Saturday, November 21, 2009

Ice Cream and Snacking: Perspective

I have always loved ice cream.

I grew up near a Baskin-Robbins in Michigan, and we would walk down there at least once a week.  I remember being especially fond of chocolate chip and gold medal ribbon (which has a caramel stripe).  I later learned to love cookies and cream, butter pecan, and other flavors.

Ice cream was actually the main indicator of my blood sugar problems.  We usually had some around the house, but we were going through about 3/4 gallon a week, and that was largely me.  In addition, I was having the odd pint for lunch at my work cafeteria.  It was one of the major reasons my wife wanted me to get checked out - I was eating far more than a normal person should, and I was still losing weight.  Well, we know how that turned out.

Ice Cream is a tricky thing for diabetics.  Let's do a quick review of diabetic types.  Type 1 diabetes is insulin deficiency, and is much more rare.  The body doesn't produce enough insulin to process the food we eat, and our blood sugar levels climb because there's not enough insulin to bring it down.  For type 2's, which is much more common (they outnumber us about 9 to 1), they make plenty of insulin, but for some reason their bodies resist that insulin and it doesn't work.  Type 1's are (as far as I know) always treated with insulin; type 2's may or may not be.  In both cases, we have to watch what we eat and count carbs - for type 1's, to dose insulin correctly, and for type 2's, to stay within their tolerances.


This leads to significant differences in the way we handle snacking.  For a type 1, occasional snacking is no big deal - count the carbs, take the insulin, eat the snack.  Maybe an extra blood test, to make sure the levels are OK.  Since most type 2's are not on insulin, that won't work for them - they have to find something that fits within their carb budget, or change other things around.

Snacking is also important because of a process called liver dumping.  When we go for a while without eating, the liver will dump glucose into our bloodstream, counting on the pancreas to release insulin to process it.  This is often done when the body feels "hungry" so ignoring hunger pangs and not eating can actually lead to a higher blood glucose level in diabetics than eating something and not dosing.  One of the primary goals of the oral meds they give type 2's is to block this function of the liver.  Frequently, we'll look for snacks that are low in carbs.  My favorites are peanuts and almonds.  Nuts in general are excellent as low carb snacks, and most diabetics I know swear by peanut butter.

So, we still need to eat, and we still need to snack.  One thing that irritates a lot of us is when people tell us we can't eat something.  I have at least once eaten it on the spot, just to prove the point.  (And then snuck off and dosed - some people are very uncomfortable with needles, but most people have never seen the needles that fit on insulin pens.)  And of course, there's the primarily psychological problem of deprivation.  It's hard to see everyone else eating birthday cake, or drinking cider, or whatever, and feeling like you can't.  So it's important to feel that we can, within limits.

That said, it's kind of dumb to blow lots of insulin on candy and other "empty" snack foods.  For one, it's a sure way to gain weight (and now that I'm back to a healthy weight there's no need for that).  For another, there are the consequences of eating the fat and other stuff.  Blood pressure and other vascular problems a re a major class of diabetes consequences that we would all like to avoid, thank you very much.

I'll post more later on some specifics that I've found about various frozen treat things.

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