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Diabetes Canada Guidelines 2018 - Physical Activity

>> Monday, May 14, 2018




There is a ton of great, new information in the 2018 Diabetes Canada Physical Activity guidelines chapter.  Here are some of the highlights:


1. Avoid prolonged sitting. Try to get up briefly every 20 to 30 minutes.  Bluntly put, this is because we now know that habitual, prolonged sitting is associated with an increase risk of death and major cardiovascular events (eg heart attack).

2. While it is still recommended to engage in 150 minutes per week of aerobic exercise and at least 2 sessions per week of resistance exercise if possible, it is now recognized that smaller amounts of activity still provides some health benefits. Something is better than nothing!

3.  Make use of strategies that increase motivation, such as setting specific physical activity goals, and using self monitoring tools (eg a pedometer that counts steps). (My editorial comment - some of these devices can also remind you to get up if you've been sitting for too long.)

4.  Medical clearance: It was previously recommended that anyone with diabetes who is about to begin a program more vigorous than walking should have medical clearance first.  This has been relaxed a little - now, this need for clearance is more focussed on middle aged and older people who wish to undertake prolonged or very vigorous exercise, and of course, anyone with symptoms suggestive of cardiovascular disease.

People with more advanced diabetic eye disease should be treated and stabilized before vigorous exercise, and people with severe diabetic nerve disease in their feet/legs should inspect their feet daily and wear appropriate footwear.   It is also recommended to ideally see a qualified exercise specialist before starting strength training (eg weights) to avoid injury.

5.  There is a great list of suggested strategies to help people with type 1 diabetes reduce the risk of lows with exercise.


Bonus Practical Stuff: 

Resources for people with diabetes: (scroll down to Exercise) - including info on how to plan and maintain physical activity, videos on resistance exercises, and more!

Resources for health care providers: under 'Management' - scroll down to 'Physical Activity and Diabetes' - tools including how to write an exercise prescription


Enjoy - and have fun!





Follow me on twitter! @drsuepedersen

www.drsue.ca © 2018







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New 2018 Diabetes Canada Guidelines - Nutrition Therapy

>> Monday, May 7, 2018





It's hard to know how to eat right - there is a lot of conflicting information out there, and unfortunately lots of claims that have no scientific backing nor evidence of long term success.
Eating well with diabetes is no exception.

Thankfully, we have the Diabetes Canada Clinical Practice Guidelines to give us evidence based recommendations on healthy eating with diabetes.

The updated Nutrition Therapy chapter in the 2018 Guidelines contains a lot of great information.   I really encourage interested readers to snuggle up with a cuppa to read the whole chapter, but let's go through some of the key points here:

1.  Nutrition therapy can reduce hemoglobin A1C (the diabetes report card) by 1-2% (that's as much as 1-2 diabetes medications!)

2.  The proportion of carbs vs protein vs fat should be flexible within the recommended ranges, and will depend on individual treatment goals and preferences.

3.  Eating low glycemic index foods instead of high glycemic index foods helps to improve diabetes control.

NEW: Aim for a fibre intake of 30-50g per day, with 10-20g coming from soluble fibre, to improve blood sugars and cardiovascular risk.

4.  Added sugars should be MAXIMUM 10% of total daily caloric intake.

5.  Intensive health behaviour interventions in people with type 2 diabetes can improve weight, fitness, diabetes control, and cardiovascular risk factors.

6. NEW: People with diabetes should be encouraged to choose the dietary patterns that best align with their values, preferences, and treatment goals. (check out the new sections on ethnocultural diversity in Canada, and on Ramadan, as well!)


Here are some of my favourite Key Messages For People With Diabetes: 

1.  Try to prepare more of your meals at home, using fresh and unprocessed ingredients.

2.  Prepare meals together and eat as a family. This is a good way to model healthy food behaviours to kids and teens, which can help reduce their risk of developing overweight or diabetes.

3.  The best strategy is one that you can maintain long term.

4.  With prediabetes and newly diagnosed type 2 diabetes, weight loss is the most important and effective dietary strategy if you have overweight or obesity.  A weight loss of 5-10% may help to normalize blood sugars.

5.  Diabetes friendly eating habits can improve blood sugars and decrease the risk of cardiovascular disease, including:

  • select whole foods instead of processed
  • avoid sugar sweetened beverages
  • pay attention to both carbohydrate quantity, and quality (low glycemic index instead of high)
  • considering learning how to count carbs
  • preferred dietary fats are unsaturated - maximum saturated fats has now been increased to 9% of total calorie intake (previously 7%) - and avoid trans fats completely
  • choose lean animal protein, and eat more vegetable protein


The data for many different diets/patterns of eating is reviewed, with many different types of diets being suggested for an improvement in type 2 diabetes control, including Mediterranean, vegetarian, and DASH diets, as well as diets that include pulses (eg beans), vegetables, fruits, and nuts.  The details of what is in these diets is provided in the chapter, and available data in type 1 diabetes is reviewed as well.  At the end of the day, the key is to choose a healthy way of eating that is in keeping with individual preferences, as this gives the greatest likelihood of being able to follow it long term.


Follow me on twitter! @drsuepedersen

www.drsue.ca © 2018






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A HEARTFELT WELCOME!

I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!


Are you ready to change your life? Let's begin our journey together, towards a healthier, happier you!!




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