Diabetes, Nutrition and Hunger by Dr. Hilary Seligman.
March 26, 2013
We asked Dr. Hilary Seligman, MD, MAS, to give us insight into how nutrition affects your body and particularly the health of people struggling with hunger. Dr. Seligman is Assistant Professor of Medicine at University of California San Francisco whose research focuses on the issue of food insecurity and its relationship to obesity. This post is part of a series for National Nutrition Month which is the whole month of March.
Having diabetes is like standing, day in and day out, on a precarious scale. Eat too much, or eat the wrong kinds of food, or don’t take your medicines, and your blood sugar goes up too high. Eat too little, and your blood sugar goes down too low. Both too-high and too-low blood sugars wreak havoc on your body. The high blood sugars can make you hungry, thirsty, tired, and running to the bathroom to pee all the time. In the long run, they can leave you with kidneys that don’t work, eyes that don’t see, amputations, heart attacks, and strokes. The low blood sugars make you make you tired, anxious, and sweaty. If you don’t eat something fast, they can make you pass out, have a seizure, or even die.
This sounds scary, and it is. More than 25 million people in the US have diabetes. These people must work hard every single day to keep their blood sugars in the normal range. Imagine how much harder it is, though, if you are living in one of the 18 million US households which struggle to put food on the table.
People with diabetes sometimes feel trapped by their inability to afford the foods that help their blood sugars stay in the normal range. These foods are often the most expensive foods at the grocery store, like vegetables and lean meats. The cheaper foods—bread, pasta, rice and other carbohydrates that are often the most easy to get—make blood sugar go up fast and stay high. What do you do when someone on your health care team begs you to stop eating so much rice—but that is almost all the food you have left in the house for the next three days? This is an all too real problem for food-insecure adults with diabetes.
Access to food in many of these households is also unpredictable. But our diabetes medicines aren’t usually tailored to this unpredictability; instead, people with diabetes take the same medicines every day. So what happens if you take your diabetes medicines on days when you can’t eat as much because you have run out of food? Your blood sugar falls too low, sometimes precariously low. And if this happens too often, you will need to start taking less medicine. But taking less medicine can allow your blood sugars to go up too high again. You can end up wobbling back and forth on the precarious diabetes scale, without every coming to rest at that steady and even state of normal blood sugars.
Our research shows that most people with diabetes who live in food insecure households worry a lot about their diabetes, and wish that they were able to take better care of themselves. With help from the Bristol Myers Squibb Foundation, Feeding America is trying to help adults with diabetes achieve some of their goals. The Hands-On Diabetes program[HKS1] allows food pantry clients with diabetes at three food banks to take home foods tailored specifically for their diabetes, including lots of vegetables, lean meats, and other proteins. It also connects these clients with primary care doctors to help manage their medicines and provides diabetes education to offer additional support in all the tasks they need to do to take care of their diabetes.
All of this makes good sense. Managing diabetes is a complicated task for everyone. Through this project, we are hoping to demonstrate how food banks can help make things just a little easier.