Insulin Isn’t Enough, Nutrition Can Transform Type 1 Diabetes

From sanfernandosun.com

By Andrew Koutnik

I was 16 when I ended up in a hospital bed and heard three words that changed my life: type 1 diabetes. What I didn’t know then – and what too few doctors acknowledge today – is that dietary changes are often the best way to combat the disease.

For decades, doctors have treated type 1 diabetes as if insulin alone could manage it. But despite billions poured into drugs and devices, most people with type 1 diabetes still don’t achieve recommended blood sugar control. I know this firsthand, as a scientist and someone living with type 1 diabetes.

When I was first diagnosed, I did what everyone told me to do: count carbs, take insulin, and hope the numbers balance out. I lived with constant blood sugar swings that left me exhausted and discouraged.

I tried different strategies, but nothing took me off the rollercoaster. My health only began to improve when I tried a diet that would put me into therapeutic ketosis. Because carbohydrates raise blood glucose higher and faster than insulin can lower glucose, cutting them out of my diet nearly entirely made my blood sugar levels far more predictable. Almost immediately, my blood glucose levels normalized and I needed less insulin. My mental health improved.

The science backs this up. 

Multiple studies have shown that people with type 1 diabetes on low-carb diets can lower their blood sugar into the normal range – slashing the risk of long-term complications like brain, vision, and nerve damage.

I’ve even added my own case in the scientific literature so researchers can benefit from the findings. For more than 10 years on a ketogenic diet, I’ve kept my HbA1c around 5.5% – the healthy target for someone without diabetes – while cutting my insulin use by 43%.

Insulin is still essential. Every person with type 1 diabetes needs it to survive. But eating in a way that minimizes blood sugar swings allows me to use insulin the way it was intended – to normalize glucose levels.

This isn’t “fringe.” Ketogenic diets were standard of care in diabetes treatment dating back to 1797. Despite centuries of evidence, nutrition remains an afterthought in diabetes care. Over two-thirds of healthcare professionals are uneducated about these strategies.

Insurance coverage for nutrition and monitoring remains patchy at best. Access to continuous glucose monitors has improved in recent years, but patients still face hurdles with high costs and insurance denials. And ketone monitoring – a critical safeguard for those of us on low-carb diets – is inconsistently covered.

If my health results had come from a new drug, it would be hailed as a breakthrough. Because the intervention is food, our system dismisses it. That must change.

After 17 years with type 1 diabetes, my life isn’t dictated by blood sugar chaos. Insulin saves lives – but pairing it with low-carb diets transforms them. It’s time for our healthcare system to catch up.

Dr. Andrew Koutnik, Ph.D., is a research scientist specializing in nutrition, exercise, and stress on metabolic health, and an advisory committee member for the Coalition for Metabolic Health.

https://sanfernandosun.com/2025/12/31/insulin-isnt-enough-nutrition-can-transform-type-1-diabetes/

There’s Now A Type 5 Diabetes And Doctors Say It’s Been Ignored For Decades

From timesnownews.com

After decades of confusion, Type 5 diabetes finally has a name and a global push for recognition

 In 2025, the International Diabetes Federation has officially recognised Type 5 diabetes as a distinct form of the disease, ending nearly 70 years of debate. The organisation is now urging global health bodies, including the World Health Organization, to formally acknowledge it as well.

What Is Type 5 Diabetes?

Type 5 diabetes is not linked to obesity, lifestyle, pregnancy or the immune system. Instead, it is believed to be caused by long-term malnutrition, which damages the pancreas and reduces its ability to produce insulin. First observed in Jamaica in the 1950s, patients were young, thin and undernourished—but unlike Type 1 diabetes, they did not develop ketoacidosis, a dangerous complication. They also didn’t fit the profile of Type 2 diabetes, which is usually linked to insulin resistance and excess weight.

Type 5 diabetes is believed to be caused by long-term malnutrition

Previously known as malnutrition-related diabetes mellitus (MRDM), this condition was briefly acknowledged by the WHO in the 1980s but later dropped due to limited evidence. Now, growing research suggests it may affect up to 25 million people worldwide, particularly in low- and middle-income countries across Asia and Africa where food insecurity is common. This is why scientists think Type 5 diabetes happens when chronic undernutrition prevents your pancreas from fully developing.

Experts say misdiagnosis is a serious issue. Because Type 5 diabetes behaves differently, standard diabetes treatment, especially high doses of insulin, may be ineffective or even harmful. Patients often need very small amounts of insulin or alternative treatments to avoid dangerous blood sugar swings.

The IDF has now formed a dedicated Type 5 Diabetes Working Group to develop clear diagnostic criteria, treatment guidelines, a global patient registry and training for healthcare professionals. Researchers believe official recognition will finally unlock funding, awareness and better care for a condition that has remained largely invisible for decades.

Type 5 Diabetes Symptoms

They often overlap with other diabetes types (thirst, frequent urination, fatigue, weight loss, blurred vision, slow-healing sores) but are often accompanied by signs of malnutrition like thinness, stunted growth/delayed puberty (in youth), anaemia, and recurrent infections, stemming from early-life nutritional deficiencies rather than just insulin resistance or autoimmunity, and typically appearing before age 30.

https://www.timesnownews.com/health/theres-now-a-type-5-diabetes-and-doctors-say-its-been-ignored-for-decades-has-unusual-symptoms-article-153359184

Managing diabetes on the job

From safetyandhealthmagazine.com

Advice for workers and employers

The decision to tell people at work that you’ve got a medical condition can be a difficult one.

For workers with diabetes, a condition that requires regular monitoring, fear of “being judged” may lead them to say nothing to supervisors or co-workers, says Kathy Utter, director of health and safety for the Midwest Region Laborers’ Health and Safety Fund.

“Some people view diabetes as a poor lifestyle, which is a very common misconception,” Utter said. “That stigma can make people not want to reach out for help.” 

Diabetes is a chronic condition in which the body doesn’t produce enough insulin – or any at all. Insulin, the hormone made by the pancreas, helps move glucose from the bloodstream into the cells for energy. Without sufficient insulin, glucose remains in the blood instead of entering the cells.

The Centers for Disease Control and Prevention estimates that 38.4 million people in the United States (about 12% of the population) have diabetes. 

Managing the condition can lower the risk of developing related health issues, such as damage to the heart, eyes, kidneys or nerves, as well as some types of cancer, according to the National Institutes of Health.

“If you’re not telling people about it, that makes it harder to manage your diabetes,” Utter said.

                                                                                  Photo: New Saetiew/gettyimages

Signs and symptoms

Diabetes symptoms can vary, so making sure colleagues know about them can help keep everyone safe at work. 

“A person has to advocate for themselves when they’re living with diabetes,” Utter said. “They need to let their HR, their managers and their colleagues know. Speak out and educate others, not just your family, your friends, your community, but also your workplace.” 

When workers with diabetes have high glucose (blood sugar) levels – known as hyperglycaemia – they may experience frequent urination, drowsiness, thirst, shortness of breath, and nausea and vomiting.

On the other hand, hypoglycaemia (low blood sugar) can result in symptoms such as sudden dizziness, shakiness, mood change, headache, confusion, sweating and pale skin (depending on the person’s skin colour). 

To help prevent the onset of symptoms, planning for the workday is a necessity – especially for those who work in unique settings such as a remote location or confined space, or who spend their days on the road. That plan may include taking a cooler with snacks and medications to the jobsite, along with a monitor and test strips. Physical activity required for various tasks can also affect a diabetic’s blood sugar levels. 

“Every day you’ve got to be thinking, ‘What am I doing and what do I need to manage my diabetes?’” Utter said. 

Tips for employers 

Supportive employers and managers can help spread knowledge and awareness of diabetes through education and training. 

Formal education can involve first aid training from organizations such as the National Safety Council or a local community group. 

Informal training, meanwhile, can include toolbox talks or safety talks. 

“It’s critical to have that training,” Utter said. “You learn those signs and symptoms and what to do. It lets employees know about diabetes and does help reduce that stigma.”

CDC says employers who are more aware of diabetes can “maximize” worker health, and it may require only small adjustments.

Reasonable accommodations – many costing little to nothing, according to the American Diabetes Association – include: 

• Breaks to check glucose levels, eat a snack, take medication or use the bathroom
• A place to rest until glucose levels return to normal
• The ability to keep diabetes supplies and food nearby
• Being allowed to test glucose levels and inject insulin anywhere at work, including a private place, if requested 
• Working a modified or standard schedule instead of a swing shift
• Permission to use a chair or stool for workers with diabetic neuropathy, a nerve disorder
• Larger computer monitors or other assistive devices for workers with diabetic retinopathy, a vision disorder

Utter added that HR teams can assist by ensuring employer health insurance plans include a diabetes management program, along with coverage for glucose monitors, test strips and medications. 

A shared responsibility

For anyone facing the idea of disclosing a diabetes diagnosis, “it’s normal to have emotional strain or stress, anxiety,” Utter said. 

But having multiple resources can make managing the disease easier. 

“It’s going to help you with not only the management of your condition, but make you feel better about your mental health too,” Utter said.

Most importantly, she added, sharing a diabetes diagnosis at work can enhance the employee’s safety and the safety of others.

“Everybody has a part to play to make that individual safe at work and to make other people safe as well.” 

https://www.safetyandhealthmagazine.com/articles/27661-managing-diabetes-on-the-job

How Nick Jonas' Diabetes Management Has Changed Over 20 Years

From healthline.com

• Lead singer Nick Jonas has been living with type 1 diabetes for 20 years.
• The Jonas Brothers band “JONAS20: Greetings from Your Hometown Tour” celebrates its 20th anniversary alongside Nick Jonas’s 20-year journey with diabetes.
• Nick Jonas shares how both milestones have impacted his life and how he uses his music to raise awareness for type 1 diabetes.

This year, the number 20 holds special significance for iconic singer Nick Jonas.

As the Jonas Brothers celebrate their 20th year as a band, 2025 also marks 20 years since their lead singer’s type 1 diabetes diagnosis.

“It’s crazy how it lined up,” Jonas told Healthline. “It’s been a wild journey in both… in the Brothers sense, it’s been the ride of a lifetime, and we’ve been so fortunate to be able to do this for 20 years now and to have the support of the world’s greatest fans.”

Parallel to the band’s experience over the last two decades, he said he has had great and tough moments living with diabetes. The struggles of managing his condition have been the lows, while advocating and connecting with others as a spokesperson for Dexcom and through his non-profit, Beyond Type 1, have brought him joy.

“Overall, I’m really grateful to have been able to be transparent about [type 1] and to connect with all these wonderful people from all regions of the world who are experiencing their own diabetes journey, and it’s a really big thing to feel like you’re a little less alone in it,” said Jonas.

Nick Jonas’ A1C shoutout to fans

To thank his fans, on World Diabetes Day (November 14), he took to the stage during a Jonas Brothers concert and surprised his audience by sharing an inspiring message of hope, accompanied by a shout-out to his A1C.

“My A1C, which is a collection of numbers over a three-month period, was the best it’s ever been, actually, most recently,” said Jonas.

The show was attended by members of the Dexcom Warrior community — a group of more than 30,000 people globally who share their experiences with diabetes to help spread a message of strength, perseverance, and optimism.

“It was really special for me to get to use the Jonas Brothers’ platform as a place to speak about something that’s obviously very personal to me and on World Diabetes Day, I think it’s natural to get reflective and to tap into kind of what life looks like for me as a now 33-year-old person living with this disease,” he said.

Jonas dedicated the song “A Little Bit Longer” — a tune he wrote early in his career and diabetes journey, to those living with the disease.

“It’s a really important time for me to get to speak on stage like that and play a song that I wrote about these experiences when I was 14 and to see the impact it still has to this day with the fan base,” he said.

While the song has taken on a new meaning for him as an adult, he said it is still relevant.

“Now I [have] this great, big community that I belong to that has lifted me up in so many different moments. I think my outlook is perhaps a lot more positive now. It is possible to live a big, busy life while living with this disease and outlook and perspective and all that is an important piece to powering through.”

As the Jonas Brothers celebrate their 20th year as a band, it’s also been 20 years since Nick Jonas’ type 1 diabetes diagnosis. Photo courtesy of Dexcom

Advancements in type 1 diabetes

Not long ago, life with type 1 diabetes meant more than five insulin injections a day and finger sticks 10 or more times daily. This was a constant cycle of needles, guesswork, and vigilance, said Victoria Finn, MD, board certified endocrinologist with Medical Offices of Manhattan and Labfinder.com contributor.

“Insulin pumps replaced multiple daily insulin injections. With time, insulin pumps became lighter and smarter, and eventually learned to ‘talk’ with the glucose monitors,” Finn told Healthline.

“Algorithms began adjusting insulin automatically, creating hybrid ‘artificial pancreas’ systems that lift some of the mental burden people with type 1 carry every day.”

Jonas is impressed with how far technology has improved since he was first diagnosed.

“The fact that I can receive real time readings of my glucose straight to my phone or smart watch or it can be [shared with] my wife or other family members who I’m traveling away from that’s just an amazing thing,” he said.

In addition to technology, new treatments aimed at managing diabetes and slowing or altering the disease itself are in development.

“The first immune-therapy capable of delaying type 1’s onset was approved, and research into preserving or even replacing the body’s insulin-producing cells gained real momentum. In labs around the world, scientists are growing stem-cell–derived pancreatic beta cells and experimenting with ways to protect them from immune attack,” said Finn.

“Smart insulin” is also being engineered to activate only when blood sugar rises, promising a future where insulin works as intuitively as the body once did.

“More advancements will absolutely continue to develop. We’re no longer just improving tools; we’re getting closer to changing the disease itself,” Finn said.

However, while Sean Oser, MD, a family physician and member of the American Academy of Family Physicians, agrees that further advancements will continue to develop, he notes that managing type 1 diabetes remains an intensive undertaking — physically, cognitively, and emotionally.

“I sincerely hope that we’ll see more and more attention to talking about and helping with the burdens and the demands of living with and managing T1D. We need far more of that, too,” he told Healthline.

Jonas turns to self-care to manage his diabetes

In addition to medication and technology, Jonas shared some strategies he leans on to manage his diabetes.

First, he said he learned to take pressure off himself.

“You’re never going to have the perfect day living with this disease and even if you’re super on top of your diabetes management, there are just things that are a little out of your control and being able to take a deep breath, reset, and know that it’s going to be OK on the other side is really important,” he said.

While this is hard to do at times, he said he learned to practice this early during his diagnosis.

Recently, he has focused on taking vitamins, caring for his skin, and staying hydrated.

“It’s a simple thing, but the more water I drink, my glucose levels are better. I don’t know exactly why, but I just find that hydrating has a lot of health benefits,” said Jonas. “I didn’t put as much focus on it earlier in my life as I do now, and it’s been really beneficial.”

He also walks daily for 30 minutes or longer for his physical, mental, and emotional health.

“It really centers me and even when it’s cold out, getting out in the fresh air is really important when a lot of my day too, is spent indoors for hours at venue or on a film set or something,” he said.

He leans on his therapist regularly, too.

“I think it’s really important to do that self-work,” Jonas said.

Most of all, he encourages everyone living with type 1 diabetes to take part in the diabetes community.

“There will be good days, there will be tough days, but you can climb this mountain, and there’s some incredible people out there whose stories will really inspire anybody that’s going through tough moments,” said Jonas.

https://www.healthline.com/health-news/nick-jonas-type-1-diabetes-disease-management-20-years-later

Sleep and Diabetes: Why the 2025 Guidelines Say It’s Time to Prioritize Rest

From diabetesincontrol.com

Sleep and diabetes are more connected than ever before. According to the newly released 2025 guidelines, sleep has officially joined nutrition and exercise as a core pillar of cardiometabolic health. Why? Because science shows that poor sleep isn’t just tiring — it can directly impact blood sugar levels, insulin resistance, and diabetes management. This article explores the critical link between sleep and diabetes, offering insights into the physiology, practical screening tools for clinical visits, and realistic ways to support healthier sleep in patients living with diabetes.

Why Sleep Matters for Diabetes

Traditionally, diabetes care has focused on diet, physical activity, and medications. But new research reveals that sleep plays an equally important role. In fact, consistently poor sleep is linked to higher blood sugar, increased insulin resistance, and higher HbA1c levels. Patients who struggle with sleep often have more trouble maintaining stable glucose levels and experience more diabetes-related complications.

Additionally, sleep disorders like obstructive sleep apnoea (OSA) are especially common in people with type 2 diabetes. Left untreated, OSA can worsen insulin resistance and elevate cardiovascular risk. Recognizing and addressing sleep issues can significantly improve overall diabetes outcomes.

How Sleep Affects Glucose and Hormones

Sleep deprivation disrupts the balance of key metabolic hormones. Elevated cortisol from short or poor sleep raises blood sugar levels. At the same time, disrupted sleep interferes with insulin’s effectiveness and increases appetite by altering leptin and ghrelin levels. These changes drive cravings, promote overeating, and raise diabetes risk.

Even sleep timing matters. Shift workers and those with irregular schedules are more likely to experience circadian misalignment, which impairs glucose metabolism. Simply put, both the amount and timing of sleep directly influence blood sugar and long-term diabetes health.

Simple Sleep Screening in Clinical Visits

Adding sleep assessments to diabetes care doesn’t require complex tools. Clinicians can begin with four straightforward questions:

• How many hours do you typically sleep per night?
• Do you have difficulty falling or staying asleep?
• Do you feel sleepy during the day or fall asleep unintentionally?
• Do you snore, gasp, or stop breathing during sleep?

Patients reporting less than 7 hours of sleep, daytime fatigue, or loud snoring may benefit from further evaluation. Consider using tools like the Epworth Sleepiness Scale or referring for a sleep study when needed.

Evidence‑Based Sleep Interventions

Improving sleep in patients with diabetes starts with simple behavioural strategies. Encourage these evidence-based techniques:

• Stick to consistent sleep and wake times, even on weekends.
• Reduce evening screen time to avoid blue light exposure.
• Make the bedroom quiet, dark, and cool.
• Avoid heavy meals, caffeine, and alcohol before bed.

For insomnia, Cognitive Behavioural Therapy for Insomnia (CBT-I) has shown strong results. If sleep apnoea is suspected, referral for CPAP therapy may improve both sleep quality and glycaemic control. Modest sleep improvements can produce measurable metabolic benefits.

Practical Tips for Patients

Here are simple, actionable tips to share with patients looking to improve their sleep and diabetes outcomes:

• Schedule it: Set a fixed bedtime and wake-up time.
• Wind down: Develop a 30-minute bedtime routine to signal rest.
• Light control: Dim lights at night and get bright light exposure in the morning.
• Monitor overnight glucose: Especially if night-time awakenings are common.
• Track sleep patterns: Encourage use of wearables or sleep diaries.

Conclusion

Sleep and diabetes management are deeply intertwined. The 2025 guidelines reinforce sleep as a critical factor in achieving better glycaemic control and improving patient outcomes. From screening to simple interventions, clinicians can make a big impact by asking a few extra questions during routine visits. It’s time to treat sleep with the same clinical attention we give to diet and exercise—it’s essential, not optional.

Frequently Asked Questions

What is the ideal amount of sleep for someone with diabetes?
Adults with diabetes should aim for 7–9 hours of quality sleep each night to support glucose regulation and metabolic health.

Can lack of sleep raise blood sugar levels?
Yes, inadequate or disrupted sleep can increase cortisol and impair insulin sensitivity, leading to higher blood sugar.

Is sleep apnoea common in diabetes?
Very. Up to 50% of people with type 2 diabetes may have undiagnosed sleep apnoea, which can worsen blood sugar control if left untreated.

Are sleep medications safe for diabetics?
They may be used in specific situations but should not be the first-line treatment. Behavioural strategies are generally preferred.

How quickly can sleep improvements help blood sugar?
Some benefits appear within days, while changes in HbA1c and insulin sensitivity may take weeks to months.

This content is not medical advice. For any health issues, always consult a healthcare professional. In an emergency, call 911 or your local emergency services.

https://www.diabetesincontrol.com/sleep-and-diabetes-prioritize-rest-2025-guidelines/

8 Ways Diabetes Can Raise Your Heart Attack Risk—and How to Lower It

From verywellhealth.com

Type 2 diabetes is closely linked to heart health. When left unmanaged, it can lead to a higher risk of cardiovascular-related events, such as a heart attack or stroke. However, knowing how diabetes affects your risk can help you take proactive steps to protect your heart.

                                             Having diabetes can increase your risk of certain heart problems.  Halfpoint Images / Getty Images

1. Damages Blood Vessels

Having high blood sugar over time can cause damage to the blood vessels, as well as the nerves that regulate your heart and blood vessels. Over time, this damage can cause heart disease, raising your risk of heart attack and stroke.

The good news: Keeping your blood sugar within your target range as much as possible can help protect your blood vessels and reduce your risk of heart disease.

2. Causes Inflammation In the Body

Diabetes is associated with inflammation throughout the body. Having this inflammation for a long time starts to cause damage in the blood vessels, which makes it more likely for plaque to build up. Over time, the plaque becomes hardened, causing the arteries to narrow. This affects blood flow to the heart and other organs.

You can manage inflammation by controlling your blood sugar, making lifestyle changes, and taking your medications as directed.

3. Raises Blood Pressure

Diabetes causes kidney scarring, which leads to salt and water retention and eventual high blood pressure (hypertension). Blood vessel damage, as mentioned above, also contributes to high blood pressure.

People who have both diabetes and hypertension (high blood pressure) have about twice the risk of heart attack and stroke, when compared to people who have high blood pressure but do not have diabetes.

You can take steps to control your blood pressure by following a healthy diet with limited salt, exercising regularly, and taking your blood pressure medication as prescribed.

4. Causes High Cholesterol

Having diabetes can lower your high-density lipoprotein (HDL) or "good" cholesterol and increase your low-density lipoprotein (LDL) or "bad" cholesterol and triglycerides. This is called diabetic dyslipidemia, and it raises your risk of heart disease and stroke. Studies have found that this can even occur before an official diagnosis of diabetes.

Talk to your healthcare provider about steps you can take to control your cholesterol levels, such as dietary changes, increased exercise, and taking cholesterol-lowering medication.

5. Increases Risk of Obesity

About 86% of people with type 2 diabetes have obesity or are overweight. Having obesity is a risk factor for ischemic heart disease. This happens when arteries narrow and reduce the movement of blood and oxygen to the heart. This can lead to a heart attack.

Losing 5% to 10% of body weight can significantly improve heart health. Talk to your healthcare provider about ways to accomplish this goal, such as through dietary changes, exercise, and possibly medication.

6. Can Damage the Kidneys

Kidney damage is one of the long-term complications of diabetes. Having high blood sugar for an extended period can lead to damage to the blood vessels and other small structures in the kidneys, as well as kidney failure. People with diabetes and high blood pressure can also have kidney damage, as mentioned above.

Having kidney disease increases your risk of heart disease, and vice versa.

You can take steps to protect your kidney health by keeping your blood sugar under control, managing protein intake, and taking medications that help manage your blood pressure. Talk to your healthcare provider about your options.

7. Increases the Risk of Blood Clots

People with diabetes are more likely to have heart disease and blood clots, which can increase the risk of heart attack and stroke. Up to 80% of people with diabetes are considered at risk of dying due to a clot-related cause, such as deep vein thrombosis (DVT) or pulmonary embolism (PE).

There are ways to reduce your risk of blood clots if you have diabetes. Keeping your blood sugar in range, maintaining a healthy weight, exercising, and avoiding smoking and vaping can help lower your risk.

8. Increases the Risk of Heart Failure

Heart failure can happen when the heart cannot pump blood forcefully enough, causing symptoms like fluid retention, difficulty breathing, and fatigue.

People with diabetes are more than twice as likely to develop heart failure and have worse outcomes in terms of hospitalization and prognosis.

You can reduce your risk of heart failure by maintaining a healthy haemoglobin A1C Level, taking your medication as prescribed, following a balanced diet, and engaging in regular exercise.

https://www.verywellhealth.com/can-diabetes-cause-heart-attack-11853363