Another Diabetic Question: Finding Optimism and Hope
December 17, 2021 2:44 PM Subscribe
I've had diabetes for years, though as of 2019 I went into remission and was able to stop taking insulin as long as I kept my diet steady. I did this. Steady with all the wrong foods. I'm feeling really discouraged as I start from scratch. I need some help/hope to be successful again.
Going into the holidays and watching relatives feast on carbs and sugars has me so down in the dumps. I'm just not sure how to deal with it. It's been a few years since I've had to deal with this and I had more time to establish myself and brace myself for it. It's only been a month since my downfall and needing treatment, but here I am doing ok with a diet. My kids came home this week and are eating things like sloppy joes and ordering out food from restaurants. I can't even function in this environment.
What have fellow diabetics or just friendly people to offer? What has worked for you? How can I not feel hopeless this early in? It's not just the holidays, its the every day things. I hate cooking and prepping meals, so all the great recipes out there aren't for me. I've been pretty much buying deli turkey and eating that with vegs and hummus.
Okay, this was ranty. I'll take anything you can wrench out of this. Sorry to be a mope. Happy Holidays to you.
Going into the holidays and watching relatives feast on carbs and sugars has me so down in the dumps. I'm just not sure how to deal with it. It's been a few years since I've had to deal with this and I had more time to establish myself and brace myself for it. It's only been a month since my downfall and needing treatment, but here I am doing ok with a diet. My kids came home this week and are eating things like sloppy joes and ordering out food from restaurants. I can't even function in this environment.
What have fellow diabetics or just friendly people to offer? What has worked for you? How can I not feel hopeless this early in? It's not just the holidays, its the every day things. I hate cooking and prepping meals, so all the great recipes out there aren't for me. I've been pretty much buying deli turkey and eating that with vegs and hummus.
Okay, this was ranty. I'll take anything you can wrench out of this. Sorry to be a mope. Happy Holidays to you.
Hi OP, maybe you would enjoy this blog. The author is very smart (she has a gastric sleeve and so does her husband) and most of the recipes are low carb/keto, and delicious. I found them most helpful when I was having to be very careful about diet. I love baking, I love sweets, and to have a sympathetic and realistic source of recipes to deal with all kinds of cravings was very useful for me.
She has or had a FB group as well, but FB groups being what they are... lots of kitten pictures, you know what I mean.
posted by fingersandtoes at 3:21 PM on December 17, 2021 [3 favorites]
She has or had a FB group as well, but FB groups being what they are... lots of kitten pictures, you know what I mean.
posted by fingersandtoes at 3:21 PM on December 17, 2021 [3 favorites]
Are there medications short of insulin that can help you out? They might give you some blood sugar control and allow you to liberalize your diet a little bit.
posted by SLC Mom at 7:42 PM on December 17, 2021
posted by SLC Mom at 7:42 PM on December 17, 2021
t2d here. there are other drug options. ask your md. no one can be an angel all the time. maybe schedule one or two 'cheats' a week. high qual dark chocolate is my go to - delish and nott too much sugar. portion control the cheats, tho.
posted by j_curiouser at 10:46 PM on December 17, 2021 [1 favorite]
posted by j_curiouser at 10:46 PM on December 17, 2021 [1 favorite]
Another t2 here. Non-insulin injectables that help control blood sugar. I'm on Victoza and it also helps control appetite too. I also thought you could cut yourself some slack over the festive season - you're not going to do yourself too much harm if you indulge a couple of times over the next week and then get back to the regime at New Year.
posted by Martha My Dear Prudence at 12:26 AM on December 18, 2021 [1 favorite]
posted by Martha My Dear Prudence at 12:26 AM on December 18, 2021 [1 favorite]
Best answer: I'm sending you a hug, because I feel like you haven't had the benefit of a diabetes care team that has given you all the support you need. So here's a blast of info.
It sounds like maybe you haven't gotten good diabetes education training? If you're in the US, your health insurance should cover you going to a program. It should also cover you sitting down with the registered dietician at your endocrinologist's office (or one affiliated with him or her). And OMG, if you're only going to your family medicine doctor/internist and not to an endo, please make an appointment with one. It makes so much difference when you're working with a specialist who knows what's new (and on the horizon) in D-health.
Next, there are a LOT of options in between nothing and insulin. I took (long-acting) insulin (Lantus) for the first two months after my T2 diagnosis 10 years go. That brought my A1C down so much (15.8 to 7.8, and then to 6.1) that I could just go on oral meds. I take Janumet (one before breakfast, one before dinner) and one metformin. And a Flintstone's multivitamin (preferably a purple Dino) and that's all. No biggie, but my numbers stay pretty steady all day. And though I haven't tried them, there are non-insulin injections that keep blood glucose levels in control, some of which you only have to take once a week.
(Obviously my diabetes is not your diabetes, but the point is that you have way more tools at your disposal in your diabetes care tool kit than a hammer and Scotch tape. There are people, groups, resources, food options, med options, and so much more than I can fit in one MF response. You are NOT ALONE! If your doctor hasn't discussed LOTS of options in between nothing (or just lifestyle changes) and insulin, know that it's your absolute right to get guidance on all of this.)
Make sure you're testing often enough. Make sure your doctor prescribes enough test strips that you are testing frequently until you really know what your "regular" typical breakfasts and lunches do to you. Your doc should be paying attention to which meter and strips are in your insurance plans formulary. And then you should go to the manufacturer's website and register to get a patient discount card. Used in concert with your insurance, you can get hundreds of strips for a reasonable price, but if your pharmacist knows the proper way to enter it all, the amount paid by the pharma card counts toward your deductible even though you're not the one paying. It's like magic. (If you're using a continuous glucose monitor, then the above paragraph isn't key, but based on what you've described, it sounds like you're not getting enough real-time feedback to guide your decisions. That just adds to the stress!)
Trust me, the more you test, the more insight you'll have into what foods cause what blood glucose reactions in your body, and that insight is so helpful for figuring out what you eat and in what combinations. (So, let's pretend it's not COVID times and you're in a restaurant and you REALLY want that high-carb dessert. If you know how different foods impact your blood glucose, you can have the fish with a non-carby sauce, and instead of the potato, have the delicious grilled veggies. That lower carb entree and sides means you can have that dessert (or much of it) guilt-free. (Not that you should feel guilt about eating.) With diabetes, personalized knowledge is power.)
You absolutely don't have to be able to cook, though it helps if you can at least "assemble" stuff on a plate in a way that's appealing, but if you have resentment about cooking (and resentment about having limitations on your eating) then that's going to turn into a gnarly feedback loop. As a T2, you can absolutely eat WHAT everyone else is eating; it's not an allergy. But you have to watch the AMOUNT you're eating so that you aren't exceeding the carb count your doc/nutritionist has guided you to consider. The more you experiment with eating AND TESTING post-meal, the better you'll know what certain foods do to blood glucose levels.
Other than boiling water for pasta (get Dreamfields, way lower in net carbs), I don't "cook," and the idea of HAVING to cook all the time would make me so miserable I'd probably either never eat again or spend all my money on take-out. Instead, I've found a balance, and generally buy healthy prepared foods. Sushi turned out to be a surprise winner for me. You definitely need to experiment with testing your blood glucose before and two hours after meals to know how each food type impacts your personal situation. (If you read up on that, it's called "testing in pairs.")
But I absolutely do count carbs and make sure I don't eat anything unless I know the carb count and that it's in the range my doctor suggested to me. I get exercise (lots and lots of walking). I set alarms to take my oral meds. It's been 10 years and I've stayed under 6.5 all these years. Getting support (of which, more later) is really important. Nobody can be (or has to be) "perfect" all the time, and doing it on your own without anyone to talk to about it can be really rough on the psyche. You need diabetes-buddies.
Back to meals. For me, I don't want to even think about this stuff in the mornings, so I found a breakfast for which I know the exact carb count (for the right amount of juice, milk, and cereal) and only ever eat THAT for breakfast unless I'm traveling abroad. I have the palate of a picky five-year-old, so I have a set few lunches that I make, with sort of rotating modules for sandwiches (if you have Nature's Own whole wheat where you are, it's shockingly low in carbs and doesn't taste at all like whole wheat unless you toast it -- don't toast it), a fruit or veggie, cheese, etc. But I only eat things I like/love, and I make sure that I pick flavors that appeal to all the senses. A dill pickle and some sharp cheddar cheese as a snack makes my afternoon swing; you need to know what *real food* and not processed, fake food makes your mouth, stomach, and blood glucose happy.
Dinners are hard because they're always complex. So look at what you LIKE to eat, and figure out what's working and what's not. Take the Sloppy Joe's. They have meat, which I don't eat, so I went to look at a recipe just now: ground beef (no impact on diabetes, per se, as there are no carbs), bell pepper, onion, garlic (all negligible carbs), and a sauce with tomato sauce, brown sugar, yellow mustard, and Worcestershire. Literally the only things in that whole recipe to concern yourself with are tomato sauce (because some versions may be higher in sugar or corn syrup) and the brown sugar, so talk to a registered dietician about how to figure how many carbs are in that.
And then the bread. That's the only higher carb part of it. If the other stuff you're eating with your meal isn't high in carbs, regular toasted buns might even be within the carb count allowed/preferred for your dinner. If not, look at rolls/bread with different/lower carb counts. Or make Sloppy Joe "stuff" and have it with pita or tortillas or eat it like chilli.
My point isn't to live your life on Sloppy Joe's. Just figure out what you like, look at the carb counts of each of the ingredients, and figure out the little tweaks to make it all work. You can also order food (just like your kids) from restaurants. But order real food, not crappy junk food that will make you feel sluggish. (I'm not saying you can't or even shouldn't indulge in things that taste great even if they're bad for you, but there's a lot out there that tastes great AND IS GOOD FOR YOU if you experiment.)
But you don't have to be perfect. Just cutting out soda pop and junk food (if you drink/eat either) can be a huge help. But beyond that, knowledge is power. Yes, if you've never paid attention to healthy eating, then it's a different way of living. I grew up in a household where my mom only cooked healthy meals, and I was a picky eater, so I was miserable eating properly cooked but boring vegetables and whatnot...until I went to college and lived in an international dorm and ate lots of international varieties. I found LOTS of "healthy" foods I liked; they just had different seasonings and unfamiliar cooking methods. Don't think in terms of what you have to give up; think in terms of what you can DISCOVER! (Again, you don't have to cook it, but you have to be abel to recognize it.)
Finally, be assured I do remember standing in the grocery store and crying almost every week for a while after my diagnosis, because all of the information was overwhelming. I'd spent my whole life paying attention to calories and fat grams, and now I had to focus on carbs? And I don't eat meat, so everything I like has carbs. I wailed! For two months, I was afraid (and resentful) and ate nothing except carefully, miserably planned meals and cucumbers, celery, and (my beloved) cheese.
When all you can think about is what you can't have, it makes you miserable. Instead, explore all the things you can have and all the support you can acquire.
TLDR? See an endo, not just an internist. Take the diabetes education courses. See a registered dietician. Make sure you're on the right meds. (There are lots of different oral meds and non-insulin injections, some only injexted weekly). Experiment with foods and seasonings. Learn that healthy eating for PWDs (people with diabetes) isn't about denying ourselves, it's about knowing how much of something we can eat without it raising our blood glucose higher than is healthy for is. Learn how to carb count and what the appropriate number is for your different meals and different physical activity levels. Learn what works for your body by testing in pairs. Focus on gaining knowledge about how YOUR body works.
And recognize that diabetes is impacted by SO MUCH MORE than just what we eat, everything from genetics to stress to sleep (amount and quality) to hormones to (yes, believe it or not) *weather patterns*. You can't control much of it, but most of what you can control isn't about denial.
And here's another hug.
Finally, I can't tell from your profile, but if you identify as a woman and are in the US, check out Diabetes Sisters, which offers a great support system (with a web site bearing tons of useful info).
You're not alone.
posted by The Wrong Kind of Cheese at 1:02 AM on December 18, 2021 [24 favorites]
It sounds like maybe you haven't gotten good diabetes education training? If you're in the US, your health insurance should cover you going to a program. It should also cover you sitting down with the registered dietician at your endocrinologist's office (or one affiliated with him or her). And OMG, if you're only going to your family medicine doctor/internist and not to an endo, please make an appointment with one. It makes so much difference when you're working with a specialist who knows what's new (and on the horizon) in D-health.
Next, there are a LOT of options in between nothing and insulin. I took (long-acting) insulin (Lantus) for the first two months after my T2 diagnosis 10 years go. That brought my A1C down so much (15.8 to 7.8, and then to 6.1) that I could just go on oral meds. I take Janumet (one before breakfast, one before dinner) and one metformin. And a Flintstone's multivitamin (preferably a purple Dino) and that's all. No biggie, but my numbers stay pretty steady all day. And though I haven't tried them, there are non-insulin injections that keep blood glucose levels in control, some of which you only have to take once a week.
(Obviously my diabetes is not your diabetes, but the point is that you have way more tools at your disposal in your diabetes care tool kit than a hammer and Scotch tape. There are people, groups, resources, food options, med options, and so much more than I can fit in one MF response. You are NOT ALONE! If your doctor hasn't discussed LOTS of options in between nothing (or just lifestyle changes) and insulin, know that it's your absolute right to get guidance on all of this.)
Make sure you're testing often enough. Make sure your doctor prescribes enough test strips that you are testing frequently until you really know what your "regular" typical breakfasts and lunches do to you. Your doc should be paying attention to which meter and strips are in your insurance plans formulary. And then you should go to the manufacturer's website and register to get a patient discount card. Used in concert with your insurance, you can get hundreds of strips for a reasonable price, but if your pharmacist knows the proper way to enter it all, the amount paid by the pharma card counts toward your deductible even though you're not the one paying. It's like magic. (If you're using a continuous glucose monitor, then the above paragraph isn't key, but based on what you've described, it sounds like you're not getting enough real-time feedback to guide your decisions. That just adds to the stress!)
Trust me, the more you test, the more insight you'll have into what foods cause what blood glucose reactions in your body, and that insight is so helpful for figuring out what you eat and in what combinations. (So, let's pretend it's not COVID times and you're in a restaurant and you REALLY want that high-carb dessert. If you know how different foods impact your blood glucose, you can have the fish with a non-carby sauce, and instead of the potato, have the delicious grilled veggies. That lower carb entree and sides means you can have that dessert (or much of it) guilt-free. (Not that you should feel guilt about eating.) With diabetes, personalized knowledge is power.)
You absolutely don't have to be able to cook, though it helps if you can at least "assemble" stuff on a plate in a way that's appealing, but if you have resentment about cooking (and resentment about having limitations on your eating) then that's going to turn into a gnarly feedback loop. As a T2, you can absolutely eat WHAT everyone else is eating; it's not an allergy. But you have to watch the AMOUNT you're eating so that you aren't exceeding the carb count your doc/nutritionist has guided you to consider. The more you experiment with eating AND TESTING post-meal, the better you'll know what certain foods do to blood glucose levels.
Other than boiling water for pasta (get Dreamfields, way lower in net carbs), I don't "cook," and the idea of HAVING to cook all the time would make me so miserable I'd probably either never eat again or spend all my money on take-out. Instead, I've found a balance, and generally buy healthy prepared foods. Sushi turned out to be a surprise winner for me. You definitely need to experiment with testing your blood glucose before and two hours after meals to know how each food type impacts your personal situation. (If you read up on that, it's called "testing in pairs.")
But I absolutely do count carbs and make sure I don't eat anything unless I know the carb count and that it's in the range my doctor suggested to me. I get exercise (lots and lots of walking). I set alarms to take my oral meds. It's been 10 years and I've stayed under 6.5 all these years. Getting support (of which, more later) is really important. Nobody can be (or has to be) "perfect" all the time, and doing it on your own without anyone to talk to about it can be really rough on the psyche. You need diabetes-buddies.
Back to meals. For me, I don't want to even think about this stuff in the mornings, so I found a breakfast for which I know the exact carb count (for the right amount of juice, milk, and cereal) and only ever eat THAT for breakfast unless I'm traveling abroad. I have the palate of a picky five-year-old, so I have a set few lunches that I make, with sort of rotating modules for sandwiches (if you have Nature's Own whole wheat where you are, it's shockingly low in carbs and doesn't taste at all like whole wheat unless you toast it -- don't toast it), a fruit or veggie, cheese, etc. But I only eat things I like/love, and I make sure that I pick flavors that appeal to all the senses. A dill pickle and some sharp cheddar cheese as a snack makes my afternoon swing; you need to know what *real food* and not processed, fake food makes your mouth, stomach, and blood glucose happy.
Dinners are hard because they're always complex. So look at what you LIKE to eat, and figure out what's working and what's not. Take the Sloppy Joe's. They have meat, which I don't eat, so I went to look at a recipe just now: ground beef (no impact on diabetes, per se, as there are no carbs), bell pepper, onion, garlic (all negligible carbs), and a sauce with tomato sauce, brown sugar, yellow mustard, and Worcestershire. Literally the only things in that whole recipe to concern yourself with are tomato sauce (because some versions may be higher in sugar or corn syrup) and the brown sugar, so talk to a registered dietician about how to figure how many carbs are in that.
And then the bread. That's the only higher carb part of it. If the other stuff you're eating with your meal isn't high in carbs, regular toasted buns might even be within the carb count allowed/preferred for your dinner. If not, look at rolls/bread with different/lower carb counts. Or make Sloppy Joe "stuff" and have it with pita or tortillas or eat it like chilli.
My point isn't to live your life on Sloppy Joe's. Just figure out what you like, look at the carb counts of each of the ingredients, and figure out the little tweaks to make it all work. You can also order food (just like your kids) from restaurants. But order real food, not crappy junk food that will make you feel sluggish. (I'm not saying you can't or even shouldn't indulge in things that taste great even if they're bad for you, but there's a lot out there that tastes great AND IS GOOD FOR YOU if you experiment.)
But you don't have to be perfect. Just cutting out soda pop and junk food (if you drink/eat either) can be a huge help. But beyond that, knowledge is power. Yes, if you've never paid attention to healthy eating, then it's a different way of living. I grew up in a household where my mom only cooked healthy meals, and I was a picky eater, so I was miserable eating properly cooked but boring vegetables and whatnot...until I went to college and lived in an international dorm and ate lots of international varieties. I found LOTS of "healthy" foods I liked; they just had different seasonings and unfamiliar cooking methods. Don't think in terms of what you have to give up; think in terms of what you can DISCOVER! (Again, you don't have to cook it, but you have to be abel to recognize it.)
Finally, be assured I do remember standing in the grocery store and crying almost every week for a while after my diagnosis, because all of the information was overwhelming. I'd spent my whole life paying attention to calories and fat grams, and now I had to focus on carbs? And I don't eat meat, so everything I like has carbs. I wailed! For two months, I was afraid (and resentful) and ate nothing except carefully, miserably planned meals and cucumbers, celery, and (my beloved) cheese.
When all you can think about is what you can't have, it makes you miserable. Instead, explore all the things you can have and all the support you can acquire.
TLDR? See an endo, not just an internist. Take the diabetes education courses. See a registered dietician. Make sure you're on the right meds. (There are lots of different oral meds and non-insulin injections, some only injexted weekly). Experiment with foods and seasonings. Learn that healthy eating for PWDs (people with diabetes) isn't about denying ourselves, it's about knowing how much of something we can eat without it raising our blood glucose higher than is healthy for is. Learn how to carb count and what the appropriate number is for your different meals and different physical activity levels. Learn what works for your body by testing in pairs. Focus on gaining knowledge about how YOUR body works.
And recognize that diabetes is impacted by SO MUCH MORE than just what we eat, everything from genetics to stress to sleep (amount and quality) to hormones to (yes, believe it or not) *weather patterns*. You can't control much of it, but most of what you can control isn't about denial.
And here's another hug.
Finally, I can't tell from your profile, but if you identify as a woman and are in the US, check out Diabetes Sisters, which offers a great support system (with a web site bearing tons of useful info).
You're not alone.
posted by The Wrong Kind of Cheese at 1:02 AM on December 18, 2021 [24 favorites]
Another fellow t2d here to offer you sympathy and support. Holidays suck for us because there is so much temptation. I also control mine with diet and exercise and that can be properly difficult sometimes.
I generally treat Christmas as a bit of a holiday from my diabetes and eat some things I shouldn't (Christmas cake being a particular favourite) on the basis that if I don't it'll be miserable as sin, and what's the point of that? Life is still for living, even with diabetes. The rest of the time I try to have more discipline, but still, sometime you slip up and often without even realising. ESPECIALLY when relatives are continually eating all the stuff you want and can't have. So don't beat yourself up, it's not easy and the fact you were able to come off insulin in the first place is brilliant. Pat yourself on the back!
Lots of other people will have good advice on the diet side. My best advice is walking. If you can walk a bit every day, you'll help yourself a lot. It doesn't have to be far, especially if you're struggling with mobility or lack of fitness, just a regular daily habit of walking. It seems to really help my bloods, and there's some evidence that regular moderate exercise can be better for blood sugar levels for t2ds than high energy exercise. But any daily exercise will help your bloods and your mood.
I can't comment on any drugs because I'm not on any, but I'd definitely talk to your medical provider about whether controlling it with drugs is right/necessary for you or not. There's no correct answer, just the correct answer for you.
posted by underclocked at 4:48 AM on December 18, 2021 [1 favorite]
I generally treat Christmas as a bit of a holiday from my diabetes and eat some things I shouldn't (Christmas cake being a particular favourite) on the basis that if I don't it'll be miserable as sin, and what's the point of that? Life is still for living, even with diabetes. The rest of the time I try to have more discipline, but still, sometime you slip up and often without even realising. ESPECIALLY when relatives are continually eating all the stuff you want and can't have. So don't beat yourself up, it's not easy and the fact you were able to come off insulin in the first place is brilliant. Pat yourself on the back!
Lots of other people will have good advice on the diet side. My best advice is walking. If you can walk a bit every day, you'll help yourself a lot. It doesn't have to be far, especially if you're struggling with mobility or lack of fitness, just a regular daily habit of walking. It seems to really help my bloods, and there's some evidence that regular moderate exercise can be better for blood sugar levels for t2ds than high energy exercise. But any daily exercise will help your bloods and your mood.
I can't comment on any drugs because I'm not on any, but I'd definitely talk to your medical provider about whether controlling it with drugs is right/necessary for you or not. There's no correct answer, just the correct answer for you.
posted by underclocked at 4:48 AM on December 18, 2021 [1 favorite]
An option is to focus on the outcome you want: well controlled blood sugar throughout the day to avoid further problems. And be less worried about which combination of things you do to get there. Everything has some kind of disadvantage, whether that's side effects from drugs or hassle involved in detailed meal planning or having to self-inject or just financial cost. But there's no morally better or worse way to control blood sugar, just different methods with different advantages and disadvantages. You can choose the method or combination of methods with the best balance of those for you.
posted by plonkee at 7:42 AM on December 18, 2021 [1 favorite]
posted by plonkee at 7:42 AM on December 18, 2021 [1 favorite]
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posted by The Underpants Monster at 2:59 PM on December 17, 2021