There are certain professions or professionals in which we have an innate trust. Doctors used to be that profession for me. That is not to say I mistrust all doctors, but these days, it is far too common – rightfully so – to question the advice of our healthcare team. I not only have experienced this myself, but also have heard countless stories from others sharing the advice given by physicians. Quite frankly, some of it is appalling and simply dangerous.
A girl in one of my diabetes support groups is now terrified to eat carbs. She was recently diagnosed with T1D and was told by her endocrinologist that insulin causes weight gain and there isn’t much you can do about it. Now if you’ve read some of my previous posts, you know that I struggled for many, many years with an eating disorder. Not exactly something you want to mess around with, particularly when you have T1D. To say I’m lucky to be alive is a gross understatement. Now here is this young girl who, in her words, is “scared of getting fat.” What that doctor told her was not only absolutely wrong, but also extremely dangerous and ill-informed. I can’t say enough how angry it makes me when physicians spread falsities like this and the person on the receiving end doesn’t even realize that what they’re being told could be wrong.
When I was younger, I would have reacted exactly as this girl did. I trusted authority and never even thought to question a doctor’s advice. The truth about taking insulin is, you may gain weight if you have several lows throughout the day because you need to eat when your sugar drops. If you need to eat 3-4 extra times a day to treat a low, yes you could gain weight until you figure out your correct doses. If a non-diabetic ate 3-4 extra times a day, they would gain weight too. Nothing to do with insulin. It’s hard to believe that a person with a medical license would actually say something that absolute and add that there is not much you can do about it. False, false, false.
I recently had the opportunity to meet a family whose son was recently diagnosed. Their CDE, or certified diabetes educator, told them “no more than three treats per week.” I immediately rolled my eyes, and the mom did acknowledge that she knew better. I couldn’t believe that in 2018, this was still being told to patients. Yes, this is good advice, if it were 1988. Insulins work much differently than they did back then. In those days, they required a strict adherence to a diet that included a certain number of carbohydrates, fruits, proteins, fats, vegetables (think the food pyramid). It required eating those foods at specified times throughout the day, and not doing so resulted in some pretty out of control blood sugars. Imagine if you weren’t very hungry when you woke up, but you were required to eat 30g of carbohydrates, a protein, fruit, and dairy. Insulin back then peaked at a certain time, and if you did not have enough food on board, well, you were about to experience a pretty severe low.
It’s 2018. It’s never a good time to get diabetes, but getting it now is a heck of a lot better than getting it in the 80s or 90s. Newer insulins and advanced technology allow a diabetic to live as close to a normal life as possible. I eat what I want when I want. I know my body well enough to know how certain foods affect my blood sugar and how much insulin I need to cover each meal. Newer pump features allow you to extend your insulin over the next several hours, the type of feature you would use if you were at a buffet or a picnic, somewhere where you will be eating throughout the day. We pride ourselves on being able to eat like a non-diabetic, so hearing things like “three treats per week” sets us back a few decades to say the least.
I stand by this. No doctor or endocrinologist will ever be more of an expert than a veteran type one diabetic who lives 24 hours a day with this disease. You can be very knowledgeable, don’t get me wrong on this, and you can know the endocrine system inside and out, but you will never be able to say exactly how a certain food will affect a person, how exercise will influence blood sugar, or even how many treats you are “allowed“ per week. That is utter nonsense. Even a veteran diabetic can’t tell you those things, they can give you an idea, but diabetes is very much trial and error. I have type one friends who have given up on trying to figure out pizza. That is a fight I was not willing to give up! I love me some pizza, and after a lot of trial and error, I finally figured out how much I need to take and how I need to take it. The how is as big of a piece of the puzzle than anything. This is one of those foods that I have to use the advanced features on my pump, definitely not something that was available decades ago. Like I said, many doctors are still living in those days, and it’s sad to hear some of the advice they give to patients, especially the newly diagnosed who don’t know any better.
Think about it. If you were diagnosed with a disease, any disease, wouldn’t you want to talk to somebody who has walked in your shoes? If you tragically lost a loved one, do you want to talk with a grief counselor, or do you want to talk with somebody who’s been there, has been through every stage of the emotional process, and who can assure you that you will find your smile again one day.
This is in no way saying that you should not heed the advice of your healthcare team. I am simply saying that not all medical advice is good advice, and unfortunately, a lot of it is just simply outdated. I love my endocrinologist, and one of the reasons is that she is on the board at JDRF and knows the latest developments and understands this disease in 2018. She will be the first to say that you should never deprive yourself of any food and that you can eat how you want to eat, you just need to figure it out. People are always saying to me, “Are you supposed to be eating that?” (sidenote: if you say that to me, be prepared for me to unleash). Here’s the rule of thumb. If it is bad for a type one diabetic to eat, it is bad for a non-diabetic to eat. A double cheeseburger and fries with a snickers bar for a dessert isn’t healthy for anyone. But, it doesn’t mean people don’t indulge every once in a while. So, if you ask me, “Should you be eating that,” I’m going to ask you, “Should you?”
This blog is by no means meant to be medical advice. This is just one diabetic’s perspective and thoughts on the world we are living in.
As always, I am happy to talk with you or answer any questions you may have about T1D. Please leave a comment, or you can send me an email through my contact page.
Thank you for reading today. I know it’s been a while since my last blog, the summer is getting away from me! Have a great week everyone!