In message , Andrew Hodgson
writes

There are two types of diabetes, one where the Insulin is not produced
at all (caused by an auto-imune problem I think) which is called type
1 diabetes. This happens in younger children, and you must take
medication (Insulin injections) for this type of diabetes. The other
type is called type 2 diabetes, and is where the Insulin is produced,
but your body is not using it for some reason. In this case, people
can either not take any medication (i.e, diet and exercise), take
tablets, or in some more extreme cases take Insulin injections.
A gross oversimplification, and not in line with modern thinking on what
diabetes is or on the variety of methods of treatment, which change over
time for any one diabetic.

This
tends to happen in more older people who are sometimes obese.
A common medical error is to assume that if two symptoms occur together
then one is the cause of the other. It is not and never has been true.
Obesity is certainly linked with diabetes. There is no certainty that
obesity CAUSES diabetes or that diabetes CAUSES obesity. Both could be
the result of some other cause.

Nor is the genetics of diabetes or its (apparently) increasing incidence
in the world a simple cause/effect relationship. Studies have shown, for
example, that in some tribes of native americans (redskins, to the
politically incorrect) where there was no record of diabetes a few
generations ago there is now a virtually 100% incidence of diabetes.

An argument is that the pre-diabetic metabolism has a survival value in
some kinds of cold conditions, especially where hunting does not involve
swift movement. In those conditions a thick layer of blubber acts as
both insulation and 'slow' energy store. So people with a pre-diabetic
metabolism will preferentially survive to breeding age, and hence the
genes for diabetes will be endemic in the population. Feast-and-famine
keeps the diabetes more or less under control at the pre-clinical stage.
There is no pay-off in actual Type II diabetes if normal age at death is
under 40 and the Type II cuts in at over 45. Then the situation changes.
There is no famine to use up reserves of blubber, and cold weather
hunting is no longer necessary. 'Modern medicine' allows most of the
tribe to survive to 40, 50, 60, even older. So in a couple of
generations the apparent incidence of diabetes goes from 0% to 100%.
There is no way that could be a genetic change.

Worse still, diabetes is not actually a disease! It is the name of a
symptom. That symptom can arise from interference at many different
steps in metabolic pathways; and that means there are as many diseases
as there are steps in which the metabolism can go wrong. That is also
why some treatments work for some patients but not others. They might
have the same symptoms but they don't have the same disease.

For the ladies, it is worth noting that some women (usually comfortably
plump) become diabetic when they get pregnant. In most cases the
diabetes disappears after they give birth. That really puts the cat
amongst the pigeons on all simplistic descriptions and theories about
diabetes.

Worse still there is a correlation between nature of profession and the
incidence of diabetes. It is independent of genetics and lifestyle. It
so happens that the profession with the highest incidence of diabetes is
organic chemistry, my own first profession. That points to some chemical
we handle in the labs being weakly diabetogenic. Last I heard, nobody
had found which chemical it is.

If you
want more info look at www.diabetes.org.uk or read the diabetes
newsgroups uk.people.support.diabetes or alt.support.diabetes.uk
(which is where the OP should have made his post originally imho).
Ah! This is how moderation would work, is it? You wouldn't have let me
post the foregoing on your moderated disability group. You'd have
insisted on it going elsewhere. But I think it more useful to put it in
front of people who are not dedicated specialists in diabetic matters
rather than in front of those who are already deeply involved. In this
group I can exercise my judgement. In your world of moderation, I can't.


This is only scratching the surface, and I am sure that someone more
knowledgable than me will be along to give you more advice.
I'd already given the advice before you posted your scratchings. I'll
repeat it. Anybody who insists on buying special (expensive) 'diabetic
bread' is either mad or being conned. Portion control of perfectly
ordinary, cheap, bread will achieve all that is necessary. There isn't
any reason why 'bread' in the form of jam doughnuts shouldn't be eaten,
but the portions would have to be so small there wouldn't be any
enjoyment in it, which is why it is pointless eating any high-sugar
flour-based product.

In my opinion, the tastiest way to go for calorie control is in the
direction of high-fibre wholemeal bread with interesting additives. Some
can be bought commercially. Making your own is a tad pricier but allows
the option of juggling tastes to meet personal preferences.

I mentioned a brown loaf I make with three different nuts and a large
amount of orange zest soaked in whisky. It's a bit like having bread and
marmalade without any of the sugar in the marmalade.

There's another one where the main additive is ripe old stilton. It goes
very well with some soups.

There are many more, but they all carry the same warning. All of them
hot out of the machine smell and taste wonderful. It needs discipline to
count the calories and not have another slice, and another, and ... .
There is no getting away with excuses about the vitamins, minerals and
fibre which have been added and are good for you. You still have to
count the carbohydrates actually in the mix. A diet suitable for
diabetics does not have to be dull; nor unnecessarily expensive.

Don


Hth,
Andrew.

--
Dr D P Moody, Ashwood, Exeter Cross, Liverton, Newton Abbot, Devon,
England TQ12 6EY
Tel: +44(0) 1626 821725 Fax: +44(0) 1626 824912