Diabetes Q&A
As some of you may already know, my fiance, David, was diagnosed with Type 1 diabetes in 2004. Since there's no one better to give insider knowledge than someone living with it everyday, I asked him last week if he would want to help me write a post on the subject. Little did I know a friend of mine would be diagnosed with Type 1 diabetes a few days later. Since the hospital set her up with a nutritionist who seems to have no qualifications for working with diabetics, let alone one who's vegan, the three of us went to dinner so David could share his personal experiences.
Understanding diabetes:
There are two types of diabetes: Type 1 and Type 2, both of which can occur at any age. Potential side effects of diabetes may include blindness, kidney disease, nerve damage, amputations, heart disease, stroke and infections.
Type 1: also referred to as juvenile or insulin-dependent diabetes (only accounts for 5-10% of cases). The pancreas cannot make its own insulin* and therefore relies on insulin injections. Type 1 is not curable and can occur in anyone at any age, regardless of physical health, and causes are unknown.
Type 2: also referred to as insulin resistant diabetes ("more than 29 million Americans are diabetic and 86 million more are prediabetic (Mackey, 111))." The pancreas secretes a small amount of insulin but requires assistance in the form of injections or pills. This type occurs in people with poor diet and physical health, although it can be reversed once diagnosed. Taking insulin helps to control blood sugar but only masks the underlying issues rather than solving them. Type 2 diabetes is preventable by changing one’s diet and lifestyle choices, preferably to a whole foods, plant-based diet.
*Insulin allows glucose (sugar) to enter the cells from the bloodstream which breaks down into energy
Q&A with David:
M: What are some common misconceptions?
D: I don't think most people realize that there are two types of diabetes - they tend to group the two together and assume diabetes in general is caused from lack of exercise and poor diet. This can be frustrating, especially for people with Type 1 who may have been in perfectly normal health before being diagnosed.
The second most common misconception is that people with diabetes shouldn't eat sugar or are forced to consume a special diet. These are both wrong. Diabetics don't need to avoid sugar anymore than anyone else. Any processed foods or refined sugars that are bad for you are also bad for me. Any good sugars, such as from fruits, vegetables, etc, that are good for you are also good for me. The only difference is that I have to be aware of how much of these foods I am eating so I can treat myself with insulin.
M: What are your most asked questions?
D: After clearing up the misconceptions above, people often ask about the insulin injections, finger pricks and blood sugar levels. No, the injections do not hurt. The needles are even smaller than ones used for flu shots, and are injected into fatty parts of the stomach, legs or arms. As for finger pricks, there's a good chance you've experienced one at a doctors office - maybe during a physical, routine checkup, or in an attempt to diagnose an illness. Your fingers eventually build up calluses (same as they would from rock climbing or playing an instrument) and they become less and less noticeable.
People often ask is "what's my blood sugar?" I'm no psychic but I'm willing to bet it's between 70-100. Your body's blood sugar is a highly regulated system. If you ever ate too much Halloween candy as a kid and experienced a headache it was from a spike in your blood sugar. This occurred because candy and chocolate bars are fast acting sugars (more on this below), and all entered your bloodstream at the same time causing a rapid rise in your blood sugar level. Likewise, if you have ever fasted for an extended period of time or had to work through your typical lunch hour, you may have experienced a low blood sugar. If you have a low blood sugar you may feel: shaky, light headed, dizzy, or tired.
M: How does your typical day differ from someone without diabetes?
D: Managing diabetes is as simple as adding another routine to your daily life. I look at it like brushing my teeth, its just something I do every day. Pricking my finger to check my blood sugar takes no more than 30 seconds, giving myself an insulin shot takes no more than 30 seconds, and carb counting is something I do subconsciously (this will be the most time consuming part for someone who is new to diabetes - as they must learn to read food labels and be able to estimate portion sizes).
M: How do different foods affect your blood sugar levels?
D: There are two categories of food to be aware of when monitoring blood sugar levels: fast-acting carbs and slow-acting carbs.
Fast-acting carbs are carbs that will cause a rapid rise in blood sugar levels. It is important to note that fast-acting and slow-acting carbs have nothing to do with "good" and "bad" carbs. Fruits are a fast-acting carb as they contain a lot of healthy sugars. Some fruits, such as pineapple, contain higher levels of sugars than other fruits, such as apples. Fast-acting carbs will enter your system quickly but will not stay for very long as they break down easily. Some examples are: fruits, cereals, sweet breads or baked goods, juice, soda (or any sugary sports drink), fruit snacks, candy, chocolate, yogurt.
Slow-acting carbs enter your system gradually and cause a steady rise in blood sugar levels. The carbs are more complex for the body to break down. These can sustain in your system for much longer periods of time than fast-acting carbs. Some examples are: potatoes (including chips and fries), rice, beans, pasta, bagels, pizza crust, tortillas.
M: How does exercise effect your body?
D: Exercise is the most important aspect of controlling blood sugar levels. Your body pulls energy from your blood sugar when you exercise which helps to lower blood sugar levels. When you do not exercise, the sugars remain in your bloodstream and do not get used. This causes elevated blood sugar levels which can lead to a variety of problems.
Intense exercise (and adrenaline) will cause your liver to release extra sugar into your bloodstream so that it can be used by the muscles (which need the extra energy). Because insulin is needed for sugars to get into the muscles, diabetics will often see their sugars rise during these periods of intense exercise. This is okay, as the blood sugar levels will eventually even out and the added benefit of increasing your heart and body's health far outweighs the temporary spike in levels.
M: What advice would you give to someone newly diagnosed?
D: I would advise them to routinely exercise, learn to count carbs, and to always check their blood sugar. I think I covered exercise so I'll move on to carb counting. Diabetics have to take a specific amount of insulin depending on their current blood sugar level and the amount of carbs they are consuming. The goal is to find a ratio of carbs to units of insulin that you can use to determine the amount of insulin you take. It is very important to be able to accurately estimate the amount of carbs in your meal so that the ratio is effective. It also allows you to make adjustments to the ratio if it is not keeping your blood sugar at the optimal levels. Some tips on carb counting: learn to read food labels, use measuring cups for foods such as cereal and rice so you understand the serving size, never assume a bagel is 50 carbs because it is a bagel (the size will effect its carb count and so will the flavor), "healthy" foods are not always low in carbs and "unhealthy" foods are not always high in carbs.
One of the simplest and most effective things you can do to better control your blood sugar levels is to check your blood sugar. This may seem obvious but it can be easy to assume your levels are fine and there is no need to check. After 13 years I am still checking my sugar before I eat and before I go to bed. Knowing your levels will allow you to understand if your sugar is rising, falling, evening out, etc.
M: What do you think of carb-based diets?
D: Unless you're cutting things out of your diet such as soda (which is high in carbs and has 0 nutritional value) I don't think there is any value in diets that cut out foods that are considered "high" in carbs. Potatoes are high in carbs but will also provide you with a steady stream of energy throughout the day (along with other nutritional value) - as opposed to a fruit smoothie (which could be even higher in carbs depending on the fruit and if yogurt is used) which will enter your bloodstream quickly but will not remain in your system very long. The problem with grouping foods into "high" and "low" carbs is that you are ignoring the potential benefits that individual foods provide your body.
Like anything, you should eat in moderation, and also provide your body with a variety of "fast" and "slow" carbs so you have on demand energy when you need it and lasting energy throughout the day.
Type 2 diabetes is a disease of affluence that is caused by poor diet and lifestyle choices. Fortunately, it is often preventable and reversible by changing one’s diet, preferably to a whole foods, plant-based diet. A diet rich in fruits, vegetables and whole grains, with little to no refined grains and processed foods, is the ideal diet for everyone, diabetic or not. Again, taking insulin helps to control blood sugar but only masks the underlying issues rather than solving the problem.
I hope this information straightens out stereotypes and sheds some light on the severity of the disease. Not everyone is given a choice but, to those of us who are, a clean diet is crucial for prevention.
- Mallory Herb & David Hettler
Source:
Mackey, J., Pulde, A., MD, & Lederman, M., MD. (2017). The Whole Foods Diet: The Lifesaving Plan for Health and Longevity. Grand Central Life & Style.
