Showing posts with label food. Show all posts
Showing posts with label food. Show all posts

Monday, December 28, 2009

Post Holiday Post

Resting in the lull between Christmas and New Year's.

Christmas went well.  I've had some days where my averages are a bit higher than I like, but nothing earth-shattering.

I've snacked a lot less this year than I have in years past.  I can't say I don't miss grabbing a handful of cookies, whether homemade sugar cookies, oreos, or whatever else is handy.

One thing I've noticed is that I have gotten very cold sensitive, which is unusual for me.  I used to have incredible cold tolerance, even for a kid from Michigan.  (I once did a dorm fire drill in shorts and a t-shirt in the snow, and I was fine.)  Just before my diagnosis, I noticed a definite change in my ability to tolerate cold, and it seems to have gotten worse in November and December.  We don't get too much cold weather here, but it's affecting more than I think it should be.

Tuesday, December 8, 2009

Pizza Two Days in a row...

...and I'm still here! :)

Pizza is notoriously hard to bolus for, and I'm kind of old-school in that I'm using pens and a regular glucometer. (No pump, no CGMS.)

For me, it seems to be true that I can't overbolus for pizza.  I wound up taking 16 units for lunch (three pieces) and it worked out perfectly.

Still, my numbers have been consistently very good, and I've been very happy with what I've been doing and how it's been working for me.

Lots of people in the DOC seem to have been posting about their CGMS experiences.  The DexCom 7 seems to be a favorite.  I'll ask around locally about them; not sure what my insurance plan will and will not cover.  The opportunity to get readings every 5 minutes, and trending info, seems very important.

Saturday, December 5, 2009

A Bit More on Ice Cream

I had some more ice cream tonight - normal ice cream, though for me, it was guilt free.  (Sorry, couldn't resist that one.)

I've done some research on ice cream, and consistently the lowest in carbs are plain chocolate flavors, which seem to run about 17g/half cup.  Other varieties may run as much as 25g/half cup for things with high-carb ingredients like Cookies and Cream.  Different flavors vary, so read your labels and dose accordingly.

I've seen other diabetic bloggers (and heard other diabetic friends) complain about ice cream and pizza frequently.  They seem to be relatively hard to bolus for.  (In my case, I went up 60 points after eating it - to 151.  A little higher than I'd like, but no reason to take drastic corrective action.  I took an extra unit and claimed victory.)  I think one of the things is that it's hard to get serving sizes precise with ice cream.  A scoop is close to a half cup, but sometimes the scoop wants to get more, or less.  Or maybe that's just me.

So we come back to the question of Sugar Free ice cream that was raised here a couple of weeks ago.  Is it worth it?

Most "sugar free" items feature about the same overall carb levels as regular ice cream - in the vicinity of 16g/serving.  Usually, a decent percentage of these are "sugar alcohols", a particularly unfortunate term since they are not truly sugar and not truly alcohol.  The reason these chemicals are used is that they are not completely absorbed by the intestines, which means they wind up passing through.  This leads to gas, bloating, and some other unpleasant consequences.  In the class I took from the CDE, we were told that you can subtract half the total "sugar alcohol" content from the net carbs.  So for most sugar free ice cream, that would be about 3g/serving, and most ice creams would net out around 13g/serving.

That may make a huge difference to someone on a very strict carb control diet, but I'm not in that situation.

I've illustrated for several people what it means for me to eat things like that, but showing how much insulin I'd have to take to cover it.  (You should see the way people's eyes pop when I show them what I'd have to take to cover a Sonic slushie.)  Most people, though, are still affected by the perceived horror of taking a shot every time they eat, and so they blow that aspect of it out of proportion.  The simple fact is that 3g more or less per serving is going to mean at most 1 unit of difference for me, and for smaller servings, could get lost as rounding error.

Let me put it another way - to eat anything more than a spoonful or two of ice cream, I would have to take *some* insulin.  So the big deal-maker or deal-breaker is not how much carb is in a given item, but whether or not I have to take insulin for it at all.  Since I'd have to take insulin for "reduced sugar" ice cream anyway, it's not compelling as an option.  Also considering that the most common way to get ice cream at most grocery stores is by the half-gallon (more or less), that would be a lot of servings to get through.  I've found that other members of my family will happily eat the lower-carb varieties of normal ice cream.

Does that make sense?  It seems to be a very hard thing for non-diabetics.  Mostly because a lot of them have a hard time getting past the idea that we inject ourselves a lot, so it's not the extra units that make a difference, it's whether we have to inject ourselves at all.  I'll happily eat something I don't have to stick myself for, so I eat a lot of almonds and peanuts, which net out about 2g carbs/ounce.

Friday, November 27, 2009

The Importance of Averages

There are a number of things I've always enjoyed about Thanksgiving, and now that I've got one in the rear-view mirror (so to speak) I can rest a little easier.

Two of my favorite things about thanksgiving dinner have always been stuffing and potatoes.  I did well with those; I think I've gotten pretty good at counting carbs effectively.  That's surprised me a bit because I've never been good at estimating distance or volume.  Well, now I have to be. :)

It was the cheesecake that spiked me.  Make no mistake, my wife makes the best cheesecake *EVER*.  This time, she made one with cherry topping, and really thick (from scratch!) graham cracker crust.  I love the crust.  I love it a lot.  The crust from scratch is especially good, since she makes it with real butter.

I guessed 64 and bolused 8, but I undershot.  (I told you the crust was good.)  I was on a bit of a rollercoaster for the rest of the night - I had tested 99 before the cheesecake, but tested 175, 146, and 192 that night, and finally 149 before I went to sleep.  Not ideal, but in retrospect I worried about it more than I should have, and that probably helped to keep me up.  I wound up putting in a lot of corrective, and I'm well within normal limits now.

If I had run the averages, I probably would have been a little less worried.

The other big thing was that I worked the program I was taught, and it worked for me, though a bit more slowly than I had hoped.

Though it does seem that the higher I go, the more insulin resistant I get.  I'd love to hear if anyone else has similar experiences that way, or if I'm looking at it incorrectly.

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.

Thursday, November 19, 2009

Ice Cream!

I had plain old ice cream today.  Ah, the things you learn to appreciate...

Interesting trivia - plain chocolate ice cream (Yarnell's, at least) is the lowest carb available of the major flavors I've seen, at 16g/half cup.  Homemade vanilla was highest at 20g/half cup.  Cookies and cream was 19g/half cup.

Sugars have been in pretty good control these last couple days.  I'm getting more aggressive about taking insulin when I'm high.  Gotta keep those numbers down...

Sunday, November 15, 2009

Small Victories: Pizza

Pizza is a tricky food for diabetics to eat.  It has two key attributes that make it tricky for those of us who have to worry about our blood sugar levels:

1)  High carb count due to crust and pizza sauce
2)  High fat content, which can delay digestion of the carbs

The first one means we have to push a lot of insulin to process pizza, the second means that if you push it too early, you could go low.  But I like my pizza, so it's a problem worth solving for me.  Plus, who wants to let a little thing like diabetes get in the way of enjoying one of life's more enjoyable foods?

I learned a neat trick from my CDE for dealing with pizza - push the insulin *after* eating the pizza instead of before it.  That gives your system a little margin, since your sugar will go up a little as the carbs process, which will give the insulin something to work on and hopefully won't take you low in the meantime.

This worked for me today:  Two slices of green pepper/onion/black olive/pepperoni hand-tossed pizza.  Estimated 88g carbs, blood sugar prior: 93, 2 hours later: 124.  Huzzah!

Tuesday, November 10, 2009

Back to Sonic

I went back to Sonic today, and it was all I hoped it would be.  I got the Cheddar Peppers because they were lower carb...than the fries.

I can't remember ever actually ordering a drink from Sonic...I've always gotten the Strawberry Fresh Fruit slush.  That's not really an option for me now.  (By the book, the Route 44 strawberry slush is 188g carbs - that would be about 24 units of Novolog at my current dosage, without counting anything else.)  It's always taken me about 90 minutes to finish a Route 44, too, which would be very tricky to dose for.  Not impossible, but more of a challenge than I really want to undertake.  Well, I had a Blizzard very early in my journey, but I only took 8 units for it...should have taken at least twice that much.  I had a record high of 328 after that, which is the highest I've tested since I started insulin.  One of the key indicators my ratio was way off.

So because I'd never ordered one, and because Sonic recently changed their menu structure, I couldn't find the drink list...I asked if they had Diet Dr. Pepper, and they did.  Score!  (I can drink Diet Coke too, but prefer Dr. Pepper and Mt. Dew, because I'm a technology professional and we have to support the smaller colas, especially Dr. Pepper.)

The Cheddar Peppers were by far the tastiest I've ever had...maybe it's just me, but the food tastes better when you have to count carbs and stick yourself three times to eat it.  (Testing before and after, plus the insulin dose.)  I certainly appreciate such things more than I used to.