John and his Candy Bars

Everybody knows that diabetic people aren’t supposed to consume sugar.
From my previous week alone:

‘Do you take sugar in your tea….?  Oh you can’t can you?  I wasn’t thinking…’


‘I’m feeling guilty eating chocolate in front of you.’


‘What would your doctor say if she could see you eating that?’


The sentiment is wearisome, but not the people:  these are kind people.  They have remembered that I am diabetic and are trying to be helpful.  Their conviction that sugar is my biggest nemesis and temptation is based on a ‘fact:’ that sugar causes diabetes and that we are supposed to avoid it.

A Facebook forward that has been popular in recent months takes the form of a child’s maths test.  Here it is:

math test

This post has thousands and thousands of likes.  My friend shared it on his page.  The following conversation ensued:

Me – Somebody educate that child before I do!  John merely has a stomach ache.

Him – Diabetes does seem unlikely from one-off consumption.  But sugar consumption does increase the risk of Type-2 diabetes.

NO!  The incidence of Type 2 diabetes has NOT been shown to depend on sugar intake.  Sure, obesity is a strong risk factor.  And I suspect that the causes of obesity are changing:  when I was a kid, it was all about how much saturated fat you ate.  Nowadays, supermarkets take fat out of food so they can call it ‘healthy’ and bung in extra sugar instead to keep the taste.  Sugar is even added to our rice, so I suspect it contributes significantly more to obesity that it used to do.

But even if we take Type 2 diabetics who are obese: whether they became obese from eating too much fatty bacon (no sugar!) or from eating too many lollipops (lots of sugar), from not exercising or, more likely, from a combination of reasons quite different to this, the increased liklihood of Type 2 diabetes is exactly the same.  Obesity is a major risk-factor in determining whether you get diabetes or not; sugar consumption isn’t.  Therapy for Type 2 is often based around weight-loss, but not on banning sugar.  The difference is subtle but present: ‘Diabetic Chocolate’ may be sugar free but it is quite fatty (not to mention full of sweetners that are laxative).  In short, it isn’t very helpful.

As it happens I am lucky enough not to be obese and to be a Type One (not diet related).  I do not make insulin.  As long as I take artifical insulin (increasingly the dose appropraitely according to the number of carbohydrates I am eating), my consultant is happy for me to eat a nornmal diet.  Uber-fast sugars, like orange juice (which I find much worse than cake) and – admittedly – candybars, send my sugars too high before the insulin I’ve taken has time to kick in.  So I do tend to avoid these unless my sugar is low.

But what of my colleagues?  Are they thinking ‘Why does she eat that when she knows it’s no good for her?’

A hospital consultant family friend once challenged me when I chose trifle for pudding.  This surprised me until I realised that diabetic treatments had changed a lot since she last studied them.  Even the other day, at a rare catch-up with the GPs nurse (I am usually treated at hospital) she asked me how I was finding the diet.

When I said I wasn’t on one, she looked confused.  Then ‘Oh!  Are you one of those dose-adjustment people who matches your insulin in your carbs?’

If we are so rare, we shouldn’t be.  Does that mean all her Type One patients still have to a follow a diet?

Anyway, the point is this: if a consultant surgeon doesn’t know; if GPs nurses still expect us to be on diets; if many type one diabetics are yet to discover the joys of carb-counting, then no wonder the public are confused.  No wonder the receptionist at work assumes that I am ignoring medical advice when I eat chocolate.

Diabetic treatments have come on in recent years; education needs to follow.


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