What the Heck Does “Hungry” Mean?

When you’re me, and the weather starts to cool off, and you start to realize that a lot of your clothes from this time last year don’t fit so well, and you decide you want them to fit well, and you resolve to take steps to make that happen, diabetes can get in the way. Surprise!

Sensible, normal-people healthy weight advice always includes this nugget of wisdom: “Pay attention to your body. Eat when you’re hungry, and stop eating when you’re full.” It’s exactly the kind of “no duh” advice that works for people who don’t have diabetes, but takes a little extra work when factory-produced insulin gets thrown into the mix.

Carbohydrate exchanges and meal plans (or the lack thereof) for people living with diabetes are different than they were 21 years ago, when I was diagnosed. See, back then, no one really gave a crap if you were hungry, or if it was dinner time and all you felt like eating was a couple of crackers. Eating very specific things at very specific times of day was part of diabetes management, and there were (and still are) insulin doses to account for, plus habits, hormones and daily activities.

So, if I had given myself an injection for 55 grams of carbohydrates for lunch, and I realized I wasn’t hungry after ingesting 30 of those carbohydrates? Too damn bad. I would have to finish that peanut-butter-and-honey sandwich anyway, or I would suffer the consequences. And if I came home from school starving, it was the same idea: I had a very limited set of options. I’d eat what I was supposed to, and then I’d distract myself with something else. (Of course I never snuck an ice cream sandwich or an extra bag of microwave popcorn without accounting for it. What kind of diabetic teenager would do such a thing?)

Zap back to 2011, a time when technology, fast-acting insulin, and a better understanding of how carbohydrates work has given us all more choices when it comes to food and diabetes. And I’m still complaining.

I have a hard time eating less, because I feel like I honestly don’t know what it’s like to be plain old hungry. To me, hungry — even just a little — means I’m on the road to hypoglycemia hell. It’s always been my first symptom, so I take efforts to avoid it. Which means eating more.

At the same time, I know all too well what it feels like to be obscenely, nauseatingly full and see a down arrow on my CGM screen. These occasions call for one or more post-giant-meal snacks, which always leave me feeling like Adam Richman at Willy Wonka’s Chocolate Factory — without the encouraging crowd.

Then there’s the otherworldly hunger and subsequent binges that tend to accompany moderately low blood sugars, especially when they strike in the middle of the night. There’s no rationalizing with that kind of urge and, in the face of what feels like certain impending death, nutritional awareness disappears like three bowls of Cocoa Krispies and a liter of juice.

I’m fully aware that these things can be managed. All I have to do is read a few books about human anatomy and metabolism and test my basal rates and check my blood sugar more often and count carbohydrates more accurately and — is anyone else hungry, or is that just my brain imploding?

15 comments on “What the Heck Does “Hungry” Mean?

  1. Kathy says:

    …,” she said, after eating two mini Hershey bars, three pretzel sticks and a Target fruit snack to treat a 55 mg/dL. Oh yes oh yes, I too have been on the “feeding schedule” exchange system and have no metabolic awareness either. And did I mention the latest low symptom – nausea – and how much fun it is to cram sweet stuff down your throat when you feel like, um, well…!

    People should pay to join our club. We PWDs have all the fun );-)

    • Yep. I hear you.

      After 27 years now – I don’t really know what hungry feels like. I too am no longer on the Regular/NPH combo shots with defined meal times and exchanges for food choices. I am free to eat whatever and calculate the insulin needed to cover the carbs.

      But – I still eat at the same times and the same amounts. I don’t really know if I am hungry or not. Sometimes it is just easier to stay with what my body knows so well.

  2. Willis says:

    Ha! This is funny and insightful, and I don’t officially have diabetes yet! (call me in November after my next dr. appt.)

    • Jonah says:

      I’ve been experimenting with using regular in the last few months, after having been put on Novolog at diagnosis, a bit over five years ago. One of the most unexpectedly liberating parts of the experience has been eating slowly.

      On Novolog, if I inject to cover 100 grams of carbohydrate, eat 80 and feel full, I’m probably going to go low soon.
      On Regular, if I inject to cover 100 grams of carbohydrate, I eat 60 grams now and 40 grams in an hour or two, which means I do a lot less uncomfortable eating while full. Small frequent meals, which I always figured would be a pain in the butt, are making me feel better over all. I’m not finding myself going hypo while full so often.

      I don’t think it’s a coincidence that in the trials comparing Novolog to Regular, there were five complaints of stomach pain on Novolog compared to one on Regular.

  3. v6shell says:

    Thanks for the post, an enlightening & fun read for me here. I don’t remember what those hungy hippo things are, but the image made me laugh enough to lighten my spirit :)

    For what it’s worth, I reverted to old insulin tech (i.e., Humulin R & Humulin N) about a dozen years if I remember correctly (using the walmart reli-on versions of them now for cost reasons). I do have to say that as seemingly inflexible as they are… I’ve no complaints with them. They don’t break the bank for me here, but new insulin tech is not even a possibility.

    I eat pretty much whatever I want (not exactly when I want though) & do a variation of the same carbo-gram counting as others with D. I do know what it feels like to be plain old hungry (starving as I type this). Cheers :)

  4. Meagan says:

    Diabetes is always sabatoging my weight loss efforts! My favorite is when I excercise and then have to eat all the calories and more to compensate for the low blood sugar. LOL on the Hungry, Hungry Hippos. :)

  5. Sara says:

    The last paragraph explains it all so perfectly and so frustratingly accurate.

  6. wow, what an incredible post, my friend. you hit the nail on the head, perfectly. food is such a loaded issue for all people with diabetes. it’s not “just food,” but so much more.

    and low bg binges are the worst. i feel so gross afterwards.

    thanks for your honesty and for sharing this. love you!

  7. Jim says:

    Very insightful. I’m 6 months in with the big type 1 D and this is already starting to sound familiar. Great post and a good read.

  8. So, so true! Love this post.

  9. Great freaking post. I swear my wires are all crossed up from so many years on NPH & Regular, and having to totally disconnect my hunger from most eating situations.

    I hate that everything food related is so complicated for me.

  10. Shay says:

    Brilliant post! It’s so true! Even after pumping for 10 years it’s still an adjustment to see food as FOOD not “medicine”. I hate that even when doIng things right there is always a tinge of “disordered eating”.

    Thanks for sharing and making me want to play Hungry Hungry Hippos!

  11. mhr says:

    I. Love. Your. Blog. Actually, I love all diabetes blogs at the moment. (Diagnosed 7 years ago, and only just barely reaching out to an on-line community. Because my whole damn family and every last damn friend has no f***ing idea what it’s like.) Indeed, there *is* always a tinge of disordered eating…. Except for those of us for whom there is a truckload. And those of us who were disordered eaters long before the big D hit. Anyway, in reference to the OP, my brain also implodes. Regularly. Thanks for telling the story we all experience.

  12. your 3 bowls of cocoa crispies and a liter of juice…was my 2 bowls of crispex (with sugar), 2 pieces of toast and 3 juice boxes last night. ouch. I laughed and sympathized with that :)

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