Nine times out of ten, after someone learns that you have diabetes, questions will be asked. Some are not pleasant and downright rude. Others are kinder and seek to understand more about this often misunderstood chronic illness. One question that can be interpreted as either rude or kind is this one:
“What can you eat?”
Here’s my simple answer:
It’s obviously more complicated than that, but as a person with Type 1 diabetes, there is not a food on this planet that I am not permitted to consume. (There are many that you couldn’t pay me to try.) It’s a common misconception that we must never allow a doughnut to touch our lips or eat anything sweet, perpetuated by misguided self-promoting diet gurus and the manufacturers of sugar-free candy. I believe those manufacturers secretly work to undermine the laxative industry. Don’t eat a lot of sugar-free candy in one sitting. Trust me on this.
Diabetic Exchange Diet
When I was diagnosed in 1983, it was the Diabetic Exchange Diet that was thrust upon us and one that was adhered to diligently until I went away to boarding school a year and a half later. It was based on a calculation of calories broken down into neat categories: Meat, Bread, Fat, Fruit, Vegetable, Milk, and Free. (To this day, I subconsciously think to myself as I drink a glass of milk: “I could have traded this for a Meat and a Bread.”) We weighed and measured meticulously and I injected the same amount of insulin every day. It’s still used by some people with diabetes, but I have never been a fan.
I hated it. That “diet plan” got chucked quickly to the curb when I was on my own at school making my own food choices. (Let’s just leave it at… I was in a rebellious phase.) My relationship with food has always been a rocky one, but I will tell you that now, it’s better. Thanks to carbohydrate counting and the ability to dose insulin based on my blood sugar levels and the number of carbs I ingest at a snack or meal, I eat what I want and when I want.
My life changed shortly before I began insulin pump therapy. (“So, insulin pump… tell me about your mother.”) I began to use a sliding scale when injecting multiple daily doses of insulin to keep my blood sugars in range. I sat with a dietician who rocked my world with the revelation that as long as you understand the carb count (and the intricacies of carb counting, which while simple in theory, is not in practice), you can accurately match your insulin intake to your carbohydrate intake. Once my insulin pump and I were joined at the hip (sometimes literally), eating was no longer looked upon as a choice between “eat what your diet plan says you can eat and feel good about yourself” versus “eat what you want and feel guilty”.
Before you go all willy nilly bellying up to the buffet bar, know that you still need to know how many calories you should be ingesting and other tidbits that a registered dietitian works magic with your food. Here’s an nifty article on carb counting from Joslin Diabetes Clinic.
Then, there’s the glycemic index. Hat tip to wikipedia, for defining it simply:
The glycemic index, or glycaemic index, (GI) provides a measure of how quickly blood sugar levels (i.e., levels of glucose in the blood) rise after eating a particular type of food. The effects that different foods have on blood sugar levels vary considerably.
Foods can be defined as low-, medium-, or high-GI. Low-GI foods will raise your blood glucose levels more slowly and steadily than high-GI. When you make food choices, the type of “GI” category can make a difference in insulin dosing and blood sugar excursions.
If you are interesting in learning more about the Glycemic Index and how to factor it in to your existing food choices, my first choice of website has always been this one by the University of Sydney. (There are a ton of books out there, but I can’t recommend one…) While not everything I ingest is low-GI, I do make small efforts – sourdough over white bread, brown rice over white, etc.
You Said That You Can Eat Everything. Explain That!
I can eat everything. If I want to have ice cream, I have some. I try to get the carb count and dose appropriately and enjoy a little bit. I do not eat two pints of Ben & Jerry’s Red Velvet Cake in one sitting. Cheesecake? Sure. A small slice, not the whole round. Chocolate must be the good “high end” stuff and not sugar-free. (Again. They are laxatives in disguise and they taste just as appetizing as Ex-Lax.)
Everything in moderation is the motto I try to live by when it comes to food. I know that some foods will send my blood glucose on a five-ticket roller coaster ride for hours, but I still eat them occasionally. Why? Because I can. (Does that sound like a cranky toddler? Probably, but I’m an adult and I still hate being told what I can and can’t do.)
I avoid daily consumptions of foods that I know will not help me in the long run. I prefer chicken to huge hunks of fatty meat (bacon is in another category…) and yogurt and I love each other very much. Do I indulge in a juicy steak on occasion? Yep. But like I said, everything in moderation. Peanut butter cups and crème brûlée every day isn’t healthy for anyone.
To Each His Own
I’m one person with diabetes. I have met individuals who are happy following a food plan to the letter. I have met individuals who live with celiac disease and deal with extra restrictions but still enjoy food choices.
So, as you are sitting down to eat a cupcake to celebrate something important (Like, “It’s Tuesday!”), after checking your blood glucose and dosing appropriately, and someone asks you: “Can you eat that?”, smile and say:
“I am person with diabetes. I can eat anything.”
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The DAM series is part of Diabetes Awareness Month, because despite what you think you know, you don’t know everything. Neither do I. Let’s learn together.