Can diabetics eat red meat

Does Eating Red Meat, Processed Deli Products Boost Your Diabetes Risk?

With Shira Zelber-Sagi, RD, PhD, Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, and Larry Tucker, PhD

If your meal of choice regularly includes red and processed meats, often grilled or fried to ”well-done” status, you may be increasing your risk of diabetes and liver issues.

A new study from Israel found that a diet with higher levels of those foods substantially increases the risk of insulin resistance (making your blood sugar levels rise to unhealthy levels). The foods also boost the risk for a liver condition known as NAFLD—non-alcoholic fatty liver disease—which is linked to obesity and type 2 diabetes (T2D).1

It’s not just the amount of meat that matters but also the method of cooking,1 says the study leader, Shira Zelber-Sagi, PhD, RD, head of the nutrition, health and behavior program at the University of Haifa and the Tel-Aviv Medical Center in Israel. She explains, “High consumption of heterocyclic amines, or HCAs, form when cooking meat at higher temperatures for a long duration, and meat cooked in certain methods (grilled or broiled to a level of well done and very well done or fried) significantly increase the chance for insulin resistance.”

Findings from a Harvard-led study, appearing in Diabetes Care, confirm that preparing meats using an open flame or at high-temperature for both red meat and chicken was associated with an increased T2D risk among adults who consume animal meats at least twice a week.2

Meat Portions May Be Linked to Diabetes Risk

The Israeli researchers gathered information on meat-eating habits from 357 adults, ages 40 to 70 years. They divided them into those who ate less than 1.1 daily portion of meat—that was the median intake–and those who usually had more. A portion was considered about 3.5 ounces.

Out of the total participants, 39% had liver disease and 30% had insulin resistance.

“In our study, one portion of meat translates to about 100 grams (3.5 ounces),” Dr. Zelber-Sagi says. Her team found that ”a weekly consumption of more than two servings of red and/or processed meats is associated with NAFLD and insulin resistance.”

Having a weekly consumption of more than one portion of processed meat was linked to a higher risk of insulin resistance, which predisposes someone to develop diabetes. Unhealthy cooking methods seem to increase insulin resistance risk, too.1,2 Fatty liver disease is linked to a higher diabetes risk, and many people with type 2 diabetes already have NAFLD.

Despite the findings, Dr. Zelber-Sagi emphasized that red meat has healthy nutrients, including ”protein, iron, zinc, and B12 vitamin.” She advises choosing leaner cuts of meat and unprocessed deli meats like turkey or roast beef, and avoid meats that grilled to well-done or fried. “It may be better to choose roasting or baking,” when cooking your meat and poultry, she says.

What Do Our Health Providers Say?

Three US experts, including members of the EndocrineWeb advisory board, weighed in, and not all agree that the study demonstrates a strong link between meat-eating habits and insulin resistance risk or liver disease risk.

An overall unhealthy lifestyle is what promotes insulin resistance, says Elena Christofides, MD, FACE, CEO of Endocrinology Associates in Columbus, Ohio, voicing some concern about limitations in the research.

She is not convinced of a link between processed meat, red meat and insulin resistance based on this new study. Those who ate higher amounts of meat also tended to drink more alcohol, to get less physical activity, and to smoke, for instance; although the researchers say the link held even when they took those factors into account.

“The big picture is what is important,” Dr. Christofides says. She tells patents to focus on eating healthy, enjoying all foods in moderation, managing their weight, and getting some physical activity every day.

In a previous study,3 Larry Tucker, PhD, a professor of exercise sciences at Brigham Young University, found that a diet of moderate or high meat intake was linked with increased insulin resistance in the nearly 300 non-diabetic women he studied. However, he explains that the link may be driven by high body fat and a higher body mass index (BMI) rather than the meat intake per se.

Also, eating very lean mean (eg, chicken, fish, turkey) was not linked with increasing insulin resistance.3 Very lean meat, according to the American Diabetes Association, has zero to 1 grams of saturated fat per ounce whereas high-fat meat has 8 grams per ounce.4

Take A Closer Look At Your Eating Choices

Dr. Tucker tells EndocrineWeb that the new findings ”are consistent with the literature. Each year, more and more evidence indicates that red meat and processed meat increase the risk of disease and are not the best choices.”

Experts offer a number of ideas as to why red and processed meat may affect diabetes risk. The iron in red meat may increase oxidative stress and increase insulin resistance. High levels of amino acids found in red meats may interfere with the normal metabolism of blood sugar, which can promote insulin resistance.4

Dr. Tucker points to the US Dietary Guidelines for Americans, which note that lower intake of meat including processed meats and poultry can reduce the risk of heart disease.5 Some evidence suggests those eating habits may also reduce the risk of type 2 diabetes and other ills, according to the guidelines.5

It is important to keep the study findings in perspective, says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, program coordinator at the Teen and Adolescent Diabetes Transition Program at the University of Chicago’s Kovler Diabetes Center.

“I think what we can take away from this is that larger quantities of red and processed meats may increase risk. But one food does not topple the entire diet. What we do need is to focus on food patterns, and choosing eating habits that can reduce risk,” she tells EndocrineWeb.

None of the researchers or practitioners have any relevant financial disclosures.

Last updated on 03/27/2018 View Sources

The Truth About Red Meat and Diabetes

Not all red meat is created equal – some isn’t even good enough to even be considered food.

Yet when a news article talks about red meat being bad for you, you can bet the author (or the study behind the news) failed to distinguish between processed meat and unprocessed meat, as well as overcooked meat and properly cooked meat. That’s not even considering grass-fed meat vs. industrial meat, which I’ve blogged about extensively.

“Red-meat-is-bad” articles don’t always deserve a rebuttal because *most* red meat actually is bad for you. However, it’s a major mistake to say all red meat is bad for you. This post serves to confront misleading headlines about red meat and diabetes risk. Let’s ask a few questions, see what the science actually says, and talk about the Bulletproof recommendations.

Processed meats like hot dogs, bologna, deli meats etc. contain high omega-6’s, often have mold toxins called mycotoxins, and nitrates that can combine with bad gut bacteria. All of these can be correlated with an increased risk of diabetes. Instead, insist on eating grass fed, low toxin meat to promote good health and optimize performance.

Research Doesn’t Distinguish Between Processed Red Meat and Unprocessed Red Meat

When articles suggest red meat causes chronic diseases like diabetes, you would expect a high degree of specificity and accuracy. Unfortunately all you get are alarming headlines and half-truths.

When you see blog posts like “Hot Dogs, Bacon and Red Meat Tied to Increased Diabetes Risk,” you should ask yourself how the authors justify lumping hot dogs (a blend of soy, wheat, MSG, and cast off animal parts) in with meat and what the study design looked like. Of course, the recent news about diabetes referenced a study that did not distinguish hot dogs, bologna and deli meats from unprocessed red meats. It also only used questionnaires vs actual tests, and failed to take into consideration how the meat was cooked.1 This study says that increasing red meat consumption over time is associated with an increased risk of type 2 diabetes mellitus (T2DM), but all conclusions were based off participants’ self-reported food frequency questionnaires (FFQ). FFQs are known to have accuracy issues that inhibit researchers from drawing honest correlations.2

Because many studies like this one have shown mixed results using unreliable measures, researchers at the Harvard School of Public Health (HSPH) conducted a systematic review to distinguish between types of meat. This review found that eating processed meat was associated with a 19% higher risk of type 2 diabetes; however, the researchers did not find any higher risk of diabetes among individuals eating unprocessed red meat, such as beef, pork, or lamb.3

This study defined unprocessed red meat as any meat from beef, pork, or lamb that hasn’t been preserved by smoking, curing, salting, or with the addition of chemical preservatives. Examples of processed meats include salami, sausages, hot dogs, and lunch meats. HSPH researchers suggests that more research is needed into which factors in processed meats contribute to poor health and diabetes.

With the current efforts to update the United State government’s Dietary Guidelines for Americans, policy makers should focus on reducing intake of processed meats for multiple reasons.

How Processed Meats Harm Health and Increase Risk of Diabetes

A) Most processed meats throw off your omega-6:omega-3 ratio

Processed meats fed from soy and corn also have extra omega-6 oils. The correct balance of omega-6 to omega-3 fats is essential to optimizing your health and reducing your risk of diabetes, cardiovascular disease, cancer, depression, Alzheimer’s, and rheumatoid arthritis. According to anti-aging researchers, the minimum ideal ratio of omega-6 oil to omega-3 is 4:1, but the typical Western diet is between 20:1 and 50:1 because people consume far too many processed and fried foods like vegetable oils and industrial meat. After I started eating totally Bulletproof, my omega-6: omega-3 ratio dropped to 1.28:1.4

Although all meat, even grass-fed, contains some omega-6’s, processed, cured, and overcooked meats contain higher levels of oxidized toxins in omega-6’s called 4-Hydroxynonenal (HNE). These toxins are absorbed into your tissues and cause inflammation, which drastically increases fat oxidation in your cells.5

This is one reason the Bulletproof® Diet recommends grass fed meat that is carefully prepared at lower temperatures. It’s also one reason most studies on meat consumption and health are woefully inadequate – they fail to consider how the meat is cooked.

B) Dry-cured meats are breeding grounds for mycotoxins

Mold toxins are common contaminants of all industrial meat, but there are even more in dry-cured meat products.6 Mold toxins, also known as mycotoxins, are damaging compounds produced by various molds and fungi. In addition to causing poor human performance, they can also cause cancer, brain damage, and heart, liver, and kidney disease. High performance people should minimize all routes of exposure.

C) Bad gut bacteria mixed with processed meats may decrease insulin sensitivity

Your gut bacteria help to maintain your health, partly by maintaining the intestinal barrier that prevents toxins from entering your bloodstream. Bad gut bacteria actually form new toxins from processed meats, and increase their ability to enter your body.

Poor quality processed meats tend to be pumped with antibiotics that are harmful to gut flora. Studies show that antibiotics cause a profound and rapid loss of diversity and a shift in the composition of the gut flora that can not be recovered without dietary interventions.7

Nitrates in processed meat, especially bacon, get a lot of attention. Although processed meat contains up to 50% more nitrate than unprocessed meat, nitrates themselves are only a problem when you have bad gut bacteria. With an imbalanced gut flora, diabetes experts say that nitrates lessen the release of insulin, which reduces glucose tolerance and increases risk of diabetes. This negative effect on glucose levels helps explain why Harvard researchers found that eating just one serving a day of processed meats (i.e. two slices of salami or a hot dog) was linked to a 20% increase in risk for diabetes.3

Bad gut bacteria will also make nitrosamines from dietary nitrate. See below for more…

D) Nitrosamines in processed meats are linked to increased risk of stomach cancer

Swedish researchers found a higher risk of stomach cancer among those who ate processed meat.8 In Hawaii, researchers followed participants for seven years and concluded that those who ate the most processed meat showed a 67% greater risk of pancreatic cancer over those who did not eat processed meat.

The best way to avoid nitrosamines is to avoid overcooking processed meats, or insist on eating grass fed meat cooked on low heat. If you do choose to eat processed meats on occasion, you can help prevent nitrosamine formation in the body by taking at least 250 mg of vitamin C with your meal, or a lot more. (I do at least 1 gram.) Vitamin C with red meat can increase iron absorption. Increased iron levels (ferritin levels) are correlated with diabetes. Elevated iron levels are not normally an issue for menstruating females, but men should get their iron levels tested regularly, or just donate blood every 3-6 months.9

Bulletproof Solutions to Reduce Risk of Diabetes

  1. Avoid processed meats, unless they are cured with ascorbic acid (vitamin C) and nitrates at the same time, which prevents nitrosamine formation. I cure my own bacon this way – video to come! Most often, insist on grass fed meat, wild-caught fish, or other low toxin unprocessed meats. Celery powder is simply organic nitrite; don’t be fooled.
  2. Eat a doctor-recommended diet like the Bulletproof® Diet to better balance your omega-6:omega-3 ratio and reduce intake of mycotoxins.
  3. Follow the macronutrient guidelines from the Bulletproof® Diet and aim for around 50-70% of your calories from high quality fats and oils to prevent eating too much protein and promote a healthy omega-6:omega-3 ratio.
  4. Cook your food correctly. Cook your foods on moderate to low heat for shorter periods of time, erring on the side of less rather than more. However, the right cooking methods vary for each type of meat. This is why I wrote Upgraded™ Chef, a recipe book that teaches you exactly how to prepare the least inflammatory food for optimal performance and health. Including antioxidant spices is a great idea too.
  5. If you do eat processed meat, take at least 250 mg of vitamin C with it to help block nitrosamine formation in the gut. Men should give blood on occasion too to prevent excess iron buildup.
  6. Work on improving your gut flora– stay tuned for an upcoming series on biohacking your gut biome.
  1. Changes in Red Meat Consumption and Subsequent Risk of Type 2 Diabetes MellitusThree Cohorts of US Men and Women
  2. Improving Food Frequency Questionnaires: A Qualitative Approach Using Cognitive Interviewing
  3. Red and processed meat consumption and risk of incident coronary heart disease, stroke, and diabetes/ A systematic review and meta-analysis
  4. The importance of the ratio of omega-6/omega-3 essential fatty acids
  5. 4-hydroxynonenal as a bioactive marker of pathophysiological processes.
  6. Characterization of molds from dry-cured meat products and their metabolites by micellar electrokinetic capillary electrophoresis and random amplified polymorphic DNA PCR.
  7. Incomplete recover and individualized responses of the human distal gut microbiota to repeated antibiotic pertubation
  8. Processed meat consumption, dietary nitrosamines and stomach cancer risk in a cohort of Swedish women.
  9. Interaction of vitamin C and iron

All Meat, All the Time: Should People with Diabetes Try the Carnivore Diet?

When Anna C. received a diagnosis of gestational diabetes during her pregnancy at age 40, her doctor recommended a standard gestational diabetes diet. This diet consists of lean protein and about 150 to 200 grams of carbohydrates per day, divided between three meals and two snacks.

“It didn’t take me long to see with my glucose monitor that this amount of carbohydrates — even the healthy, whole food ones — were spiking my blood sugar quite high,” she tells Healthline.

Against medical advice, she switched to a very low carb diet for the rest of her pregnancy in order to control her blood sugar. She ate around 50 grams of carbs per day.

But after she gave birth, her glucose levels worsened. She then received a diagnosis of type 2 diabetes.

She was able to manage it at first with a low carb diet and medication. But as her blood sugar continued to rise, she chose to “eat to the monitor”: only eat foods that didn’t cause spikes in blood sugar.

For Anna, that meant gradually reducing her carb intake until she was at or close to zero carbs per day.

“If I avoid carbs and eat only meat, fats, eggs, and hard cheeses, my blood sugar rarely cracks 100 mg/dL and my fasting numbers are never over 90,” she says. “My A1C has been in normal range ever since eating zero carbs.”

Anna’s never looked back in the 3 1/2 years since starting the carnivore diet. She says her cholesterol ratios are so good, even her doctors are shocked.

How the carnivore diet works

The carnivore diet has gained popularity recently thanks to Dr. Shawn Baker, an orthopedic surgeon who completed his own very low carb, high fat diet experiment and saw improvements in his health and body composition.

That led him to experiment with a 30-day carnivore diet. His joint pain vanished, and he never went back. Now, he promotes the diet for others.

The diet consists of all animal foods, and most people favor high fat cuts. Red meat, poultry, organ meats, processed meats like bacon, sausage, hot dogs, fish, and eggs are all on the plan. Some people also eat dairy, particularly cheese. Others include condiments and spices as part of the diet, too.

Anna’s typical meals consist of some meat, some fat, and sometimes eggs or egg yolks.

Breakfast might be a few strips of bacon, a slow cooked egg, and a chunk of cheddar cheese. Lunch is a kosher hot dog mixed with mayonnaise and a side of egg yolk, rotisserie turkey, and a scoop of mayonnaise.

The carnivore diet’s effects on health

Proponents of the diet tout its ability to aid in weight loss, cure autoimmune diseases, decrease digestive issues, and improve heart health.

People with diabetes say it’s been able to help them stabilize their blood sugar.

“From a biochemistry standpoint, if you’re eating only meat, you’re largely not taking in glucose, so your blood glucose levels would not be affected,” says Dr. Darria Long Gillespie, clinical assistant professor at the University of Tennessee School of Medicine. “But there is more to diabetes than just your blood sugar level.”

Measuring blood sugar looks at the short term, immediate effect of food. But over time, eating a diet of mostly or only meat can have long-term health consequences, she says.

“When you go meat only, you’re missing a lot of nutrients, fiber, antioxidants, vitamins, and minerals. And you’re getting very large amounts of saturated fat,” Long Gillespie tells Healthline.

Most of the experts Healthline spoke to for this story advise against going fully carnivore, particularly if you have diabetes.

“We know from extensive research that people with diabetes are at a much higher risk for heart disease,” explains Toby Smithson, RDN, CDE, a spokesperson for the American Association of Diabetes Educators. “We also know that a diet high in saturated fat can lead to heart disease.” Even if you’re careful to choose lean meat, a carnivore diet will still be higher in saturated fat, she says.

When Harvard researchers recently reviewed over two decades of data from more than 115,000 people, they found that higher intakes of saturated fat were associated with up to an 18 percent increased risk for heart disease.

Surprisingly, even replacing just 1 percent of those fats with the same number of calories from polyunsaturated fats, whole grains, or plant proteins lowered the risk by 6 to 8 percent.

Could science be wrong about meat?

But not all people agree with the body of research that points to the negative effects of heavy meat consumption.

Dr. Georgia Ede, a psychiatrist who specializes in nutrition and eats a mostly meat diet herself, says the vast majority of research suggesting that meat consumption is linked to cancer and heart disease in humans comes from epidemiological studies.

These studies are done by administering questionnaires about food to people, not done in a controlled setting.

“At best, this method, which has been widely discredited, can only generate guesses about connections between food and health that then need to be tested in clinical trials,” Ede says.

Her argument is common among carnivorous eaters. But the large body of population-based research that’s linked overconsumption of meat to health conditions is usually enough to lead health professionals to advise against it.

A 2018 study also found that high consumption of red and processed meat is associated with nonalcoholic fatty liver disease and insulin resistance, a concern that should turn heads in the diabetes community.

Anna notes that while she’s aware of the mainstream medical advice that fatty meats are dangerous, she feels like the risks of chronic high blood sugar are graver than any potential hazard from eating meat.

Should you try the carnivore diet?

Most of the experts Healthline spoke to for this story advise against going fully carnivore, particularly if you have diabetes.

“After about 24 hours of fasting or no carbohydrate intake, the liver glycogen stores are not available,” explains Smithson. “Our muscles need insulin for them to get glucose into the cells, so a person with diabetes may have elevated blood glucose readings when omitting carbs.”

Additionally, a person with diabetes who’s taking medication such as insulin may experience hypoglycemia, or low blood glucose levels, by eating only meat, Smithson says.

To bring their blood glucose levels back up, they’ll need to consume a fast acting carbohydrate — not meat, she explains.

A healthier diet for people with diabetes

If not carnivore, then what? “The DASH diet, or Dietary Approaches to Stop Hypertension, is a more beneficial diet for people with diabetes,” says Kayla Jaeckel, RD, CDE, a diabetes educator at the Mount Sinai Health System.

The DASH diet not only lowers the risk of developing type 2 diabetes. It’s can also decrease insulin resistance in people with diabetes as well. It’s high in fruits and vegetables, whole grains, and emphasizes leaner protein choices, such as fish and poultry, low fat dairy, and beans. Foods higher in saturated fats and added sugars are limited.

For another option, recent research found that a low fat vegan diet could improve type 2 diabetes markers in people who haven’t developed diabetes. This further suggests the importance of plant-based foods for diabetes prevention and management.

The Mediterranean diet plan has an increasing body of research to support its effectiveness for diabetes prevention and managing type 2 diabetes.

Sara Angle is a journalist and ACE certified personal trainer based in New York City. She’s worked on staff at Shape, Self, and publications in Washington, D.C., Philadelphia, and Rome. You can usually find her in the pool, trying out the latest trend in fitness, or plotting out her next adventure.

Red alert: processed and red meat

Last year, the World Health Organization (WHO) gave its verdict on the cancer risks of red and processed meat, putting our meat-eating habits in the spotlight. With the evidence stacking up, what does this mean for meat eaters with diabetes?

With the help of Cancer Research UK, we go behind the headlines to explain the facts.

What’s the story?

After assessing more than 800 studies, the WHO broke the news that processed meat is being classified a ‘definite’ cause of cancer, and red meat being a ‘probable’ cause.

The headlines that resulted made many people wonder if red and processed meats should be avoided. The week after the news broke, supermarket sales of pre-packaged sausages fell 15.7 per cent and pre-packed bacon by 17 per cent, compared to 2014.

But, although this latest announcement is significant, the link between certain types of meat and some forms of cancer – particularly bowel cancer – isn’t new: ­the evidence has been growing for decades, and is supported by thorough research. In fact, bowel cancer is more common among people who eat the most red and processed meat.

Cancer Research UK has looked at what this announcement means and how red and processed meat affect your risk developing cancer.

What is red and processed meat?

Red meat is any meat that’s a dark red colour before it’s cooked – such as beef and lamb. Pork is also classed as a red meat.

Processed meat is meat that’s been cured, salted, smoked, or otherwise preserved in some way (such as bacon, sausages, hot dogs, ham, salami, and pepperoni). However, this doesn’t include fresh burgers or mince – putting meat through a mincer doesn’t mean it becomes ‘processed’ unless it is modified further.

Both of these types of meat are distinct from white meats (such as fresh chicken or turkey) and fish, neither of which appear to increase your risk of cancer.

How does processed meat cause cancer?

It’s not about the quality of the meat, or whether it’s from the local butcher or supermarket, that’s the issue. The evidence so far suggests that it’s probably the processing of the meat, or chemicals naturally present within it, that increases cancer risk. Researchers are still trying to pin down exactly how red and processed meat cause cancer, but the main culprits seem to be certain chemicals found in the meat itself.

Processed red meats contain chemicals, such as nitrite preservatives, that generate certain compounds in the gut that can cause cancer.

Cooking meat at high temperatures, such as grilling or barbecuing, can also create chemicals in the meat that may increase the risk of cancer. These chemicals are generally produced in higher levels in red and processed meat compared to other meats.

There are also other theories, says Cancer Research UK – some research suggests iron in red meat could play a part, and the bacteria in the gut might play a supporting role, too.

What’s the risk?

The most convincing evidence of a link to bowel cancer comes from the World Cancer Research Fund (WCRF), who in 2011 combined the results of a number of previous studies, to try to get a clear overall picture.

They were able to group the research findings according to those who ate the most red and processed meat and those who ate the least. A key finding was that red meat and processed meat aren’t equally harmful – processed meat is more strongly linked to bowel cancer than red meat.

Relative risk

The results showed that those who ate the most processed meat had around a 17 per cent higher risk of developing bowel cancer, compared to those who ate the least. This might sound like a lot – but this is a ‘relative’ risk, and in reality, everyone’s risk will be different as there are many different factors at play.

The facts

  • Out of every 1,000 people in the UK, about 61 will develop bowel cancer at some time in their lives.
  • Those who eat the lowest amount of processed meat are likely to have a lower lifetime risk than the rest of the population – about 56 cases for every 1,000 people.
  • Of 1,000 people who eat the most processed meat, you’d expect 66 to go on to develop bowel cancer at some point in their lives – 10 more people than the group who eat the least processed meat.
  • In 2011, scientists estimated that around three in every 100 cancers in the UK were due to eating too much red and processed meat – that’s around 8,800 cases every year. This compares to 64,500 cases every year caused by smoking (or 19 per cent of all cancers).

How much should we eat?

Red meat is a good source of some nutrients, such as protein, iron, zinc and vitamin B12. It’s just about being sensible, and not eating too much, too often.

The evidence so far doesn’t point to a particular amount of red and processed meat that’s, in terms of cancer risk, likely to be ‘too much’. But the risk of cancer is lower the less you eat, so it’s a good idea to cut down on the amount of red and, in particular, processed meat you eat.

Based on a range of health considerations, government advice is that people who eat more than 90g (cooked weight) of red and/or processed meat a day should cut down to 70g or less.

Three simple swaps

We’re recommended to eat less than 70g of red or processed meat a day. Here’s how to make some easy cuts…

Try eating smaller and fewer portions

  • Two sausages and three rashers of bacon = 70g
  • One sausage and one rasher of bacon = 25g

Choose chicken or fish instead

  • Two slices of ham = 50g
  • Chicken or tuna = 0g

Bulk it out

  • Minced beef in a regular portion = 100g
  • Use less meat and add beans or veg = 15g

If you are managing diabetes, try to eat a healthy, balanced diet with plenty of fibre, fruit and vegetables; and cut back on red and processed meat, and salt, too.

  • Originally published in Diabetes Balance magazine – become a Diabetes UK member and get your copy.

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