Sugar Turned On Me

NOTE: I’m out of town for the next week, so I won’t be posting to my blog. The next  exciting update to Sugar Turned On Me will be on Wednesday, Sept. 3rd.

Experience, they say, is what you get when you don’t get what you want. While I don’t claim to be an expert on living as a diabetic, just someone who is learning as he goes along, there are one or two things I’ve noticed. Here are five of them:

1.  A slice of bread is a unit of measurement - When I looked in my little book that came with my monitor about living with diabetes, it pointed out that a slice of bread is usually around 10-15g of carbs. My target number is 45-60 for most meals, so that means I can have three slices of bread. I started seeing other foods as bread equivalent. When I look at a bag of chips that reads 30 carbs, in my head I immediately translate that as two slices of bread.
2. Most restaurant meals are really two meals - Quantity equals prosperity in the American mindset. As a result, restaurants try to make sure they provide generous helpings to make it look like you’re getting a lot of value. The problem is that most places up the things that have the most sugar, usually your drink and potato based side. This is especially apparent if you go to a fast food place and ask for another side besides fries. It usually confuses the cashier and the first time I tried it, I got fries given to me anyway.
3. Having a stash is not just for compulsive eaters - If you have dietary restrictions, it’s never a bad idea to keep a stash of food with you. It doesn’t have to be huge, but just enough to get you through if you end up hungry and there’s no good spots to acquire  lo/no sugar food. I personally keep stevia packets on me.
4. Nobody expect you to order anything besides Coke - Vending machines are prejudiced. Water or syrup, that’s your choice.
5. Sugar is everywhere - Ketchup. Hot dog buns. Hot dogs. Spaghetti sauce. Added to juice. Used to pack fruit. Some brands of toothpaste. Avoiding added, unnecessary sugar is a little like trying to avoid sunlight in the desert.

Anything interesting you’ve learned by being diabetic? Comment below.

See you next week

We all do things we know we shouldn’t do. It’s not that we’re irresponsible or we don’t want to be good, it’s just there’s something that seems worth the risk. One of those things for me is that last snack before bed.

Snacks aren’t bad things in and of themselves. Even ones right before bed are okay. Where the problem lies is that while one is asleep, your body isn’t using much fuel and as a result, any sugar you have right before bed stays with you till morning.

This is frustrating for someone whose snack cravings run towards more bready textures.

The way I usually get around this is with a couple of cookies. By couple, I actually mean two. I usually look at the carbs on the side of the box and make sure that it’s at least lower than 15g. A small cup of milk usually  accompanies them, though I’m trying to get used to the idea of water instead, as milk adds extra sugars to the experience. In lieu of that, I’ve had a bite of chocolate (no more than 1/6 of a bar) or a small piece of fruit.

In the morning, though, if I’m looking at my monitor and it’s a few points higher than I expect, then I always ask myself how good of an idea was whatever I had for my nightcap.

Maybe I can learn to jog in my sleep?

It’s neat when I find out something I am already doing is good for helping with diabetes. It’s even better when I find out it’s something I enjoy, such as going to a spa.

For example, in preparation for going out of town, I got a pedicure this past weekend. I’m going to be wearing a pair of boots that I don’t take out of the closet very often and the extra space near the toes (and reducing the risk of scraping my wife’s calves when we sleep) seemed like a good idea. While I was there, I talked to the nail technician about a numb spot on the outsides of my big toes.

I was sure that the numbness was just callouses or something. Since diabetics are prone to peripheral neuropathy (loss of feeling in the peripheral nervous system) I figured it’s something I should pay close attention to. I realize that peripheral neuropathy is something that is more likely to affect people with more advanced diabetes than myself, but it is still enough of a concern for me that I felt I should not ignore it.

My nail technician was very good. She pointed out I had impacted skin under the nails of those toes which was the likely cause of the numb spots. She then proceeded to dig out said impacted skin, a process which involved a brief but intense bit of pain. She told me she has more than one diabetic client and she recommended that I get treatments every 5-6 weeks.

The reason that pedicures are good for diabetics is that advanced diabetics can have difficulty fighting infection. If you can’t feel your toes well, due to peripheral neuropathy, then you might not notice an infection in your nail bed due to impacted skin or an ingrown toenail. Unchecked, this could spread to other parts of your body and turn into a serious illness, possibly even a fatal one. Pedicures bring attention to that part of the body and a good nail tech can help prevent infections there by just doing what they do.

The caveat I’d throw in here is that not all nail technicians are equal and neither are all spas. If you were to look into to getting regular pedicures, you’d want to make sure that the spa cleans its tools and tubs after every client because otherwise, you increase your risk of getting infection. Also, all states in the US now license nail technicians, so you want to make sure that a spa displays their certifications or at the very least will verify that they are certified. You should also talk to your nail tech about being diabetic and what your concerns are; a professional will listen and talk to you about what they can do and what they recommend.

Some spas won’t do the treatment if you’re diabetic, mostly because they are aware of increased risk of infections and don’t want to accept the liability. While this is unfortunate, it may still be best to be up front with the person you’re working with. And as with anything that might affect your health, talk to a doctor and get their opinion if you have any doubts at all.

Me, I’ll have a standing appointment for as long as they’ll let me. And next time, it shouldn’t hurt so much. I hope.

Further Reading:
A discussion on how to prepare for a pedicure and what to ask and not ask for.
An ariticle on what to look for in a spa.

There is an art to being able to say no gracefully. I’m not saying that I know it, I just know there is one. And being diabetic means practicing saying no a lot.Usually, for me, it’s just saying no to myself. The first big “no” I did was telling myself that the Dr. Pepper I had before I went in to get my first A1C results was going to be my last one. I’ve had to say no to a side of fries even when the meal will be the same price, turn down the second piece of candy or say “no, thanks” to second helpings at my mom’s house.

For me, the polite no is a matter of discipline. My diabetes is mild and I’m trying to make sure it never gets any worse. I’m glad I can accept the first piece of candy and that takes the sting out of not being able to have two or three.

It would be easy to play up the martyr like aspect of it all, but making a big deal of it would just make me look like a drama queen. For that matter, saying no with a set jaw and grim countenance would do little besides make people around me sad for asking. I try to make my refusals politely with a smile if I can.

I keep in mind that the people who are offering me food I shouldn’t have are doing so usually either out kindness (like my mom) or because it’s their job (like the person offering me a side of fries). And usually, when it’s just me, I’m not thinking in terms of “this will hurt me if I have it”, I’m just thinking I’m hungry. There’s no reason to be a jerk to those offering or to myself for wanting.

Saying no is like anything else: you get better with repetition. The important thing is to be consistent, ingraining the activity until it’s second nature and no longer awkward. Once the family gets used to the idea, then they stop asking and if you’re lucky do so without any fanfare. By the time that happens, it’s much easier to say it to yourself.

When I first became aware of my diabetes, I decided very quickly that was going to be good at saying no. It was part of taking the long view. I want to be healthy enough to say yes to the things I can have for a very long time, which means saying no to a lot of things now.

For me, the trade is worth it.

I like news stories about how things I’m already eating or drinking will help my diabetes. I’m less fond of news stories about how things I’m already eating or drinking are going to kill me. Recently, I got turned towards an example of the latter.

Everyone knows that arsenic is poison. What you may not know is that there are compounds that break down in the soil and when they do they produce arsenic that sometimes ends up in ground water. Like the water that ends up coming out of your kitchen faucet. Like the water you may be drinking aside.

Why I’m writing about this here is that trace amounts of arsenic in the body have been linked to the development of type 2 diabetes. By testing urine samples, researchers found that type 2 diabetics have a higher concentration of trace arsenic than do non-diabetics. There is some question as to if diabetes is caused by the concentration of arsenic or if arsenic is concentrated in the bodies of diabetic folk, but at the very least there seems to be some connection.

Statements engineered to induce panic aside, arsenic in the the groundwater is a problem that the US Government is already aware of and has standards for. Within the past 10 years, these standards have become more strict.

I looked into water filters to see if my Brita pitcher at home was effective in removing arsenic from my water. Looking at the list of things they advertise as being effective, I was saddened to find that arsenic was not on them. There are filters I found that hook up to your faucet specifically to remove arsenic, though they started at about $120 and went up to over $400.

Water is a diabetics best friend most days. It’s cheap. It’s got no carbs, no fat and is good for you. But like everything else these days, it’s important to check the quality of what you’re getting.

The best thing I think you can do is get informed:
The article that sparked my interest.
The US Government’s website on the subject.
A fact sheet about arsenic in the water.

Chili, in some parts of the country, is not merely a dish but a subject of controversy argued with the same fervor usually reserved for gun control or religion. Purists will argue that there are no beans in chili. Others will differ on whether chili is a side dish, main dish or topping. There is difference of opinion as to if it should be ground meat or chunks of meat. The issue is complicated.

None of this mattered the day I decided to try my hand at chili because I was hungry and wanted to cook. Also, I was looking forward to something that was high protein, low carb. So here’s the recipe I used:

1 pound Ground Sirloin (90% lean, 10% fat).
1 large can (28 oz) Crushed tomatoes
1 large onion, chopped
1 can of pinto beans, liquid drained
3 cloves of garlic, minced
1 teaspoon chili powder
Salt
Pepper

• In a medium skillet, brown your beef. Add salt and pepper here and maybe about half of the chili powder.
• In a medium sized pot, put a little olive oil in the bottom of the pan, heat up to medium and add the onions. Stir every once in a while and when the onions start to turn clear, add your garlic. Give it about another minute or so.
• Put your beef into the pot with the onion and garlic. Add the tomatoes, beans, the rest of the chili powder and more salt and pepper.
• Cover, simmer for about ten or fifteen minutes, stirring occasionally. Produces four servings of almost two cups each.

The spices are a suggestion only. The above will produce tasty but not terribly spicy chili. You can add additional chili powder to make that happen. Also, check your chili powder to get an idea of what’s in it. I like mine to contain a little cumin.

This recipe is really a base. From this platform, it’s easy to experiment adding additional spices, whole chili peppers, soy sauce, peanut butter… the possibilities are manifold and varied.

But don’t take this as written to a chili cook off. The beans might get disqualified if you’re lucky. If you’re not, they might get you lynched.

This recipe on NutritionData.com
Note: This recipe does have about 1g of trans fat per serving, so if you’re avoiding that, keep this in mind.

I never liked reading labels on food. At the store, I would just grab something that looked tasty or at least non-offensive and go with it. Due to diabetes, reading labels is now something I have to do to remain healthy.

For most foods it’s easy: I pick up the item, check the carbs and fiber, check the fats, make sure it has no high fructose corn syrup or partially hydrogenated oils and go. The problem comes when I get food that isn’t labeled so well, like say apples or sweet potatoes. And then what about food I prepare at home?

Fortunately, the web knows everything.

I checked out a site suggested by my doctor:NutritionData.com. It’s has the nutrition info for a large number of foods and displays it in a format similar to the nutrition labels on food packaging. It includes common dishes, individual food items like apples and chicken as well as the items at a lot of restaurants. It also displays their gylcemic index numbers, their relative fat to carbs to proteins ratio and a lot of other information that is beyond my needs but is still worth having.

When you log on, if you set up an account, you can add foods to your “pantry”. You can then go back and make recipes from your pantry and get the nutrition data from that. The only thing that irks me is that you can’t just cut and paste a whole recipe.

There are also some foods that are missing from the list. I went looking for curry paste and could only find curry powder, for instance. In comparison to what the site offers, this is a forgivable gap.

One thing that’s good about being diabetic in the 21st century is that we have access to a lot of information. By making use of the tools available to me, I have felt a lot more informed and in control of my diabetes. And more in control is better than less.

Check out the site whether you have diabetes or not. It’s worth the look.

There’s a saying that when the only tool you have is a hammer, then every problem looks like a nail. Likewise, when you have a chronic disease, every problem in your life begins to look like a symptom. Little things that were minor annoyances pre-diagnosis, like fatigue and the occasional spot of fuzzy memory, are now the things that make you sweat at night.

Recently, I started having pains in my low back. They’re pretty consistent and have been going on for a few weeks. I started wondering if I might have kidney disease. According to the National Kidney Foundation, anywhere from 10 to 40 percent of adults with type 2 diabetes will suffer kidney failure. I didn’t know this statistic, I just knew my back hurt and I started to get nervous.

I looked up the symptoms and I have exactly one, frequent urination. This symptom is common to diabetes  and kidney disease. A little relief followed, but I know that every time I see one of the other symptoms on the list (which include things as innocuous as itching, pale skin, and puffiness around the eyes) I’m going to be a little more tense.

There’s a balance I have to strike in my head between hypochondriac-esque caution and Devil-may-care confidence that I’m not all that unhealthy. I have to remember that I have a problem, but I can’t freak out about it constantly. After all, stress is bad for blood sugar.

The answer to most of my issues is keep a list of them and discuss them with my doctor. There are tests that can be done to detect kidney disease, heart disease and other things that being diabetic puts me at risk for. Also, I’m already trying to control my diabetes, so anything I do towards that lowers my risk for other problems. Focusing on the things I can control helps me relax and not worry.

But I have to listen to my body. Sometimes I hear something from my body that I didn’t pay attention to before. And when I do, sometimes it comes with jitters.

Recently, I’ve talked about the importance of support from your family in dealing with diabetes. What I didn’t talk about is what you should tell them. Below are a few tips for you and few tips for anyone who is going to be helping you with diabetes in your life. Some of these are derived from personal experience, others from people I’ve known.

For Them:

• The person you know and love who now has diabetes looks the same and may not be showing any outward weakness you would normally expect of someone with a chronic illness. Don’t be fooled into not taking it seriously. They have a disease and one for which there is no cure.
• Just because someone shouldn’t have a lot carbs and sugar in their diet doesn’t mean they’ve lost the taste for them. Be considerate when you’re eating them, especially when the new diabetic in your life is getting used to their new eating habits.
• Get involved with them. This means educating yourself as to what their blood sugar numbers mean, what their numbers are for any given day and finding out what they need to add, change or delete from their pantry. It really does make it less weird for all involved.
• Keep your loved ones honest. Once you know what their numbers mean, help them maintain them. Don’t let them shy away from the doctor or not take it seriously themselves.

For You:

• Be upfront with your family both about what the diabetes is and what it isn’t. Don’t be surprised if your family members freak out. Don’t be surprised if they don’t. You’re going to be the one with the information. Make sure that they have it soon thereafter.
• Don’t get offended if someone eats something that you can’t or shouldn’t have. They are most likely not doing it to annoy you. They may not be aware that they are bothering you. Tell people gently, but don’t expect or demand that the house you live in is going to change their diet with you.
• Make sure that if you’re on medication that your family knows what it does, where you keep it and when you need it.
• Get prepared to repeat yourself. Anyone going through a major life change is going to get to explain it to everyone they are in close contact with. You’ll get asked what being diabetic means and what you can and can’t eat.
• If you’re scared or freaked out by being diabetic, tell your family and friends. I know the encouragement I got was one of the big factors in adjusting to my new situation. You need to know it’s not the end of the world so that they will know it’s not the end of the world.

Education is the first step to understanding. Once something is understood, it’s a lot less scary. Diabetes of any degree is a major issue and requires major life changes.

Don’t do it alone.

My mornings always have a little good or a little bad news in the form of my daily fasting blood sugar. Low numbers make me feel normal. Higher numbers make me feel a bit nervous.

My schedule is such that I eat breakfast right after I take my blood sugar. When I get a higher number than I’m expecting, breakfast seems like a lot less of a good idea. But this is where I’m wrong.

Studies have shown that if you don’t eat breakfast, your body suffers. After six or eight hours of sleep, your body is expecting some fuel. Also, eating is likely to keep one from just trying to make due with coffee or some other little shot of caffeine. If you eat breakfast, your mind and body work better and your morning improves as a result.

But then there’s that number staring me in the face.

The solution I’ve found is to focus on proteins and fiber. My usual breakfast items are:

• Peanut Butter on Brown Rice Cakes: One is usually sufficient to keep me going to lunch. It fits in the hand well and I can usually munch on it while checking email and otherwise getting started at work.
• Fruit: A good backup, mostly for the fibers and the fact it requires no additional preparation.
• Granola Bars or Fruit and Oat Bars: Also convenient, but with these I scrutinize the nutrition info.
• High Fiber Cereal: It’s not just for your granma anymore. There are a lot of palatable options on the market, including non-bar form granola. Again, read the package so you know it’s healthy and not just advertised healthy.
• Water: As much as I love my caffeine, the morning is a good time to start staying hydrated.
• Milk: A little goes a long way and adds some protein. I’m unwilling to drop below 2% but if you can do it, go skim.

Every few months, another study crops up confirming the cliche that breakfast is the most important meal of the day. I’ve listened. It’s worth working around the hurry and the morning rush to get my body working like it should.

If you don’t have it scheduled, make time for it. The results are worth the effort.