Sugarless Tuesdays: A Teaching Moment for Type 1 Diabetics


Paula Deen doesn’t understand very much about diabetes.  That’s the feeling I was left with after interviewing her a few weeks ago.  She was delightful to talk to – warm, charming, and eager to share.  It’s no surprise she’s incredibly popular.  I could have listened to her for hours.  What made me sad, though, as I listened to Paula speak was the fact that she felt getting diabetes was an inevitable part of growing old.  Then at the end of our conversation Paula said something that made me more than just sad.  It made me cringe.  Paula said,”My goal at the end of my life…If you hear the name Paula Deen, what is the first thing you think of?  I hope it’s not butter. ”  Of course, I can understand that – who wants to be eternally associated with churned milk, right?  But what I wanted Paula to have said was not that she feared being remembered as the queen of butter.  I wanted her to say she feared an everlasting association with sugar. 

Paula Deen, don’t worry about the butter.  The problem with your recipes is the refined carbohydrates and sugar.

I’m not the first person to say this.  While there have been hundreds of articles written in the last month calling fat a culprit in Paula Deen’s diabetes, a few have also spoken up in fat’s defense.  David Mendosa, an avid low-carber said he doesn’t blame Paula for “the fat and salt in her recipes, but all the carbs.”  And a few days ago I read an article by Dr. Jonny Bowden, Paula Deen: The Lost Teaching Moment. This is his main point:

“Paula Deen is not diabetic because she eats too much butter. She’s not diabetic because she cooks with too much fat. She’s not diabetic because she eats “unhealthy” stuff like meat. She’s diabetic because her body can’t effectively process sugar.  Period.  In fact, if all she ate was fat and protein, we probably wouldn’t be having this discussion. (But of course, there would also be no Paula Deen show.)  Diabetes educators, the American Diabetes Association, and virtually everyone else in the mainstream is jumping on her high-fat cooking as the “cause” of her diabetes, but nothing could be further from the truth. Fat is NOT the enemy in the American diet. Fat doesn’t make you fat, and it most certainly doesn’t make you diabetic.  Let me explain.  Type 2 diabetes is a disease of carbohydrate intolerance. Not fat intolerance. Not protein intolerance. Carbohydrate intolerance. And the reason the “teaching moment” is being lost here is because everyone is parroting the same old, past-its-expiration-date garbage about the “dangers” of fat, while ignoring the simple fact that it is carbohydrates — especially sugar and processed carbs — that create the blood sugar havoc that ultimately results in diabetes.”

Now I know that Dr. Bowden is oversimplifying.  It’s not only a sugar-rich diet that leads to type 2 diabetes, however, it is certainly a major contributing factor in many cases.  Something I’ve thought about many times since I was diagnosed with type 1 diabetes is how much I’ve learned about carbohydrates and carbohydrate metabolism.  Even if you disagree with me that eating fat is okay, consider this point seriously for a moment: Who knows the effect of carbs on the human body better than a person with type 1 diabetes (or the caregiver of a person with type 1 diabetes)?  I believe the answer is no one.  We’re the world’s experts. Who among us does not know the effect of a cupcake on blood sugar levels versus the effect of a steak on blood sugar levels?  Doesn’t this knowledge make us natural teachers?  Is the teaching moment being lost not on Paula Deen but on us?

Not sure what needs to be taught? 

Like it or not (and believe me, I wish this weren’t true!), sugar is toxic to our bodies, and not just if you have diabetes.  In a recent article in Nature, Dr. Robert H. Lustig and his colleagues called for government regulation of “added sugar”, as there is with alcohol and tobacco.  Their argument is essentially that the metabolic effect of sugar, particularly fructose, is equal to that of ethanol (drinking alcohol).  Regulation, they suggest, “could include tax, limiting sales during school hours and placing age limits on purchase.”

I once argued for something along the same lines when I objected to a proposed soda tax on the basis that not just sodas, but all sugars, should be treated equally, as we treat all cigarette brands equally. I wrote, “Perhaps we can institute laws that require supermarkets to make a junk food section with a tollbooth at its entrance and charge $5 per person to enter. Such a draconian and expensive measure might really lead to a considerable reduction in the consumption of all junk food.”

But even the tollbooth is not enough.  None of it will work without education.  And don’t think those  little black and white nutritional labels on our junk food are meaningful education.  How many people look at those labels before purchasing a product?  My guess is very few.  The reason is because we don’t view our food products something dangerous, poisonous, or something that requires review.  We assume that what’s for sale in our supermarket is okay for us to eat. We also assume that if people were to read nutrition labels, they would understand them. Not true.  Moreover, how many people know that refined carbohydrates and sugar are the same to our bodies?  Do the people who drink six cans of soda a day have any idea what 28 grams of sugar per can means?  If we labeled soda cans with a skull and cross bones instead of “20 grams sugar,” maybe people would get it.

I’m not, however, really a fan of scare tactics.  I also find it hard to believe that the majority of our society will ever be able to “fear” sugar.  But we who truly know the effects of sugar in the body can begin the long and difficult process of educating people.  We can bring diabetes awareness to a whole new level.

I’m not suggesting we follow or promote one diet or another.  I’m not suggesting that we all treat our diabetes in the exact same way.  No two bodies are alike.  The one thing, however, that we do all have in common, is our inability to metabolize sugar. Then why do we boast that we can eat whatever we want?  Why do we get angry and defensive when someone asks “Should you be eating that cake?”  We should do the hard thing and say “No, I shouldn’t be eating this cake, and neither should you.”

It’s not easy.  It’s anything but easy.  I have been able to reduce my sugar intake to close to zero, though I have days when I fail.  What I haven’t been able to do is prevent my children from eating sugar.  Part of that is because I don’t want to make my sons “different.”  I don’t want them to feel deprived.  But another reason is that while I can stop myself from eating sweet food, I haven’t succeeded in changing in the way I think about it.  I can’t imagine a birthday party without a cake.  I can’t really imagine a world without dessert, if not for me, then for others.  I want to be able to change the way I think about food. 

So, facing my own weakness, I come back now to the “teaching moment.”  Do we who understand the effects of sugar on the human body in the most intimate way have a responsibility to speak up and help the dozens of millions of type 2 diabetics and pre-diabetics?  If we are real trailblazers who are going to make a difference in diabetes awareness, I think the answer is yes.

In November 2010, to mark Diabetes Awareness Month, I started a Facebook page called Eat Responsibly.  I hoped hundreds of thousands of people would support the campaign, however, fewer than 40 people “liked” it.  Perhaps this coming November we can raise the bar.  Awareness needs to be more than promoting a symbol or a color.  We need to take action. In the meantime, would you join me in Sugarless Tuesdays? (Note: In case of hypoglycemia, please do have sugar!)  One a day a week without sugar and junk food.  Can we do it?

 For more on the dangers of sugar (and the defense of fat) visit Peter Attia’s blog, War on Insulin.

Graph from Nature:

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10 years ago

@Tessa, Thanks for your comment.  I’m also baffled by the ADA diet. 
@Ann B. Please join me in promoting Sugarless Tuesdays!  I will check out your links.  Thanks for your comment.

Ann B.
10 years ago
Ann B.
10 years ago

Jessica, I love the Sugarless Tuesday idea!  I have been worried about the fact that so many PWD are wondering around thinking carb counting is the answer to all things!  But it is not!  Your point about our bodies not being able to breakdown sugar is exactly right, yet the type1 pop seems to lack clarity of what that means.   At the start of this year, I cut out several things and what I’m noticing is better balanced energy and more of it, as well as weight loss which was not the goal. I don’t think people realize the… Read more »

10 years ago

Great post.  Finally somebody is acknowledging the true culprits: sugar and carbs instead of repeatedly beating the high fat and butter drum.  I was diagnosed diabetic a year ago (first incorrectly as t2, and just recently t1.)  The ADA diet should be outlawed for anybody, especially diabetics.  I learned more on my own about my disease than any of my medical educators taught me in the first few months.  Peter Attia’s blog helped me evolve my view on fat and solidify my belief that carbs are no man’s friend.  I still struggle.  Every day. But, knowing is half the battle.… Read more »

10 years ago

I’m reading Gary Taubes book right now and very much appreciate your post today. As an elementary school teacher, I also struggle with the dilemma of feeding my students crackers for snack, and serving the birthday cupcakes, as well as seeing the hot lunches they’re served, all while knowing what I’ve learned these past few years. Your post is well written, and spreads the message clearly. I’m not sure what to do at my school, but have made more changes at home that really have helped my both my husband’s and my own bg numbers. Thanks again.

10 years ago

@Paul – Thanks!
@Christine – Your marketing experience sounds great.  If you’d like to help promote Eat Responsibly that would be awesome.
@Karmel – I think I acknowledged that Bowden’s argument was oversimplified.  There is always more than one factor involved in a diabetes diagnosis.  As for the calories in/calories out and fat discussion.  It’s way too complicated for a comments discussion, but I highly recommend reading Gary Taubes for his thoughts on the soft science of dietary fat.  Peter Attia’s blog is relatively new, but also a good source. 

Dr. Margaret A. Morris
10 years ago

While I agree that we should reconsider our sugar intake, I disagree that sugar is the only or even primary evil. “She’s diabetic because her body can’t effectively process sugar.  Period.  In fact, if all she ate was fat and protein, we probably wouldn’t be having this discussion.” — That’s actually not supported by what we see. If she ate tons of sugar, but remained in her target weight, she may or may not have diabetes. If she ate no sugar but was overweight or obese, statistics indicate she would still have diabetes. So it’s not fair to say if… Read more »

10 years ago

Of course she knows nothing about diabetes. Her doctor and her diabetes educator are telling to eat half her calories in the form of carbohydrates and to avoid saturated fats. It is amazing to me that the people who know diabetes can’t figure out that someone who is having trouble metabolizing carbohydrates shouldn’t eat them. Just looking at her recipes it’s easy to tell that while the woman can cook, she’s not a nutritionist. 

10 years ago

I read this whist sucking on a Tootsie Pop. Perfect timing… I have had type 1 for … counting…. counting… 38 years and I feel that gives me the right to say something. I eat carbs. This is why I give my insulin… 4 times a day. I eat pasta, I eat toast, I eat apples (with and without peanut butter) and yes, I occasionally indulge in a Tootsie Pop. So what I have to say is this. Pay attention and moderation. This includes moderation in the butter department. I do believe that butter in excess will help you gain… Read more »

10 years ago

Great post. When I was diagnosed with Type 1 a year ago (as an adult), I threw myself into learning as much about metabolism, carbohydrate processing, and any other related topic I could learn about. Now that I know what I know, it’s definitely hard to watch people (especially those at risk — or already having — Type 2) continue to eat large amounts of highly refined carbs and sugar. Your suggestion of turning the standard “can you eat that” question on its head is a good one. It’s hard to know how to get the message out without people… Read more »

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