Let’s Change the Way We Treat Diabetes

 In the spring of 2002, very shortly after my husband Mike was diagnosed with Type 1 diabetes, I overheard him speaking on the phone in a raised voice. He was talking to the pizza place we’d ordered dinner from because our pizza had taken forever to arrive, and when we finally got it, it wasn’t what we’d ordered. So, Mike called and complained, which was fine, but then he proceeded to complain, and complain, and complain. After several minutes, I tapped him on the arm to get his attention. “Just order another pizza,” I said. “It’s not such a big deal.”

I was very, very wrong.

In anticipation of eating 3-4 slices of pizza, around 30 minutes after we placed our pizza order Mike had bolused 10 units of insulin. But the pizza arrived late. And then we sent it back because it had green peppers.

If you live with someone who takes insulin, you’ve probably seen severe hypoglycemia. It’s an actual meltdown, physically and emotionally. Doctors had told us about the physical symptoms to look out for, like sweating and shaking. No one ever said to watch out for rage, inexplicable tears, or extreme stubbornness. No one ever said that if you take too much insulin you may yell at the pizza guy for 30 minutes, and become entirely irrational. And most regrettably, no one ever told us Dr. Bernstein’s law of small numbers – low carb + low insulin dose = minimized risk of hypoglycemia. Intuitively, it makes perfect sense. But although Mike was always riding the blood sugar roller-coaster, it took us years to figure out that there was an easy fix to severe hypos: don’t eat the carbs.

The same trick worked for hyperglycemia. It’s hard to go really high when you cut out the food that causes blood sugar to spike.

I wouldn’t call a low carb diet a cure for diabetes, but it is a gamechanger. When I was diagnosed with LADA (or Type 1.5 diabetes) in 2008, I was already on the path to figuring out that carbs weren’t going to serve me well.

As I recently wrote in Diabetes Voice:

“Nearly a decade after being diagnosed with LADA, and almost as long on a low carb, I don’t use insulin or any other blood sugar lowering medication. I’ve never had an HbA1c over 6%. Of course, this is only anecdotal evidence. One story of one woman with LADA who has managed to extend the life of her too few remaining betas cells and avoid injecting insulin for a decade by eating low-carb, is not proof of anything. But, here’s a simple truth. We don’t need a long-term study to know what we should be eating. People with diabetes have all the proof they need about the best diet for their bodies. It’s right at our fingertips. All we have to do is check our blood sugar after eating. The number on the glucometer says it all.”

And that’s the message I’d like to get out there this Diabetes Awareness Month: Look at what’s right in front of our eyes. This week the U.K.’s Telegraph ran a story titled, 500 diabetics dying each week, many from ‘avoidable’ complications. The article says, “The figure comes from analysis of the NHS National Diabetes Audit, which shows deaths have increased roughly 10 per cent over the past three years.”

Among the things the Audit found are:

1. People between the ages of 35 and 64 living with type 1 diabetes are three to four times more likely to die prematurely than those without the condition.
2. Those in the same age range who have type 2 diabetes are up to two times more likely to die prematurely.

In August, the British medical journal The Lancet published a study that showed, “Women who developed type 1 diabetes before the age of ten years die an average of nearly 18 years earlier than women who do not have diabetes. Men in the corresponding situation lose almost 14 years of life. The lives of patients diagnosed at age 26-30 years are shortened by an average of ten years.”

Look at those statistics. Those aren’t the numbers of success. Something is broken in the way we treat diabetes and instead of fixing it, we’re covering it with insulin. “There are over 100 complications of diabetes and they are all caused by hyperglycemia,” says RD Dikeman, founder of the group TypeOneGrit, which advocates for treating children with diabetes according to Dr. Bernstein’s low carb method. “We now know that high blood sugars lead to dementia and damage to the developing child brain. Chronic hyperglycemia will also result in a dramatic shortening of life. So you have to ask yourself – is that something I want to shoot for?”

Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and has continued to write essays and fiction while raising her three sons (and many pets).

View Author Blog

Jessica Apple

Jessica Apple grew up in Houston. She studied Bible and Ancient Near Eastern Studies at the University of Michigan, and completed an MA in the same field at the Hebrew University. She began to write and publish short stories while a student, and continues to write essays and fiction while raising her three sons (and many pets). Jessica’s work has appeared in The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review, Tablet Magazine, and elsewhere. She is the diabetes correspondent for The Faster Times. In 2009 she and her husband, both type 1 diabetics, founded A Sweet Life, where she serves as editor-in-chief. Jessica loves spending time with her sons, cooking with her husband, playing with her cats, reading, biking, drinking coffee, and whenever possible, taking a nap. Follow Jessica on Twitter (@jessapple)