Because diabetes management is also food management, you can imagine, if you don’t have diabetes, that the issue of food for a diabetic, is indeed a complicated one (much like this sentence).
5 Reasons why food becomes an issue for people with diabetes:
1. Carbohydrates must be consumed to level out a low blood sugar or to prevent one due to active insulin.
This is the case even if you’re not hungry, even if you’re nauseated, even if you are stuffed on Thanksgiving Day. Carbohydrates are full of calories so weight gain can become an issue if someone is having too many lows. Carbs are also filling and eating while not hungry or just to fix a low tends to push a person into an unhealthy habit of eating to pacify a symptom (perhaps depression or anxiety) or to fix feelings of fatigue or tiredness. Next think you know, a person is apt to think they need a snack every time they have a headache or feel weak or are nervous or feel sad. The list goes on and on and since food really is medicine for people with diabetes, the stable use of food easily derails.
2. Some foods are much harder than others to cover successfully with insulin, creating a good foods, bad foods war.
A popular idea out there is that there are no bad foods. I understand the thinking behind that train of thought but personally, I do think there are bad foods. It all depends on your definition. For me, something that doesn’t support health but rather damages it, is “bad”. While you and I might disagree on that, we probably agree on this: Because rice is trickier to cover with insulin than say, chicken, we get into negative feelings about rice over time. Not all of us, but if rice doesn’t give you any hurdles, just replace it with whatever does-like pasta or pizza. The point is that a perfectly healthy food like brown rice can become demonized in our minds simply because of our frustration with it’s complex carb load. I like brown rice but I almost run from it screaming because of how difficult a time I have covering it with insulin. I eat a few fork full and I know I need to be done. It’s a shame that we also find that cheese, often full of saturated fat and sodium, tempts us to eat too much of it because it’s so easy to cover with insulin.
3. More insulin means more fat so people who use insulin therapy have a unique weight management challenge.
Let me explain. The more insulin one takes, the more fat they will gain. So let’s say that I’m having a rough year (which is quite human of me, right?) and as a result I don’t carb count and measure and insulin dose as accurately as I should (also normal human behavior), well, because I’m sometimes giving a little too much insulin and needing more food to cover for that fact and because I’m sometimes giving too little insulin resulting in a higher amount of insulin needed to bring blood sugar down after the fact, I’m apt to gain a few pounds between consuming more calories than I’d like and giving insulin to cover a high blood sugar that a non diabetic never has to worry about. Phew! The key to weight management is carefully counting carbs and covering those carbs at the right time and with the precise amount of insulin. That key, my non diabetic friends, is not one that humans hold, it’s in the hands of Zeus and his friends. So, what do diabetics taking insulin do? I don’t know but I know what I do, I eat less than most people and I exercise more than most people. That’s what I do. Others probably count carbs carefully and probably don’t have a disposition to insulin resistance (which causes one to need more insulin and thus gain more weight). Still, others eat low carb so that insulin intake is low and so is weight. The rest of us may have a few extra pounds we could do without, seeing as we didn’t even earn them. Sigh. What a dilemma.
4. Due to the above, it becomes tempting to skimp insulin in order to manage weight.
This is a scary one I’ve never personally tried. However, it’s a realistic problem for many people with diabetes at some point or another. Some people get quite desperate to manage their weight that they don’t take their insulin. This causes high blood sugar, ketones, and body fat burning. This also causes death and if you or someone you know is doing this, get help ASAP. I write about this one because while it may seem pathetic to the outsider, it’s not at all. I understand that it probably starts with just a moment of desperation, a longing to be thin without having to work doubly hard as everyone else. Diabetes that isn’t tightly managed usually begets unwanted pounds so I can understand how it’s tempting. But like I said, it’s very dangerous and something that you should never ever do if you have diabetes.
5. Eating becomes an abnormal event.
When someone who takes insulin before a meal does so, they have to start some math in their heads. They have to take note that their fast acting insulin begins in about 15-30 minutes. Then they have to recall their blood sugar and figure out how long it will take the insulin to start pushing down the blood sugar. If my blood sugar is 150, for example, I don’t eat right away. I wait about 25 minutes instead of my normal 15 minutes because I want to start eating when my blood sugar is a little lower than 150 but higher than 100. Are you still following? OK. Then, I have to make sure that I eat the amount of carbohydrates that I’ve just given insulin for. So, when one of my toddlers needs something in the middle of dinner and I get up to do it, that means when I sit back down, I have to now speed eat. I have to stuff myself to make sure I don’t get a low, providing I don’t already have one. Or let’s say I’m at a restaurant. I either try to guess when the food is being brought out or I let my food get a little cold before eating. Sometimes I’m a little high but I’m hungry so I eat really slowly. Sometimes I have literally inhaled my meal because of a low. Either way, I can’t always just sit down and enjoy. my. meal. This speed eating might also become a habit. And you know what else? When we eat while low, we become used to eating when feeling trembly or weak or flushed. So I’ve noticed when I’m nervous or anxious or tired, I eat really fast! It’s like I’m used to shoving food in my mouth in an effort to make those symptoms associated with low blood sugar, go away. Why? Because when we have a low blood sugar, we’re essentially on the way to death and our body makes us feel really awful so that we get the message, follow what our body is saying, and eat some carbs! Preferably fast acting carbs.
Diabetes and food, they go together like a knot.
So what can we do?
Ok, this post was all doom and gloom so here is the light at the end of the tunnel. Next week I’ll post what I have set up as some rules that work rather well for me and others I know. These rules have helped me enjoy food more and stress over it less. This doesn’t mean some of the above doesn’t still occur but I have lessened the occurrences which is something.
Coming next week: 5 Helpful Food Rules
Can you think of any other ways that the relationship between food and a person with diabetes is complicated? If so, share!