I was listening to a physician (Dr. Gabe Mirkin) who has a radio program, and he said that anyone with diabetes should never eat any food containing flour. His theory is that because flour is ground, it enters the bloodstream quickly causing a rise in blood sugar. He applies this to any grain in a ground form and says that whether or not the bread is whole wheat doesn’t matter. The doctor told the caller on his show that if someone with diabetes ate bread, it was like “suicide”. It was a little alarming to say the least!

We didn’t receive any information like this when our son was diagnosed with type 1 diabetes three years ago. Would this only apply to people with type 2 diabetes, or should this be a concern for us as well?

My impression of what the doctor is supposed to have said (I say this because I cannot speak to the accuracy of the statement) is that this is not in step with what is being taught and thought of as mainstream information about nutrition and diabetes. In order to answer the question completely, it should be determined whether credible nutritional science has been applied to the question, as opposed to an opinion that may not be substantiated. The truth is that it is recommended that roughly 50% of the calories taken in be from carbohydrates. This is unavoidable. Part of the calories will come from breads and grains. The emphasis is on measuring the serving size and not to eat an excess of any type of food. The comment about suicide is not balanced and not the standard reply from most care providers in the area of diabetes care.

JTL
Additional comments from Dr. David Schwartz:

I am not familiar with this individual, but it sounds as if this is another twist on the glycemic indexing of foods. It is not “suicide” for someone with diabetes to eat grains or any other carb (including sugar for that matter!). Virtually everything that you eat that contains calories will be metabolized into glucose sooner or later: table sugar and fruit sugar essentially within minutes; complex starches some what longer; protein after several hours. Fat does not get metabolized to glucose but can affect the absorption of other foods. Foods that do not contain calories (e.g., water, vitamins, minerals) do not get converted to glucose.

This web site can link you to other questions regarding the glycemic index of various foods. Essentially, the proposal is that the higher the glycemic index, the higher and more quickly the blood sugar will rise after consumption of that food; the lower the glycemic index, the longer and less high the glucose excursion.

Certainly, dietary measures are tremendously important in overall glucose control, but the key is insulin, and perhaps more so, the balance of insulin to food to physical activity. Please do not change your child’s diabetes regimen without consultation of your child’s own diabetes team.

DS

[Editor’s comment: This doctor seems sadly ill-informed. At his website, he claims that “Insulin is a bad hormone. It constricts arteries and causes heart attacks and strokes” and that “diabetes causes… deafness…”. I’d take anything he says with a grain of salt, and perhaps a slice or two of bread.

WWQ]