Eating With Diabetes

1) Type 1 -- NOT curable OR reversible. Period. No carbs? That won't work for any Type 1 who’s physically active. Which is far more people than you and most doctors realize.

2) Type 2 -- too many misconceptions and biases here to even list.

Bottom-line, there is no silver bullet for either T1D or Type 2. They are complex diseases, only partially understood, that require 24/7 attention to myriad factors to successfully manage. And even then, you don't always get the A1C you want.

How many of the self-appointed experts here are actually deeply knowledgeable about, say, the biochemistry of energy balance and metabolism in Type 1 and Type 2?...OR actually have and live with either Type 1 or Type 2?

Frankly, if you're not an expert and/or diabetic -- shut up, you're in the peanut gallery.

Educate yourself via the many Facebook groups of T1 & Type 2 people who actively manage their diabetes -- some with carbs, some with fewer, depending on their specific situation and goals.

You'll be shocked to find that it's possible to be at a healthy weight AND active AND intentional about what you eat AND med-compliant-- and STILL HAVE Type 2.

(You'll also learn that people like most of the commenters here are the biggest source of annoyance for empowered Type 1s and Type 2s. The second biggest source of annoyance? CDEs, RDs, and docs.)

My Suggestion About Diabetes

Diabetes is the inability to properly process carbohydrates so the treatment should be to not have carbohydrates. The concern is not that carbohydrate-laden snacks will displace anything but that carbohydrate-laden anything will be eaten.

The Atkins low carb diet starts at 20 grams per day not the 120 grams suggested here. 120 grams is better than the 300 grams the average American eats but why stop there if your metabolism is already disordered? The advice to take that many carbs and spread them through the day to mitigate glucose spikes is like telling an alcoholic to spread out martinis through the day to mitigate being drunk.

There are plenty of free low carb/diabetic information sources on the net. A readily available blood glucose meter (often free) and plenty of test strips (shop around) tells you what your particular body does in response to the particular foods you eat.

Low carb diets can be rich and delicious. They are also significantly more expensive than diets made from cheap corn and wheat. The cost of health care is so extraordinarily out of whack that paying more upfront to never see your doctor or dietitian again is worth it.

An Eating Disorder in People With Diabetes

Although most likely unrelated to the eating disorder difficulties described here, one rare complication of poorly controlled type I diabetes was reported in the medical literature from the 1930s at least through the 1980s, called Mauriac syndrome. The children were not only underweight, but exhibited short stature as well (and liver enlargement plus some other endocrine signs). Because of its rarity, it may be unknown by more than a generation of pediatricians, There was no description of "intentional" or behaviorally disordered eating in the literature on Mauriac syndrome, but in general, the children were described as having longstanding, poorly controlled diabetes. Their eating habits might have been relatively unknown or poorly characterized. They were most often adolescents, just as are the patients described here.

A diabetic child who is markedly underweight and living in a setting of inadequate or non-existent regular medical care might merit evaluation for this broader complication, and should not be assumed to have weight loss due to disordered eating.

I learned about this rare condition almost 40 years ago, in medical school at the Riley Children's Hospital in Indianapolis. Sometimes, it only takes one case for a very rare condition to stick in the memory of a physician, even near the end of a career.