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Paula Deen has type 2 diabetes – was this inevitable?

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Jan 16

Ok, first off, I am not gonna hate on Paula Deen. She is a successful woman with a pretty inspiring life story. She also happens to be in the news this week because she has revealed that she has type 2 diabetes (see this link for an NIH description of different types of diabetes). The story in the NYT can be found here. One interesting twist to the story is that in conjunction with this revelation, she has announced that she will be promoting a new drug for type 2 diabetes (see here for her face on the drug website).

Ok, so here is where I’m a bit concerned.

First, type 2 diabetes is basically insulin resistance and it is the most common form of diabetes. This type of diabetes develops in response to having a lot of sugar in the diet (being overweight and inactive also increase the risk of developing type 2 diabetes and are probably pretty well-correlated with having a lot of sugar in the diet). In any case, the body releases insulin to metabolize all the sugar that is taken in and over time (with a lot of wear and tear), this system burns out. Either the pancreas cannot release enough insulin to handle all of the sugar, or the fat, muscle, and liver cells no longer respond to insulin appropriately. When that happens, you now have type 2 diabetes.

So, it seems to follow (from science and logic) that one must acknowledge the role that sugar plays in the development of type 2 diabetes. However, according to the NYT, “Ms. Deen said she would not change her own lifestyle or cooking style drastically, other than to reduce portion sizes of unhealthful foods. ‘I’ve always preached moderation,’ she said. ‘I don’t blame myself.’ Now, I’m not really concerned about blame (it doesn’t do anyone any good in retrospect), but as an educator, I am concerned about proper education and I think that it is disingenuous to leave sugar out of the discussion (to her credit, she has apparently given up sweet tea, which is a great start).

Second, implicit in this story and the publicity surrounding it is the promotion of the decision to take a drug while making few changes to one’s lifestyle. There are several problems with this approach. A personal problem involves the risks associated with taking the drug. If you look at the prescribing information (link here), there are several warnings and precautions associated with the drug including a black box warning (the strongest type of warning issued by FDA) stating that, “Liraglutide causes thyroid C-cell tumors at clinically relevant exposures in rodents. It is unknown whether Victoza® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as human relevance could not be determined by clinical or nonclinical studies.” So, decide for yourself if you want to take that chance. A more societal problem has to do with how we decide to treat type 2 diabetes and whether it is better to invest $500 or more per month (the cost of the drug) on injections or to invest that money in ways that will improve our diets, food supplies, opportunities for movement, etc., etc.

So, for my dollar, I’m gonna try to cut back on the sugar as much as possible and to avoid things (drugs and otherwise) that carry risks of developing cancer. That’s a pretty simple solution, don’t you think?