Not diabetic? How safe are you?
Nobody said you were diabetic so you think you are just fine. Maybe! To understand how safe you should feel, you need to know just a bit about what happens when you are diabetic.
Type 2 diabetic
You have type 2 diabetes (T2D). Your doctor is satisfied when your A1c is 7. He or she didn’t instruct and maybe even discouraged you from checking your blood sugar at home at all. I see that happen. Who are you to challenge the doctor’s direction? (Your doctor is “he” from here on in this post because I am already weary of typing “he/she”.)
You expect your doctor to be the expert and you don’t know beans about it. And there really are reasons in your doctor’s mind why the “standard of care” in diabetes allows that number. But it probably isn’t in your long term best interest.
The Doctor’s Primary interests
I’m sure your doctor is exceptional, but we have to remember that he has some important challenges. First he is wedging you and all his patients into a very tight schedule. He gets paid by your insurance (hopefully you have insurance) for a small increment of time and the action he takes. In other words, he is getting paid the most for the least investment of time, thus explaining the “take this medication and see me again in xx months” pattern.
Secondly, he also wants to assure that you don’t die on his watch. He went to school to learn how to save lives right now with a certain “standard of care.” If it isn’t an easy fix, or, God forbid, there is a chance you might actually die he would prefer it be on some other, better qualified doctor’s watch. So a lot of referring to specialists can go on.
After all, the typical family practice doctor is probably an expert in treating a cold, the flu, infections, and making symptoms go away but not much else, a mile wide and an inch deep so to speak. He wants to avoid immediate complications. Complications are for experts which explains the number of specialists.
So when it comes to diabetes, avoiding complications and not dying on this doctor’s watch primarily means avoiding LOW blood sugar. Very low blood sugar can take you out quickly. There are serious penalties to high sugar but it doesn’t usually kill you right away.
The higher your blood sugar is allowed to stay, the less the chance that you will encounter low blood sugar. An A1c of 7 is an average blood sugar of 154 for the last 3 months or so. You know what they say about averages. I assure you that average means frequently you were WAY above that number and sometimes lower. But the lower is unlikely to go really low, low being maybe 50. See how this works?
So you are walking around fat, dumb, and happy, faithfully taking whatever medication the doctor prescribes, with frequent incidents of extremely high blood sugar whenever you eat. And every one of those incidents is followed by an insulin surge as your body works to save you. So what is the price you pay for that situation? It’s not pretty.
The price a diabetic pays
My book, It’s All About the Food, puts in plain words how the food you eat impacts your blood sugar (glucose). Published in late 2015, it explains insulin (the hormone that reduces glucose in your blood), how it works, and how its production goes awry. And the book provides a lot of detail about how this glucose/insulin thing results in diseases like diabetes, cardiovascular disease, kidney disease, neuropathy (nerves), retinopathy (eyes), and poor body healing. It’s a long list.
Lots of new information has been revealed since 2015 explaining WHY and HOW that stuff happens but one thing has not changed. How food impacts your blood sugar, how insulin is involved, and the potential health consequences are still exactly the same.
So here is a good question. If you aren’t diagnosed diabetic, how safe are you from those nasty consequences?
Not diabetic, so how safe are you?
Over the last few days I have listened to two podcasts featuring one rather famous practicing medical doctor, the CEO of Dexcom (the manufacturer of a continuous glucose monitor), and a PHD scientist and researcher. None of the three are diabetic but they do understand and manage their diets in a pattern described in my book. However, all three also wear a continuous glucose monitor (CGM) and therefore can see immediately how food, stress, and sleep deprivation impact their blood sugar. Their experience helps answers that question.
Dr. Peter Attia describes how a sack of the ever popular Trail Mix raised his blood sugar to 130 and how five grapes raised his blood sugar by 15 points. He gave up Trail Mix and grapes because he knows the penalties of high blood sugar. For clarity here, “normal” blood sugar would be mid 80’s to 90’s. A move from normal to 130 is a lot. Dr. Attia also noted how his blood sugar stays elevated when his cortisol level is high overnight.
Kevin Sayer, CEO of Dexcom, ate a small cup of yogurt covered raisins from an airport dispensing machine. His blood sugar went over 200 within 30 minutes and then overshot downward (insulin response) to the low 70s. The crash was described as “feeling like crap.” Yogurt covered raisins are off his list.
You can listen to Dr Attia and Mr. Sayer’s conversation here. Learn how the continuous glucose monitor was developed, how it works, and the benefits it brings particularly to insulin dependent diabetics.
Dr. Rhonda Patrick found that eating bananas, apples, and oranges in her smoothies made her blood sugar spike. She now limits and largely avoids fruit all together. She took two “baby” bites of an Epic bar she bought for her son. Her blood sugar went to 170. As a new mother encountering the inevitable baby is up all night she found that the sleep effect was profound. Her fasting blood sugar would be 15 – 20 points higher and remain higher all day. even though she ate the same food.
Dr. Patrick described several studies showing that shift workers (nurses, fire fighters, etc.) with difficult sleep situations have major cortisol elevation response with the inevitable blood sugar increase. She explained that cardiovascular disease is “rampant” among shift workers and that they also have a higher incidence of cancer than the general population. She emphasized eliminating refined junk food and limiting fruit to low sugar like berries.
You may listen to Dr. Patrick’s podcast here. Dr Patrick has a new baby. Her followers were particularly interested in her supplements during pregnancy and in lactation and what the baby is being fed. This particular podcast is an “ask me anything” with her followers so there is a lot of other topics discussed as well.
Dr. Attia, Mr Sayer, and Dr. Patrick all encountered and reacted to minimize future incidents. If, instead, they just keep eating Trail Mix, yogurt covered raisins, certain fruit, and ignoring their sleep/stress situation they could actually drive themselves into the chronic health situations described in my book. In other words, if you are exposing yourself to these situations, you are probably not safe long term.
Can I get a CGM?
As the Attia/Sayer podcast shows, you aren’t likely to wear a CGM any time soon. They cost a LOT of money, a significant portion of which will be out of your pocket, must be prescribed by a doctor, and at best are approved by insurance only for insulin dependent type 1 and type 2 diabetics. But what you CAN do is be conscious that food, stress, and sleep impact your blood sugar and adjust your lifestyle accordingly.
How can you do that? Read the book, It’s All About the Food. And on this website enter “diabetes” in the search line, and read what you find. Links to the two podcast discussed here and other relevant posts will be be on the list.
Pat Smith is the author of “It’s All about the Food,” a book that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. All proceeds from her book benefit the Montgomery County Food Pantry. Her website is http://allaboutthefood.org/. Telephone number 870-490-1836, email email@example.com