I absolutely love food. I know everyone says they love food but it really is an interest/hobby of mine. Going to a restaurant I’ve never tried before excites me; I love the challenge of testing out a new recipe; my holiday itineraries are based around places I want to eat; in book shops I love to browse through the cookbook section; baking a cake or a loaf of bread is a relaxing way to spend an afternoon for me and my favourite TV shows include Masterchef and GBBO. I’m obsessed.
However, when you have type 1 diabetes, there are more things to consider than which takeaway to try out on a Saturday night or how much your dough has risen…
You need to think about exactly how many grams of carbohydrate are in what you are eating to calculate a precise amount of insulin to give yourself, to avoid high or low blood sugars. But aside from the carb content itself, you also need to think about protein levels if you’re having little or no carbs, fat content which can make blood glucose rise more slowly; whether carbs are simple or complex or the glycemic index. When you start to think about all these factors, it can take the enjoyment out of food and make it feel quite stressful.
I’m an all or nothing kinda gal, as in the type who goes to the gym every second day for a fortnight then I have to miss one class for an appointment or something, and I don’t go back for 3 months… Stupid, I know. This is an attitude I really need to work on changing, any suggestions welcome! But this means I’ll spend about a week putting 110% effort into my carb counting and insulin ratios, weighing out all my food, keeping a food diary, reviewing my blood sugars and trying to spot patterns and make adjustments. This approach works (to a degree, at least – there will always be outlying factors e.g. stress caused by a traffic jam; unplanned exercise in the form of having to lug boxes up and down the stairs at work; or sweating on a hot day) but it’s exhausting and takes a lot of time and mental effort. Then, when I get thrown off by a busy day in work or a birthday night out, or if I get discouraged by some unexpected highs or hypos, I give up. I take it so personally, consider myself a failure and ditch the diary.
When I give up, I feel as though I can really enjoy my food again, not put too much thought into the nutritional make up of it and still take an injection that roughly covers the carbs at a glance and a guess. However, this comes at a price. The price is guilt and regret. After every meal or snack, I feel that horrible knot in my stomach. This does not help my anxiety and in a different, more indirect way, it takes the enjoyment away from eating, just as the intensive carb counting is.
The other thing I have little self control with, and therefore more guilt, is grazing. I like to snack between meals. I feel peckish when I get in from work and like to have a packet of crisps or a banana at 4, followed by a meal at 6 and then a cup of tea with some chocolate at 9. If someone has brought a packet of sweets into work, I can’t see them lying on the desk without picking up a few. When controlling blood sugar with insulin based on carb counting, you should really have 3-4 hours between food. This constant grazing makes it very difficult to get a true blood sugar reading and means that your blood sugar will never properly settle between food, making it difficult to see if a correction dose is needed or not. With this comes more food related guilt.
It is important to say that I have never had an eating disorder, or considered my diabetes monitoring, carb counting or eating practices to be unhealthily obsessive. However, it is easy to see how people with diabetes commonly develop eating disorders, and how it is difficult to overcome this and still look after their diabetes in recovery from an eating disorder- particularly when insulin can also make you gain weight. There are very little stats on how common eating disorders are in PWD but it is very serious due to the fact it can lead to complications such as blindness, kidney failure and neuropathy.
So how do we create a healthy balance? A balance of monitoring blood sugars regularly, counting the carbohydrates we eat, as well as considering other contributing factors but also not letting this take over our lives, or beating ourselves up over one ‘bad’ blood sugar reading or one meal where we’ve taken a wild guess at the carb content?
My honest answer is, I don’t know, as I haven’t found that balance yet. At the moment, I am trying to remember that, as Kerri Sparling says, in her book Balancing Diabetes, “life with diabetes is not a perfect science and perfect diabetes isn’t an achievable goal”. As long as I’m testing my blood sugar when I should, I’m doing a good job and the sooner I realise no one is ‘perfect’, the sooner I’ll be able to cope with my day to day life. I’m trying to use each blood sugar as information like Kerri suggests, information to work on and lead to a healthier me. I hope that over time, I can learn to stop attaching emotions to my blood sugar readings and that with this I will find more peace around food, and less anxiety in general. I feel I could go on and on here, but maybe emotions in relation to blood sugar readings, is one for a future blog post… 🙂