The best diet for optimal blood sugar control & health
Author: kaitiscotland
I am a Scottish doctor who is working to improve the outcomes for people who have diabetes using a low carb diet, and advanced insulin techniques when necessary. Professionally I provide expert witness reports in the clinical forensic and family medicine areas and I also provide complementary therapies. I enjoy cooking, cinema, reading, travel and cats.
Cambridge University professor of biostatistics, David Spieghalter, has produced an easy to understand tool that can help you quantify your daily habits in terms of added or reduced life expectancy.
If you have got to 35 years of age, you could reasonably expect to live till age 80 if you are a man and age 83 if you are a woman.
For men this is how to live a shorter life:
Smoke 15-24 cigarettes a day cut 7.7 years For women cut 7.3
have one drink of alcohol a day ADD 1.1 years For women ADD 0.9 years
have another one up till six more CUT 0.7 years per drink For women CUT 0.6 years
For every 5 units above a BMI of 25 cut 2.5 years For women cut 2.4 years
for every 5kg above your optimal weight cut 0.8 years For women cut 0.9 years
Spend two hours watching the television cut 0.7 years For women cut 0.8 years
For every red or processed meat portion you eat, equivalent to a burger 3 oz cut 1.2 years Same for women
Now for the good news:
If you eat 5 or more fruit or vegetable portions a day men add 4.3 years For women add 3.8 years
If you drink 2-3 cups of coffee a day add 1.1 years. For women add 0.9 years.
For the first 20 minutes of exercise add 2.2 years. For women add 0.81 years.
For the next 40 minutes add 0.7 years. For women add 0.5 years.
Take a statin add 1 year for men. For women add 0.8 years.
If you live in a relatively unpolluted area, less than London for example, add 0.6 years for both genders.
Adapted from BMJ 13 Nov 2021from American Journal of Epidemiology.
Measurements using an Actigraph were taken from 13,000 adults and children in the USA to determine what a “normal” sleep duration was. The amount of sleep taken by individuals can be highly variable, and this can also change due to their age and stage of life and occupation.
For females, the 50th centile, the middle of the sleep range, was 8.3 hours a night, starting from age 6. As a young adult, this reduced to just over 7 hours and stayed constant till there was a small increase at age 65.
For males, the middle of the sleep range was 8.1 hours at age 6 and reduced to 6.5 hours in early adulthood and increased slightly at age 60.
My comment: I’ve always needed a lot more sleep than this. 10 or 11 is better for me and in autumn, just after the clocks change, I can sleep for 14 hours a night if I am not disturbed. I perk up a little bit in the spring and can cope with 9 hours a night. For much of my life, particularly working as a doctor on call and having young children I had a lot less sleep than I really needed. I have seen that sleeping a lot is associated with a higher rate of dementia, but too bad!
In California, a longitudinal study of more than 50,000 women, looked at how environmental influences affected how long it took to get to sleep and how long the sleep lasted.
Shorter sleep duration was associated with exposure to artificial light at night and air pollution. (Associated with cities). Where there was a lot of environmental noise, it took longer to fall asleep.
Contrasting with this, living in areas with more green space led to women falling asleep faster and staying asleep longer.
The Alcohol Health Alliance UK has called for better labelling on alcoholic drinks after an analysis found that wine from the ten leading brands contained as much as 59g of free sugars per bottle.
None of the bottles had the sugar content on the label.
Government guidelines recommend no more than 30g of free sugars a day for an adult (My comment: they conveniently forget about starch though!) This is equivalent to 6 teaspoons of sugar and it can be contained in just two medium glasses of wine.
In February at the Low Carb USA conference in La Boca, Florida, Gemma Kochis, who is a qualified Sommelier, who works at Keto-Mojo, presented information for those on a ketogenic diet who would still like to drink wine.
She says that for the most part, wines with the highest alcohol content will tend to have the highest sugar content. If you want to drink wine and stay in ketosis, you will need to test your blood ketones about 2 hours after trying a new wine.
In general she recommends wines that grown in cooler climates, mainly old world compared to new world. She thinks that you have to stick below 12.5% alcohol wines and that even then you may have to go lower.
Red wines that can be fruity and have a low alcohol content include Beaujolais and Gamay.
Reisling, Vinho Verde and Muscadet are good white wine choices and Champagne Brut is a good sparkling wine choice.
Dr Malcolm Kendrick who is a GP, and Zoe Harcombe who is a PhD researcher, have raised a court action against the Mail on Sunday, because they think that their reputations have been damaged by being called “statin deniers whose deadly propaganda has endangered lives.” Their influence was described as “being worse than the MMR scare.”
Mr Justice Nicklin describes the case as a most significant piece of defamation litigation. The claimants assert that they have been accused of putting many thousands if not millions of people at a greater risk of a deadly or debilitating heart attack or stroke by misleading them into the false belief that statins do not work and/or have debilitating side effects.
Both Malcolm and Zoe write blog articles, have given lectures and written books. Malcolm writes, “Readers will know there is not one cause of heart disease. Equally, you are not going to protect yourself against heart disease doing one thing. You need to do many.”
Associated Newspapers who own the Mail on Sunday, say that their articles are substantially true, express an honest opinion and also say that they are protected by qualified privilege or by the defence of publication on a matter of public interest.
My comment: I was most concerned when I read about this case. There is a lot of controversy over the use of statins and the public should be able to hear both positive and negative information on health matters, so as to help them make up their own minds, or to stimulate further personal research. Dr Kendrick and Zoe Harcombe are both highly intelligent, well informed and well meaning people. They both support low- carbing for health care, and we have corresponded and met up personally and online at discussions and conferences of common interest. I am concerned that there is financial resource asymmetry here and that this case will be potentially ruinous for them. I await the court’s findings with interest and trepidation.
In an observational study reported in JAMA 1,746 type one patients were compared with 272 type two patients. All had developed their diabetes before the age of 20. My comment: It is not clear whether the duration of diabetes was adjusted for, as the onset of type one diabetes tends to cluster around puberty, although it can occur as early as soon after birth, and the onset of type two diabetes tends to arise in later teenage years. Thus if average 30 year olds were compared head to head in the study, for instance, one would expect the type 1 patients to have more complications purely based on having had the condition much longer on average than the type 2s.
Nevertheless, the prevalence of diabetic kidney disease, retinopathy and peripheral neuropathy was significantly greater in the type two group compared to the type one group, even after they adjusted for differences in glycated haemoglobin, body mass index, waist to height ratio, and mean arterial blood pressure.
This study provides information that early age of onset of type 2 diabetes is a real problem, as once established, it does a lot of damage, that is difficult to control with standard therapies.
After a heart attack, the risk of sudden death is influenced by your past levels of physical activity.
People who performed moderate levels of leisure time exercise reduced their risk by 33% and those who performed high levels of exercise reduced the risk by 45%.
This study combined data from ten European longitudinal studies and found 30,000 people who had a heart attack. Around 5,000 people (18%) died within 28 days. Of these, 3,000 (62%) died instantly.
European Journal of Preventative Cardiology
Fish oil supplements however had no worthwhile cardioprotective effects according to a Cochrane Systemic Review done several years ago. A study looking at secondary prevention in 70-80 year olds, recently found similar effects. There was no difference between the omega 3 fish oil supplemented group and placebo over two years.
NICE are recommending that the anti diabetes drug Semiglutide is used for its anorexic properties in non diabetics who meet certain criteria.
Trials have found that patients given diet and exercise advice plus Semiglutide lost 12% more weight than lifestyle advice alone.
The drug is given in a weekly, self administered injection. My comment: I have used similar drugs with my type two patients and they were all surprised at how easy this was to do and how effective the drug was as an appetite suppressant.
To be considered for the treatment you have to have a BMI of at least 35 and have a related co-morbidity.
If you have a BMI between 30 and 34.9 you may be eligible for the drug if you are of South Asian, Chinese, black African or Caribbean family background or if you have been referred to a tier 3 weight loss service. This is because the drug is cheaper and safer than bariatric surgery and also because certain ethnic groups are more at risk of co-morbidity at lower BMIs than those of white European ancestry.
My comment: I can envisage that there will be huge market for this drug. One issue is that patients tend to regain weight on stopping and I understand that newcomers are expected to stay on the drug for two years.
Adapted from Update on Advice for Physical Activity in Type 2 Diabetes by Marlene Busko http://www.medscape.com 11 Feb 2022
The American College of Sports Medicine has updated advice from The ACSM/ADA joint statement in 2010 for type two diabetics. Their recommendations have been published in full in the February issue of Medicine and Science in Sports and Exercise.
The key information is that everyone with type two diabetes should engage in regular physical activity, reduce sedentary time, and break up sitting with frequent activity breaks. Workouts can be modified if necessary. Anyone who wants to lose weight should consider workouts of moderately high volume 4 or 5 times a week.
Regular aerobic exercise improve glycaemic management. Blood sugar spikes are reduced and you can expect a reduction in A1c between 0.5-0.7%.
High intensity resistance exercise, when performed safely, is better than low to moderate intensity resistance exercise for glucose management and to reduce the amount of insulin you need to take. You can expect to an improvement in strength of 10-15%, improved bone mineral density, lower blood pressure, improved lipid profile, higher skeletal muscle mass and improved insulin sensitivity.
Exercise after meals, such as taking an after dinner walk, at an easy pace, helps stabilise blood sugar levels.
You should reduce sedentary time by taking regular activity breaks. These will result in small improvements in post meal blood sugars particularly in those who have more insulin resistance or who are overweight.
To prevent low blood sugars during or after exercise, people who take insulin, or drugs that promote insulin release, should reduce the amount injected if they can, reduce the medication, or if necessary increase carbohydrate intake.
If you are on beta blockers, you can’t rely on a heart monitor to measure your workout intensity. You can use a perceived exertion scale instead, eg Borg. Be guided as to the required intensity by a certified exercise professional.
Weight loss of more than 5% can improve A1c, lipids, and blood pressure. Visceral fat can be reduced by moderate exercise 4 or 5 days a week.
In young people who have type two diabetes, intensive lifestyle interventions plus metformin were no better than metformin alone for blood sugar control. Their physical activity goals should be the same as non diabetic individuals.
Those who did regular exercise before and after bariatric surgery, got better surgical outcomes.
In 2017, more than 17 million American adults reported experiencing at least one major depressive episode. (1) In 2020, as we deal with the COVID-19 pandemic, racial injustice, and increased stress and uncertainty, those numbers appear to be rising. According to one study, stressors related to the pandemic led to a three-fold increase in the rates of depression across all demographic groups studied. (2) If you’re struggling, you’re not alone. Embracing a root-cause-based Functional Medicine approach to depression may help you get relief, potentially without the use of antidepressants.
The Functional Medicine approach to depression involves identifying the root cause, like chronic stress or sleep deprivation. iStock/PeopleImages
While antidepressants can be life-saving for some people—and, if you’re currently taking antidepressants, you should not stop doing so without the guidance and support of your doctor—they’re not a good fit for everyone. For some people, they don’t alleviate depressive symptoms, and for others, they cause a new set of disruptive side effects. Other people don’t want to take antidepressants long-term or they can’t afford the financial investment to do so. Whatever your reason, there is a way to address the root cause of your depression directly, without long-term antidepressant usage: Functional Medicine.
The Functional Medicine approach to depression—and in fact, the Functional Medicine approach to any chronic condition—is to identify and address the root cause of the problem. That means treatment is focused on fixing the reason for your depression, whether that’s gut dysbiosis, chronic stress, infection, or another of the 10 possible causes I discuss below. Keep reading for more information on what could be causing your depression and how a Functional Medicine-based approach can help.
The Conventional Treatment for Depression: Antidepressants
Depression takes a heavy toll on physical health, day-to-day functionality, and relationships. It causes symptoms like: (3)
Profound feelings of sadness
Hopelessness
Fatigue
Feelings of guilt or worthlessness
A loss of interest in activities
Changes in sleep and appetite patterns
Irritability
Difficulty concentrating
Moving or talking more slowly than normal
Restlessness
Unexplained aches, pains, cramps, headaches, and even digestive problems
Thoughts of death or suicide
And while some people may experience just one depressive episode in their lives, multiple episodes are common. (4)
Antidepressants are the most common conventional treatment for depression. In fact, between 2011 and 2014, one in eight Americans aged 12 and up reported taking an antidepressant the previous month. (5)
Some research suggests that antidepressants are not as effective as they’re often claimed to be. Initial treatment may be effective at mitigating symptoms only around half the time, and antidepressants may not have any benefit over placebo for mild and moderate depression. (6, 7, 8, 9, 10) What’s more, these drugs can also cause side effects, like: (11)
Anxiety
Decreased libido
Nausea
Weight gain
Dry mouth
Constipation
Dizziness
Tiredness and/or insomnia
Sweating
I’m not here to say that antidepressants have no place in treating depression. That’s because, for some people, they are effective at alleviating their symptoms without causing worrying side effects. Put simply, they work for them. But unfortunately, that isn’t true for everyone, and even if they do relieve symptoms, antidepressants do nothing to address the underlying cause of depression.
For those of you who haven’t found relief in antidepressants, a Functional Medicine-based psychiatric approach may offer the help you’re looking for. And a key component to that approach? Identifying the root cause of your depression.
10 Root Causes of Depression
Most of us are familiar with the conventional explanation for depression: the chemical imbalance theory. This theory states that depression is caused by imbalanced neurotransmitters in the brain, and antidepressants are needed to manipulate the levels of those neurotransmitters—which should, in theory, correct the problem.
There’s quite a bit wrong with the chemical imbalance theory—namely, research indicates that only 25 percent of people with depression have low levels of neurotransmitters, and others have high levels of them. (12) It also fails to recognize the link we see between chronic inflammation and depression. This means if you’re not part of that comparatively small group of people experiencing a neurotransmitter imbalance, antidepressants won’t correct the problem. For that, you’ll need to address the real root cause of your depression.
1. Blood Sugar Dysregulation and Obesity
Insulin influences your central nervous system, impacts neuronal circuitry formation, and affects synaptic plasticity—meaning it plays an important role in your mental health. If your blood sugar is dysregulated and you’re experiencing insulin resistance, your brain will feel the effects along with the rest of your body, and anxiety and depression may result. (13, 14)
Obesity is closely tied with blood sugar dysregulation and depression. This connection is likely multifactorial and complex; but, as obesity is an inflammatory state, and we see evidence that people with obesity have higher levels of inflammatory signaling molecules called cytokines, it’s probable that inflammation plays a critical role in the obesity-depression connection. (15, 16)
2. Chronic Stress
Chronic stress can also have an inflammatory effect on your body. Your nervous system mediates inflammation and the body’s immune response; if something goes awry, depression, anxiety, and other mood imbalances can result. (17, 18, 19)
The relationship between your stress levels and your hypothalamus–pituitary–adrenal (HPA) axis is complex. In a healthy relationship, an acutely stressful event should spur your sympathetic nervous system into action, triggering the HPA to release stress hormones to help you respond to the stressor. After that event, your parasympathetic nervous system should take over, decreasing activity in your HPA axis and reducing stress hormone production. (20) However, if you’re experiencing chronic stress, your sympathetic nervous system and HPA axis can remain chronically activated, causing a host of health problems (depression included).
Your HPA axis also acts on your thyroid gland—any stress-related disruption in HPA axis function could lead to problems with your thyroid, which can also cause symptoms of depression.
3. Environmental Factors
Environmental toxins can also impact your mental health.Indoor mold exposure can trigger a complex inflammatory response that leads to several cognitive side effects, including depression. (21, 22) Mold exposure can trigger the release of inflammatory cytokines and impair neuronal plasticity (which can both lead to symptoms of depression). (23, 24, 25)
Air pollution is another toxin that can impact mental health (and your overall well-being and longevity). Ambient air pollution can lead to neuroinflammation, which increases the risk of depression. Those effects appear to be especially significant for people who encountered air pollution during the first 10 years of their lives. (26)
Some research also suggests that radiation produced by electromagnetic fields (EMFs) may also have a connection with depression. EMFs may contribute to depression by changing the activity of voltage-gated calcium channels in the brain. This can lead to a host of neuropsychiatric symptoms, like fatigue, headaches, insomnia, irritability, and a depressive mood. (27, 28)
4. Genetics
Certain genetic variants are potentially associated with depression:
The methylenetetrahydrofolate reductase (MTHFR) gene: Variants in the MTHFR gene are linked to depression (as well as anxiety, autism, and schizophrenia). (29)
The glutamic acid decarboxylase (GAD) gene: GAD variants may decrease the conversion of glutamate to gamma aminobutyric acid (GABA), which can result in major depressive disorder. (30)
I want to note here that our understanding of the genetic risks associated with depression is far from complete. If you have one of these variants, take that information with a grain of salt—consumer genetic testing has its own potential pitfalls, and your genes aren’t the only factor that influences your health. Often, the exposome (all of those external health determinants like your diet, lifestyle, and environment) is the primary driver behind your overall well-being.
5. Infection
Research suggests that several chronic infections are associated with depression, including:
The mechanism behind this connection could be described by the pathogen-host defense theory of depression (credit to the very forward-thinking Dr. Charles Raison for this theory). According to this idea, some of the behavioral symptoms of depression may actually be behavioral responses to infection, suggesting that human depression evolved out of sickness. (35, 36) Chronic infections are also associated with chronic inflammation, which is linked to symptoms of depression. (37)
6. Leaky Gut and Gut Dysbiosis
Your gut health impacts your mental health through the gut–brain axis. This axis transmits messages to and from the gut and the central nervous system via inflammatory mediators, gut microbial metabolites, stress hormones, neurotransmitters, and the vagus nerve. (38)
Intestinal barrier integrity and a balanced gut microbiome are two crucial components of a healthy gut—if these are disrupted, your gut health (and, potentially, your mental health) will be impacted.
Leaky gut is a condition where the intestinal barrier allows undesirable and incompatible substances from the gut to “leak” into the bloodstream. This includes endotoxins called lipopolysaccharides, which provoke the release of inflammatory cytokines after entering the bloodstream. (39) Robust research also shows that changes in the makeup of our gut microbiome are associated with major depressive disorder. (40) Factors shown to disrupt the intestinal barrier and gut microbiota may increase the risk of future mental illness. (41)
7. Loneliness, Trauma, and Social Determinants of Health
Our social support system plays an enormous role in our ability to maintain our health. That can include our network of friends, loved ones, and family, and it’s impacted by social determinants of health, like our race and socioeconomic status.
Social isolation is linked with greater incidences of depression (among other serious health conditions), while those who have a strong social support network tend to have better health and lower levels of inflammation. (42, 43) Loneliness is linked with a higher risk of death, even after controlling for factors like physical health, alcohol consumption, and smoking. (44)
Trauma can also be a trigger for depression. Experiencing trauma during childhood (including even childhood bullying) can strongly predict future risk of depression and other mental health disorders, possibly by altering the function of the HPA axis long-term and contributing to chronic, systemic inflammation. (45, 46, 47) Trauma experienced during adulthood can also cause depression; that can include things like:
Serving in the military
Involvement in a serious accident or natural disaster
The COVID-19 pandemic can also be defined as a traumatic event in and of itself, and experiencing things like the death of a loved one, job loss, and financial trouble can all certainly be traumatic. (48, 49)
Social determinants of health also have a major impact on our risk level when it comes to developing depression. These can include:
Access to healthy food
Local air and water quality
Education
Neighborhood
Socioeconomic status
Education
Race
Gender
It’s well worth discussing these determinants of health now, as we grapple publicly with social justice and racism. Health and social inequality are connected—in fact, research shows that experiencing racism or even anticipating racist encounters contributes to chronic stress and low-grade inflammation, both risk factors for depression. (50, 51, 52)
8. Sedentary Lifestyle
Regular exercise is linked to good mental health, but a sedentary lifestyle is associated with depression in people of all ages. (53, 54) As an interesting side note, while exercise initially produces inflammatory cytokines (which are associated with depression), an induction of anti-inflammatory substances quickly follows. (55) This is known as a hormetic effect, where an initial stressor creates a compensatory response in the body—and that has positive, long-term consequences for health. (56)
9. Sleep Deprivation and Artificial Light Exposure
As more and more of us spend most of our waking hours in front of a screen, our modern lives are becoming progressively more marked by increased exposure to artificial light. That has worrying effects on our sleep. Nighttime light exposure suppresses the production of melatonin and leads to increased sleeplessness, and is linked to an increased risk of depression, even after controlling for sleep quality and chronic health conditions. (57, 58, 59, 60)
10. Standard American Diet
Research shows that the consumption of ultra-processed foods is associated with depression—and the Standard American Diet is chock-full of them. (61, 62) The Standard American Diet harms the gut microbiome and can lead to leaky gut. (63) Nutritional deficiencies are also a concern with this diet.
Functional Medicine Treatment Options for Depression
Your diet and lifestyle habits impact every facet of your well-being, mental health included, so making adjustments in these areas is an important step if you are struggling with depression. As our understanding of the mechanisms behind depression grows, other potential treatments are coming to the forefront, as well, like bright light therapy, Eye Movement Desensitization and Reprocessing (EMDR), cognitive behavioral therapy, and even psychedelics. Building up your personal resilience can also help weather stressful situations in the future—and this is an especially useful tool for getting through the stress and uncertainty caused by the COVID-19 pandemic.
Change Your Diet
As I mentioned, a diet rich in ultra-processed foods is linked with depression; however, an anti-inflammatory, ancestral diet is associated with robust mental health. (64) An ancestral diet is also nutrient dense, making it a great option for ensuring that you get the nutrients that are beneficial for mental health, like:
An ancestral diet is also a gut-healthy diet. It’s rich in healthy fiber and free from foods that exacerbate gut conditions—and I recommend adding fermented foods for additional probiotic benefits.
Adopt Healthy Lifestyle Interventions
Picking up healthier habits can also help alleviate your depression. That could include:
Cognitive behavioral therapy is a form of talk therapy that is focused on changing patterns of thinking and behaviors that don’t support mental health. People who undergo this form of therapy learn new methods for coping, like: (75)
Facing their fears
Developing confidence
Learning to calm the mind
Using problem-solving skills to deal with tough situations
There are also several emerging treatments for depression available, like:
Bright light therapy: This involves daily exposure to a full-spectrum, 10,000 lux light, and has been shown to help relieve seasonal affective disorder and depression. (76)
EMDR: This form of therapy stimulates the two hemispheres of the brain, often through eye movements or specialized devices. Originally intended as a treatment for trauma, it’s been shown to be effective for recurrent depression. (77)
Psychedelics: When used in controlled, therapeutic environments, research suggests that people with depression may experience some benefit from psilocybin, LSD, or ketamine. (78, 79, 80)
Build Your Ability to Adapt in Any Circumstances
Cultivating more adaptability can be a powerful tool to use in dealing with depression. This is a crucial trait we all need to deal with uncertainty—and clearly, we need it now more than ever. We can each develop the internal and external resources needed for this, often described with the acronym “HERO.” (In positive psychology, this is known as “psychological capital.”) HERO stands for:
Adapted from Diabetes in Control Antibiotic Treatment increases risk for type one diabetes by Chardae Whitner May 15 2021
Both prenatal and first year of life antibiotic exposure may increase the risk for developing type one diabetes in childhood.
It is believed that early life risk factors which include antibiotic treatment can influence the risk of type one diabetes by affecting the gut microbiome. This affects the development of the immune system. Type one diabetes children have been found to have lower microbial diversity in their gut compared to children without diabetes. Antibiotic exposure in early life delays microbiota maturation.
Sweden has the highest rates of type one diabetes in the world despite a relatively low antibiotic prescription rate. They studied siblings, some affected by diabetes and some not. They looked at antibiotic prescriptions, mode of delivery, sex, birth year and genetic predisposition to type one diabetes. The children studied were born between 2005 and 2013. 797,318 children were studied.
Overall 800 prescriptions for antibiotics were issued in the first year of life. These were most commonly for ear infections, then respiratory tract infections, urinary tract infections, and then skin and soft tissue infections.
Exposure to antibiotics prenatally was associated with an increase in type one diabetes in childhood of 1.15 (so weakly associated). Antibiotic exposure in the first year of life raised this a little to 1.19. (still weak. You would need to have 1,475 babies have antibiotics to have one extra case of childhood diabetes before the age of ten).
Siblings of type ones have a risk of 1.36, so this is a stronger risk than antibiotic exposure.
Caesarian section did give an increased rate of type one diabetes in childhood but sex, genetic predisposition and birth year did not. The risk was 1.10 in vaginally delivered babies and 1.60 in the little caesars. So this was again a bit stronger than sibling risk.
Wernroth, Mona-Lisa et al. Early childhood antibiotic treatment for otitis media and other respiratory tract infections is associated with risk of type one diabetes. Diabetes Care May 2020.
My comment: My son Steven has type one diabetes and had a strong family history on his dad’s side of autoimmune disorders including type one diabetes in several generations. He also was a caesarian section delivery and also had a peri-orbital skin infection when he was about seven months old that required antibiotics. Poor wee soul! These days no one gets a caesarian section without a good reason and antibiotics are well thought out. There isn’t much you can do about being a sibling of someone with diabetes. What you can do is take vitamin D in pregnancy and give it to your children from birth onwards.
Diabetes Diet 