said Dr. J. A. , lead author of

the report and a professor of nutritional sciences at the University

of

Toronto. " If they're men, they have twice the risk of heart disease,

and

if they're women, they have four times the risk. If you can hit the

heart disease to which they're particularly vulnerable, you may have

something useful. "

" Pharmaceuticals used to control Type 2 diabetes have not shown the

expected benefits in terms of reducing cardiovascular disease, " he

added.

The study was published on Tuesday in the Journal of the American

Medical Association.

Some 210 patients with Type 2 diabetes were randomly assigned to a

low-glycemic diet or a high-cereal, high-fiber diet.

The high-cereal high fiber diet emphasized " brown foods " such as

whole-grain bread and breakfast cereal, brown rice and potatoes with

the

skin on. The low-glycemic diet included beans, peas, lentils, pasta,

quickly boiled rice and certain breads, like pumpernickel and rye, as

well as oatmeal and oat bran cereals.

Both diets are low in saturated fat

<http://health.nytimes.com/health/guides/nutrition/fat/overview.html?inl

ine=nyt-classifier> and trans fat

<http://topics.nytimes.com/top/reference/timestopics/subjects/t/trans_fa

tty_acids/index.html?inline=nyt-classifier> . Both groups were told to

limit their consumption of white flour and to eat five servings of

vegetables and three servings of fruit each day.

Participants on the low-glycemic diet saw their hemoglobin

<http://health.nytimes.com/health/guides/test/hemoglobin/overview.html?i

nline=nyt-classifier> A1C

<http://health.nytimes.com/health/guides/test/hba1c/overview.html?inline

=nyt-classifier> levels - a measure of blood glucose levels over

recent

months - reduced slightly, by 0.5 percent on average, but experienced

significant improvements in HDL, which increased by 1.7 milligrams per

deciliter of blood on average. Those on the high-cereal diet saw

smaller

reductions in hemoglobin A1C and slight drops in HDL.

Dietitians who work with people who have Type 2 diabetes said earlier

studies had not demonstrated the benefits of low-glycemic index foods

as

clearly as this report.

" We've been telling people to eat whole grains for a long time, " said

Emmy Suhl, a nutrition and diabetes

<http://health.nytimes.com/health/guides/disease/diabetes/overview.html?

inline=nyt-classifier> educator at the Joslin Diabetes Center in

Boston. " What this study shows is that it's not enough to have whole

grains. It's these very specific low-glycemic carbohydrates

<http://health.nytimes.com/health/guides/nutrition/carbohydrates/overvie

w.html?inline=nyt-classifier> that do a much better job. "

But, she said, following such a diet is complicated, since the

glycemic

index of a food can change depending on how it is prepared and served.

" People tell us again and again that diet is the hardest part of

diabetes management, " she added.

S. Kalman PhD, RD, CCRC, FACN

Miami Research Associates

Director, Nutrition & Applied Clinical Research

6141 Sunset Drive #301

Miami, FL. 33143

(fax)

www.miamiresearch.com <http://www.miamiresearch.com>