January 4, 2010

The National Day of Repentance

It's that day again. The tree is down. The wrapping paper and party hats went out with the recycling. The supermarket has replaced the aisle full of candy canes with one of diet shakes because it's that time of year: Time to atone for all that self-indulgence. Time for the annual Super Bowl diet.

Why do I call it the Super Bowl diet? Because 98% of those who start dieting today will have given up their diets by the time they tune in to watch the annual Battle of the Behemoths. (For those of you in parts of the world deprived of the wonder that is the NFL, The Super Bowl takes place in early February.)

I like dieting this time of year because it is so easy. With so many people cutting back on their food there's a brief period when you are spared many of the temptations that social life provides. For a few weeks, people don't sneer if you suggest there must be somewhere healthier than the Cheesecake Factory for lunch. They don't bring donuts to departmental meetings. They don't invite you over for dinners filled with lovingly baked platters of things your metabolism can't handle.

But only for a few weeks. Then the rest of the world gets over their holiday-induced resolutions and life gets back to normal.

Except for us folk with diabetes. For whom food can NEVER get back to being normal.

As is always the case when I wander out into the wider world, over the past few weeks I ran into people who have other chronic diseases, and as always happens when I expand my circle of friends, I was reminded how lucky I am to have one of the few chronic diseases that does not doom me to slow, inexorable deterioration, and which unlike most chronic conditions, offers me the ability to control--by the dietary choices I make--how bad that disease is going to get.

My friends who have MS can eat whatever they want--which I would envy, except that they also wake up every morning wondering what function they might have lost overnight, and knowing that the only thing they can do is pray researchers will come up some treatment, some time, that will work.

There is no diet that will stop the progression of MS, or hereditary dementia, or COPD, or Lou Gehrig's disease or any of hundreds of other horrible conditions that prey upon our human bodies.

But diabetes is different. All I have to do to keep this disease process at bay is pass on the toast and home fries, the fudge and the muffins, and keep my carbohydrate consumption within the limits that insulin makes manageable.

Is it a pain to have to do this? Yes, but trust me, if you have to have a chronic condition, folks, diabetes is the one you want to have.

But as grateful as I am to have a condition I can influence with my dietary choices, I don't discount the effort it takes to do it, nor do I have anything but compassion for people who find it hard to exercise the control it takes to keep the complications at bay.

When you can't go off your diet come the Super Bowl, it is tough. There are hundreds of tips and tricks that most people with diabetes don't know about, because they don't know any other people with diabetes who are striving to avoid the complications. Doing it yourself is almost impossible, and it is not accidental that ALL the people I know who are in great shape a decade or more after their diabetes diagnoses are active online and discuss strategy and technique with others who are coping with the same challenges.

Online support can really help you get through all the days when you have to pass by all the food everyone else in the world can eat and you can't. It can help you on the days when you do everything right and still screw up.

I had that kind of day today myself. I'm on a new and oddball diet I'll describe in a future post. It allowed me to eat a nice lunch at a restaurant today. (I started it ten days ago). Unfortunately, my insulin cartridge seems to have died, perhaps thanks to having been carried around in my purse and getting exposed to too much cold. So though I covered my lunch with the amount of insulin that usually gives me normal blood sugars, I ended up at 216 mg/dl two hours after eating.

I felt like crap. I felt angry, because dammit I really do work at keeping my sugars under control and it sucks that it has to be so hard--especially as I have been eating very carefully for the last week. It wasn't like I'd eaten anything that awful at lunch either. I'd had a Chinese lunch with no egg roll, no chicken fingers, no wontons, no rice.

But that's how it is, and as that is the worst blood sugar I've had in a month, I'll be fine. Fortunately, I have my online friends who know what "216 at 2 hours" means and how crappy it feels. One of them might be able to tell me how to keep my insulin from going bad in the winter. This isn't the first time it's happened. I'm glad I've got those friends. If you are having trouble with your blood sugar control, finding a few of your own might really help.

You can find online diabetes support in many different web communities. They are all different, so you'll have to visit each one to see where you feel most at home. I've listed some of the communities you might want to check out on this page:

Finding Support Online

If you need help finding palatable foods to eat and other people who have managed to make a reduced carbohydrate diet work long term, check out the Low Carb Friends support board. Their recipe forum has lots of excellent recipes and ideas. There are quite a few people active on Low Carb Friends who can help you figure out what you can eat just about anywhere that won't raise your blood sugars. Some have diabetes, most don't, but all are committed to keeping the carbs under control.

If you know of other helpful online support environments for people with diabetes, let us know about them by posting in the comment section. Getting support this time, instead of trying to go it alone, may be what makes it possible to wake up next year at this time thinner, fitter, and with a much healthier A1c.

Let's all help each other make that happen!



Anne said...

I guess I am doubly lucky as I have two conditions I can control with diet. I have insulin resistance(normal FBG and high post prandial BG) At this time I can keep below 120 by sticking with a low carb diet. I also have gluten sensitivity and I feel great as long as I am 100% gluten free.

The only difference in the two diets I maintain is that I may "cheat" a tiny bit on the carbs from time to time, but I never, never cheat with the gluten free diet.

I agree it really helps to find online and, if possible, local support for lifestyles that restrict certain foods. Don't think I could have done it by myself.

I too am grateful I can improve my health with diet alone. Yes,the diets, gluten free/low carb actually improve my health, not just cover up symptoms as so many medications do.

Sherlock said...

Excellent post!! People should never underestimate the power of online support!!

Steve Parker, M.D. said...

Jenny, did you feel physically crappy at 215, or was it emotionally?

Just curious because I see lots of people with type 2 diabetes who can't tell the difference physically when they are at 140 mg/dl versus 275 mg/dl.

I get the impression 215 was a disappointment since it was outside your goals.

Jenny said...


Years ago we took a poll on the old alt.support.diabetes newsgroup and found that roughly half of us could physically sense a high, the others couldn't.

I'm one who can. I feel downright toxic if my blood sugar rises more than about 30 mg/dl over my usual high, as if poison was running in my veins, plus I feel exhausted. It's very motivating and I feel bad for people who don't have that reaction.

Rishara said...

If my blood sugar gets above 200, I get a super nasty taste in my mouth that kind of wafts up from my throat (not like ketosis breath, different from that). I've never really seen anyone else describe the same thing, so I guess it just shows that we're all a little bit different in how our bodies react to fluctuations in bg.

Boz said...

Jenny - It seems no matter how much insulin I take, I can't tolerate Chinese food from a restaurant. If I cook it from scratch at home, no problems. I wonder if all the MSG has some sort of effect on bloood glucose?
Support from one's significant other is very important also. And education is the key to that I have found. A house full of sweets is no fun if you can't indulge at all. But, that said, depriving those that can isn't right either. A balance has to strived for. If your partner was a heroin addict, you wouldn't leave it out w/ needles on the coffee table, would you? I know that's an extreme example, but it illustrates what we go through.

Jenny said...

What exactly is in Chinese food varies greatly from restaurant to restaurant. In the area where I live they don't add extra MSG and the restaurant where I eat doesn't add all that much starch to the sauces. Several of their dishes work very well for me. Their Ginger Chicken and Green Beans will work for me without insulin. The dish I had was a bit more sugary, but I have made it work with 2 units in the past quite a few times.

It definitely was bad insulin. My new cartriged worked fine.

DrStrange said...

Swank diet seems to often work wonders for MS...

Jenny said...

The Swank Diet is the discredited Low Fat diet. Since a certain percent of people with MS do not deteriorate with or without dietary intervention, it is highly unlikely that this diet helps. The WHI showed this kind of low fat diet had no impact at all on reducing heart disease, which is now known to be an inflammatory disease.

My guess is it doesn't work better than random chance.

DrStrange said...

So far as I know, low-fat diet (that is actually low as in 10% calories)(and only real food)is not discredited. Millions around the world eat like that and have for millennia. Not after an argument, I think different diets work in different constitutions and for a very great many people, plant based, no added oil diet works quite well.

DrStrange said...

WHI and low fat diet:


Quote from article below. Two points. 1) I believe diet was self-reported and not controlled so no telling what they really were eating! People are VERY inaccurate at judging their food intake for the most part 2) More important 24% fat calories is not a low fat diet! It is only a lower fat diet. Even with that there was a small decrease in colorectal cancer risk. A true low fat diet, as defined by those who actually study and promote them is approximately 7-10% calories from fat and NONE of that from added oils. It also does not include manufactured food-like substances even if fat free.

There is a lot of research out there but unfortunately much of it is either not very good or as in this case, uses terminology that is misleading to define its parameters.

"By the end of the first year, the low-fat diet group reduced average total fat intakes to 24 percent of calories from fat, but did not meet the study’s goal of 20 percent. At year six, the low-fat diet group was consuming 29 percent of calories from fat. The comparison group averaged 35 percent of calories from fat at year one and 37 percent at year six. Women in both groups started at 35-38 percent of calories from fat. The low fat diet group also increased their consumption of vegetables, fruits, and grains. "

Jenny said...

This isn't the place for a debate on the utility of the low fat diet--a topic that has consumed many millions of dollars and sadly, hundreds of thousands of lives of people with diabetes who were put on that diet and died of the complications caused by the high blood sugars it guarantees.

If you want to blog about it, do it in a blog of your own.

DrStrange said...

Totally agree w/ you! I see the same types of errors in research on low carb diets esp calling it low carb when it really isn't but only lower than SAD.

BenFury22 said...

Since the publication of papers like:

"Treatment of Parkinson disease with diet-induced hyperketonemia - a feasibility study"
"Ketogenic diet protects dopaminergic neurons against 6-OHDA neurotoxicity via up-regulating glutathione in a rat model of Parkinson's disease"

Researchers are now interested in ketogenic diets for treating a number of disorders including MS. So actually, your MS suffering friends should quite possibly be eating even fewer carbs than you, Jenny.

Be well,

ET said...

After being on a low carb diet for six months, I started having adverse physical reactions eating even a small amounts of sweets. One night I had a white chocolate truffle. Within minutes, I turned beet red, my blood pressure skyrocketed, and I felt like crap.

However, the cravings for sweets went away several months after I stopped using artificial sweeteners. Sweet foods now taste very weird. Nobody warned me about this.