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?