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Comment by drocer88 | Hacker News Reader

From https://academic.oup.com/edrv/article/39/5/629/5060447

"Obesity, once rare in type 1 diabetes (T1D), is now an increasingly frequent problem (3–5). Accumulating evidence on the prevalence and consequences of obesity in T1D shows very clearly that this comorbidity is both underappreciated and poorly understood." .... " The considerable obesity burden in youth with T1D was confirmed, also in the T1DX, where the prevalence of obesity (BMI ≥95th percentile) was 13.5% in adolescents (mean age 15.4 years), with higher prevalences in those of black/African American descent (17.9%) and Hispanic/Latino descent (15.9%) between the years of 2010 and 2012."

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My suspicion from diabetic research I did both prior and during my wife’s gestational diabetes, is that the increase in obesity that may have occurred in the last 60 years is due to bad dieting advice for T1 diabetics.

The fundamental health issue with diabetes is managing blood glucose levels. This is best done with low carb meals with slow carbs along with small amounts of periodic insulin. But for some reason common advice for diabetics is to eat large amounts of fast carbs and then take large doses of insulin. This combination is just begging for added weight (and increased risk of insulin sensitivity to boot).

> But for some reason common advice for diabetics is to eat large amounts of fast carbs and then take large doses of insulin

That's odd, I've been diabetic for about 10 years now and have never heard this advice from any doctor or dietician that I've seen.

Are you in the US?

I've heard from several americans that this was the recommended ADA advice (luckily changed at some point in the last 5 years or so).

However, outside the US it seems that the recommendation has always beem to minimize carbs.

I’m in the US, and all of the advice I’ve recovered from every doctor and nutritionist is to limit carbohydrates. You can “cover” as you put it, and you’re trained to be able to do that when the situation arises, but the baseline diet that I was given is certainly low carb by comparison to typical diet recommendations (not ketogenic, but far from “eat whatever you want”).

While I’m sure there are plenty of nurses and doctors out there giving rushed and questionable advice, I’d be surprised to find that this advice is “common” (though many patients may “hear what they want” so to speak).

See e.g. https://feinmantheother.com/2013/12/27/american-diabetes-ass... - but you have to read at least until the middle (spoiler: this blog post is from 2013, but the recommendations therein were only embraced 2019 or so).

Author is a professor of biochemstry, who is quite well known as a good scientist (but it's likely much of his name recognition comes from sharing a similar sounding name to a more famous person ....)

This is talking about the prevalence of obesity in existing T1D's, not as a precursor or cause of T1D.

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