Last week, I reported a story about TV chef Paula Deen's announcement that she has Type 2 diabetes and her decision to promote an expensive drug — while continuing to present high-carb, high-fat favorites on TV.
I wondered how this news was playing among diabetes professionals and patients. Among the people I spoke with was Grace Lau, a certified diabetes educator and registered dietitian at St. Joseph's Hospital in Tampa.
After talking with Lau, I started thinking that even if Deen isn't a perfect role model, she might be an accurate one.
Deen has taken a lot of heat for not revealing her diagnosis until she signed a commercial deal. She says she learned she had Type 2 about three years ago, but kept it to herself while cheerfully adding sticks of butter and dollops of mayo to her TV recipes.
Few diabetics get a deal with a major pharmaceutical company. But Deen is far from the first person with Type 2 who's been slow to talk about it and slow to embrace strictly healthy living.
Lau said many of the patients she sees would rather not even think about diabetes.
"Some people are ready to make a major (lifestyle) change, but that's a minority. Some people have it 10, 20 years, but they're still in denial.''
Even if the only reason Deen is talking is because she's got a deal, her silence is understandable. Type 2's connection with obesity has stigmatized the condition and those who face it. (Which is ironic, given that more than a third of American adults are obese.)
Plus, it's a complicated disease, and there's a lot to keep straight.
"Very often, when patients come to class, they think everything sugar-free is okay,'' Lau said. "So they'll pig out on three scoops of sugar-free ice cream and think it's okay. But it's still high in carbs.''
Exercise — Deen says she has started walking — improves insulin sensitivity, allowing more dietary flexibility. The key, Lau explained, is monitoring one's blood sugar throughout the day.
Deen, who appears noticeably thinner, says she only rarely eats the kind of high-carb, high-fat food she makes on TV. She says she preaches moderation.
So does Lau.
"We focus on moderation,'' she said. "Ideally, it's not recommended they should have fried chicken all the time, but it's real life, and diabetes is something people have to live with all the time.''
And what about Deen's promoting a diabetes drug? Healthy living can arrest Type 2 in its early stages. But even the most diligent may need drugs eventually.
"For some patients it's a good incentive to work hard and stay off medications,'' Lau said. "But we also make sure patients understand that if the doctor says you need the meds, you are not a failure.''
I wish Deen weren't sending such mixed messages.
I hope people do not interpret her actions to mean that diabetes is not a serious condition. Maybe it isn't as feared as cancer or heart disease, but it should be.
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According to the federal government, diabetes is the nation's seventh leading cause of death, and that's probably an understatement. Diabetes makes you more vulnerable to other deadly conditions, such as heart disease, and it might be those complications that get on the death certificate, not the diabetes that set the stage.
Speaking of complications, I really hope that Deen is able to quit smoking, which is terrible for everyone, but particularly harmful to diabetics.
But lifestyle changes often come slowly. At least in her public persona, Deen seems to be keeping it real. And that might be her best tool if she intends to be a helpful role model for people with Type 2.
"Paula Deen is Paula Deen,'' Lau said. "And if she says, 'I'm going to make a 180-degree change,' nobody's going to believe her."