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...

Tuesday, November 17, 2009

For your amusement

The stylings of Sugasheen, with an absolutely fresh take on Beyonce's "All the Single Ladies".  It's been making the rounds in the DOC (that's Diabetes Online Community):

Ah, The Miracle of Retail Pharmacy...

I had to deal with some extra frustration today when it came time to refill my prescription for test strips.

The first time I filled it, they gave me 100.  OK, I didn't know any better.   (I actually felt pretty good that I was walking around and talking...this was the morning of Oct. 5, immediately after learning "the rules", the date my diagnosis felt real to me.)

The first time I refilled it, they adjusted it so I'd get 200 strips for my copay instead of 100.  Seemed like a good deal to me...

So I called in a refill on Monday, using the Rx number I had.  Unbeknownst to me, it's the wrong number - a new one was generated when they clarified the directions.

Thankfully, they were very good about fixing it, and I'll be good on test strips for another month.

Amazing, the things you get to learn when you're diabetic.

Sunday, November 15, 2009

Marcus Luttrell: Lone Survivor

In June 2005, American special forces in Afghanistan suffered the largest loss of life in a single day ever in their history.

A four-man SEAL team, searching for a high-priority terrorist target in Northeast Afghanistan was found and attacked by a large Taliban force.  The rescue helicopter sent to rescue them was shot down as well, killing all sixteen men aboard.

Petty Officer Marcus Luttrell was the sole survivor of this operation, and Lone Survivor is his story of becoming a SEAL and what happened on that mission.

I was privileged to hear Luttrell speak and shake his hand last week, so I knew many details of the story before I read the book.  Still it is by turns inspiring, frustrating, and harrowing.  Luttrell represents the bravado and ethos of the Navy SEALs well.  It's hard to believe that people can survive the SEAL training - I know I couldn't.  The frustration comes of understanding the dilemmas our men in the field face, especially in relation to the rules of engagement they must obey.  The story of the battle itself and his subsequent evasion of the Taliban are the stuff of legend.  Scenes from Afghanistan are intercut with scenes from the Luttrell ranch in Texas, where nearly 300 people kept watch with the Luttrell family as they awaited news of Marcus' fate.

The book is well worth reading, and I highly recommend it.  It is deeply moving, especially for its depiction of the deep bonds of brotherhood that unite the men who serve in the most elite of American military forces.  It makes me proud that we have men like Marcus Luttrell defending this country.  We owe them all more than we could ever know.  We also owe the lost men of the Operation Redwing patrol - Lt. Michael Murphy, and Petty Officers Matt Axelson and Danny Dietz.  Those men are true heroes, and Luttrell does them a great honor by telling their story.

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!

Saturday, November 14, 2009

World Diabetes Day

Happy WDD, everyone.

The whole D-Blog world is saying it a lot better than I can, but I do want to at least mention that today is the day.  My favorite so far has been this video, by Kerri of sixuntilme.com:



Until we find a cure...