So how many grams of carbs in THAT?

I hate scales. I mean I really hate them. The kind of scales that you have to step on at every doctor you ever go to once you have diabetes; the kind of scales that taunt you sitting under your cupboard in your bedroom, knowing that it is “only recommended to weigh yourself once a week” but inevitably draw me to get on them most days and sadly, see no movement in the right direction; and most of all, the kind of scales my mum used to weight every gram of carbohydrate that passed my lips once I got type 1 diabetes.

Back in those days we were given a list of “Forbidden Foods” ( i.e chocolate, lollies, sugar, ice cream, honey, most cereals and anything with the word sugar or even a suggestion of the word sugar, even cough medicine!) and a list of “Free Foods”. Now this was more interesting as it included all the sliced meats, cheese and so on that were full of fat but NO carbohydrate so go for it!

Mum did what she was told and measured and counted all of my food. We had to learn and learn fast, where there was a “portion” in all foods, which at the time was measured as 10 grams of carbohydrate per portion. Of course this was different to how they did it in America and later, we shifted across to their exchange system which was 1 exchange = 15 grams of carbohydrate.  It took me years to get this change over but now it is just the way I look at food.

At that time we also had pretty average insulin which was injected twice a day only and we had set portions for every meal, 6 times a day that MUST be eaten no matter what. Essentially we were injecting insulin and then “feeding the insulin”. Thankfully we now operate more on a matching insulin to what we eat system but in essence, the old portion or exchange system is still the mainstay of the “diabetic” diet. Whatever that is.

On an insulin pump you are told, you need to count every minute scrap of carbohydrate to “get it right”. This means if there is 2 grams of carbohydrate in your milk added to a cup of tea you “should” count this and have a tiny drip of bolus insulin. Hmmmmmmm, I am not sure in practice this is the case for most of us.

I certainly don’t count the milk in my copious amounts of tea every day!

The hardest thing of all is working out carbohydrates and how much bolus insulin to have when eating away from home. When you have a package and can work out carbs, not too bad; when you make something at home and can work it our fairly closely, better; when you are out and someone dumps a plate of food in front of you, or a nice dessert in particular – not so easy!Add to that the complexity of GI which we now know about and it gets even trickier.

Point in fact – I was at a lunch with a table of Diabetes Educators and a dessert plate with mixed little cakes came out – “how much carb do you guys think is in that?”  I ask? “How much insulin would you all take?”    Blank looks from all.

Nobody could possibly get this exactly precise.

At a Melbourne Cup charity lunchen we were working at this week my lovely volunteer who like me, has had type 1 diabetes for many years, is on a pump and knows her stuff – asked me how much insulin I would bolus for the yummy custardy dessert  ( of which I had two!) – ” I don’t really know!” I replied. You know what I do? I “guesstimate”, then keep an eye on my BGL for a few hours, adding in small bolus if needed later. Is this “right”? I don’t think there is a right. I remember years ago hearing a presentation at a national diabetes conference where some dietitians had done a study with children “guesstimating” the carbs on their plate vs exacting every morsel – and they had almost the same outcomes – proving that the guesstimation was just as good.

I don’t know about you but I don’t carry scales with me; I don’t carry a carb food guide with me everywhere I go and then spend ages trying to find every food in the book before I eat a meal, get all the calculations of the various components of a meal and then add it all up before I ate. Maybe if I did I would be thinner as I would never get time to actually eat the food or would give up!

I say we are so lucky to have the vast array of foods we have here so enjoy food, be healthy, have regular treats, aim to keep BGL on target, do your best with making your insulin match the carbs you eat – but never ever become a slave to those dreaded scales and turn food into something to dread, rather than something to delight in and be joyful about.

 

Diabetes makes your brain bigger…..

Ok so just back from a normal morning of getting up past the alarm, finding the 17 year old son was going to school late so I had to take the 11 year old instead of him, getting myself, the 11 year old and the 2 year old ready to go out the door, battling rush hour to get the 11 year old to school, pulling into the truck lane to get to the shops to do the weekly food shopping before the man coming to fix the air conditioner calls to say he is on the way ( as of course I have nothing to do in my day and can happily sit around waiting all day until he comes, coz they can’t give you a precise time they are coming – more fool me I forgot their lives are SOOO much busier than mine), and get to the shops, toddler in the trolley- check; green bags for shopping – check; shopping list – check….oh oh….blood glucose – yep you got it – check! Of course I am now hypo, standing in the aisle about to start shopping, toddler ready to go, people wondering why I have a little machine ( is it a pager??) and am pricking my finger at 9 am on a Friday morning in Foodland.

So a few lollies later and a little moment and I am off and running again. Now here is the thing, is it motherhood that makes me able to multi task like this? Yes I think it is. But I also think that diabetes actually grows our brains bigger. Now this is not based on any scientific research, papers from experts, or sitting through one of the many diabetes conferences I have attended since starting work in diabetes a decade ago. Nope, this is based on pure experience – of my life and observation of the many thousands of people with diabetes I have had the pleasure of talking to over the years.

Is it only me or does it seem people with diabetes fit a very large amount of additional thinking, considering, debating, deciding, correcting and worrying in our day, than those without diabetes? The above scenario is just one of hundreds that happen each and every day for a person with diabetes. I have also noticed that people with diabetes, in particular those who grow up with type 1 diabetes, are high achievers. It seems we get things done!

I think that having to consider so many things in every day, not being as carefree as others, thinking about your body and the impact of all the choices we make, as well as dealing with the roller coaster, the worries and fears, the hassles and sadness that can come along, make our brains open to so much more than people who don’t have to think about these things. We know our bodies and we know what it is like to feel like you have not got control of your body. A hypo is something you can not possibly understand unless you have experienced it….we can try to explain it, but I don’t believe it can ever be relayed properly how scary it can be during a hypo. This alone is an extra worry that can mess with your brain.

So if anyone ever says that diabetes can make your memory go, can lessen your capacity to do a task, or carry out a job, or be responsible for something – that is total rubbish. I guarantee  you that when they woke up, ate without even thinking about the carb content of their breakfast, showered and cruised off for the day, their brain had done less than half what a person with diabetes would have done – and I rest my case. But I am saying this in a positive light – we get to have bigger brains! And you know what, what matters in life is that you have the gift of having a life – that a life well lived is all it is about, diabetes or not. So grab your blood glucose monitor, dial up your insulin pen, check the carbs in that piece of cake and feel proud that you are in fact growing your brain!

The battle of the fat – survivor vs designer

As a long term “diabetic” “person with type 1 diabetes” “pancreatically challenged person” or whatever you may like to call it, I have also battled a life long war with weight….I am one of those lucky people who got not only the gene that led to type 1 diabetes and other autoimmune problems, but the “fat” gene – lucky old me.  I am wondering how many more of me there are out there? I imagine there are many of you.

🙂

This has meant that at various times of my life I have been slightly pudgy ( a good term for a 10 year old girl with “puppy fat”), quite overweight ( a good term for an adolescent with type 1 diabetes, really does heaps for the way you feel about yourself and the fitting in with everyone that can be so hard for young people with diabetes), fat (an often said term by young men when out and about as a young woman who is overweight and does wonders for your self esteem- not), overweight (the doctor when you hop on the scales – why do ALL doctors, even those to whom weight is irrelevant in their job ask you to get on the damn scales?), obese (now this one hits home hard when you have had your first baby and in response to post natal depression and a total lack of ability to control type 1 diabetes post baby and breastfeeding for the first time, you eat yoursefl silly) and finally “curvy” (by a loving husband that wants something to hang onto!)

As a now 43 year old woman who is proud of having had 3 beautiful children despite type 1 diabetes, still has her own legs, eyes and kidneys and is travelling well despite a number of health issues, I am trying to embrace my body. Yes I am still carrying weight from my now 2 year old son, but I am trying hard to love my body and thus myself.I am also a lover of chocolate and having given up many foods during my life long battle, I have now given this up – maybe it is temporary, maybe this week I will break and have some, who knows?

Here is the dialogue – “If I can just l lose 5 kilos….10 kilos…..life will be so much better, I will feel so good” – sound familiar??

But will it? And how much will I go through to get there? Is this yet another trick that keeps us ever yearning for more? Like the need for shiny shiny cars, houses and designer babies, is the battle of the fat just another part of this mythological perfect life?

Wouldn’t it be nice if life were simply about nothing but life? You know what  I mean? Like getting up and getting food for the day, hunting and gathering and storing this, spending time with your people, looking after the fire and keeping things safe – maybe life like it is on “Survivor” is what we humans are really all about.

As a person with type 1 diabetes, losing weight means constant vigiliance on the carbohydrates, to reduce insulin and thus lose weight; constant vigilance on the insulin to deal with hypos not wanted but commonly coming as carbs and weight drop off; constant vigilance to deal with exercise made pointless in the weight loss battle by those nasty hypos….and many many choices. Weight, fat and body become all consuming in an attempt to stop consuming.

At the moment, each time I eat I am trying to see it as a choice. I can choose to have processed foods, chocolate and the things that tend to become habitual for me and which tell me that they “make me feel good” – what a lie that is, such a temporay high! OR I can choose to have some fresh fruit, light crackers, a handful of nuts, sugar free jelly and low fat yoghurt, a large salad and some fish – and really genuinely feel good about that, if not a little deprived.

The problems come when this has to be maintained in the long run to keep the weight at bay and as I get older this gets harder.

So here I sit cup of tea in hand, bowl of strawberries and cherries beside me, hoping that chocolate will not rear its head this week and that I can stay off the scales for a day – seems the battle will continue….let’s see if I can be happy with wherever I am today, here and now, alive and lucky, slightly pudgy, somewhat fat, a little bit overweight, not necessarily obese, cuddly and curvy, a wonderful survivor and definitely, most definitely, happy.