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The buzz on the Internet this weekend is the news that insulin glargine (Lantus) might increase cancer rates. Needless to say, this is very upsetting news to a lot of people, although Lantus has been linked with cancer in the past.
Dr. Bill Quick has provided a good overv...
nice post- all things in moderation is the wisdom that keeps resurfacing throughout the $zillions in research
my thought on your (rhetorical?!) question about the ADA is that it is their somewhat pessimistic, PC approach to diet counseling- that is, the philospophy used is that everyone wants to have their cake and eat it too, so who are we to judge, etc etc- so the pre-research based decision is to incorporate carbs/sweets into the DM diet, cuz they'll eat it anyway- i have personally seen this debate in planning hospital diet patterns for DM- the PC administration conservatively adds in sweets and juice into the meals in order not to offend anyone- so how ironic when i get cussed out by a DM pt. exclaiming "why am i getting cake and juice on my tray- you tryna kill me?" :)- sigh- i personally fall in the low CHO camp, but in the end, if a diabetic patient wants to make 'starch the star', i will agree to disagree with them, but still advise how to attenuate the GLC from there
The original reason the ADA and others prescribed a high-carb diet was that they believed that fat caused heart disease and a lot of protein caused kidney problems. The only thing left was carbohydrate, and they figured you could cover that with insulin.
Since then, the fat hypothesis has been questioned by a lot of people and it's been shown that protein doesn't harm healthy kidneys. Furthermore, with the CGMs, they've shown that even if insulin can "cover" carbs in the sense that BG is normal before the next meal, it may go very high in between, when people didn't use to mention, and some people feel that these swings are dangerous.
So the question is when the ADA is going to change their position. They'll never admit they were wrong, instead they'll say, "New research shows that on high-carb diets, postprandial BG levels are too high," something that patients with meters have known for a long time.
Many patients who continue to eat sweets and bread do so because their CDEs have told them it's OK as long as they're low fat. Some people will continue to eat those things no matter what, but others would switch to something else with support from their CDEs.