Diabetes
Fri., July 26, 09:32 AM
Diabetes
This is especially for Tattodnanny, who is so very upset by her recent diagnosis. However, it may be of interest to anyone adjusting to this new way of life, so I’ll post it instead of just writing a letter. It’s a mixed bag, a few things I’ve picked up over the last few years.
When I was diagnosed four years ago, I wasn’t the least bit surprised. As a little girl, I watched my dad give his mother an insulin injection every morning before he went to work. He developed diabetes himself at the age of forty-eight, and he took pills for it. Medical advances and better health care notwithstanding, I developed it too. And despite the fact that I wasn’t surprised that I had it, I had just as hard a time adjusting to it. Taking medication was only part of it.
No one ever mentions that the rules change. Foods that were supposed to be good for you are suddenly taboo. I was dieting during Passover, a wonderful time to fill up on no-fat foods like matzo and dried fruit. My sugar was over 400 when I went in for a routine blood test. The first thing they told me was “stop dieting.” My aunt, a registered nurse who is very big on staying slim, absolutely cannot understand that; she is so sure that losing weight is the answer to everything. (Other side of the family – what does she know about living with diabetes?)
Nevertheless, the first thing you have to learn is to eat less. There’s no way around that; some foods you will never eat again. (I have decided that doughnuts don’t exist.) And you have to learn just how certain foods will affect you, and there is no way to do that except to keep testing – even though you feel obsessive because you have to keep pricking yourself so you can check your blood sugar. There are shocks and revelations, both good and bad.
I’ve always been suspicious of extreme regimens like the Atkins diet, but the fact is that Atkins – or modified Atkins – is appropriate for diabetics because it’s low carb. Carbohydrates are metabolized into sugars, and sugar is sugar whether it’s natural or refined and will affect you the same way. (Honey is sugar too.) You can allow yourself just a little bread, potatoes, rice, or pasta, usually under special conditions. Fruit juices hit hard (orange juice actually makes me ill), but you can eat fruit occasionally, because you eat it slower and because absorption is slowed down by the fiber mixed with it. We have been eating berries this summer, slightly sweetened with Equal and mixed with sour cream.
That’s one of the goodies – fats slow down the sugar a lot. Obviously you’re not going to eat a lot of fats since you don’t want to put on weight. But I can enjoy butter – and lots of seeds – rather than jelly on my sorry half bagel. A handful of olives is a helluva lot more satisfying than mashed potatoes. Just a tablespoon of real salad dressing on vegetables – raw or cooked – not only makes them taste good, you metabolize them better. (Some veggies are high in sugar; go easy on the onions, though they really do improve the flavor.)
Oatmeal is probably good for you, but I never checked it out because I’ve hated it since I was a kid. The only kind of cereal I’d been using was crushed corn flakes, as a coating on baked chicken. I’ve given it up. Corn seems to work better for me than wheat, and Kettle Corn microwave popcorn, sweetened without sugar, provides a lot of satisfaction for 16 mg. of carbs.
Fortunately, I never cared much for white bread (and that includes things like hot dog buns). Rye bread works better for me, though I usually eat only one slice at a time. Sandwiches are made with one slice cut in two. Every whole grain bread has to be evaluated by itself, since many of the best ones have sugar or honey added. For everything I eat, I try to decide whether I can do it without bread. A tablespoon of ketchup and a splash of Worcestershire sauce season a burger on a plate, eaten with fork and knife. A portion of egg salad spooned into a quarter of green pepper.
Rice was a real disappointment. I discovered that chili with beans went down well, but the same bowlful containing rice with the chili and beans sent the numbers up. They say you can eat brown rice, but I haven’t tested it out yet. It’s such a pain to cook if it’s only for one person. I really miss my pastas, with meat sauce or cold in salads. But on occasion I have eaten spaghetti with no ill effects; I don’t know whether it was the type of flour (durum semolina, I’ve heard) or the sauce I ate with it.
Exercise is vital, but sometimes you have to improvise. In the best of all worlds, you eat your bigger meals early in the day, and you exercise after you eat. In reality, you do what you can. It’s very hard to eat light while you’re fixing a big dinner for your family, particularly if that’s the only time you really spend together. People who work outside their homes while also running those same households don’t necessarily have the time (or the wherewithal) to spend at a gym.
Consider, however, that walking through a supermarket – which you have to do anyhow – can be a decent workout. Ditto on housework; making beds uses your upper body as well as your legs. How much walking do you do? I hate exercise as much as most of us, but I have always liked to walk. How about parking your car at the far end of the parking lot and walking the distance to the store? I started that years ago, to protect my car from sloppy drivers trying to crowd in. While we don’t all have new cars, it might be a consideration.
In managing diabetes, you have a choice: you can eat and do everything according to what a dietician or doctor tells you, or you can learn how it all works and make the decisions that work for you. Once you’ve gotten some idea of what you can and can’t eat – and only you will know what’s right for you – you can start to experiment. There’s no reason why you have to eat the same stuff all the time. I can manage a couple of slices of pizza, or a big bowl of hot and sour seafood soup. Diet Coke becomes the default when you’re eating out, because every place has it and you don’t have to ask what’s in it. (Why don’t more places have unsweetened iced tea?) But at home you can experiment with sugarless sodas and other flavorings.
Finally, because diabetes has been recognized for such a long time, there are products on the market that can help. Equal, Sweet & Low, Sugar Twin, Splenda – even though none of these tastes like real sugar, you can find one that you’ll become accustomed to, and then sugar will taste funny. There are sugar-free candies and cookies that can ease withdrawal symptoms. There are ice creams made without sugar, but I’ve been happier with ordinary ice cream. The best one for me is Stop & Shop’s coffee ice cream – without sugar-laden goodies. (You know my motto: There's nothing wrong with me that a little ice cream can't fix.) Gymnema sylvestre, an herb used to treat diabetes in underdeveloped countries, is sold in the U.S. as a “sugar blocker.” According to my doctor, it can be used even if you’re taking prescription meds. I use it when I eat out, for example, or before drinking juice. It does make a difference.
You must take charge, because you have a place in the world and things to do. I’m telling you, you can do it!
