Cause of Death: American Diabetes Association Recommendations

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I was diagnosed with type 1 diabetes (LADA) when I was pregnant with my third son. I had been previously misdiagnosed with gestational and type 2 diabetes, and my husband had been living with type 1 for seven years at the time of my diagnosis. You could say I knew a few things about diabetes by the time I received my proper diagnosis. For example, I knew that Insulatard, the insulin I was taking, was not a great name for a product, and I knew that diabetes was a disease of carbohydrate intolerance. And the latter is where I kept getting stuck. Why, I asked the pallid dietician I saw every three weeks in the high-risk pregnancy clinic, are you so adamant about pregnant women with diabetes eating bran flakes?  

“Fiber,” she said.

For a short while, I bought into the bran flakes-fiber theory. Except there was one undeniable problem: bran flakes made my blood sugar soar. So did the whole wheat bread I was supposed to eat as a snack at 11:00 a.m., even if I wasn’t hungry. So did the portions of fruit that had been assigned to my diet. 

About halfway through my pregnancy, the dietician and I had a falling out.

“I’m not eating bran flakes,” I said.

“Then have corn flakes ,” she replied. “Less fiber, but still good.”

I looked at her, feeling the same sense of bewilderment that overcomes me when the president tweets.

“Why should I eat something that makes my blood sugar go up so much?” I asked. “It doesn’t make sense.”

“That’s why you take insulin,” she said. “To bring your blood sugar down.” 

Right. More Insulatard, the medication I’d begun to pretend was named after a prince in a Nordic fairy tale. I stared at the food pyramid diagram she was showing me for the third time.

Back then, I didn’t really comprehend what eating low carb entailed. I don’t think I’d ever heard of the ketogenic diet. And the only thing I understood for certain was that just as 1+1=2, carbs+diabetes=significant rise in blood sugar. So, although when it comes to following my health care professionals’ instructions, I’m normally, compliant, adherent, obedient, strict, and straight-laced, when a recommendation is illogical, I question it.

I asked my endocrinologist if I needed to eat bran flakes. He told me the dietician at the clinic was great. I asked my obstetrician about the bran flakes. “As long as they aren’t sweetened, it should be fine,” he said. My GP told me carbs were important for happiness. He dismissed my argument that I didn’t feel happy when my blood sugar was high. In fact, nothing stressed me out more than the realization that with every vapid bite of bran, I was harming my baby. When I turned to the American Diabetes Association for guidance, the recommendations were the same as my doctors’. Eat whole grains and take your medication. And still today, nine years after my pregnancy, the American Diabetes Association is preaching a low fat diet rich in whole grains and fruit. Click through their website and you will find recommendations like this, “Dried fruit and 100% fruit juice are also nutritious choices.” 

Excuse my language, but WTF?

Those are good choices only if your goal is high blood sugar, diabetes complications, and early death. The Association is lying to people with diabetes, and the health care professionals who subscribe to its guidelines are complicit in the lie. The argument that a low carb diet is not sustainable is not an argument. Of course, it’s a given that not everyone is capable of sticking with a low carb diet. I’m guilty of the occasional slice of pizza or piece of fruit, too. But at least I know the truth: the only reason a person with diabetes should ever have fruit juice or dried fruit is when they are experiencing hypoglycemia. It’s time for the Association to own up to the truth that people with diabetes should not be encouraged to eat carbohydrates. And yesterday, in a way, it did. The Association sent out a fundraising email with the subject line: Cause of Death: Diabetes. It’s a punchline of sorts, and loaded with irony, because if you live according to its recommendations, death by diabetes may very well be the case.

Finally, a truth.

Here’s another one. A low carb diet isn’t all that difficult. It does take some thought and planning ahead. But there is a wealth of good content online to help people with diabetes get started on a low carb diet. There are recipes for low carb versions of almost every meal and dessert. Sometimes it’s hard to say no to the things our bodies can’t tolerate. But good health requires realism.

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Leah Solliday
Leah Solliday

BRAVO to you, Jessica!! It’s truly criminal what diabetics are being told by the medical community meant to help them. Against medical advice, I reversed T2D in two months by following a Low-Carb, High-Fat, Moderate-Protein “diet” – in quotes because this is the way I will eat for the rest of my life. P.S. It took some thought and a bit of relearning to cook without sugars, grains, starches, and the chemical sh*tstorms of processed/packaged garbage, but I’ve honestly never had more delicious foods EVER. All real foods – no “program” that costs money to follow. I’m not missing a… Read more »

Cathy
Cathy

I ate the ADA way after my Type II diagnosis for 2 years. My diagnosis A1C of 8.5 skyrocketed up to a high of 10.8, and I was put on insulin. My weight also ballooned up 25 pounds. Desperate for answers, I hunted FaceBook for diabetic groups and stumbled on a low carb diabetic one. I started doing what they said, cut out carbs and sugar, fought through the cravings for 3 weeks and kept telling myself what they told me, that it was temporary. The cravings eventually left, the carb monster that kept me hungry and eating every 2… Read more »

Judith
Judith

Good for you!!!! I had the same fight on my hands when I was on the Edge of Dialysis compliments of the ADA Dumb Diabetic Diet. I fell into a low carb 23/1 Intermittent Fasting type plan because I’m just not hungry. I also no longer end up in the hospital with a low glycemic attack I used to have on the ADA DDD plan. I read “The Diabetes Solution” written by Dr. Richard K. Bernstein, one of the oldest T1Ds in the world. I have had A1cs of 5.2 to now 4.6 for 1.5 years now. My last food… Read more »

Dwayne R
Dwayne R

Sorry my tablet crashed Docs say fiber can be discounted But even doing so only takes off five of so grams of carbs What of the remainder??? Does it magically become a non issue because of the fiber??? Does it suddenly decide to not raise glucose just because it’s feeling super friendly since it’s been wrapped up in fiber??? Idiocy Salad greens can give you the same or more fiber amounts without the butt load of carbs attached to it. The ADA is the worst friend diabetics can have! Contrasting the results of carb restriction with the results of the… Read more »

j j
j j

FYI, there’s a difference between soluble and insoluble fiber. It’s disheartening that doctors and nutritionist don’t address this, yet expect us to carb count??!!
https://www.livestrong.com/article/539858-do-you-subtract-soluble-and-insoluble-fiber-when-getting-net-carbs/

Dwayne R
Dwayne R

So much to say
Props first
Great article!!!

So let’s discuss in a bit
Docs say fiber doesn’t

Jonah
Jonah

The ADA stands behind a high carb diet. If people start to consume less sugar and carbs, it may effect insulin sales… and we wonder why they haven’t released the cure. Protection of big pharma and all of the other jobs and products that depend on diabetes to exist.

Denise
Denise

Great points! Diabetics deserve normal blood glucose levels. Many of us do it with a ketogenic diet with or without medication feeling pretty darn happy with our food choices and body parts intact and fully functioning. It is about time more people start calling out the ADA.

Ivan
Ivan

I have been following the ADA diet as a type1 diabetic for forty years and have perfect health and no complications. I will continue this diet as long as it works.

Jim
Jim

I also follow the ADA diet with no heath problems after decades of type1 diabetes.

Dave
Dave

I have no problems with the ADA diet.

Andrea
Andrea

More articles like this need to be written and start to infiltrate the misinformed who have never heard any other advice or demonized a low carb approach. I think the most popular argument is people saying they want to live their life and don’t want to be told what not to eat. The result is not subpar glucose levels and they might not explore any better alternative until they experience complications and consequences for their choices. Someone eating whatever they want will never give them normal blood sugars of a non diabetic like a low carb diet can produce. I… Read more »

Fervor Meek
Fervor Meek

Fantastic article, I couldn’t agree more. I stopped listening to dieticians so-called advice many years ago and my A1C is always around 5.8 – 6.1 and I eat healthily.

Alex
Alex

Eating choices can be such a sensitive topic when it comes to diabetes. Two T1D people can eat the same food at the same time and have completely opposite results. But contradictory nutritional information from doctors, the ADA, dietitians, and let’s face it, pop culture, can lead one to really question what foods constitute “good nutrition”. Ms. Apple raises many good points with regard to a discussion about how her body responds to different foods. However, she confuses the question of, “What is good for my blood sugar?” with “What is good nutrition?” and they are not one in the… Read more »

sandy
sandy

Thanks for this email. I understand the writer ran into a dietitian who clearly didn’t “listen” to her concerns. The dietitian should have heard her concerns and modified her recommendations.As a RD, CDE and a person with diabetes myself I have learned that each individual case of diabetes is different. When organizations such as the ADA provide advice based on scientific data, they often do so on “population” studies. By definition, there will be variance. So what what works for one won’t work for everyone and what is advised for most in general won’t always be the exact fit for… Read more »

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