Monday, 7 August 2017

Sugaring the pill

It has been recently reported that moderate alcohol consumption reduces the risk of developing Type 2 diabetes. This is yet another contribution to the huge body of research suggesting that moderate drinking is beneficial to health, and further undermines the Public Health objective of being able to claim that any level of alcohol consumption is harmful.

As those of you who follow me on Twitter or Facebook may be aware, I was diagnosed with Type 2 diabetes earlier this year. Obviously such news takes you back a bit but, given that my father had the condition, and, in hindsight, I recognise that I had been experiencing some of the symptoms, it wasn’t a total bolt from the blue.

Well, Mudgie, you may say, you have spent forty years living on a diet mainly consisting of beer, pork scratchings and pizza, so you shouldn’t be too surprised, and really only have yourself to blame. However, risk factors are not direct causes. General lifestyle factors in society have raised the likelihood of people developing diabetes, plus diagnosis is now more likely than it once was, and people are living longer.

In the past, given that the immediate symptoms can be far from obvious, many people will have gone to their graves without it being spotted. My father wasn’t diagnosed until his late seventies. Whether you develop it has far more to do with heredity and chance than the actual lifestyle you live, and I know plenty of people who have drunk deeper and gorged more yet have remained immune. While I make no claim to have rigidly adhered to healthy living guidelines, I have for many years tried to make sure my alcohol consumption is kept under control, and have never been more than moderately overweight. Indeed, my current BMI is about 26, which I don’t think is anything to get too worried about.

As the news report indicates, drinking alcohol isn’t incompatible with diabetes, despite what some may imagine. However, obviously a bit of care is needed, and I’ve set myself a target of reducing my consumption by 25% compared with previously. On reflection, I was often going for “oh, let’s just have one more” when it added little to the experience. Over five months, I’ve achieved 23%, which isn’t too bad going. But that doesn’t in the slightest deter me from seeking out new pubs and drinking experiences.

In the past, the view was often taken that people with diabetes should completely avoid certain foods, especially those with a high sugar content. However, the current line is that nothing should be considered completely off limits, and that diabetics should basically just adhere to the dietary recommendations for the general population. But I’m a bit sceptical about that. The key factor triggering diabetes is sugar, and the sugar contained within carbohydrates, while fat, while it may not do you much good overall, has no particular implications. So it might make sense to go easy on bread and cakes, but there’s no problem with milk, butter and cheese. Indeed, in recent decades, the general dietary advice has been to eat a low-fat diet with plenty of wholegrain carbohydrates, which has been accompanied by a marked rise in cases of diabetes.

Not surprisingly, the subject is a magnet for various kinds of dietary cranks and single-issue obsessives, especially the zealots advocating a zero-carbohydrate diet. The forum at diabetes.co.uk is so infested with them as to be virtually unusable. And some people seem to have become “professional diabetics”, endlessly analysing their diet and blood sugar readings.

I certainly take the subject seriously, and I would be a fool not to. But my objective is to aim to manage it with the least amount of intrusion into my daily life, not to allow it to become an all-consuming fixation.

And pork scratchings, which contain no sugar or carbs, are in a sense the ideal diabetic food.

As a total aside, this subject gives an opportunity to listen again to this unforgettable classic of Sixties bubblegum:

10 comments:

  1. I was diagnosed at 35, 5 1/2 years ago.

    In my experience, variation in diet and drinking only ever had a negligible effect on my blood sugar levels, both the immediate and long term measurements.

    The Metformin, however, had a very significant effect.

    So, basically, what worked for me is to take the pills and not worry about what I consume.

    Mind you, I'm not a slender, toned, lithe slip of a thing with a 26 BMI...

    ReplyDelete
    Replies
    1. I think it's something where individual people's reactions can vary quite significantly, so it's difficult to generalise. I have been taking Metformin for five months and was a given a blood glucose meter at the beginning of May. Initially I had quite a scary HbA1C figure and blood glucose readings, but broadly speaking they've now come down to within the acceptable range.

      I've stopped eating chocolate and putting sugar in tea and coffee and on cereals, but otherwise not really made any drastic dietary changes. The one thing that was really spiking it was breakfast, despite only having a small glass of orange juice and a couple of Weetabix, which are about the lowest-sugar cereal around.

      Delete
  2. If you buy pre packed orange juice it contains lots of added sugar bizarrely isn't declared and weetabix metabolises quickly because while it looks like whole grain, it's actually quite highly ground down then extruded as flakes. Hence your spike.

    ReplyDelete
    Replies
    1. Are any other cereals any better in that respect, though?

      Delete
    2. Unprocessed porridge - not the instant stuff. It's got a low GI so you won't get such a spike.

      Delete
  3. I recently completed an “X-Pert” diabetes course, which included a lot of useful information, but involved a commitment of time that would be difficult for anyone in full-time employment. The level of resources devoted to diabetes by the NHS cannot be criticised, for example in the 15-point plan offered to people with the condition. There is, however, a rather stark contrast with the often half-hearted and inconsistent response to depression.

    I would be the last person to criticise anyone over their weight, but it has to be said there was a rather Marjorie Dawes-like irony about being lectured about increasing physical activity by one of the two female presenters who would undoubtedly have qualified as clinically obese.

    There remains an inconsistency between the dietary information I was given by the GP practice, which states carbohydrates are OK in moderation, but ideally should be of the whole grain variety, and that on the course, which rather stressed overall carb reduction and seemed to argue that all carbs are much of a muchness. I have to say I find it a bit hard to believe that 20g of refined sugar is no worse for you than the same amount of wholegrain cereal.

    There was an underlying assumption that people were able to prepare the vast majority of their meals themselves at home, which for anyone who travels a bit and has a social life is a touch unrealistic. On a related theme, I saw an article on a diabetes website entitled “9 ways to enjoy takeaways while staying healthy” that in fact offered recipes for home-cooked alternatives, which is totally missing the point. A bit of sensible advice about how to deal with eating-out scenarios would come in handy.

    On a personal note, I recently had a blood test which showed that my HBa1C figure, the key measure of long-term blood glucose level, had come down from a rather alarming 108 at the beginning of March to 36, which is within the “normal” range. Clearly this is good news, although it doesn’t mean that I am in any sense cured or can afford to let up on things. As described in the post, I have made a number of diet and lifestyle changes, which obviously must be working, but I certainly haven’t been taking things to extremes.

    ReplyDelete
  4. Dining out and eating in the real world is a big issue and it's very hard socially to comply with healthy eating regimes,regardless of whether they are for diabetes or not. Of course a big problem is also vast portion side,particularly for older generations who were 'taught'to consume everything on the plate,because of past history of older relatives,and food shortages elsewhere in the world. Leaving quantities of food does appear to be a shameful waste in itself,but portion sides are now so big,you have to leave or overconsume,or not go out.Diabetes wise of course it's all about the rate the sugars feed into the blood stream,the slower the better being the key criteria.Of course for most,if they can afford to dine out,it is culturally a time not to skimp on food,usually after a hard weeks toil.In summary,the advice and resource is very good,and you are right,proportionately much better than mental health support,but that doesn't assist with practical living in the real world often,I agree.

    ReplyDelete
    Replies
    1. Agreed - portions are often ridiculously big, especially for us old 'uns, and it always looks a bit insulting to the chef if you leave a lot of food on the plate. Added to this (for reasons I won't try to go into here) I'm a rather eccentric and fussy eater, which makes conforming to the "ideal diabetic diet" effectively impossible.

      Delete
  5. I was diagnosed as diabetic about four years ago and put on a course of pills, one of which made me ill and had to be changed. About two years ago I was in Poland and contracted food poisoning. My wife (who is Polish) took me to a hospital and they did a much more thorough check-up than I have ever had from the NHS. At the end of it, they told me that I was not in fact diabetic after all and advised me to drop the medication, which I did. I wonder if the NHS is over-cautious, or likes to 'big-up' conditions so as to help it press for more money?

    It might be worth thinking about what sort of sugar you are using. My father has sought for many years to avoid white sugar in favour of brown, and is still going strong at 92 with no sign of diabetes.

    ReplyDelete
    Replies
    1. I am perhaps fortunate that I haven't experienced the adverse reactions to Metformin that many other people have reported.

      I'm not a medical professional, and can't really comment on misdiagnosis, but I'd suggest that an HBa1C score of over about 60 would be a pretty sure-fire indicator of diabetes.

      Delete

Comments, especially on older posts, may be subject to prior approval. Bear with me – I may be in the pub.

Please be polite and remember to play the ball, not the man.

Any obvious trolling, offensive or blatantly off-topic comments will be deleted.

See this post for some thoughts on my approach to blog comments. The comment facility is not provided as a platform for personal attacks on the blog author.