Ain't No Thing But a Chicken Wing

Linda here!  I'm Derek's proud wife and am honored that he asked me to provide a little guest post for his blog.

Often, when I provide nutrition counseling to someone who has recently been diagnosed with diabetes, he usually tells me that he was advised to avoid all white foods (sugar, white bread, cake, potatoes, chips, etc).  While this advice is OK and partially true, I find it is inadequate. I think the more knowledge one has about the different foods in his diet, the better chance he has of staying on track with managing his disease.  (They don't call diabetes a self-managed disease for nothing).

So, where does one start?

Well, I think a good starting point is to know a little bit about carbohydrate foods, that is, the foods that turn into sugar when we eat them.

Most clients/patients I talk to know that sugar, potatoes, rice, white bread, pasta, and grits are carbohydrates, but when I tell them about wheat bread, fruit, milk, and yogurt also fitting in to this category, I am met with a good deal of surprise.  Before I go on, I want to mention, carbs are not bad; they are not the enemy; they are not evil.  In fact, out of the 3 main macronutrients carb, protein, and fat, our body most readily uses carb as a source of energy.  However, since diabetes can be defined as a problem with glucose metabolism, I think it is important to achieve the appropriate balance.

OK, so what are the foods that most directly affect blood sugar (aka carbs)?

Starches - this includes (but is not limited to) rice, pasta, legumes/beans, peas, corn, potatoes, bread (even whole grain, whole wheat etc), crackers, cereal, grits, oatmeal, hummus

Fruit - ALL fresh fruit, canned fruit, dried fruit, frozen fruit.  ALL juices.

Milk/Yogurt - Milk (all types, cow's milk, almond milk, soy, rice etc), yogurt, pudding, ice cream.

Sweets/Sugar - this seems like a no brainer, but this is a good time to mention that honey, agave nectar, brown sugar, sugar-in-the-raw, evaporated cane juice, and maple syrup are all considered forms of sugar, and they all affect blood sugar.

and lastly, a little something I like to call.....

Sneaky Carbs - these are the foods that many people think contain very little or no carbohydrate, but then are left with a big surprise when they check their blood sugar a couple hours later.

• Chicken wings, those delicious little bite sized treats, what are they covered in?  Some form of sauce that probably contains sugar (BBQ sauce, tangy sauce, sweet and sour, siracha glazed, bourbon maple, you get the idea).
• Other sauces - gravy, spaghetti/marinara, sweet and sour, teryaki 
• Salad dressings - while not all contain carb, think about honey mustard dressing and certain fruit based vinaigrettes.
• Carrots and other sneaky veggies - Vegetables are so good for you.  Most of us should eat more of them, but certain ones do contain significant carbohydrate.  
• Fried chicken/meat - the meat contains NO carb, but the breading does.  Bummer.
• Peanut butter/nuts - most will say these are very low carb foods, but if you eat a nice sized portion, and eat them often, they can be contributing to those higher blood sugar readings.

So, knowing the foods that affect blood sugar is the first step.  The next is knowing how to read the label and decipher how much to have.  But, not to worry, we'll have more on that another time.  Thanks Derek for asking me to blog this week.  I am happy to be your wife and little diabetes nerd/guru.  Aren't you glad you married a dietitian?! HA!

I tried to keep this post short and concise, however, I plan on elaborating more in future posts. Please feel free to ask questions in the comments.  Peace.   

          

A Sociology of Preventable Disease States

Some of us have more of it than others.  Sometimes it shows up robust and unexpected.  Other times we must search the depths just to find a sliver of it.  But many times even a sliver can change lives.  What is this illustrious phenomenon, you ask?......none other than motivation.

It is with this word in mind that I watch my kids grow and reflect with wonder on the generosity and sacrifices that my parents, my wife, and other family and friends have made to ensure that my diabetes stays in check.  I acknowledge the fact that this disease does not exist in isolation.  It's not a little pill that's taken before bed and forgotten for 24 hours.  It's actually a lifestyle that involves the help and coordination of those closest to the patient.  Frustration, excitement, fear, accomplishment, confusion, comraderie, and temptation are all present in this community from time to time.  The patient's goals become common goals.

This communal aspect of diabetes brings me back to my original thoughts on motivation.  Because complications can be either prevented or prolonged (And in some cases of Type II, this applies to the disease itself), we hold an incredible opportunity to show our gratitude to our loved ones.  The motivation to remain controlled flows like a fire hydrant under the perspective of continuing the hard work of my parents, and living a long and healthy life with my wife and children.  It is the only thanks they want, and the only thanks that will even begin to come close to sufficing.

Diabetics get a bad rap because we don't take care of ourselves, we take a bag of meds, we have 13 doctors, we're always in the ER, we all have the same excuses, and we lie through our teeth about all of it.  I dare say this is the kind of reputation we get when we live for ourselves.  It is only under the purpose of living for others that we are able to find the motivation to take care of ourselves. 

What's your motivation?  If you don't have it, then find it.  And then........let's get less than seven, greater than low!   

  

Testing....testing......1-2-3

"I'm sorry, sir, but the insurance will not cover you to test that many times per day."

"I don't have any other patients testing that much, there must be some other issues going on.  I know your A1c is good, but you shouldn't have to test that often."

I've heard these lines and many others just like them, discouraging me from doing the only thing that gives me hard evidence as to how to manage my diet, insulin, and lifestyle: ........testing my blood sugar.  But as the Bible says, ask and you shall receive.  Consequently, every return phone call has resulted in insurance coverage, doctors heeding my request, and suppliers coming through.  Is it really that easy?  Yes.  It is that easy because even though my request may be unusual, it is completely reasonable and logical.  I am asking to have a better record of my blood sugar readings throughout the day.  Isn't that the key to managing diabetes?  Isn't that what decades of research and development have created with CGM's (continuous glucose monitor)?  Isn't that what helps us to recognize patterns and tendencies?  Yes, yes, yes.  And ultimately, it is what helps us to reduce complications and live longer.  Here are my 4 absolute testing times:

1. Before breakfast / Upon waking in the morining.
2. Before lunch.
3. Before supper.
4. Before bedtime. 


Testing in between these times can also be very helpful to determine post meal glucose, reaction to exercise or stress, and variable schedules.  I also recommend testing during the night if the bedtime glucose is out of range.  This will help to prevent dangerous hypoglycemia or long-term hyperglycemia.  Let's get less than seven, greater than low.