Thinking About Diabetes With Every Bite

November 23,2009

 New York Times

Thinking About Diabetes With Every Bite                                                                        By Cathernie Price

When I look at food, I don’t see food. I see sugar — in the   form  of  carbohydrates — plotted on a multidimensional graph with proteins and fat and serving sizes and sickness and exercise and times of day.   Catherine Price 

I didn’t always do this. Before I received the diagnosis that I had Type 1 diabetes, I saw food as food, and ate it as such — simply, casually, with no real thought attached.

The winter of my senior year of college, after a bad cold and painful breakup, I began eating more — not to cope, but to feel full. I was hungry, always hungry. Hungry and thirsty and tired, piling my tray in the dining hall with pasta, cheese, dessert, getting up in the middle of the night to slurp water from my dorm’s bathroom faucet.

I gorged myself and yet my pants were looser, my arms thinner, my stomach flatter. One afternoon I threw it all up, convinced I had food poisoning. My stomach eventually settled, but my mind did not. The world swirled. I couldn’t stand without stumbling. On Feb. 17, 2001, I entered the hospital, and since that day, food has never been the same.  

To live with Type 1 diabetes means to be aware, constantly aware, of insulin — a hormone produced in the pancreas that unlocks your cells so they can use the energy in your food, which circulates in your blood as glucose. A healthy person’s pancreas pumps out insulin in exact, perfect doses, masterfully managing the level of available glucose so that it never rises too high, which could lead to complications, or too low, which could kill you on the spot.

My pancreas, however, doesn’t make insulin. It can’t. For reasons no one can fully explain, my own immune system killed off the cells that produce it. That’s what Type 1 diabetes is — an autoimmune disease in which your body turns against itself. It’s frequently confused with the more prevalent form of diabetes, known as Type 2, but the diseases are not the same. Unlike Type 2, Type 1 diabetes can’t be prevented or managed with diet, exercise or oral medications. Instead, it requires artificial insulin — through injections, not pills — to stay alive. Before insulin was discovered in 1922, Type 1 diabetes was a terminal disease.

Today, artificial insulin means that a Type 1 diagnosis is not a death sentence. But living with diabetes takes much more than simply giving yourself shots. It requires constant, unwavering attention to your meals, lifestyle and medication — and even the most conscientious person with diabetes will never achieve the balance that a healthy pancreas effortlessly maintains. If I take too much insulin, my blood sugar will drop too low; my body will sweat and tremble; I will become anxious, irritable and confused. If I don’t quickly eat something to give my body the glucose it needs — or, worse, if it’s the middle of the night and I am too deeply asleep to notice the warnings — I could lapse into seizures and unconsciousness and never wake up.

It would be easier to keep my blood sugar a little too high, to coast comfortably above the turbulence of tight control. But doing so would mean ignoring the destruction caused by high sugar levels — slower than a seizure, but devastating nonetheless: the capillaries in my eyes bursting from too much glucose, the tiny vessels in my kidneys overwhelmed by sweetness, the nerves in my feet losing their ability to feel.

Instead I calculate constantly, measuring my food’s potential effect on my blood against my desire to eat it, trying to walk a Goldilocks tightrope where my sugar is not too low, but also not too high. My blood sugar’s reaction to food depends on far more than the food itself. If I exercise before or after eating, it is different. If it’s the morning, it is different. If I have my period, it is different. If I am tired or stressed or sick, it is different.

From the outside, diabetes is invisible. Look closer, though, and my fingertips are calloused where I prick them to test my blood sugar 10, 12 times a day. A bulge in my pocket reveals my insulin pump, a machine connected to me by a tube that, in giving me insulin, keeps me alive; scars from its insertion sites pepper my hips. My pump means fewer injections, but it has no brain — I still decide how much insulin to take. Instead, it is a literal tether, its plastic stint in my side a reminder, as I sleep with it, exercise with it, and go to dinner with it tucked in my bra, that I have a disease, that there is something wrong. Diabetes’s subtlety is both a blessing and a curse, saving me from stares and pity but keeping the difficulty of the disease — and its severity — hidden as well.

I hate it, diabetes — wish I could take a vacation from it, eat a slice of bread without calculating carbohydrates or have dinner with friends without fear. But I can’t. So instead I try to flip things around, to use the challenges of diabetes as an inspiration to live as fully as I would if I didn’t have it — if not more so.

One of the best decisions I ever made was to participate in a clinical study for a new experimental drug as soon as I learned my diagnosis; I encourage everyone to do the same. As my endocrinologist, himself a Type 1 diabetic, explained to me, “We need just about every single newly diagnosed person to get involved in a trial. It’s the only way things won’t be the same in five years.” You can find a clinical trial for Type 1 through the Juvenile Diabetes Research Foundation, the National Institute of Diabetes and Digestive and Kidney Diseases, the Immune Tolerance Network or ClinicalTrials.gov.

I have also started writing for a diabetes Web site called A Sweet Life in hopes that, by sharing my own experiences with Type 1, I can help other people feel less alone. But there is plenty about my life that has nothing to do with having Type 1, like co-authoring a cookbook and writing a parody travel guide. My most recent non-diabetic adventure was to join a no-audition hip hop dance group.

Living with Type 1 is an exercise in measurements and judgments and willpower and constant self-restraint. For me, the most difficult part is accepting that I will never be perfect; I will always have bad days and, perhaps worse, there is no way for me to “win.” Like everyone with Type 1 diabetes, I will have to keep at it — every day, every hour, until we finally figure out a cure.

The best I can do in the meantime is to control my disease without allowing it to control me, and to not let the autoimmune attack on my pancreas develop into an emotional attack on myself.

And, of course, to dream of a day when I can once again think of food as food — simple, enjoyable, with no strings attached.

Catherine Price is an Oakland, Calif., freelance writer whose work has appeared in “The Best American Science Writing 2009,” Popular Science and The New York Times. She is the author of “101 Places Not to See Before You Die,” to be published in 2010 by Harper Paperbacks.

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.

Travel and Weight Loss

For years I have been a regular traveller and for years I really struggled with my weight and blood sugar while on the road.  I’m sure it had to do with all the crap I’d eat.  It was always so easy to justify eating garbage because I was travelling.  What a great excuse not to lose weight.  I’m travelling.  What a great excuse to eat garbage.  It never made me feel great in fact it never made me happy.  All that would happen is I’d feel fat and have high blood sugar numbers.

This month I’ve been travelling a lot.  I have made a concerted effort to focus on healthy eating.  Because of this I am actually losing weight, seeing my blood sugar be more controlled and I feel good.  Being away from my family is not high on my priority list, however I learned something when I was out of town for 2 weeks straight.  I have better control without influence from the family.  I can and do make good choices for myself.  I also have less of a desire to cheat.

I haven’t figured out how to ensure that I eat better at home, so for now I think I’ll just live life on the road.

Sugar is EVIL

Of all the foods in the world that we eat none makes us happier than sugar.  It’s in almost everything that is sweet and tastes good.  Often we eat it because it’s there and once eaten it finds it way to all the happy cells in our bodies.  None is happier to be nourished by sugar than Cancer cells.  I didn’t believe it at first, but it’s true.  Cancer loves sugar and while I am NOT a Cancer expert I’ve recently become associated with the Center for Advancement in Cancer Education (CACE).

The recent quarterly that CACE puts out discusses a fermented wheat germ extract called Avemar.  The premise behind Avemar is that it chokes off the energy supply of cancer cells which reduces their ability to proliferate and eventually causes cancer cell death.  I was not aware that cancer cells utilize glucose (sugar) at a rate of 10-50 times higher than normal cells, however based on this information it’s easy to conclude that sugar is BAD for people who have Cancer as well as those of us with Diabetes.

This week I’d like to dedicate a moment to a close friend of my wife’s that was just diagnosed with stage 4 Breast Cancer.  It’s a tough topic and much more shocking when diagnosis is not done until this stage.  On a more positive note, I’ve recently met someone that was diagnosed as stage 4, three years ago and today is in complete remission.

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.

Diet Soda or Donuts…how about both?

When I want to binge I often go to the worst place possible and then think that having a diet soda helps fix the problem.  It’s not often but it does happen and for those of you who are attempting to keep yourself under control, let me simply say I am too.  It’s rare that I really get the urge to binge, but I did recently and here’s how I handled it.

I decided that what I really wanted was a french cruller.  You know the kind with the pretty pattern on top, it holds more of the sugary icing.  I figured just one would do it for me until I saw the glazed buttermilk donuts.  So I took one of each.  I needed something to wash it down with so I took a diet orange soda and boy was I set.

When I looked at the label and saw that there was High Fructose Corn Syrup in it.  I was turned off.  Here I am trying to help others and myself maintain and improve our health and it wasn’t the donuts that soured me…it was diet soda.

I decided it was time to reassess this snack and I grabbed a bottle of water and took a walk without the sugar.  I guess that sometimes self control can hit before I sabotage myself.

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.

Whole Grain is only half right

I’ve found that the things I’m told by Dietitians and Nutritionists are not always right for me.  This is because I live with diabetes and have real life experience with the end result of food converting to blood sugar.  I test my sugar multiple times after I eat a food I’m concerned about to see how quickly it converts to sugar in my blood.

Whole Grains are great for you.  They give you fiber and other great nutrients, but they convert to sugar at different speeds based on how you prepare them.  First, you prepare the food, next you eat the food and finally your stomach goes to work on breaking it down and converting it to sugar.  When you cook a grain in water you are softening it up.  This activity makes the digestion process go much faster.

Take Oats for example, when you cook them they become very soft and the starch is drawn out.  This causes them to convert to sugar quickly. Granola Gourmet bars use raw Oats.  You can’t tell but the cooking happens in the mixer and because of this the product has a firm texture but sticks with you longer.  I know it’s unlikely you are going to eat raw grains, but keep in mind that the more you soften your food up the quicker it’s going to convert to sugar in your body.

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.

Cinnamon and Diabetes

For several years now I’ve been hearing that Cinnamon was good for Diabetics.  There have been only a handful of studies on the subject.  Each of the studies looked at different groups and had different results.  One of my biggest questions was finally answered.  HOW MUCH CINNAMON DO YOU NEED TO TAKE EVERY DAY?

Published in the journal Diabetes Care in 2003 one study evaluated 60 people with type2 diabetes around the age of 50. They were divided into six groups of 10 patients each.  Half received Cinnamon, half received a placebo.

Treatment lasted 40 days. Researchers analyzed fasting glucose, LDL cholesterol, triglycerides and total cholesterol.  The cinnamon groups reductions in fasting glucose (down18% to 29%), triglycerides (down 23% to 30%), LDL cholesterol (down 7% to 27%) and total cholesterol (down 12% to 26%) were reported.

A German study evaluated 65 patients with type 2 diabetes.  This study was similar to the one above except half of the patients received placebo while the other half all received 3 grams (2/3 teaspoon) of cinnamon daily for four months. In this study no difference between the two groups was reported for LDL or HDL cholesterol, triglycerides or HgbA1c. Fasting glucose levels dropped about 7 percent more in the group receiving cinnamon.

In the spring of 2006, another study of cinnamon appeared in the Journal of Nutrition. This study evaluated 25 post-menopausal women with type 2 diabetes who were treated with 1.5 grams (1/3 teaspoon) of cinnamon daily for six weeks. Cinnamon was not associated with a significant change in insulin sensitivity, glucose tolerance or cholesterol profile.

Bottom line,  the evidence is not conclusive today.  You’ll need to take around 2 teaspoons per day over a sustained period to see if it helps you.

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.

Nutrition Labels LIE!!!

It’s not enough that we have become more diligent about eating and paying attention to the ingredients in our food.  We must root out the deceptive serving sizes and focus on realistic claims made on nutrition labels.  You’ve probably heard that anything can be justified with numbers and we do it all the time.  It amazes me when I look at the claims manufacturers make and then I look at the label and I feel like they are lying to me.

Look for yourself.  Next time you grab that muffin, chips or other food item.  How much is a serving.  Often you’ll see 1/2 of a muffin, or 1/4 cup of granola or 7 chips.  It’s time to vote for foods with a realistic serving size.  After all in today’s world where everything has been super-sized how often do you just eat half a muffin or ACTUALLY measure 1/4 cup?  I don’t and I have yet to find someone else that does in the normal course of a day.

It’s ok the cheat on your eating plan once in a while when you know you are, but because of these ridiculously small serving size listings on the Nutrition Facts panel of food you are probably being deceived WAY more than you are cheating.  Don’t fall for the trick.  Know your food and buy the ones that calculate realistic serving sizes.

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.

Who needs Blood Sugar?

You and I do!  A fundamental element that we all need in our bodies is sugar.  Sugar IS Energy.  It powers our bodies so we can live.  Movement requires energy but where does this energy come from?  Energy in the form of sugar is created by the process of converting food to sugar.  Sugar is also created by your Liver.  On an as needed basis for short term consumption your liver(primarily) creates a substance called Glycogen.

Glycogen is a starch that causes your blood sugar to rise and enables your body to have additional energy as needed.  For years I had no idea that this occurred in my body.  I have found that when my blood sugar is higher than it should be that walking brings my sugar down.  What really confused me was that I found my blood sugar to be higher after a strenuous workout.

When running and working up a good sweat my blood sugar would be higher after my workout.  It wasn’t until after I learned about Glycogen that I understood what was happening.  Since the muscles utilize sugar in your blood as energy your liver makes sure there is an adequate supply when you press your body to workout harder.   Check your sugar before and after you workout.  If you find that your numbers are higher after a workout, this may be why.

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.

There goes another toe!

I recently spoke to a woman that is married to a diabetic.  She quickly told me that she loved the granola bars and that she needed some for her husband that “NEVER eats anything that is good for him”.  I was not surprised when I heard this, it is a common theme for many Diabetics.  I asked her how she responds when her husband eats poorly, her response was “there goes ANOTHER toe”.

It amazes me how often the people that love us go negative and think that’s going to help us.  There is absolutely a psychological component to managing your diabetes and it includes being positive and knowing that the people that care for us will support our situation.  My response to this woman was simple, STOP THAT!  Show your husband you love him by making sure the right foods are available at home and to stop reprimanding him when he selects a poor choice.

True as a diabetic he may have physical problems if his diabetes is not well controlled, but to get him to control his urges and make them less frequent you must think about how you’d react when someone jumps on you for eating wrong treat him the way that you’d want to be treated.  No one wants to hear the negative stuff all the time.  Be positive and you’ll reap the rewards of better health and more happiness.

 

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.

DON’T FREAK OUT!

It’s going to be OK!

Yesterday I spoke at our local Whole Foods in Valencia.  My talk was entitled “Eating for Diabetes and Good Health”.  We had a standing room only attendance so make sure you RSVP when we schedule our next talk.

What if you’ve just been diagnosed with Diabetes and you didn’t know what it was?  This was the case for the mom of a beautiful 7 year old that attended my workshop.  Just 2 weeks ago her daughter was diagnosed with type 1 Diabetes.  Looking for resources her Chiropractor recommended she attend the event.  While everyone in the room was attentive, I noticed how attentive this woman was.

After the meeting she shared her touching story with me.  Her physician was not thinking there was a blood sugar issue, so when the tests came back the next day, she was told to rush her daughter to the hospital and that they were ready to receive her daughter.  If that’s not enough of a shock for anyone to live with learning to manage the day to day and 3AM insulin injections she is waking up to give her daughter have been.

They are in the honeymoon period and it’s really not fun.  I just wanted to commend this woman on her level headedness and ability to manage this difficult situation.  I was impressed at how nicely they are progressing and know that soon they will have a more normal life.  Life with Diabetes changes things.  This is their opportunity to improve the health of their entire family and make lemonade out of the lemons they’ve been handed.

Disclaimer: This information is provided for general informational purposes only. Granola Gourmet does not treat, cure or prevent diabetes or any disease, and is not a substitute for professional medical advice, diagnosis or treatment.