Sep 25, 2007

Fitting Diabetes Into Your Lifestyle

Jan Chait

My first "real" dietitian was Amy K. I say "real" like that because the ones I’d had before tended to snap out orders. Those commands consisted of a long list of foods I could no longer eat for the rest of my life and the ones I could eat, but had to be consumed in conjunction with other stuff. In no way did it resemble the way I ate.

Well, that lasted all of about two weeks.

Amy K. asked me what I liked. What did I usually eat for breakfast? Lunch? Dinner? What did I like to snack on? What brands? What times did I normally eat? Could I handle doing this? What about that?

In short, what she did was work with me to design a meal plan that I could live with; to fit diabetes into my life instead of cramming me into a box labeled "diabetes" and expecting me to stay there. Interestingly, although it's been more than a decade since I met Amy K., the plan is still doable.

I have one main criterion when it comes to food: If I have to physically or mentally weigh, measure, or count it, and then commit even more math to figure out how much insulin to give myself, then it's going to by golly taste good. I like to cook; it relaxes me. I enjoy trying new foods. I love the feeling of bread dough under my hands as I knead it. One of my comfort foods is potato soup. With saltine crackers

For the most part, I eat lean meats, fresh fruits, nonstarchy vegetables, and whole grains. Sometimes I eat pasta and garlic bread—and other goodies.

I think we all need to cope with diabetes in a way that's best for us. For me, that has meant learning all I can. What do different foods do to my blood glucose? Physical activity? Stress of any kind? If I know why things happen, then I know how to take care of them. For the most part, anyway: Diabetes tends to have its "moments." Knowledge, along with insulin and self-monitoring, has freed me to...well, just freed me.

In addition to reading a lot about diabetes, I had help from some awesome educators who understood that fitting diabetes care into individual lifestyles would make people more likely to continue doing their best to manage it.

For years, I didn't pay attention to my diabetes at all. I avoided going to the doctor because I didn't want somebody telling me "you have to do this; you can't do that." I didn't want to get blamed (again) for giving myself Type 2 diabetes. I was tired of people telling me "you need to lose weight" (I'd been trying for years) and "your sugar is too high; you're cheating on your diet" (I needed insulin).

Imagine my surprise (and relief) when I got to a place where the first thing on the agenda was not "you need to lose weight," but "let's get your sugars under control." Where Amy K. worked with me to design a meal plan I could live with. Where Sonja began to teach me the reasons behind why certain things needed to be done. The guilt was absent and the focus was on helping me reach my goals in a way that I could handle.

I don't believe there is one meal plan that is good for everybody. I think that, as individuals, we need to find something we can live with and do whatever is necessary to make it work. I prefer the low-fat lifestyle. You may prefer low-carb. I wouldn't want to be forced into low-carb any more than you would like to be forced into eating carbs. I don't believe either of us is wrong: I do believe that both of us should get the assistance we need to make the plan we prefer work with diabetes.

If you do like carbohydrates, what's more important? Waving off meds and making yourself miserable trying to fit the square peg of your diabetes into the round hole of your life, or carving the peg to fit? For me, the bottom line is to keep my blood glucose in range as much as possible and I've been willing to do whatever it took to realize that goal.

Historically, I've jumped on my bicycle first to start my blood glucose on its way down. That's been more difficult lately because of construction in my neighborhood. I'm happy to report that we finally got a road on Friday and, while the entire neighborhood isn't paved yet, there are now enough finished roads to justify airing up my tires and hopping on the bike again. We even have a paved road now that will get me out of the neighborhood so I can ride to the park or the biking/hiking trail and venture a bit further.

It's a good thing, too. We appear to have some bagels in the house.

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