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From Checklists to Practice: Reframing Behavior Change in Clinical Care
I recently read a quote from James Clear that felt timely. In summary, he writes that many meaningful parts of life cannot be finished. Work, exercise, parenting, marriage. The goal is not to be done, but to settle into a daily lifestyle you can sustain and make steady progress within. It made me reflect on how often our patients approach health with a finite mindset. They want the checklist. The meal plan. The workout. The medication adjustment. Something to complete so they can feel done. But health is not a project with an endpoint. There will always be another meal,…
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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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Double Diabetes: Supporting Patients Through the Diagnostic Overlap
If you’ve never heard the term “double diabetes” before, don’t be alarmed. It’s not an official diagnosis, and you likely won’t find it in a medical textbook. However, it’s a term that’s gaining traction to describe a growing population of adults whose diabetes doesn’t fit neatly into the diagnostic criteria for either type 1 or type 2. Sometimes referred to as “hybrid diabetes,” “type 1.5,” or “LADA” (Latent Autoimmune Diabetes in Adults), recent research suggests that the distinction between type 1 and type 2 diabetes is less clear-cut than previously thought. In some cases, features of both types can coexist.…
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Destigmatizing Diabetes
Diabetes stigma refers to the negative attitudes, judgment, discrimination, or prejudice directed at individuals simply because they have diabetes. This stigma can manifest both internally and externally. Internal stigma arises when individuals with diabetes internalize negative beliefs, often leading to feelings of self-blame, shame, and guilt. This can result in a sense of personal responsibility for their condition, undermining their self-esteem. In contrast, external stigma is imposed by others through judgmental attitudes, discriminatory behaviors, or insensitive comments. This external stigma can reinforce harmful internal beliefs, further exacerbating the emotional burden on those living with diabetes. The most damaging aspect of…
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