Turning Diabetes Risk Factors Upside Down
Updated: Jul 27, 2020
Time to get serious for a minute...
Being a Type 1 Diabetic (T1D), I am considered to be in one of the highest risk categories for severe complications or death if I were to be infected with Covid-19. "Diabetes" (type 1 & 2) is classified as a chronic illness. And according to the initial data, 7.3% of diabetics who were confirmed to have been infected, died. This is the 2nd highest rate of death after cardiovascular disease...
There is likely to be some cross over between those 2 groups, but it is clear that diabetes is not something you want to be living with at a time like this. Considering the rates of people diagnosed with diabetes are climbing every day, this doesn't bode well for a large percentage of the world's population.
Now I want to tell you why this data doesn't worry me, personally that is. Of course, I am 100% concerned for friends, family and a world full of people who DO have compromised immune systems (That's why I'm writing this!). And I fully recognise that like anyone else, I could be a carrier without ever showing any symptoms. Which is why I'm doing my best to follow the guidelines on social distancing and hygiene, just as everyone should. But my motivation for this post and what I want people to understand, is that being a diabetic, and specifically a type 1, doesn't mean you are at risk by default.
The risk comes with elevated blood glucose levels (BGLs) which are the hallmark of "uncontrolled" diabetes. Hyperglycemia (high blood sugar) has been shown to suppress the immune system in multiple ways. This in turn increases the likelihood of infection occurring, and lowers the body's ability to fight an infection once it takes hold.
Diabetics have long been told that having a slightly higher than normal BGL is acceptable, because hey, they're diabetic, we can't expect much better right? Wrong! If you are a diabetic (type 1 OR 2), achieving normal blood sugars is entirely possible when you adjust your diet and lifestyle accordingly.
While it varies slightly from country to country, T1Ds have been advised that they should aim for an HbA1c (average BGL over the past 3 months) of no higher than 7%, equating to an average blood glucose of 9.4mmol/L. Let me put this into context for you. A healthy non-diabetic adult will wake up with a fasting level of around 4.7mmol/L and may go as high as 7.8mmol/L after a meal depending on what they ate. And a normal healthy HbA1c is around 5%, equating to an average of 5.4mmol/L.
Imagine how high a person's blood glucose level is going if their average is 9.4mmol/L...
And only around 1 in 5 T1Ds are reaching this target. Considering how they've been taught to manage their condition, this isn't at all surprising.
Once upon a time, before the discovery of insulin, the only way to manage and extend the life of a T1D was through diet. Carbohydrates were restricted because they were known to be the main cause of elevation in blood sugar. This only helped to prolong life by a few years because insulin is still vital for survival no matter how you eat, but it was well known that a diet of fat and protein was the best option they had.
In 1922 insulin was first used in the treatment of diabetes and it was a godsend. In the first successful patient, a blood glucose of 28.9 was reduced to 6.7. Children who were wasting away, comatose and dying were brought back to life. It was one of the greatest discoveries of all time. Unfortunately, the wise dietary advice was lost over time and the mantra became "you can eat whatever you want as long as you cover it with insulin".
Clearly this advice isn't working. Injecting insulin to match what you eat is not quite as easy as it sounds. The action of the insulin can vary depending on where you inject it, what kind of meal you ate, if you've exercised, etc. etc. And it can't match the rise in glucose as perfectly as a normally functioning body producing it's own insulin can. Then there is a huge list of other factors involved...
Minimising the role food plays in this tightrope walk is key.
Since making the decision just over 2 years ago to limit my carbohydrate intake to roughly 20-30g a day, I have managed to keep my HbA1c between 5.1% and 5.4%. This is without using an insulin pump, I use a pen/needle to inject multiple times a day. Very little use of continuous glucose monitoring as it can be very expensive (I'd definitely use one more regularly if it were cheaper!). I test my BGL via finger prick 6-10 times a day. And without access to regular insulin, which is longer acting and known to be a better match for the digestion of protein. Instead I will inject rapid acting for any small amount of carbs in a meal upfront and then an hour or so later, inject more to cover the slow rise from protein.
And even though my way of doing this isn't ideal, I can still maintain an average blood glucose that is considered normal for a healthy non-diabetic person! Carbohydrate restriction in combination with access to life saving insulin means that I can live a long and healthy life without fear of sickness and eventual complications.
For every 1% drop in HbA1c, the risk of developing complications dramatically decreases...
Targets like 7%, "just cover your carbs" and advising type 2 diabetics to fill their plates with "heart healthy" grains has left a lot of people in our society vulnerable right now.
So yes, I am a type 1 diabetic. But by keeping my blood sugar in normal range, I keep myself out of the "diabetic" risk category. And you can too! If you're type 1, type 2, or have been told you're pre-diabetic - these are not death sentences. They are manageable or reversible when you adjust your diet. Even if you aren't diabetic but have other health concerns like high blood pressure or a few too many pounds, changing your diet can have powerful effects. Anyone can strengthen their immunity by taking a closer look at what they eat.
There is no better time to start on the path to a healthier you than right now.
Sign up for my free online course (new chapters to come) which will help guide you in making better food and lifestyle choices. And make sure you join the Facebook group I created just for course members to share their journey.
Take care of yourselves - and don't stress (another post covering that is on the way😉)