The authors of “Choose Your Foods” should choose their words with as much care

November 30, 2012

I had a visit with a diabetes dietician today.  The meeting went well, but I was taken aback.  I oftentimes get a vibe from health care professionals that they think I’m pretty screwed up with my diabetes management.  Today the dietician said multiple times that she thought I was doing excellent.  She actually said it at least twice, once using the word “great” to exalt my efforts; excellent is the word she used the second time.  This was after downloading all my meter readings and hearing the tales of the last months, and the 30 years that led to those conditions.

The reason I was taken aback is because I did not get that negative vibe.  If anything I got more of a “you don’t really need my help” kind of vibe.  That’s a good vibe to get, and I have to get used to it.  I want to be used to it.

I got a lot of handouts from that visit.  One was called “Choose Your Foods / Exchange Lists for diabetes.”  The reason I got that handout was because I asked about alcohol.  The word exchange always bothered me for many reasons.  It doesn’t seem like a real scientific unit of measure.  I know exchanges translate to more precise units but two problems I have with that.  That translation, or conversion more accurately, is different for each type of food so there isn’t an easy to remember standard.  This book, BTW reminds me of all the big books I got as a kid.  Something about them just speaks to the idea that you should stay at home in your little bubble of carb-counting and eat your fixed amounts of food without variation.

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Don’t teach me how to follow a plan; especially one that I did not make.  Instead, teach me how to adapt to any given situation so I can adjust appropriately if something does not follow the plan, which happens often.

Let me stop the micro rant within my primary rant and get to the point.  On page 53 of this book, under “[alcohol] Selection Tips” it states that “While alcohol, by itself, does not directly affect blood glucose….”

Whoah, Nellie.

It does not directly increase  your blood glucose, but it certainly affects it.  Lowering is an effect, dear author.

This is the kind if confusing crap that makes it harder to manage your glucose.  Had I not known any better, I might read that and think I could do shots of vodka all night and I’d be fine.  Wrong.  I’d be dropping into a diabetic coma while being drunk on top of it.  I’ve been there.  Not the coma, but all the most serious effects of low blood sugar combined with being drunk is a really trippy place to be.  As great as that sounds to you recreational drug users out there, it’s not because you didn’t plan to get to that “high” and therefore not really sure when you’ll come down.  You’d always wish you weren’t there if you were cognizant enough to generate that thought.

A lot of the info you get on diabetes assumes you’re in a very controlled environment.  There should be more info out there for people on how to deal with all the variations.  Don’t give people a static list of a bunch of food and their “exchange” amount.  Teach people how to solve the problem up front and don’t try to program them into an un-shifting regimen.  I hate to use the word problem, but I’m speaking entirely from a mathematical point of view.  How do I adjust the scope, slide the scale, hit that curve ball?

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Posted by breeze773

Why now?

October 14, 2012

If you knew me really well you’d know that I’ve had type 1 diabetes for over thirty years.  There are only a few who fall on that list, by the way.  That is the first reason for starting this blog.  I really don’t mention that I’m diabetic.  Ever.  When I feel the need to test or shoot up, I run to the closest restroom like I’m a superhero who won’t don his cape in public for fear of revealing his secret identity.  So this is a diabetes coming out of sorts.

The second, more immediate reason is that about a month ago I began to lose vision in my right eye.  As an example of how bad my vision currently is, when I close my left (good) eye I can see the black border of my computer monitor and a white blur from Word, but I can’t see any of the text I’ve written.  It’s not blurry.  It just ain’t there.  So, I went to the doctor.

There will be many more posts on that topic later, but there’s still a chance that the loss of vision is not diabetes related, but let’s hypothetically say it is for now.

The last big reason I want to do this is because I myself don’t have a lot of availability to people who have type 1 at all, let alone ones who are social drinkers.  Hopefully, some of you like me will see this as a place to find a kindred spirit.

I see doctors more often than your average bear, especially now that this eye problem has cropped up.  I find that most of them will tow the medical profession’s company line of, “you need to control your blood sugars, so don’t eat or drink anything you’re not supposed to.”  The “not supposed to” list is a long one.  That mentality doesn’t leave a lot of room for variability.  The lack of openness to variation on any of the factors that affect blood glucose made me over-compensate and start to change them all.  I’m a man who goes from one extreme to the other.  “If insulin lowers my blood sugar then if I eat an entire pizza, I’ll just take more insulin,” is what I always told myself.  That’s great in theory if you have enough data to know how many more carbs that pizza is and what your carb to insulin ratio should be.  I did not know those things.  Not well enough anyway.

I’m already digging myself a hole, right?  Then came college–of course.  Alcohol was flowing freely everywhere I wanted to be.  “Let’s drink before the football game.”  “Let’s drink before we go see that movie.”  “Let’s drink before we go out–to drink.”  Alcohol was that awkward dorm buddy you brought along to parties because you never knew what crazy thing he was going to do next.  Unfortunately, that crazy thing caused problems more often than turn the night into a hell of a lot more fun.

So, I started drinking.  Not a lot, at first.  I would dabble and make sure I still felt ok.  That feeling was never verified by a glucose test, however.  After gaining some comfort with my immediate safety not being at risk, I amped things up and drink more in quantity and frequency.  Nothing significant happened to me early in those days.  My pancreas or liver never spontaneously combusted after a night out and the fact that I didn’t test only enforced the notion that I could just wing it.  It was a bad habit I developed over the last twenty-ish years.  Now is the time to change the habit.

One current philosophy I have on life is to try to do things in moderation.  This goes against my natural tendency to bounce between extremes, but I think it introduces a more sustainable change to whatever aspect of your life you are applying it to.  This is why I’m not saying quit now and don’t look back.  Unless you are more able to go extreme.  In that case,  don’t think about adding the wildcard of change that alcohol introduces to your glucose management.  Let this be the only post you read.  To the rest of you, I’m going to tell you stories that you can consider anything from cautionary tales to commiserating conversations over a virtual drink.

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Posted by breeze773