Inconsistency, thy name is Diabetes.

I realized two things while beginning this post:

1. Holy craps it’s been a long time since I’ve posted anything.See what I did there?

2. I still have not finished my two-parter I started so many months ago.

We’re (and by we I mean me) going to work on that.

But I wanted to address something!

Diabetes, type 1 or type 2, sucks. It’s not fun, it’s not cool, and it rarely gets you as much sympathy as something like–well insert your own disease that is typically considered “serious” so I don’t offend anyone. Let’s just say I said lupus.

Now all of us know that diabetes is a serious disease so we can scoot past that discussion, but it’s also an extremely discouraging one.

For TTD’s you’re faced with stupid stuff like this on a daily basis:

This was the tray insert at McDonalds in Beaver Dam, Wisconsin. Really McDonalds? That piece of paper says, “Eat well!” It should say, “Eat well and P.S., BTW, don’t eat here!”

(And yes, half of that is my food…)

For certain TODs, part of your pancreas still functions or at least secretes insulin occasionally. Same with TTDs. Your pancreas still works, your body is just resistant to the insulin your body puts out. This means that some days, or some weeks, or some months your body may secrete and be very receptive to the insulin it’s producing. THIS means that having consistent blood sugars goes out the window. And you can’t prepare for it.

As much as I hate to say this, the only way to really understand when this is happening to you is to check your blood sugars. Without that data, you really can’t know what you’re dealing with.

I like to write EVERYTHING down so that I know my blood sugar is high/low because I missed some insulin or I ate something that spiked my sugars or I exercised some time the week before… the only downside to writing everything down is that it is really easy to get sick of doing it and just quit.

Someone I love very much was recently given the gift of TTD. He has literally busted his butt and completely changed his WHOLE life to adapt. He even eats vegetables now. He lost a ton of weight and walks miles and miles a day.

Honestly, this man now eats fruit and vegetables, drinks soy milk, exercises twice a day, and is just in general an exemplary diabetic.

His sugars are almost always low 100’s.

But he went to his doctor the other day and had an A1C done (which was UNDER the limit for diabetes) and sent me an email that sounded a little bit discouraged because his A1C was not as low as he was expecting.

It breaks my heart that someone who is and has worked SO hard could still feel like they weren’t doing enough.

But that’s what diabetes is. It is a constant struggle, adaption and feeling inadequate.

So here’s what we’re going to do. We are going to give the proverbial middle finger (or whatever expression of disdain your culture has) to diabetes and it’s inconsistency.

No, it won’t change anything but I am of the opinion that it is healthy to express a little anger and it is OK to be mad about diabetes, it is the WORST.

Next, we are going to pat ourselves on the diabetes.

Good job us. Good job diabetes.

Now let’s move on. Try to remember that yeah, diabetes is a pain in the tukhus but we are doing our best so we deserve to feel good about ourselves.

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Cool New Blog, I support you!

It has been such a long time since I’ve posted anything on “ye olde blog” and I apologize sincerely!

My dad recently became a member of the diabetes club and I owe him some good posts!

(Just in case anyone DIDN’T know, that is a member’s only jacket)

I think I’ve mentioned the fact that I work in a hospital in the Food Service and Nutrition Clinics. Because of this, I see a lot of nutritionists on a daily basis.

Two really great nutritionists from the hospital recently started a blog. I thought it’d be great to share the link here on Diabetiquette.

                         Nutrition Divas

 

 

 

 

 

Laura Isaacson                                                                                         Kelly Nuckolls

They don’t have much up so far, but as actual Registered Dietitians they will be able to offer some really stellar advice! And probably more accurate than mine…

I hope everyone had a great holiday season and more importantly, has stopped following the All-Potato-Chip Diet plan…

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Eyes, meet Stomach.

“You’ve enjoyed all the power you’ve been given, haven’t you? I wonder how you’d take to working in a pocket calculator…”

You, as a TOD have been given the power to control your metabolism. As a TTD, sadly, you’re up a creek sans paddle.

I’ve said before, that if I gave advice I’d try my best to help you follow that advice so here goes:

Portion Size.

Them is fightin’ words in some parts of the US. (Here’s looking at you, Wisconsin… and the South)

Regardless, portion size and portion control are important for any and all types of diabetics.

Over the years America’s portion sizes have grown out of control. Well most have grown and some, like vegetable portions, have shrunk. Some people call it portion distortion.

Now, I tend to shy away from eating foods that aren’t pre-packaged and drinking milk that doesn’t come in a carton because I never remember how to estimate how much half a cup of something is when I’m out at a restaurant or at a friend’s house or I just don’t care.

First:

Let’s talk portion control. (Talking about this stuff always makes me want a cheeseburger)

I digress.

If you are a TTD and need a simple way to figure out how much food you should be eating, well welcome to diabetiquette!

There is a very easy trick any dietitian will tell you about if you ask them nicely. Or even if you don’t and they just catch you eating cake for lunch.

Preferably you eat off of a round plate, preferably your math skills aren’t sub par, and preferably you also know what vegetables, proteins, and starches mean.

We can tackle this one problem at a time.

No round plate? No problem! Fractions and percentages work with ANY geometric shape.

Bad math skills? Well, just don’t think of it as math. You need roughly half of your dinner plate to be veggies. That’s easy. Break the plate in half and put vegetables on it… just watch the ceramic shards afterwards. If it’s too tricky to find the 30% and 20% of your plate, just do 25%’s (that’s 50% cut in half!)

Don’t know what veggies, proteins, and starches are?

Well, you can buy a book that will tell you what each food you’re eating IS, or you can guesstimate. For instance, vegetables are typically crisp when you bite them, have leafy parts,

and/or can be found in the vegetable section of the grocery store.

Proteins are meats. People eat a lot of meat in this country. This is not necessarily good for the economy of OTHER countries, but that’s besides the point. You do NOT need to eat a meal entirely comprised of meat or some meat byproduct. What you do need is roughly a quarter of your plate to be protein related.

Technically, almost all foods have protein in them, but to simplify your life. We are doing this:

Starches are trickier if you aren’t familiar with foods and haven’t been beaten to mental death by a nutritionist. Some people think of starches as carb-y things. Actually, after typing that, THAT’S how I want you to look at starches. Basically, anything that tastes sweet (or fulfilling) when you eat it, has carbohydrates in it.

Please keep in mind that is a VERY very basic way of describing starches and carbs and is just a “rule of thumb” and not actual science. Starches are foods like potatoes, corn, breads, pastas, and other grainy type foods.

These foods need to take up only a quarter of your plate each meal. 25% or half of the half of your plate that’s not being taken up by veggies.

You also need fruits and stuff too, but that’s going to complicate our plate…

Second:

If you’re a TOD and a carb counter (which you have to be to know how much insulin to take) you need to be able to estimate how many ounces or servings you’re eating.

That brings me to another point. Servings.

You can look at your bag of potato chips and see that it’s 15 carbs. Well yes, it’s 15 carbs in one serving.

But, then you have to look at how many pieces make a serving and how many servings are in the entire bag:

 

 

 

 

 

 

 

So, you eat the whole bag, you should be taking insulin for 120 carbs, NOT the 15 that it appears to be in the serving size. And WOOFTY that’s a big difference when it comes to blood sugar levels. I have learned this the hard way.

Editor’s Note: I feel this post is becoming extremely long and long-winded. Therefore, I will be breaking it up into TWO posts! That’s right, two for the price of, well nothing as these posts are free.

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Speak of the Devil!

I was just browsing one of my favorite time-wasting sites ThinkGeek and saw this:

This pint glass, while not only looking sweet, will accurately measure how much alcohol you’re drinking!

So, don’t ever let it be said that I told you do something and didn’t try to make it slightly easier for you to do it!

Now, back to your regularly scheduled daytime activities…

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Things I Wish People Would STOP Telling me about Diabetes

I started writing this: Things I Wish People Would Have Told Me When I Got Diagnosed post and then I stopped.  

People told me SO much stuff when I first got diagnosed, and so much stuff throughout all 20+ years of doctors appointments, support group meetings, nutritionist talks, and diabetic counselor discussions  that I just stopped listening.

Changing gears then, here’s a short list of the topics or phrases I wish lay people (not doctors or nutritionists) would STOP trying to tell me:

1. You can’t eat that!

Excuse me? I’m 24. As long as it’s not poisoned please refrain from shouting “you shouldn’t be eating that!” at me while I’m trying to enjoy my tiramisu. I am fully aware that my body cannot handle copious amounts of sugar, that’s what my insulin pump and carb book are for.

2. Diabetes is chronic.

Thanks, I claim that on my taxes every year.

3. Diabetes is nothing to joke about!

Yes it is. However, the absence of your sense of humor is nothing to joke about.

4. You’re just like everyone else! (Not to be confused with: You’re normal!)

Oh give me a break. This isn’t the hour of Barney I used to enjoy on Saturday mornings, this is real life. That statement implies a commonness.

If you were to say to me, “Abbi you have brown eyes, you’re very common!”

I’d say, “You’re right good sir! Please continue to share your wisdom!” But you didn’t. You’re generalizing things and pissing me off.

Last I heard all people didn’t check their blood sugars, carry around glucose tabs, wear insulin pumps, take insulin injections, etc etc.

I LIKE being different. Don’t take that away from me because it makes YOU feel better.

5. You’re normal!

I know.

6. They’re going to cut your feet off!

Oh really? I wasn’t aware you could predict the future. I guess if you COULD, you’d know I’m planning on dying waaaaaaay before they cut my feet off.

7. Diabetes is a serious disease.

In the words of James Woods:

“I get it. I got the concept.”

8. Maybe they’ll be a cure in your lifetime…

Maybe. I’d feel more confident about it if you didn’t say it with those big stupid puppy dog eyes which tell me you don’t believe it. And honestly, stop getting my hopes up. I feel like that’s just another one of those things people say to make themselves feel better, especially if they aren’t personally involved in some type of diabetic research.

9. You should really be doing that this way. (Or some variance)

I don’t walk around changing your “your”s to “you’re”s and “to”s to “too”s so please don’t think because your pancreas works properly that it makes you an authority on how many times I should check my blood sugar.

10. It’s so great how well you’re doing!

What? Did I just get dumped? Am I a recovering alcoholic? I’m not saying I don’t appreciate the good feelings, but be aware how condescending this can sound depending on your tone of voice.

11. Check your blood sugars.

Check yours.

12. What’s your AIC?

Do you even know what that is? If you can’t tell me the word that precedes those letters/number, you don’t need to know and you certainly don’t need to judge.

As childish as some may seem, these are my top least-favorite things to hear about or surrounding diabetes.

Any to add?

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Blame it on the Alcohol

We are doing this.

We are sitting down and having the talk.

“Ok, so I know we’ve been hanging out a lot lately… and I mean, like, and if not that’s totally cool but, I wondered what you thought about us, like, dating…”

No, no not THAT talk.

This talk:

People drink. Adults should be the only ones (according to USA laws) but that’s not always the case. And people, whether legal or not, drink irresponsibly.

I think I’ve mentioned that I’m not here to tell you what to do so drink or don’t drink, just don’t be an asshole about it.

Coincidentally that is also my life philosophy: Do it or don’t, just don’t be an asshole about it.

For the sake of argument, let’s say you’re 21 years of age or older. Let’s also say that you have diabetes. Fantasy over right?

Tell me about it.

So, you’re of age and a TOD and you’re either out with friends or sitting alone in your room, in the dark watching Breaking Bad or playing Soul Calibur (the GameCube version because it’s the best) and you have a couple. By “a couple” I mean alcoholic drinks.

Your body starts to digest it shortly there after.

First, where does it go?

Mouth, Pharynx, Trachea, Esophagus, Stomach, Small Intestine (where the Pancreas, Liver, and Gall Bladder help out), Ileocecal Valve, Large Intestine/Colon, and Rectum?–damn near killed ’em!

Now, what happens?

Your saliva actually starts breaking down the sugar to start. And loved ones, that’s what alcohol is when you get right down to it, sugar, and not the useful kind. That’s why Dietitians call it “empty calories”. Protein and Carbohydrates hold 4 calories per gram, Fat holds 9 calories, and Alcohol holds 7. It’s less than fat that’s true but think of how many drinks you suck down in an hour versus how many Volcano Tacos you can eat and you’ll see their point.

A series of muscles and magic pushes your food around but what breaks down the sugar?

Enzymes. Enzymes are catalysts. They break your fat into fatty acids, your proteins into amino acids and your carbs into sugar.

In “normal” people, when their bodies encounter glucose their pancre-i secrete insulin. In TODs, well nothing happens. If you have a partially functioning pancreas you’ll get some insulin but it won’t cover everything you’ve eaten.

Let’s get back to the alcohol.

When your body metabolizes things, it’s really converting it to another substance. When your body metabolizes alcohol, it’s making it non-toxic. I don’t know if any of you have ever played around in a lab or have peeled your own skin off and put it under a microscope “just to see”, but adding alcohol to cells destroys their integrity.

Same with drinkable alcohol, that’s why your body converts it, else you would die upon drinking.

Enjoy the dead wombat to your left.

Depending on your nationality (not kidding) and/or weight and body composition, your body gets good feelings for a while from breaking down the ethanol.

Of course, then that ethanol starts to feel like poison and you want to die a little.

Luckily (and I mean that sarcastically) diabetics already have trouble with metabolism.

The thing about alcohol is, is that it’s really easy to drink.  The more you drink, the easier it is to forget about things like carb counting and you can end up either not taking any insulin or taking too much.

I have done both.

If you like to drink to the ridiculously unhealthy point of passing out, you better make sure you have a friend around who ISN’T intoxicated and can watch you for alcohol poisoning AND low blood sugar.

On the flip side, you can also fall into a coma because your blood sugar is too high. If you’ve had enough that you’re falling down drunk and haven’t taken any insulin, chances are pretty good your sugars will shoot up and you actually could “take a coma” instead of that nap you wanted.

 Actually, click this link and look under the Diabetes heading. It sums up what I just said, but better.

So how do you drink responsibly with diabetes?

Well you can just not.

Or, you can make sure you’re checking your sugars before you start and that you have a Designated Diabetes Watcher with you while you do. Or, you can promise yourself not to have too much and actually keep that promise. (That’s what I usually do because then I don’t have to depend on anyone else which means EVERYONE has fun… usually. Unless EVERYONE shares drinks that night and then two weeks later EVERYONE has strep throat.)

Make sure your DDW knows how to use your glucose meter, knows where your Glucagon is if you have one, knows how to give injections or use your pump, and is dependable in general.

If you can’t find a good one, be prepared to look out for yourself.

There are certain types of alcohol that are “better” for you than others, as far as carbohydrates go.

Examples: dry red wine has less sugar than a sweet white.

Vodka and light beers are usually safest. Liquors are usually the riskiest. Amaretto, for instance,  has 25 grams of carbs in 1.5 ounces. That is NOT a lot of Amaretto and almost 2 carb exchanges. This is fine if you know what to count for, but if you don’t your blood sugar can jump up really quickly.

Similarly to greek yogurt thing, additives are what you have to watch out for. The vodka is good but the orange juice and Amaretto you mixed it with adds tons of carbs.

So, moral of the story: keep your wits about you! (If not your wits, at the very least a liquid scale so you know how much you’re drinking.)

That is kind of the anti-alcohol mantra, but you were one of the chosen ones. And with great power comes great responsibility.

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Get ‘Em to the Greek

Lately, my All-Potato-Chip diet has started to fail me.

I know what you’re thinking, “But Abbi, your steady diet of  Taco Bell and processed foods is a failsafe plan!”

To you I say, “You’re right! I lost seven pounds this month!”

And I’m not kidding. I went to the doctor on June 1st, got weighed, went back to the doctor June 27th, got weighed, and there was a seven pound difference!

But, what I didn’t add into that sequence of events was the horrific stomach flu I got that lasted almost 3 days. What I also didn’t add was that my oh-so-nutrient-deficient diet was mostly to blame.

I also got an A1C done, but we aren’t talking about that today. Or tomorrow. The same adjective applies to both my stomach flu and my A1C. Sorry doc.

Anywhoo, I took a vacation and when I came back to work I decided to make a change for the better! Instead of my fallback Egg and Cheese McMuffin or Strawberry Creamcheese Croissant, I went for the Greek Yogurt:

Again, I know what you’re thinking:

“Abbi, that looks like someone vomited into a bowl, gave you a spoon, and told your diabetes to take a hike.”

Well, you’re right again! But it isn’t vomit.

I swear.

People go on and on about Greek Yogurt, to the point where I want to start stabbing jugulars, but they’re mostly right.

And if you’re thinking, “But Abbi, I don’t like eating things that don’t TASTE like anything.” Then I’d tell you, “Hey. Stop complaining and add stuff to it.”

E.G. Nuts, Granola, Cherries, Grapes, Strawberries… blah blah blah

The fact is, Greek Yogurt is good for you. Not only does it have the normal benefits of yogurt (calcium, aids digestion, etc) but it’s lower sodium, lower carb, higher protein, AND you can use it in recipes to substitute for fattier things like mayonnaise.

God, I love mayo.

Right, back to the point: if you can get around the fact that it doesn’t really taste like anything, it’s a good diabetic snack. With fewer carbs than regular yogurt you can either eat twice as much (therefore getting twice as full on yogurt and less full on T-Bell) or eat the regular amount with more nutritional benefit and less insulin to take!

Be aware though, I always forget this, if you ADD to the yogurt (damn you Maraschino cherries) that WILL add to the carb count. I am usually so preoccupied trying to figure out how many ounces of yogurt I’m eating that I forget to add carbs for fruit.

If you’re looking for different varieties of Greek Yogurt (live cultures, low-fat) then look here. That is a nice short blog post about Greek Yogurt with a list at the bottom for different kinds. The comments are good too!

Over this Fourth of July weekend remember: if you are also on the All-Potato-Chip Diet, or the All-Beer Diet, or even the Healthy Diet, adding something new like Greek Yogurt can be your small step towards a slightly healthier life.

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Catching ZZZ’s

I’m sure this goes without saying, but sleep is IMPORTANT.

Last night I got between 3 and 4 hours of sleep due to some “domestic” arguments in the apartment below me, some drunk people next to me, and the rest of the apartment complex trying to get those people to shut up.

I was expecting this to be fine when I woke up at 7am and started getting ready for work but I was wrong.

As it turns out, I fell asleep on the bus and almost missed my stop. When I got inside the hospital I consumed more than HALF my daily calorie allowance. Before 9am. Yes the Egg and Cheese McMuffin was delicious and yes, the Strawberry Cream Cheese Croissant made me remember why I like to be alive… but now for the rest of the day I have about 400-500 calories to burn.

This is NOT ideal.

So: sleep is important for regular people and, as these things go, it’s even more important for diabetics.

First, I’ll go through the reasons from Harvard Health:

1. Memory

You  know how you feel after a night of no sleep: drunk. And you know what you remember from the night of being drunk: nothing. That doesn’t need a whole lot more explanation.

2. Metabolism

Lack of sleep alters hormone levels that tell you when to eat. When you’re sleep deprived, your body knows it needs to be awake and it knows it needs energy. So it tells you you’re hungry. And then you eat 900 calories before 9am. See Taco Bell post for the dangers of that one.

3. Safety

Sleepy people fall asleep. While doing things you need to be awake for.

4. Mood

Sleep deprived new parents are some of the crabbiest people I have ever met (no offense). It’s the same for non-new-parents. Anyone who is tired and in a good mood has probably taken some kind of mood-altering drug.

5. Cardiovascular Health

Less sleep = more stress. Stress is bad for your heart. Also: diabetes is a heart disease. Any extra stress put on a heart that is working too hard to begin with is bad news. As a diabetic, your heart needs to be attended to and getting enough sleep is an EASY and EXCELLENT way to not add stress to your life.

6. Disease

Getting too little sleep affects how your immune system works. Let me give you a hint: it doesn’t make it work better. The same with heart disease, sleep is an EASY way to help your body work properly. Give yourself a chance to be able to fight off the infections that you’ll be more prone to anyways with your diabetes.

Second, let me break it down for you:

Sleep will lift your mood, keep your weight down, and help keep your diabetes under control. Don’t add to your body’s stress by keeping it from resting.

Thanks Harvard, for spelling that our for us.

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Born This Way

“I’m on the right track baby I was born this way…” whoever writes Lady Gaga’s music for her.

Genetics is a fascinating and growing field these days. Our genes make up who we are, after all.

I think many people are familiar with the Dominant and Recessive gene idea (see Mendel’s pea plants). Basically the super-simple-speedy explanation is that when two people make a baby, what they’re really doing is exchanging information. Genes are the blueprints for life and both people have their own copy of each gene.

Through a series of complicated pairings and crossing overs, certain amounts of mom’s genes and dad’s genes are smooshed together to make… a baby!

Let’s say a human is as simple as a pea plant. If mom is short, and dad is short (and their predecessors were also all short) you, as the baby will be short. If mom is tall and dad is short, it’s kind of a crap shoot as to how you’ll turn out depending on each parents ancestors. But to simplify things, you will be tall because tall  is Dominant over shorty-pie dad.

That basic overview was meant to prepare you for discussion! Now, for a quiz:

Diabetes is:

a. passed genetically

b. only attributable to environmental factors

c. both

d. a gift from heaven to differentiate you from mere mortals

And now for the answer… Drumroll…

Yeah, well it depends on what version of diabetes you have. Usually, the answer is C.

Type Two or adult onset diabetes is considered genetic. There are genetic factors that influence obesity which is a major player in TTD. After reaching the point of obesity, your body can become insulin resistant (meaning it’s still being made, but not used) making you diabetic. There are other factors as well, not only obese people have TTD. You can be genetically predisposed to High Blood Pressure which makes you more susceptible to TTD. You get the idea. That’s not to say that people without a family history of diabetes cannot get TTD. If you’re healthy but don’t care about what you eat, you can just as easily McDonald’s your way to some diabetic fun.

TOD, or Type One Diabetes, sort of follows the same pattern. Typically diabetes itself is not “passed” but if your parent’s genes mix in just the right way, it will make you more likely to get infection (or something) which could lead to diabetes. That’s how I got it! That’s how my friend Kelsey got it too. Genetically, we were lucky enough to be prone to infection and some BAD infection (me chicken pox, her pneumonia) killed off our pancre-i and left us with TOD. It would be very difficult to shut down a pancreas with environmental factors, usually those factors will give you pancreatic cancer or pancreatitis instead of the ‘betes. (I’m not linking to either of those things, don’t look them up)

Hopefully that happy pancreas will cheer you up!

So parents don’t blame yourselves and kids don’t blame your parents. They just loved each other (or you know) and had a kid. You can’t plan where your genes are going to go. Maybe someday you could, but for now you were just Born This Way.

The real quiz answer, C. The quiz answer I think is true, D.

I’m pretty sure the heroes of Greek mythology all suffer through life, but they are the heroes and always win at the end. Be patient and remember “baby you were born this way.”

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Apologies and Thanks

I wanted to take a few sentences to thank the few, the proud, the followers of this blog.

I know I haven’t been posting much lately but with summer vacation coming up, I AM BACK.

Sometimes the people you think will always be there for you completely let you down, and in ways you didn’t even imagine.

Keep people in your life who keep you sane, who DON’T tell you that you’re crazy, and who speak honestly with their hearts. Those people are rare and will be a constant support to you in your lifetime.

Emotions and diabetes can be tricky to manage, and when both of them aren’t being taken care of, it’s a recipe for disaster. Be kind to yourself. Take the time to know that you’re ok. Life is easier to manage when your diabetes is managed, and diabetes is easier to manage when you’re protecting your life.

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