Planning for Health With Diabetes

I don’t know how many of you reading this ever experienced the days of strict meal planning — for us Type 1 folks, it went away with the advent of fast-acting insulins like NovoLog and Humalog. For people with Type 2, meal planning can play a bit more of a role because you can’t “match the insulin to the food,” and with limited insulin sensitivity it becomes more important to make sure no one meal has too much in the way of carbs. But nothing quite compares to the meal planning that used to be required of us Type 1 folks.

I was diagnosed with Type 1 diabetes about 23 years ago, before the advent of fast-acting insulin. During that time, we had Regular insulin and long-acting insulin. The Regular insulin wasn’t fast — it lasted in the blood about eight hours, and you generally had to wait a solid half hour after injecting it before you could eat. Furthermore, because it lasted eight hours, the morning shot would cover breakfast AND lunch. This meant the two meals had to be spaced about four hours apart, and that schedule had to be kept pretty strict. And both meals had to follow a set plan for the number of carbohydrate exchanges and protein exchanges. The dinner shot had to be taken early enough that you could cover dinner, and then wait another three to four hours before eating the evening snack that would cover the remaining insulin still floating around in your body.

When fast-acting insulin came on the scene, it really changed things for us. Suddenly we had the flexibility to match our insulin to our food, rather than matching our food to our insulin. We could have a large intake of carbs — we just had to match it with the appropriate amount of insulin. We could have breakfast at 10 AM, skip lunch, and have dinner at 8 PM! It was a revelation! And it was, absolutely, a great forward step in Type 1 diabetes treatment. But now, years later, I’m discovering a secret gift that the old strict meal planning offered; one that my teenage self wouldn’t have ever thought about.

Limiting our options
I’m 37 now, and I know, beyond any shadow of a doubt, that losing weight is something I can no longer pretend isn’t important. It is. It will make me healthier; it will cut down on my risk of complications; it will make my insulin more effective; it will lengthen my life; it will give me more energy. In other words, it is a good idea with no downsides! And yet it’s a very hard thing to do. Changing our behaviors is not easy. That’s particularly true when what we’re trying to do is LIMIT OUR OPTIONS, which is what losing weight entails.

And it’s not just a matter of altering the food we take in; exercise MUST be a part of any plan to get healthier. There’s no way around it. So now we’re trying to limit our food choices, while ADDING activities to our schedule (a schedule that, for most of us, already feels full enough!). It’s no wonder our plans fail as often as they do.

Just follow the plan!
Now here comes the lesson of meal planning. Like I said, back in those early days, my schedule was set; it had to be. My exchanges in each meal were set; they had to be. But within that framework, I could mix and match. I didn’t have to have the literal SAME meal every lunch and every dinner. I just had to have the same proportions, and keep to the schedule. And you know what? It was surprisingly easy to do. Once we figured out the foods that worked and how to fit them into the plan, all I had to do was follow.

Now as a 37 year old, I’m “rediscovering my roots” in a way. I have created a kind of “modular weekly schedule,” and into that schedule I add a set number of music practice “blocks” (no relation to diabetes on that one, but I figured if planning worked so well for diabetes, it can work for other goals, too), exercise “blocks” (usually in the form of biking), and, equally important, “grocery” and “cooking” blocks (I have a blog-writing block, as well — check!). My work schedule isn’t movable, so it stays put, but the rest of those “blocks” can be wherever they need to be. But just like my days of following a meal plan, I don’t have the option to leave them out.

The beauty of all this is that I can look to the week ahead, and arrange those blocks on my little daily grids. And once they’re set, the work of living healthier gets easier. It doesn’t take away all challenges, but there’s one very important thing that planning like this does: Instead of having to constantly redirect myself AWAY from the poor choices, I simply need to direct myself TOWARD the path already laid out. And because that path includes conscientious food shopping and cooking time, my wife and I can make sure that we have healthy snacks always ready; we can make sure we always MAKE the time to cook a healthy casserole for the week so that we’re not stopping at the drive-thru or ordering take-out because there’s no prepared dinner food in the house; in other words, we can plan our choices ahead of time, and then simply reach for what we have made available for ourselves. We choose once, and follow for the week, instead of forcing a thousand little choices that come with a thousand little chances to drop the ball!

Just two servings of fatty fish a week may decrease the risk of diabetic retinopathy, according to new research. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more.