Two doctors with diabetes, one cameraman, nine donuts, 15 minutes—action!
Sounds like the beginning of a bad and insensitive joke, but this is the description of a YouTube video made by two doctors – Dr. Jeremy Pettus and Dr. Steve Edelman – and it wasn’t meant to be a cautionary tale.
Dr. Steve Edelman is a well-known figure in the Type 1 diabetes community. He is the person behind TCOYD (Taking Control of Your Diabetes), a program/ diabetes conference that draws many people with diabetes and their families every year. He’s known on social media as somewhat of a jokester, a physician with Type 1 himself, who often posts about eating junk food, high carbohydrate cereals, snacks, and the likes. Many people with diabetes find him and his attitude refreshing, as so many experience dread before appointments with their own endocrinologists, often due to feeling judged and scolded. Edelman’s antics, therefore, appeal to them. He’s relatable, the “telling it like it is” type. Nobody likes the “diabetes police,” after all.
But where should we draw the line between joking and diabetes care? Have these doctors crossed it? These are questions we should be asking. We should also ask whether a doctor should be entertaining us by consuming food that leads to unpredictable and dangerous blood sugars. Is it appropriate for a medical doctor to appear on YouTube eating three donuts very rapidly, taking large, potentially dangerous amounts of insulin, with boluses and then correction boluses (essentially stacking insulin), and then running around in a parking lot to make the insulin more effective, only to be downing lemonade a short while later to prevent hypoglycemia?
In the video, both doctors attempt to stay “within range” during their donut experiment, but their range is set to 70-180 mg/dL. Any doctor should know that 180 is well above normal blood sugar. Doctors should also know that the range of normal blood sugar does not change for you because you have diabetes. Hyperglycemia leads to diabetes complications. The goal of every person with diabetes should be to achieve normal blood sugars, which these physicians have crassly demonstrated, is not possible while eating donuts. In the short duration of this video, the two doctors—both with CGMs—struggled to maintain the blood sugar levels within their very liberal range of normal. Their numbers and trends go up and then come crashing down. It’s labor-intensive on their part and exhausting to watch. All the while their non-diabetic cameraman “control subject” who started the experiment at 91 mg/dL pre-donuts, reached a high of 115, and then quickly landed at 93. Dr. Edelman was at 135 while at the donut shop, then took insulin, and yet was 142 before his first bite. Then he was 120 with 11 units of insulin on board. He then continued to run blood sugars of 90 -108, do some exercise, only to find himself sipping a sugary drink to prevent dangerous hypoglycemia.
The video ended without actually showing us what happened next. Everyone with Type 1 knows about the “pizza effect,” or the unpredictable blood glucose that results from eating a high carb and high fat meal like pizza (or donuts). The pizza effect can lead to unpredictable spikes many hours after a meal. By cutting the video short, Edelman and Pettus haven’t truly shown us the full effect of eating three donuts. They gave us a little snapshot of two privileged doctors with junk food and high-tech devices making light of what it means to live with Type 1 diabetes.
Sadly, Dr. Edelman has diabetes complications. He has shared videos about his battles with frozen shoulder and retinopathy—both tough consequences of uncontrolled blood glucose levels. There is a way to prevent diabetes complications, but it requires a low carb diet. Because diabetes is a disease that causes carbohydrate intolerance. A person with diabetes may choose to eat junk food like donuts, but no doctor should be encouraging it.
This doesn’t mean donuts are off the menu. You can still indulge in normal serving sizes of low-carb donuts (or delicious keto muffins) while keeping blood glucose levels in range, without dangerous amounts of insulin, and without having to do laps in a parking lot.