Sunday, November 8, 2015

People with type 2 diabetes can eat anything in moderation, or can they?

This subject, when discussed, can quickly turn into a heated argument. Many people with type 2 diabetes can currently control their blood glucose by adjusting their diet and adding exercise. Others do that and also take oral medications. Still others are using injected insulin to help control their blood glucose. Nearly all of the advice you can find online (or from a physician’s office) tells patients that they can continue to eat pretty much whatever they want, with some adjustments like whole grains vs white foods, etc. Moderation is the key. Well, as someone who can’t eat just anything she wants, I often take issue with this advice. I feel it leads patients to think that they’re ok if they just moderate and they often don’t test before and after a meal or snack to see what’s really going on inside their bodies.

Today, I did something incredibly stupid. Instead of just being mad at myself, I decided to use a bunch of test strips and do an experiment. I had a theory and I wanted to test that theory. You know… science stuff.

So what stupid thing did I do? Let me tell you.

I went to the grocery store at about 10 AM in the hopes of beating the crowd. I hadn’t eaten a thing (which, lately, isn’t all that unusual. I know, don’t judge me.) I had taken my meds with my daily concoction of psyllium husk (fiber) and warm water (homemade Metamucil without all the junk they add). I wasn’t hungry and my shopping list consisted of good things like veggies and stuff.  I needed to buy a loaf of bread for my mom so I found myself near the bakery and goodies. No worries, I had self-control. And then I saw it: a Hostess Lemon Pie. They never have lemon but today they did. Before you go “ewwww, why would you want that?” I need to explain that I am a whore for lemon. Lemon pie, lemon loaf from Starbucks, lemon cookies, lemon E V E R Y T H I N G!!!!! I used to eat these horrid things and I had a wave of nostalgia come over me. “Surely, one wouldn’t hurt me! ‘They’ say I can eat anything in moderation!” (Even though I know better.) I bought it. I inhaled it in the car. It was horrible. As I’m licking the disgusting sugar glaze off my fingers I realized what I had done and was ashamed. I felt like a drug addict in a back alley shooting up my Precious. Gawd, what an idiot.

After I got home with the groceries (and Ray helped me put them away. He’s a gem) I decided to check my blood glucose to see what damage I had done. It had been about 20 minutes since I had gorged. 124. What? I had started out with a 130 fasting reading. This can’t be right! Instead of gloating and thinking I had gotten away with something, I decided to continue to check at one hour intervals. Here are the results:

1 hour:  193
2 hours: 243 (began consuming mass quantities of water.)
3 hours: 201 (it’s coming down!!)
4 hours: 157 (I have a stomach ache.)
5 hours: 108 (YAY! Still have a stomach ache but I will eat dinner.)

I decided to stop checking after 5 hours, mostly because I saw such a great number on my meter. I had eaten nothing else all day other than a couple of spoon licks and cups of green tea. Someone out there is thinking, “Well your liver probably dumped because you didn’t eat, moron.” I beg to differ. Although I’m not a doctor or scientist I’m pretty sure my liver would realize that I was already dealing with way too much glucose in my system. Maybe not, but it really doesn’t matter. There is no way I felt like eating anything. Stomach ache, fuzzy head, guilt, remorse and I wanted to see what would happen.

So my theory was that the horrible, no-good, very bad thing I ate would eff up my blood sugar for hours and hours. My testing shows that my theory was pretty darned accurate. So why in the world am I confessing this STOOPID mistake to you? To educate.

When someone has diabetes and they don’t use insulin to control their blood glucose, they can’t necessarily eat whatever they want if they desire a longer and healthier life. One of the problems with type 2 is that we don’t always see immediate ramifications for our actions like our type 1 friends do. If we splurge or continue to eat in an unhealthy way, we don’t go into DKA or throw up or any of those other unpleasant results. We don’t realize that high blood glucose is coursing through our arteries, toasting our kidneys and eyes; ruining our nerves, unless we check. Unless we use our meters to learn what different foods do to our blood glucose. We can’t/shouldn’t wait 3 months to see what our A1c shows. It won’t show this awful high I had today because I will attempt to get back on track tomorrow and my lower readings will negate this high.

I was an idiot: a very human idiot who just impulsively ate something she shouldn’t. Will I eat a Hostess Lemon Pie again? HELL NO! (it was truly horrid) Will I ever eat something I “shouldn’t”? You bet I will. Will I do it all the time? Nope. I care enough about my future to attempt to control what I eat and whip the beast called diabetes into submission to the best of my ability.

I’m pleading with you now. Please, please, please think about what you’re eating on a daily basis and make adjustments as you can in order to try to control your blood glucose. I don’t care if you eat low carb, high fat, low fat, Vegan, vegetarian, Paleo or cinnamon-okra water. Just pay attention. Use your meter. Care enough about yourself to pay attention and learn. I was an idiot and, because of that, maybe you won’t be.

19 comments:

  1. I have a few weaknesses - Snickers, Nutty Bars, brownies, homemade chocolate chip cookies... Even if I know I will be ok with small quantities, it's often difficult once those goodies hit my lips. I mean, who can eat just one chocolate chip cookie? And don't you need milk with it? What you say is very true. Even a once in a while treat can cause my numbers to go crazy.

    ReplyDelete
    Replies
    1. I know that moderation can work for awhile, I just think it's important to think about the ramifications of our choices. (and your weaknesses are mine as well! Those, and potato chips. :)

      Delete
  2. Kate, I'm with you on the lemon stuff. Extra SF gum used to make a lemon square flavor, but you can't find them in stores anymore. If you're interested, see if you can find some online: Amazon says not available.
    http://www.amazon.com/Wrigleys-Extra-Dessert-Delights-Square/dp/B00AKOGPXC. Maybe some backwoods Mom and Pop store has some squirreled away.

    ReplyDelete
  3. Insulin does help but in general I can't match the action of the insulin to fast-acting carbs like Hostess Lemon pies. I would very likely have a similar BG profile to what you shared except that I would probably end up with a low of 50 when the insulin finally decided to work. How come carbs taste so darn good?!? Very good post, Kate.

    ReplyDelete
    Replies
    1. Sometimes I can almost feel the sugar working its way into the pleasure centers of my brain. Totally unfair! I agree that it's equally important that all PWD think about how foods affect their blood glucose.

      Delete
  4. Great post, Kate! Eating that lemon pie was not stupid. You are human and you are not perfect (none of us are). The fact that you don't eat them every day shows you care about your health. And I agree that there isn't one diet that works for all people with T2. -- Nikki Thomason

    ReplyDelete
  5. http://akaralnik.trustpass.alibaba.com/product/166606521-0/Wrigleys_Extra_Dessert_Delights_Lemon_Square.html

    This place says they have it in 40-foot containers . . . Maybe too much for even you.

    ReplyDelete
  6. I can oh so see myself in your post. Especially the guilt afterwards. I do have a question about testing though. I read recently that in order to see when you peak after a meal, you should start testing 15 minutes after the first bite and every 15 minutes until you see a decrease. This seems like a lot of testing, especially when I know I won't peak even as early as 30 minutes after a meal. Probably more likely 1 or 2 hours after the first bite. What is your experience?

    ReplyDelete
    Replies
    1. Really good question! I would agree that every 15 minutes seems excessive and not likely to give you any good feedback. The problem is that your peak may vary based on what you've eaten so you can't just do it once and know how it will always be. In my past I did do some testing but I did a comparison between 90 minutes and 2 hours. 2 hours is usually the recommended time but I found that I peak at 90 minutes more often (unless I'm eating Hostess Lemon Pies. :/). So, to answer your question as a completely non-medical person who has had some experience: You might try testing at 90 minutes and again at 2 hours after a few meals. Then decide which time works best for you. In all reality, if you're not using insulin it isn't a huge deal but it is important to know. Why? Because if you want to test to see how a certain meal or food affects you, it's good to know if you're likely looking at the peak or not. Lengthy answer, hope it helps. (and thank you so much for reading!)

      Delete
  7. Look at it this way. By spiking your BG with the lemon pie, you juiced your metabolism for additional fat loss. More T4 will be converted to the more metabolically active T3. You also temporarily increased your serum lepton levels.

    You basically did a mini carbs cycling to boost your metabolism to facilitate better future fat loss.

    ReplyDelete
    Replies
    1. I have no idea what any of that means but I don't need any encouragement to eat crap food. I'm sure there is a better way to accomplish said "carb cycling". I'd rather stick to attempting to eat whole, real food and stay away from unhealthy processed stuff. But thanks for trying to put a positive spin on my train wreck!

      Delete
  8. Super words of advice. And I'm a sucker for the peach pie, which I never see anymore. It's all probably for the best.

    ReplyDelete
  9. (I don't know if this made it to the server, so here it is again, Kate. You can delete either one if you get both.)

    Kate, do you know anyone doing research in that area (why your sugar drops when you eat carbs, or why a type 2 should cut ALL carbs, even whole wheat)? (I've been doing what you did - being my own guinea pig - for about a year now.)

    I've developed a theory that may make living with type 2 as easy as living with Celiac's or lactose intolerance - we're eating wrong. (I've been off ALL diabetes meds for 6 months, hover around 90 no matter what I eat (my daily limit is about 20-30 gms of carbs of any kind, lots of protein and enough fat. If once in a great while (my birthday in June, Thanksgiving, etc.) I go off that and eat carbs, my fasting sugar the next day is lower than normal. (And the "eat 6 small meals a day" thing is, according to my theory, at least backwards, if not slow suicide. I eat one meal every other day - it's huge, but there's very little carb. It starts with about 2 pounds of Iceberg lettuce. [Try eating that and being hungry for 24 hours - it won't happen - and there's about 32 gms of carbs and about 3 people full of filling up.])

    But I don't have a PhD after my name, so only my endocrinologist agrees with my diet, and she's not a researcher or well known. She's discharged me because "I'm not a diabetic". Oh, I am - that's determined genetically. If you're totally lactose intolerant and never ingest lactose, you're not suddenly not lactose intolerant, you just don't eat what your body can't handle.

    Type 2 diabetics can't handle carbs. They get turned into fat. If there's more ingested than can be handled that way quickly, blood sugar goes up. Simple solution - don't eat carbs, and you can eat anything you want. Greasy hamburger? Great for a type 2. Hot dog (as long as you can tolerate the nitrates, salt and other garbage)? Also great. Just no rolls or buns, unless they're non-carb (like made with bacon or something). Bacon's also good, it's just your whole daily intake of sodium (assuming your kidney function is still near 100%) in a few delicious bites.

    But if someone who's doing the research wants to listen to what may sound like "I was abducted by aliens" for 5 minutes, maybe we can make life easier for a lot of people. I love eating, and I still eat, and occasionally have a high-carb food, and my sugars always good and I'm losing weight every week.

    I don't want to tell anyone else to try it (like you don't want to tell people to start eating lemon pies (no worries here - that's about the ONLY flavor I can't stand), but if someone who actually knows something (I never even took chem or bio in school - I went the engineering route) works on it and thinks it has merit, we may be onto something that will make people think we're real human beings. (Secret - we're not AND THAT'S THE PROBLEM. Doctors are trying to "cure" us as if type 2 is a disease instead of a trait, like red hair. How come they don't try to "cure" red hair?)

    ReplyDelete
  10. Sending a blog link (yours) to a friend who's recently been told she's "pre." Knew no numbers - is clueless. I also think I was successful in taking some of the blame off - I'm glad I met you! (Colleen in NH)

    ReplyDelete
  11. I was told I was "pre" decades ago. I shrugged it off. VERY bad move. I'm pretty much "under control" now (except that I usually stuff myself so much while watching TV in the evening that I'm uncomfortable, even though my fasting sugar gets me nervous when it gets over 90), but I'd probably have fewer non-diabetes problems now if I had kept it under control back then (and not put on the 100 pounds I'm losing now - 65 pounds so far, about 40 to go, probably).

    ReplyDelete
  12. Great Post Kate!

    Your post is very informative about diabetes.
    Thanks for sharing

    ReplyDelete
  13. Thanks for your post, Kate! My own diabetes is extremely draconian about carbs. One thing that's unbelievably frustrating is watching BG skyrocket, regardless of diet and exercise practices. Behave well? Lousy numbers. Behave badly? Even worse numbers. Stress is a key factor.

    ReplyDelete

I truly love to receive comments from readers, however, if your comment includes a link to a website about diabetes or information on how you "cured" your diabetes, it won't be published. If your profile name links to a website about diabetes, it won't be published. If you also write a blog and would like me to include it in my blog roll, please say so in a comment and I'll do that. Thanks.