Unsweetened. That is the name of the book I am writing. Untold stories of people living with diabetes. “The Good, The Bad and The Ugly.” I am writing this book to tell the true stories of people with diabetes. 29 million Americans are estimated to have diabetes or get diabetes, according to the American Diabetes Association. 317 million people – and counting – live with diabetes around the world. Scary big. Let’s stop blaming people who have it. Let’s stop shaming people who have it in public and around the dinner table. Let’s get real. Let’s get unsweetened.
Recently I moved to a loft apartment in a commercial building that has been zoned for use by artists. My new place has more space and an unexpected amenity: bakeries on 3 sides of the building. A bagel factory on one side. Behind me is the Dunkin Donuts facility where all of the donuts for NYC shops are made. And outside my bedroom window: Tom Cat Bakery, a huge complex that extends an entire block. Tom Cat makes custom breads for restaurants around the city.
My first night here, at 3am I was awakened by the aroma of freshly baked bread. At once I began to salivate. My subconscious brain assumed a warm loaf was coming our way. Past is prologue, right? Smell delicious food, ergo eat delicious food. I thought I must be dreaming, except I could hear the sounds of rustling paper and a running motor. I looked out the window to find men in hair nets and blue coveralls loading trucks with large carts full of baguettes and smaller bags of various shapes. I imagined what was in those. Dinner rolls? Focaccia? Sour dough? Pumpernickel? Sandwich buns? Or maybe the main event: croissants. The saliva crested in the corners of my lips in anticipation the choice of any kind of bread I wanted.
Then, the frontal lobe kicked into gear. This was madness. “You don’t eat bread at 3am” the inner voice of reason told me. Hypoglycemia is only reason I wake up at 3am and start eating carbs. Until now. All day and night the sweet aroma tricks my sense of smell while I work from home. As my thwarted appetite built up to an uncomfortable level, so did the craving reach my grumbling stomach. If I could have a little bread, maybe the distraction would go away.
The time to take an irrationally exuberant action had come. I got their number online and called Tom Cat to find out if they had an outlet store on site. The receptionist transferred me to the person who apparently takes calls from crazies like me. I explained my predicament; “I am your new next door neighbor. You guys are killing me with the smell of your bread. I would like to be come your next customer. Can you hook me up?” The proprietor explained that all of their product is destined for one of two places: either to a client or given away to City Harvest to feed the homeless.
3 weeks into my new home, the craving for bread lingers every waking hour in the back of my mind. I am hoping that my primitive brain will eventually unlearn its salivation response and I won’t even notice the smell. But for now, the good people of Pepperidge Farm have a new customer. I just have to run a gauntlet of Dunkin’s chocolate, vanilla custard, apple cinnamon filing or maple glaze on my way to the way to grocery store and back.
Claire Johnson, “Maple Frosted” Oil on Maple. (2008)
Do you have a favorite Easter candy? What is it? Jelly beans – what color? Like Peeps? Chocolate Bunnies? What about those Cadbury creme eggs? If you grew up with these traditional candies presented to you in a basket on Easter morning, whether you have diabetes or not, it is natural to have nostalgic craving for it. Happy memories are associated with it. I have a knee jerk desire for it when I see it. It is the only time of year when this stuff is available, so there that added sense of urgency. Holidays trigger emotional eating. We are faced with well-meaning hosts and “Food Pushers” you can successfully avoid the rest of the year. If your own internal challenges with eating aren’t enough, you bear the scrutiny of others and find yourself at events where you are stuck with no healthy options. Make your own rules about how you want to manage holiday eating. Don’t blindly follow Grandma’s rules because it is her house, and you don’t want to hurt her feelings at your own expense. You know yourself well enough to plan an ideal celebratory meal with the people who make you feel comfortable. If you chose to eat nothing but candy and hard boiled eggs for Easter breakfast, that’s cool. It was your choice and your plan. If you chose not to eat Grandma’s desserts because they weren’t worth the calories or the insulin to you, then Good For You! The goal is to feel happy about how you ate the day after Easter.
Dr. Steve Edelman is one of the most experienced, successful and well-loved Party Animals I know. It is impossible to have a bad time when you are around him. Steve’s video on Drinking with Diabetes is a holiday classic. It bears repeating, just like Rudolph and Frosty, and the Year Without A Santa Claus (my personal favorite)
In addition to the video, for some invaluable yet surprisingly free tips from longstanding survivors of t1D, Riva Greenberg’s article consolidates tips shared in a JDRF panel I moderated at the “Type 1 Expo”
Take away message of this post is: Using Lantus a long acting insulin with no peak, for one day, kept me within my target range: no hypoglycemia.
This was a pleasant, unexpected surprise. I started to feel better, less tired. I couldn’t believe how easy it was to adjust my eating pattern to a grazing with small amounts of food. Few prunes here, a handful of walnuts later, a handful of carrots later, an 80 calorie greek fat free yogurt later, one hard boiled egg, a serving of green peas, a cup of pumpkin soup, and later a protein bar after a workout of strengthening and yoga and rowing. Hmmm, maybe this is something I should try for a while, and taking a longer Pumpcation.
Here’s what happened: The other day, as I prepared to fill a new pump cartridge I realized that I had inadvertently thrown out the new bottle of nNvolog and kept the empty one. Dang!
I didn’t have another bottle as a back up because my pharmacy didn’t have enough Novolog on hand to fill my entire prescription. I can only refill my prescription on the last day of my 30 day supply. Why doesn’t Walgreen’s, aka Duane Reade in Manhattan, carry more than one bottle of Novolog at any time? Why don’t they realize that they have a customer that buys 3 bottles every 30 days. The insurance company and Walgreen’s want to wait as long as they can to pay. I suffer because it usually ends up in risking going without insulin for a brief period, AND it is twice as much work. I have to the pharmacy twice to pick up the remainder of the prescription.
Please share your pump vacations if you want, and state how your control was compared to your usual regimen on a pump.
29. When you hear someone say the number 29, what comes to mind? Is that the answer to the question “How old are you?” Anything is still possible at age 29. No one thinks of 29 as old. You are young and desirable. I was 29 when I was 29. Occasionally I am 29 years old, when someone asks me – because you just don’t ask a woman of a certain age how old she is. That is an unlisted number. But I was 29 a few days ago. Really, I was 29mg/dl. 29 is an undesirable number if you are a person with diabetes. You want to be 80-120 mg/dl which is generally considered normal, non-diabetic fasting range. When you are dependent upon insulin to keep you alive, you live with the ongoing risk that it also could possibly kill you within 4 hours of taking it. There is a narrow margin of error for PWD who are on relatively low doses. The lower your dose, the more sensitive you are to insulin. Sensitivity varies from individual to individual based on many factors: for example, weight, resistance to insulin, what you eat, time of day, level of activity, temperature conditions, whether or not you are sick with something else, stress, menstrual cycles, pregnancy, oral and other medications. One drop of insulin drops my BG approximately 75-80 mg/dl slowly over 4 hours, when sitting still. That’s a tiny drop of insulin for a big drop in blood sugar. Nothing bad happened, thank goodness. It snuck up me while I was laying on my bed. I did not have my CGM on because, well that’s another story. I did sense hypo symptoms, I was calm, I tested my blood, and then I panicked. Like when the broken leg doesn’t hurt until you look at it? Yeah. So I went straight for the huge bottle of apple juice and my bottle of Glucolift, sat down and started guzzling. Within a few minutes I was feeling it go up, and I kept testing until I reached 82 mg/dl about 20 minutes after the 29 mg/dl reading. I was 29 once before, and 32 once, and 42 and 49 many times, so I had confidence that I would recover. But it was scary. I look for patterns, and invariably when I have a severe low, like this one, it is because I ate at a restaurant and miscalculated the carbohydrate content. Eating out is also the usual culprit of severe highs, because I miscalculated by underestimating the glucose or carbohydrate in the food. That’s why I like to eat at home, where I know exactly what’s in the food because I prepared it. In Real Life: I prefer to revisit 29 only in my photo albums, not in blood glucose. I aspire to be be 80-something with an 80 mg/dl-something average blood glucose level. In diabetes speak, it is hip to be 80-120 mg/dl. #showmeyourG