Always a Bright Spot: Catching Up With diaTribe's Adam Brown

Since 2013, Adam Brown has penned the popular column on diaTribe.org for people living with living with diabetes, Adam’s Corner, which draws on what he’s learned since being diagnosed with type 1 diabetes (T1D) in 2001.

At 28, Brown is already a sought-after expert in diabetes advocacy circles, serving as the Senior Editor at diaTribe and a voice for patients before FDA, at the National Institutes of Health, and other venues. In May, Brown’s work reached another level with the arrival of his book, Bright Spots and Landmines: The Diabetes Guide I Wish Someone Had Handed Me.

In an interview last week with The American Journal of Managed Care^®, Brown discussed what inspired him to write the book. “People are starving for the ‘how to’ of diabetes, but there was no one guide I could hand someone—either to people who were newly diagnosed or someone who’d had diabetes for a long time—that I could say, ‘here’s my tool kit for living with diabetes.’ This book compiles that into one single guide.”

Published by The diaTribe Foundation, Bright Spots is much like its author: serious about diabetes but full of good cheer. Brown fills a room with energy, but he’s honest about how living with diabetes can be a grind, and his book strikes the same tone. It’s colorful, and it’s actionable. Brown takes care to say, “This works for me,” while noting that not every solution works for every person. The book has something for people with T1D, type 2 diabetes, or prediabetes.

Each chapter starts with short summaries of things to do and things to avoid (the “bright spots” and “landmines”), and then continues with highly specific advice. Its 4 chapters, Food, Mindset, Exercise, and Sleep, and the epilogue, Tying It All Together, offer takeaways for the person newly diagnosed or someone who has lived with the disease for years. “I felt like those were areas that were awesome to focus on, because they apply to someone who is on insulin, or someone who has prediabetes,” Brown said.

The book also gives hard-to-find advice for supporting people who have diabetes without stepping over the line, so it’s no surprise that Brown has heard from mothers with newly diagnosed sons and even a man who was diagnosed with diabetes in 1945. “He read the book and said, ‘It validates my experience. This is exactly what I would tell someone,’” Brown said. “It’s really gratifying.”

Bright Spots promotes a low-carb lifestyle, but Brown is all for taking it slow, which reflects current science. Start with cutting carbs at breakfast, he advises. “Build incrementally and do not attempt to huge leaps of change,” he writes. “Try adding or subtracting one or two things before moving on to more.”

Brown includes full-color photos of his favorite foods and spells out actual portions, along with cooking methods. He’s a fan of swapping berries for sugary desserts, goes for burgers without the bun, and snacks on plenty of nuts and sunflower seeds. If you’ve never heard of chia seed pudding for breakfast, you’ll learn about it here.

The chapter on exercise comes after the chapter on mindset for a reason: it’s as much about the mentality of developing good habits as exercise itself. He eschews the all-or-nothing mentality for fitting in walks, especially after meals to correct a high blood glucose level. He offers details on where blood glucose targets should be before and after exercise to avoid lows, as well as suggestions for at-home exercising and apps to save money.

But the breakthrough is Brown’s writing on the importance of sleep, which he correctly calls “a highly underrated diabetes tool.” Understanding of the links between sleep and diabetes and obesity has soared in the past decade; just this week, the Nobel Prize in Medicine went to 3 scientists who isolated the genes that regulate circadian rhythm and led to our modern understanding of these connections.

Brown writes that when he sleeps well, he needs less insulin, he has more energy, and most of all, he makes better decisions. The key to good sleep is managing food intake leading up to bedtime, and he also discusses the advantages of the hybrid closed loop, or “artificial pancreas” technology to help people with T1D wake up with their blood glucose in range. When it comes to the right blanket or pillow, “Do not settle,” he writes.

And to think Brown almost cut out the chapter on sleep. “I’m so glad that I didn’t, because this is the one that surprises people the most. Sleep is such a force multiplier for everything in life: lack of sleep directly impacts blood sugars; it makes them higher, it impacts hormone levels, but it also makes my decision-making far worse, which also makes diabetes worse the next day.”

“So, the chapter is partly about the managing blood sugar piece of sleep, but also how to get better sleep, and some of the tips and tricks for doing that,” he said.

At the end of each chapter are questions that push the reader to probe his or her own bright spots and landmines; these are especially helpful in the chapter on mindset, where Brown asks about stressors that limit good decision-making. How, he asks, can these factors be changed?

What’s next? Both Brown and the diaTribe Foundation are getting the book out through multiple channels—the paper copy of the book is available on Amazon, or readers can download for from the diaTribe website with a “name your price” function. “Getting [the book] into more people’s hands is the thing I’m super-focused on,” he said.