Your questions answered on World Diabetes Day

To raise awareness on World Diabetes Day, we’ve interviewed sports scientist, exercise physiologist and diabetes educator Drew Harrisberg, who has himself been living very successfully with type 1 diabetes. Here, he answers some questions and clears up the misconceptions surrounding diabetes.

Not all people with type 2 diabetes are overweight or obese.

Our understanding of diabetes has changed drastically over the past couple of decades. We now know that it doesn’t discriminate. The disease affects people of all shapes and sizes.

Type 1 diabetes used to be known as a disease that you get as a juvenile, and type 2 diabetes was a disease that you get as an older adult, usually 40 and over. But nowadays, masses of people are getting diagnosed with both types at opposite ends of the spectrum. There are 15 year olds getting diagnosed with Type 2 and 60 year olds getting diagnosed with type 1. This goes against all previous knowledge of the disease and how it manifests.

Perhaps the most bewildering part of all is that type 2 is no longer seen as a disease that only affects people who are overweight and obese. In fact, there are slim, young, professional athletes getting diagnosed with the condition. For example, there have been cases where professional triathletes and marathon runners who eat very high carbohydrate diets (in particular, simple refined sugars due to it being part of the racing protocol), who end up developing the condition.

Regardless of your shape and size, if you consume huge amounts of carbohydrates (I’m talking hundreds to thousands of grams per day), you’re putting immense stress on the pancreas, ultimately increasing the likelihood of diminishing your insulin producing capabilities.

Drew Harrisberg

Type 1 diabetes is not caused by eating too much sugar.

Type 1 diabetes is an autoimmune disease. In other words, the immune system attacks and destroys cells of our own body. In the case of type 1 diabetes, the immune system mistakes our own insulin-producing pancreatic Beta cells for invaders, and elicits a killer immune response. As a result of this brutal attack, people with type 1 diabetes can no longer produce insulin and are required to administer it themselves.

Sure, eating too much sugar probably doesn’t help the situation, but it certainly doesn’t play a role in the pathogenesis or manifestation of the disease. There are a number of lifestyle factors in the literature that have been shown to trigger the autoimmune response, but sugar has not been shown to be one of them.

In a nutshell, type 1 diabetes manifests by a process called ‘The Perfect Storm’. It’s basically a number of variables happening all at once which leads to the manifestation of the disease. Here’s an example of some variables that have been reported in the scientific literature: genetic predisposition, viruses, dietary triggers such as gluten and dairy, rapid and drastic change to your microbiome (gut bacteria) and leaky gut syndrome.

Diabetes can be prevented and even reversed.

Both type 1 and type 2 diabetes have been proven to have a genetic element to them, but that does not mean it becomes your fate. In fact, we have more control over our genetics than you think. It’s called ‘epigenetics’. In other words, the ability to control which genes are expressed and which genes are suppressed by managing lifestyle triggers.

Type 2 diabetes, for the most part, can be prevented by living a healthy lifestyle. Things like exercising every day, eating a high fibre plant-based diet, eating healthy fats and moderate protein, eating probiotic rich foods, not overeating carbohydrates and refined sugars that put stress on the pancreas, getting some sunlight, and sleeping adequately. A balanced holistic approach to healthy living is your safest bet for preventing, managing and even reversing diabetes!

Whilst this is a very controversial topic, there is evidence to show that avoiding potential dietary triggers such as gluten and a1 beta casein found in cow’s milk may reduce your chance of developing type 1. Most fascinating of all, is the case of a 6-year-old boy with type 1 who went into remission after adopting a strict gluten free diet.

Exercise is not dangerous for people with type 1 diabetes.

People with type 1 diabetes are often afraid of exercise because they aren’t on a proper insulin therapy protocol. If you are on the correct amount of insulin for your activity levels, exercise is perfectly safe and beneficial.

My philosophy is: Exercise is medicine. In order to thrive with diabetes, I need to take two types of medicine daily; exercise and insulin.

In other words, my daily dose of insulin is dependent upon my daily dose of exercise — NOT the other way around. So, on days when I don’t exercise, I require more insulin. It is quite simply a balancing act between two medications for optimal insulin and blood sugar control.

As an Accredited Exercise Physiologist, a big problem that I see in clinical practice is that people with type 1 are afraid to exercise in case their blood sugar level drops too low.  This often leaves individuals quite sedentary and significantly more reliant on insulin.

To track that I’m meeting my optimum exercise levels, I wear a Fitbit (day and night) to collect data on activity, including step count and reminders to move each hour. The device also allows me to track heart rate and understand my sleep stages which is also really important for those managing diabetes.

People with diabetes can be fit and healthy.

Diabetes should not be seen as a major issue, if approached correctly people with diabetes can use the disease as a motivation to get them into the best shape of their life.

In my personal case, I am fitter, stronger, and overall healthier today than I was before being diagnosed. A healthy lifestyle is a powerful tool to manage diabetes and being fit and healthy is within your control, regardless of your disease state.

In terms of the future of diabetic management and health, companies like Fitbit are partnering with organisations such as Dexcom and Medtronic to make chronic illnesses more manageable than ever before. These organisations are working to develop products to help people like me manage my diabetes and get a more complete picture of my overall health through mobile technology and data. This is super exciting for those with diabetes looking for management support to help them live a more active lifestyle!

About World Diabetes Day

World Diabetes Day was created in 1991 by IDF and the World Health Organization in response to growing concerns about the escalating health threat posed by diabetes. It’s the world’s largest diabetes awareness campaign reaching a global audience of over 1 billion people in more than 160 countries. The campaign draws attention to issues of paramount importance to the diabetes world and keeps diabetes firmly in the public and political spotlight. For more information and to support World Diabetes Day, head to their website.

About Drew Harrisberg

Accredited exercise physiologist, diabetes educator and author of Drew’s Daily Dose, Drew Harrisberg always thought he was a healthy person. But it wasn’t until being diagnosed with type 1 diabetes at age 23 that he began to understand the true meaning of healthy. His pillars for a truly healthy lifestyle include exercise, nutrition, insulin and blood sugar, daily living and mindfulness. Find out more at his website.