Way to go Paula

Pour some sugar on me

“Way to go Paula,” is a line from the movie, Officer and a Gentleman. Remember that final scene where Richard Gere picks up Debra Winger and sweeps her off her feet? Her teary-eyed girlfriend, Lynette, shouts out, “Way to go Paula!” as she watches her best friend being carried out of the factory where they work. It’s a bittersweet ending for Lynette seeing her best friend reveling in the happy ending she will likely never experience for herself.

That’s how I felt when I heard Paula Deen was diagnosed with diabetes and is endorsing a new oral medication to treat  her disease. For years, I’ve watched along with the rest of the country as this larger than life Southern woman warmed our hearts and enticed our bellies with recipes that went against everything doctors and nutritionists have been preaching about for years. I remember once watching Paula Deen as she dropped whole sticks of butter into a bowl with the same disregard Joe Pesci’s character in Goodfellas unloaded bullets into mobsters. The cruel twist is that Deen knew she was a diabetic for years and still she relied heavily on fatty foods without once acknowledging her condition was directly related to her obesity and eating habits. This week she admitted to being a diabetic but her announcement came suspiciously once she  signed a lucrative endorsement deal for an oral diabetic medication.

I wonder if Paula Deen and the Food Network will alter her format and use Deen’s diagnosis as a cautionary tale that this can happen to you if you eat like glutton? Improving Deen’s ingredient profile could prove deleterious to the food star who typically doesn’t mince words or cut corners. Her food is rich, high in calories and loaded with fat. I guess you could say she lives life like her hair: big, brassy and dangerous. Will the public watch a streamed down Deen? We shall see.

One out of every 10 American women is living with diabetes, which causes more deaths each year than breast cancer and AIDS combined. Still, most Americans don’t see it as a serious disease, according to a recent survey. Here’s why women should worry…

Are you overweight and hate working out?

Were you diagnosed with gestational diabetes during a past pregnancy?

If you answered yes to either of these questions, you’re at risk for developing diabetes, a chronic, incurable disease that raises the risk of heart disease, kidney failure and more. And women with the disease are also more likely to die younger.

“If you see a 40-year-old woman with chest pain, she’s not likely to have a heart attack,” says Andrew Drexler, M.D., an endocrinologist and director of UCLA’s Gonda Diabetes Center. “But if she’s diabetic, that’s not true.”

The federal government spends billions each year conducting diabetes research, with scientists searching for more efficient ways to manage the disease.
What’s the difference between type 1 and type 2 diabetes?
Type 1 is an autoimmune disease that destroys islet cells [which produce insulin] in the pancreas. Insulin controls [blood sugar levels] in the body.

[With] type 2 diabetes, the insulin is there, but it doesn’t work – not because the insulin isn’t normal but because the body doesn’t respond to it well. The body compensates by producing more insulin.

What causes diabetes?
We really don’t know what causes type 1. There’s no way of avoiding it. There is a genetic component to it, but we don’t fully understand the trigger. That’s why even if we were to catch it early, we couldn’t prevent it.

Type 2 is [largely caused] by eating too much and not being active enough. The data are pretty strong that the problem is the calories – not the type of food.

Which type is more common?
Between 90%-95% of diabetics have type 2.

We’re seeing an increase in both types, but type 2 is being called an epidemic. That appears to be true worldwide. As obesity becomes an epidemic, so does type 2 diabetes. It’s that simple.

Are the symptoms the same for type 1 and 2?
Type 1 develops rather quickly, with dramatic symptoms occurring within a week to a month. Symptoms include frequent urination, weight loss, blurry vision and thirst.

[Symptoms are] the same with type 2, but it develops more slowly.

Can someone be diabetic and not know it?
The feeling used to be that 50% of type 2 cases were undiagnosed. It’s better now, but still grossly undiagnosed. [Being diagnosed with type 2 diabetes] is more likely to happen as you get older.

Actually, something like 25% of people in their 80s have diabetes.

What problems do women have in managing diabetes?
Women are thought to have a harder time with weight than men. Excess weight makes everything worse: It makes it harder for insulin to work. You can’t produce enough insulin for your body’s needs. The more overweight you are, the more you have to produce.

How does pregnancy affect a woman with diabetes?
When a woman’s pregnant, the placenta produces hormones that make women more insulin-resistant. That’s why they develop gestational diabetes and often end up on insulin when pregnant. Nature doesn’t care a lot about you: It cares about you having children. There are a number of hormones made by the placenta – most are designed to be good for the baby and the hell with you.

What role does diet play in preventing or managing diabetes in women?
A restricted diet isn’t the most important part of preventing diabetes; women have to eat the right things. The best diet  includes whole grains, fresh fruits and vegetables, low-fat cheeses and yogurt, and baked or broiled fish and meats.

How does menopause affect diabetes?
Menopause doesn’t have any direct impact on it. But women often find it hard to control their diabetes because menopause is stressful, and with any stress, diabetes is going to get worse. Stress hormones cause a number of actions that can counteract insulin’s effect. For example, stress causes the release of glucose by the liver, which raises blood sugar.

Can you manage diabetes without medication?
Most type 2 patients end up on medication. (The starting medication is metformin.)

Exercise is critical.

Most doctors would say that cardiovascular exercise [is important], but there’s some evidence that increasing muscle [through resistance training] may help as well by increasing the use of glucose. What about insulin?
Patients may want to stay off insulin, but most physicians feel we don’t start insulin soon enough.

At some point, in almost all cases, medications fail, and when they do, the only alternative is insulin.

The goal isn’t staying off insulin; the goal is keeping blood sugars under control.



  1. Jeffrey Hudgins
    Posted January 18, 2012 at 3:36 pm | Permalink

    I just love Paula!

  2. spinellimd
    Posted January 18, 2012 at 3:48 pm | Permalink

    So do I.

  3. Posted January 20, 2012 at 7:21 pm | Permalink

    Here’s where I took this revelation on my blog last Tues.:


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