I think these guys are my favourite bunch of charlatans riding the diabetes bandwagon. Not because their advice is any more laughable than all the others (they all say much the same thing), but because of two items on their website. The first is a statement of their noble aims:
Whilst funding vital diabetes research to establish the causes, prevention and treatment of type 1 and type 2 diabetes; develop improved management and treatment options; and ultimately find a cure, we aim to ensure that people have access to the right information and support to develop a proactive self-care approach to successful self-management, to ensure that they are “staying well until a cure is found…”
Since the aetiology of diabetes Type 2 is quite well understood, and it’s easily curable (although one might split hairs over the exact definition of “cure”), I assume they’ll be shutting down most of their operations real soon now. Although I’m not holding my breath.
And the second is the little sticker at the bottom of this page:
https://www.drwf.org.uk/understanding-diabetes/information-leaflets
which says “Health and care information you can trust”. It’s the sort of thing that the Ministry of Truth might have stamped out in ‘Nineteen Eighty Four’, to hand out to favoured purveyors of approved propaganda. It really is a nice touch to put something like this on a website that’s almost entirely nonsense.
Their “What is Diabetes?” leaflet starts out fairly well, with a pragmatic (if not entirely accurate) description:
In simple terms diabetes prevents your body converting sugars and starches in your food into energy. The body uses insulin to do this. When diabetes is present the body fails to produce insulin or the insulin it does produce doesn’t work properly (insulin resistance).
When we eat food some special cells in our pancreas should produce insulin. The insulin transports glucose, made from carbohydrates in the food, into the cells, where it can be used by the body for energy. Sugars and starches are the most efficient source of food energy and are carried in the blood as glucose. If insulin is not produced, or does not work, the glucose builds up in the bloodstream instead of the cells, causing the common symptoms of diabetes.
So far so good. The layman will get the idea. But then there’s this: “Sugars and starches are the most efficient source of food energy”.
We could probably go off on a tangent about the technical definition of ‘efficiency’, and whether it’s even a useful concept in human nutrition, but we’ve just been told that diabetics have lost their ability to utilise carbohydrates for energy. So why is that sentence even there? It’s meaningless.
This leaflet then has a paragraph on the causes of Diabetes Type 2, where it studiously avoids describing any cause, preferring instead to talk about associations and correlations:
Type 2 diabetes is more likely to affect older people, although it is being found increasingly in younger people – especially if they are overweight and lacking in physical activity. Type 2 diabetes is strongly linked to obesity and tends to run in families. It is more prevalent in people of South Asian and Afro-Caribbean descent. Many people with type 2 diabetes have high blood pressure and cholesterol and may need tablets to control these too.
In other words, it just kinda happens, if you’re unlucky. This is really quite extraordinary, because the DRWF is explicitly a research organisation. In 2017, they brought in £3 million, and disbursed most of that to genuine research projects. And yet, so far, they don’t know anything at all about what causes T2D. Or if they do, they’re being very coy about it.
Not to worry, even though the DRWF doesn’t know what causes T2D, they can confidently tell you what you should do if you have it:
- Eat 5 or more portions of fruit and vegetables a day
- Reduce fat, especially saturated (animal) fat
- Reduce salt intake – the most effective way of doing this is to cut out as many processed foods as possible
- Increase intake of omega 3 oils – try eating at least two servings of oily fish per week
- Reduce alcohol intake
Although sadly, as they blithely admit, this advice won’t actually do you any good:
type 2 diabetes is a progressive condition and, in time, tablets and/or other forms of medication are likely to become necessary and may even progress to insulin injections.
And there’s really no obvious reason why their little list of non-sequiturs should have any effect. It’s the exact same advice given to the general population. But we’ve established that T2D is a disorder of carbohydrate metabolism, so why are they advising the diabetic to eat more carbohydrates?
Wait, what? That’s not in the list.
Unfortunately, it is, and they probably don’t even understand that it is. If you reduce the fat in your diet, then by definition the carbohydrate content must increase (protein is set fairly robustly by your appetite – it’s hard to eat either too much or too little of it). Given that most people only eat 200-400kCal/day as protein, and Healthy Eating advice for the general public advises 10% of calories as fat, the implication is that 70%+ of a diabetic’s diet should be carbohydrates. Let us here remind ourselves that:
If insulin is not produced, or does not work, the glucose builds up in the bloodstream instead of the cells, causing the common symptoms of diabetes.
And what does fat have to do with anything, anyway? Why do we have to reduce it? Why are vegetables and fish essential? Why is salt a factor? Maybe these things actually are important. But we’re not told why.
All that’s happening here is that the DRWF are reciting the Credo. We believe in one macronutrient, the giver of life, carbs without end, Amen.
Diabetics are told to consume less fat and salt not because their condition is exacerbated by those things, but because to consume them is a venial sin.
The DRWF aren’t doing anything unusual here. You can find virtually identical advice, and the same avoidance of (or complete misunderstanding of) the causes of T2D on many other official websites; we will stroll past the entire rogue’s gallery over the coming weeks and months. But I’m still giving DRWF four points out of five for pure holier-than-thou weaseliness. If you have nothing better to do on a rainy afternoon, I encourage you to trawl through their website yourself, and see how many untruths you can spot.
The DRWF have at least a little reassuring news for diabetics. Having diabetes can really be a riot:
Whether you have type 1 or type 2 diabetes, newly diagnosed or ‘old hat’, parent or carer, attending a Diabetes Wellness Event is a great way to meet new friends, share stories of living with diabetes, learn about all aspects of the condition and related health from a host of clinicians and healthcare professionals, in a relaxed and friendly environment.
My goodness, what fun. It almost makes up for having your toes amputated.