Can someone with diabetes be a food critic?
EDITOR'S NOTE: May is the third anniversary of the GLOB Master being diagnosed as a diabetic. UF Health Endocrinologist Dr. Juan M. Munoz Pena observations below of this continuing adventure is the secodn of three stories presented in the GLOB this week summarizing the GLOB Master's never ending odyssey in search for the perfect blood sugar strategy.
Diabetes is a complex disease characterized by the inability to maintain normal glucose or "sugar" levels due to the lack of insulin production and/or the inability of the body to effectively utilize it (also called insulin resistance). These properties will define the different types of diabetes, as well as the impact of food on blood glucose.
The main types of diabetes are Type 1 and Type 2. Type 1 diabetes refers to the absolute lack of insulin production as a result of the body's immune system attacking the healthy beta cells of the pancreas that produce it. Type 2 is secondary to insufficient amount of insulin production and insulin resistance. Type 1 occurs mostly in young and lean patients whereas type 2, in overweight adults.
In the United States, Type 2 diabetes is very common and continues to grow in parallel to the increasing obesity rates. It was once believed that obesity was a problem mainly in urban areas but recent studies have shown that the rates are also climbing, and perhaps at a larger scale, in rural areas due to poor dietary sources amongst other factors.
There are rarer forms of diabetes, including Late Autoimmune Diabetes of Adults (LADA). LADA is similar to type 1 diabetes as there is also an autoimmune attack to the beta cells of the pancreas, leading to insulin dependence, with significant inconsistency and fluctuation between very high and very low blood glucose levels. Patients with LADA are often misdiagnosed with type 2 diabetes, as they are over 30 years of age, usually lean and often experience unintentional weight loss.
Studies have found a prevalence of LADA of about 10% among patients with type 2 diabetes. LADA can be diagnosed with clinical cues and by the confirmation of the presence of antibodies with a blood test.
Initially, LADA can be managed with lifestyle interventions and possibly oral medications, but as the ability to produce insulin declines, patients will eventually require insulin.
Now, can someone with LADA, type 1 or even with type 2 diabetes work as a food critic?
Yes! The secret is in the carbohydrates.
Carbohydrates are complex sugars that cause the greatest effect on blood glucose, compared to foods containing protein or fat, and "carb counting" is a method of calculating grams of carbohydrate consumed with meals and snacks.
With the help of a health care provider, patients can dose insulin as precise as possible for the number of carbs consumed and achieve stable glucose levels. For example, the provider calculates a carb ratio of 1 to 10 which means that a patient will require 1 unit of insulin per every 10 grams of carbs consumed. It is strongly recommended that patients with LADA and type 1 diabetes see an endocrinologist, who with the help of nutritionists and other team members, can provide the care they need.
Mike, our GLOB Master, is the editor and food critic of this popular food blog and carried a diagnosis of type 2 diabetes for several years. He sought the help of the UF/Shands Endocrinology team at the University of Florida, as his condition became very brittle, difficult to manage, and was greatly impacting his ability to work and do what he loves. He was then appropriately diagnosed with LADA and his treatment was changed drastically.. He is now more energetic, is no longer losing weight and his glucose levels are much better controlled and stable. Mike is still "wrapping" his head around his condition and continues to learn about carb counting, how to dose insulin more precisely and other variables that impact his glucose levels such as activity, stress and others.
It didn't come easy but with great effort and patience, the GLOB Master can still work and enjoy every single meal as he now calls himself, "the mindful professional eater".
PREVIOUS GAINESVILLE LUNCH OUT BLOG DIABETES STORIES:
FRIDAY: When is diabetes disclosure proper?