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Three Takeaways From ADA Clinical Updates: Turning Standards Into Practice
If you work in diabetes care and education and are a member of the American Diabetes Association, you’ve likely received the nearly 400-page Standards of Care journal in your mailbox. What began as a three-page reference document in 1989 has grown into a comprehensive resource that now rivals a phonebook. The depth of guidance is incredibly valuable, but translating all of those standards into day-to-day clinical practice can feel a bit daunting. Enter the ADA Clinical Updates Conference, an important piece of the puzzle that focuses on moving evidence off the page and into real-world care. After spending the weekend…
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Nutrition and Type 1 Diabetes: Supporting Safe and Sustainable Weight Loss
I recently had the opportunity to contribute to an upcoming text from the American Diabetes Association on nutrition therapy in diabetes care. Specifically, I was tasked with reviewing and rewriting a chapter on nutrition recommendations for adults with type 1 diabetes and insulin-requiring type 2. In my excitement for its upcoming publication, I wanted to share a preview of what makes weight and fat loss in type 1 diabetes uniquely complex and highlight evidence-based strategies for supporting safe, sustainable weight management in this population. I hope this sneak peek sparks curiosity and encourages you to consider adding this valuable resource…
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Nutrition and Type 1 Diabetes: What Are Best Practices for Insulin Dosing?
I recently had the opportunity to contribute to an upcoming text from the American Diabetes Association on nutrition therapy in diabetes care. Specifically, I was tasked with reviewing and rewriting a chapter on nutrition recommendations for adults with type 1 diabetes and insulin-requiring type 2. In my excitement for its upcoming publication, I want to share a preview of some best practices for insulin dosing for individuals on multiple daily injections (MDI). What are the strategies for dosing insulin with meals? How can doses be adjusted? And how do factors like exercise, alcohol, or stress come into play? I hope…
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Nutrition and Type 1 Diabetes: What about Protein and Fat?
I recently had the opportunity to contribute to an upcoming text from the American Diabetes Association on nutrition therapy in diabetes care. Specifically, I was tasked with reviewing and rewriting a chapter on nutrition recommendations for adults with type 1 diabetes and insulin-requiring type 2. In my excitement for its upcoming publication, I want to share a preview of my key findings on the role of fat and protein. Does fat and protein impact glycemic? What is the ideal amount? Does it require additional insulin? I hope this sneak peek sparks curiosity and encourages you to consider adding this valuable resource…
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Nutrition and Type 1 Diabetes: Do Carbohydrates Matter?
I recently had the opportunity to contribute to an upcoming text from the American Diabetes Association on nutrition therapy in diabetes care. Specifically, I was tasked with reviewing and rewriting a chapter on nutrition recommendations for adults with type 1 diabetes and insulin-requiring type 2. In my excitement for its upcoming publication, I’d like to share a preview of some key findings on carbohydrates. Is carbohydrate counting still relevant today? Does the type of carbohydrate make a difference? And how do approaches like low-carb or keto eating fit in? My hope is that this sneak peek sparks curiosity and inspires…
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Nutrition and Type 1 Diabetes: A Four-Part Series
I recently had the opportunity to contribute to an upcoming text from the American Diabetes Association on medical nutrition therapy for the management of diabetes. Specifically, I was tasked with reviewing and substantially rewriting a chapter focused on nutrition therapy recommendations for adults with type 1 diabetes and insulin-requiring type 2 diabetes. This was by far one of the most challenging and rewarding projects I’ve taken on, rivaling even my graduate thesis (which included over 110 citations!). The chapter is deeply researched and reflects countless hours of work, reflection, and revision, though at this point, it all feels like a…
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Blood Sugar Trends: Defining What’s Truly “Normal”
With the rise of direct-to-consumer continuous glucose monitoring, there has been growing interest in understanding blood sugar trends. Reasons for CGM use include to improve metabolic health, prevent diabetes, enhance sports performance and recovery, or simply out of curiosity. Users can access real-time data, averages, trends, and insights at any time, day or night. With all this data, you might find yourself wondering: What do my numbers mean? Should I be concerned? Is this normal? All valid questions. Let’s explore the evidence behind defining “normal” blood sugar trends. Diagnosing Diabetes To define what is considered normal, it’s best to start…
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2025 ADA Standards of Care: 4 Key Changes You Shouldn’t Miss
The start of a new year means one thing in diabetes care and education—new Standards of Care! While the guidelines continue to grow in size and detail, much like a thick phone book, their annual updates are incredibly important for shaping high-quality care for people living with diabetes. Here are four key updates I’m particularly excited to see this year. What are the Standards of Care? The ADA Standards of Care are widely recognized as the gold standard for evidence-based guidelines in diagnosing and managing diabetes and prediabetes. Grounded in the latest scientific research and clinical trials, these guidelines provide…
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Three Surprising Changes to the 2023 ADA Standards of Care
Here are three surprising changes to the 2023 ADA standards of care.
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Move Over A1c, Make Room for Time In Range
A hemoglobin A1c test (HbA1C) has long been the gold standard for diagnosis and treatment of diabetes. It’s cheap, quick, and easy to interpret. An A1c of 6.5% or greater is considered diagnostic criteria for diabetes, while 7.0% or less is regarded as controlled once diagnosed. Completed every 3-6 months, A1c is an accessible and affordable way to monitor long term glycemic control. Yet, A1c often fails to capture the nuance of day-to-day management for so many people living with diabetes. A sleepless night of lows (less than 70 mg/dL) followed by a frantic day of highs (greater than 180…
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Diagnosing Type 1 Diabetes in Adults
The UK T1D Immunotherapy Consortium recently updated their guidance on diagnosing type 1 diabetes (T1D) in adults. This is particularly important as a large portion of new onset T1D in adults are misdiagnosed as Type 2 diabetes (T2D). An accurate diagnosis matters. It can shape selection and advancement of treatment, understanding of natural disease progression, and expectations around the efficacy of diet and lifestyle. Most importantly, a misdiagnosis can be incredibly frustrating and discouraging for patients. Clinical Features While there is no single feature that distinguishes T1D from T2D in adults, presence of the following parameters suggest the need…
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DSME/T: The Gold Standard in Diabetes Education
Managing diabetes is a lot like caring for a newborn—relentlessly needy, impatient, and often irrational. It requires numerous daily decisions and a general high level of engagement and attention. I remember hearing at a professional conference that “if patients did everything their doctors asked of them it would take over 2.5 hours per day.” That’s a lot of time to be doing anything, let alone managing diabetes. To best equip patients with tools to manage diabetes, the American Diabetes Association (ADA), American Association of Diabetes Care and Education Specialist (ADCES), and the Academy for Nutrition and Dietetics (AND) have updated their…
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