"The human race can be divided into two groups: those who produce their own insulin, and those who don't."

This is a time of year when we wallow in contrasts. On Yom Kippur, we learn that it is sealed: who shall live, and who shall die; who shall be healthy, and who shall ail; who shall die by fire, and who by water... On Sukkot — which festival we are currently celebrating, we learn that there is "a time to be born, and a time to die; a time to plant, and a time to reap... a time to break down, and a time to build up... a time to cast away stones, and a time to gather stones together". [If this reminds you of The Byrds' "Turn! Turn! Turn!", it should: the lyrics are taken from Ecclesiastes 3:1–8.]

To those of us living "on the front lines" of diabetes, my initial paraphrase of an old Creative Writing exercise is anything but true. As Bennet says, "Your Diabetes May Vary". 

There are those of us who produce our own insulin, but in insufficient amounts to handle our needs.

There are those of us who produce our own insulin, but it is malformed and (to greater or lesser degree) ineffective.

There are those of us who produce our own insulin, but our cell walls are malformed and won't accept the insulin we produce.

There are those of us who produce our own insulin, in sufficient quantities, but our livers overcompensate and release hormones to upregulate what our bodies consider "normal" glucose levels.

There are those of us who produce our own insulin, in sufficient amounts, but our fat cells release chemicals that tell the rest of our bodies to reject it.

And there are those of us who produce our own insulin, but whose bodies are actively working to destroy the beta cells which produce that insulin.

The first four of these are specific varieties of what we call "type 2" diabetes; the last describes both type 1 and LADA in their "honeymoon" periods, where there is still residual (but diminishing) insulin production.

The first three descriptions may also describe certain versions of MODY, which are forms of diabetes caused by known variations in a single gene. (Most type 1, type 2, and LADA diabetes are caused by variations in several genes, with one or more possible environmental triggers.)

Depending on which variants of which genes are present — and we don't yet know the details — each of us reacts to common foods in different ways:

There are those of us who enjoy oatmeal for breakfast, and there are those of us who will spike the rest of the day if we even look at it, there are those of us who will plummet, and there are those of us who are allergic to oats. And while some of us cannot eat oatmeal for breakfast, we may be able to handle it as an afternoon "low treatment".

There are those of us who eat fruit, and there are those of us for whom it spikes us; there are those for whom fruits cause a quick high and a fast plummet, and there are those of us whose ability to eat fruit depends on the specific fruit and the quantity consumed at one sitting.

There are those of us who can eat whole-grains, and there are those of us who cannot eat any grains.

There are those of us who can drink milk and eat yogurt, and there are those of us who will spike from either; there are those of us who are lactose intolerant, and there are those of us who cannot handle dairy proteins or dairy fats.

There are those of us who praise Atkins, and there are those of us for whom it leads to unsatisfactory cholesterol readings

There are those of us who have "safe" foods which may moderate highs or lows, and there are those of us who don't

There are those of us for whom glycemic response varies linearly with serving size, and there are those of us who have tolerance thresholds, beyond which our reaction to a particular food becomes nonlinear, our glucose levels rising much faster than our consumption 

With so many variables, it's no surprise that finding a "diabetes diet" that works for you can take time, detailed logging, and obsessive tracking. And it's no surprise that with so much going on around the time of diagnosis, people may not have the initiative or the time to start this process. Without that initiative, it has to be a challenge for even the most dedicated Certified Diabetes Educator and Registered Dietician (CDE/RD) to prescribe an appropriate diet.