Wil Dubois

Happy Saturday, and welcome back to our weekly advice column, Ask D’Mine, hosted by veteran type 1, diabetes author and educator Wil Dubois.

This week, Wil responds to two quite opposite questions -- one on those packaged diets that purport to help you slim down and control sugars, and one on the difficulties we chronically ill folk face in seeking life insurance.

{Got your own questions? Email us at AskDMine@diabetesmine.com}


Ask-DMine_buttonAnonymous type 1 writes: Please let me know your thoughts about the Medifast Diet for a type 1 diabetic. The 5&1 plan has calories controlled to around 1,000 a day and the carb intake per day is limited to approximately 100 grams. Do you think it possible for a type 1 diabetic to lose weight taking in that much carb per day? Any guidance is much appreciated.

Wil@Ask D’Mine answers: Medifast’s 5&1 Plan consists of five pre-packaged ready-to-eat small meals that you purchase, to which you add one “Lean and Green” meal of your own (shopping list included). I don’t know if their food tastes any good, but they sure can write good ad copy!

The prepared foods are largely a mix of bars, cereals, cookies, soups, and shakes. Oh. And macaroni & cheese. I spot-checked the carb counts of the “fives” and found they ranged from 11 carbs for the chicken noodle soup to 22 carbs for the Carmel Nut Maintenance Bar.

Hey, wait. What about the Mac & Cheese?

Fifteen carbs. You know, it’s hard for me to imagine an edible and sustaining serving of Mac & Cheese that’s only 15 carbs when a typical serving of pasta clocks in at 35-45 carbs. But still, I’ve not tried it, so for all I know, it might be the best thing since pecan pie. Which doesn’t qualify as a Lean and Green meal, btw.

The 5&1 starter kit runs $375, without the optional Sea Salt Popcorn ($7.95 for seven servings). That’s for a month’s Medifast 5&1worth of food. Whipping out my Staples calculator, you’re only looking at $12.50 a day—the cost of many common meals, much less a day’s worth of meals—so it’s really not that expensive. In fact, I’d bet most people would save money on it.

Medifast claims you can lose two to five pounds a week in the first two weeks, and one to two pounds a week thereafter. Their success stories on the web show allegedly real people claiming weight loss ranging from 49 pounds to 132 pounds, with a tiny little disclaimer that reads: "Results vary."

That disclaimer comes from the fact that, while diet results vary, this very diet caused Medifast’s bank account to lose substantial weight. In 2012 they ended up paying a $3.7 million-dollar Federal Trade Commission penalty for false advertising -- as they originally claimed results were typical, and that consumers would surely lose more than 30 pounds on their program.

But of course none of that really answers your question, which was can you lose weight eating 100 carbs per day, and the answer is: Absolutely. To maintain weight, ladies should cap carbs at something in the neighborhood of 50 carbs per meal, while guys can get away with 60. Those numbers are based on the more typical three meals a day, so to hold weight, women should consume 150 carbs daily and men 180. Any less, and you are likely to lose weight, so 100 carbs per day should be solidly in good weight loss territory. Medifast or other fast.

As to how good the 5 &1 diet would be for type 1s, assuming the food is edible, it should actually be quite good for your diabetes. As the carbs are broken across six meals, each is a bit over 16 carbs on average, needing only a single unit of insulin for most type 1s to cover. I suspect such small meals, if you can work that many meals a day, could actually result in a very impressive glucose response with few so-called "excursions" (spikes after meals).

Although I doubt it’s sustainable for most people in the real world, in a perfect world, swarms of small low-carb meals would be ideal for type 1s needing to lose weight and control blood sugar at the same time.

It sounds like the 5 & 1 *could* be a double winner.


Eric, type 1 in California, writes: I’ve been a diabetic since I was 2 (32 years). My wife and I tried to get life insurance last week. She was approved and I was not, and their reason was because I had diabetes. Do you know if it’s possible to get life insurance or is the company just discriminating? 

Life Insurance for diabetesWil@Ask D’Mine answers: Of course the company was discriminating, but it may very well be legal for them to do so. They can also (legally) discriminate against people with HIV/AIDS and smokers.

This is because, unlike health insurance under “Obamacare” where there’s now a federal mandate that prohibits insurance companies from refusing to cover us, life insurance is still regulated at the state level. This means coverage for people with diabetes varies a lot from state to state. It’s sufficiently confusing that the American Diabetes Association threw up its hands and recommends contacting your state’s insurance department directly; while the JDRF understatedly says, “People with T1D may encounter difficulties obtaining life insurance.”

Ya think?

That said, yes, it is generally possible for T1Ds to get life insurance, but it’s complex and time-consuming. And if you can find it in your state, expect to pay more. You may also be required to take a medical exam or show documents proving you have had your diabetes in control for some period of time, generally six months or a year.

A search of the internet actually turns up quite a few groups eager to sell us insurance, but how on earth you’d know if you were buying a real policy or paper snake oil, I can’t say. Of course, you can reach out to other T1s in forums and see what they are sharing. But again, the problem is that you won’t really know whether your life insurance is any good or not until you die.

Now, as you and your wife were looking to buy on your own, I can only assume that neither of you works for an employer that provides a life insurance option. That’s a pity, as getting in on these types of group plans is always easier. (In fact, back in the day, many T1s were literal wage slaves, staying at companies that would give them health insurance just to stay alive.)

Still, I think you should start by talking to a good Human Resources person. If you and your wife are both self-employed or working for small companies, look to your circle of friends and family for someone who works for a bigger player and see if you can meet with that person’s HR department for advice. 

They’ll know the local laws, and they’ll know who the real players are, and who the snake oil salesmen are. That way you don’t have to wait until you die to find out if your life insurance is any good :(


Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.