DAM: Diabetes & What Can You Eat?

1253971_48155847Nine 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:

“Anything.”

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.

Carbohydrate Counting

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. 

Glycemic Index

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.”

 

Are you following me on Twitter?

I’m hilarious.

@ThePerfectDblog

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. 

 

0 comments

  1. fifteenwaitfifteen

    Of course I can’t find it now, but there was an eCard thingy going around the other day that went something like: Things a diabetic can’t eat – 1. Poison. 2. Poisoned cookies. That made me giggle.

  2. RogueGirl

    And the joys of dumb and dumber questions are not mutually exclusive to T1D. I don’t wish they were. I just wish the questions weren’t asked at all.

    Great read as always!

    • theperfectd

      Thanks!
      It frustrates me to no end that the general public doesn’t often distinguish between T1 and T2, but when it does, the assumption is that T2s somehow brought it upon themselves.
      I love the DOC and the T1, T2, and T3 perspectives. I’ve learned so much from my T2 compatriots, especially about the discrimination they endure.

  3. StephenS

    My diagnosis was nine years after yours, but my experience with the Exchange diet and carb counting happened the same way it did for you. Before carb counting, I always wondered why I could eat different things, but I had to inject the same amount of insulin every day (sorry… digression, like all things, is good in moderation). Anyway, I’m loving this series of posts. Thanks

  4. Patricia Schroeder

    Very interesting info from someone on the front lines. There is something I don’t understand though. I am a 73-year-old T2 and maintain great control (A1c in the 5% range). I eat a lot (no weight issues) but I am very very strict about carbs. I read carb counts but in practice I let finger pricks tell me what I can have. I try to maintain glusocse readings no higher than 120 after meals (except for some occasional cheating, of course!). Therefore, it is a surprise to me to see menus in respected diabetes journals that include potatoes, bread, pasta, rice, etc. Those menus would skyrocket my blood sugar well over the 250 range. Is it because they are assuming their readers are using insulin or oral meds and can therefore tolerate the carbs? Any insight would be appreciated.

    • theperfectd

      As I’m not a medical professional, I can only give my opinion…. Perhaps. Those who are on a fast-acting insulin regardless of “Type” do have a little more flexibility in choosing carbs. I also question portion sizes in many recipes and glycemic loads. There is also a fiber factor that can play into how quickly blood sugars can rise. I’m with you on some of the food choices that are touted as acceptable by T2s not on medications…

  5. Julie

    I love this! And, as you say, you are hilarious! I was only diagnosed 7 years ago (while I was pregnant and was started on MDI immediately) but I remember the (I’m sure well intentioned) dietician suggesting that I eat only canned fruit (because it was already portioned for me) and hot dogs for snacks because they didn’t have carbs. Huh?! You mean I’m pregnant and you want me to eat *less healthily than I already do? Plus, at the time I hadn’t eaten meat in about 14 years. Within a week, I had researched enough to buy a nutritional scale and within 9 months, I was on the pump of my choice. Thank goodness for the Internet! I love being a member of the eat-what-you-want camp 😉

  6. Gaz

    In the UK there is a course called DAFNE or Dose Adjustment for Normal Eating is an educational course for managing type 1 diabetes,Its normally done group of eight of all ages and years of having diabetes and two main teachers are a diabetic specialist nurse and a dietician,Its a comprehensive five day course looking into all aspects of dose adjustment,Carb counting and you do things like sick days ETC,I found it comprehensive and worthwhile

  7. Katie

    I so thoroughly enjoy your blog and I’m loving these posts, such wonderful insights! Thanks from a momma of a sweet 5 year old T1 🙂

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