This blog post was originally published on Hugging the Cactus onMarch 7, 2022. I’m sharing it again today because I (and other people with diabetes) constantly battle the misconception that I can’t eat foods that contain sugar/carbohydrates. Why, just the other day, someone who has known me since I was 12 years old made a comment about how I couldn’t eat cookies! In that situation, I smiled politely and gently corrected the individual, but the bottom line remains: This is some diabetes stigma that I’d like to defeat. Read on for more…
Yes, I have diabetes.
Yes, I can eat cheesecake and pizza.
Yes, I can actually eat whatever I want – I just have to know the carbohydrate content of whatever I’m consuming (and being mindful of portion size doesn’t hurt either).
Yes, I’m telling you this because at the time of this writing, that’s actually what I had for lunch this afternoon: homemade pizza and cheesecake. The pizza crust was store-bought, but everything else – from the sauce to the cheesecake crust to the strawberry topping – was made by me and it was damn good.
I guess I’m just taking a moment to 1) congratulate myself on semi-mastering the home-cooked versions of these two foods, but also to 2) reflect on how there’s so much stigma, STILL, on what people with diabetes can/can’t or should/shouldn’t eat. It’s wild to me that there are countless people in our world who misunderstand that a diabetes diagnosis automatically eliminates certain food groups from an individual’s diet.
Let me say it louder for those in the back who can’t hear: People with diabetes can eat whatever they want. Diabetes varies from person to person, and so do dietary preferences – so just because one person with diabetes might follow a strict keto diet, it doesn’t mean that ALL people with diabetes do. It doesn’t make it right or wrong for a person with diabetes to choose or not choose to eat certain things – period, bottom line, end of the story.
And by the way – I took a big old bolus of insulin for aforementioned pizza and insulin and my blood sugar didn’t spike past 188 mg/dL several hours later – score! So I’m also using this blog post to remind myself that it’s okay to eat “treat” foods like this from time to time, and that does not make me a bad diabetic.
Any type of pizza, plus diabetes, usually equals one giant headache in terms of nailing a correct insulin dosage.
Nine times out of ten, my blood sugar ends up high in the hours following a pizza meal. This is a fairly common phenomenon for people with diabetes, because even though pizza contains high amounts of carbohydrates, it also contains a large amount of fat that ends up delaying the digestion of pizza – resulting in a belated blood sugar spike. My go-to workaround for this is to do an extended insulin bolus, meaning that I take part of my insulin dose at mealtime and my pump will deliver the remaining dose later on, but it can be tricky to nail the timing of it.
So imagine my surprise when, after enjoying an evening out with my boyfriend in which we split a very tasty flatbread pizza (half buffalo chicken, half brussels sprouts and bacon), my blood sugar didn’t spike even a little bit post-meal. In fact, it actually ended up tanking – so much so that over the course of 2 hours, I had to eat 3 packs of fruit snacks and a handful of leftover Easter candies in order to keep it from dropping too much.
My mind was blown. I had actually eaten more flatbread slices than I normally do during this meal – the two of us nearly demolished a large-size flatbread, which is quite a feat – and so I bolused for 60 grams of carbs, using the manual mode on my Omnipod 5 PDM to enable an extended bolus in which I gave myself half my insulin dose upfront with the remaining half to follow 1 hour later. I actually thought I was underestimating the total carbs I’d consumed, especially considering I had two cocktails with my meal. But nope, I had completely missed the mark on this one and paid the price as I did whatever I could to keep my blood sugar up in the hours before I planned to go to bed. You can see from my CGM graph below that this was a bit of a prolonged struggle, one that kept me up much later than I would’ve liked.
But, oh well. That’s just how it is with diabetes sometimes, and I remain optimistic that I can nail the pizza bolus next time. After all, I’ve done it before, so I can do it again. And this is the kind of bolus experiment that’s kind of enjoyable – any excuse to have some delicious pizza.
“Bolus-worthy” is a term that, I believe, is semi-universally used by the diabetes community to describe food/drink that’s worth taking insulin for. Not just any typical amount of insulin, though – usually something that meets bolus-worthy criteria is something that requires extra insulin, and probably a little bit of guesswork, too.
What makes something “bolus-worthy”? And is it always truly worth it, even if it produces less-than-desirable blood sugar outcomes? I’ll attempt to answer both of these questions from my own unique point-of-view.
I think that a food or beverage is bolus-worthy when it’s something that I can’t and won’t indulge in often. It’s important to consider the “and” between those statements because it must meet both of those conditions; otherwise, it’s simply not special enough to be considered bolus-worthy. So something like the slice of carrot cake that my mom and I shared on our annual outing to a local teashop was totally worth taking extra insulin for, whereas pretty much anything I could order from a McDonald’s menu isn’t (I only ever go to fast food restaurants as last resort, and it doesn’t make me feel particularly good to eat food like that often). I believe in allowing myself carb-laden foods – ice cream, pizza, desserts from a bakery, you name it – whenever the desire strikes, but I do try to be careful about making sure I don’t do that often so that way I can have a better handle on my blood sugar levels as well as make myself more likely to really enjoy the indulgence.
But just because something fits into my “bolus-worthy” definition, is it always worth potentially paying the price of having a blood sugar I’m unhappy with later on? It depends. On an occasion like my birthday, I like to pretend that any out-of-control blood sugar levels don’t count as I eat whatever celebratory goodies I like – even though I’m subconsciously aware that of course they do, and TBH I actually prefer to stay in-range on my birthday so that my diabetes can’t steal the day from me. I guess this is kind of the beauty of the “bolus-worthy” label, though. To me, it implies that whatever it is that I’m having is reserved for special moments. That in itself makes anything worth it, if it’s contributing to the meaning behind an occasion.
And I look forward to putting this theory of mine in action on my birthday in a few short weeks, a time that I guarantee will be filled with food and drink that I deem 100% certifiably bolus-worthy!
This blog post was originally published on Hugging the Cactus on April 12, 2021. I’m sharing it again, ahead of the Easter holiday, as a reminder to myself and others that it’s perfectly okay for people with diabetes to indulge in sweets – just like everyone else, though, it’s important to do so mindfully. Read on for my tips…
If you regularly read this blog, then you know that I’m not a strict person with diabetes, in the sense that I don’t really restrict the foods that I include in my diet.
I’ve always been of the mindset that my diabetes can’t dictate what I choose to consume, though it might limit the actual quantity of a given food type that I eat.
So while my fridge and freezer is almost always stocked with fresh and frozen fruits/veggies/proteins, my pantry often stores more shelf-stable (and usually less healthy) things like crackers, cookies, and even candy. In fact, a full week post-Easter, my cabinets contain 3 bags of jellybeans, a chocolate bunny, and several Reese’s eggs. And it’s very tempting to reach into the cupboards and help myself to as much sugary sweetness as I can stomach in one sitting – screw my diabetes/blood sugar, I’ve got delectable confections to consume!
But of course, I know that indulging my cravings will only wreak havoc on my blood sugar levels, so I’ve found a few ways to curb temptation but still keep tasty treats in my home. Here’s 4 things that have worked for me:
Only eat these treats when my blood sugar is low. I call this “medically necessary” candy consumption, and let me tell you, it makes low blood sugars a whole lot more tolerable when they’re treated with something that’s more fun and yummier than chalky glucose tablets or juice boxes.
Keep them out of sight. I do my best to shove bags of treats in the very back of my top cabinets. That way, if I’m tempted to dig into them, I remember that I won’t be able to reach them unless I get a chair and rummage through the contents of the top shelves…and usually, that’s enough to take away my desire to snack on something sugary. I’m not saying it always happens, but laziness will typically beat my sweet tooth.
Pre-portion single servings of treats. I have a real problem with snacks that come in bottomless bags – it’s hard to know when to stop and my blood sugar always suffers the consequences. So I like to study the serving size on bags and use it as a guide to portion out single servings of treats. It’s much easier to bolus for whatever it may be (or treat a low blood sugar as described in tip #1) when I know the exact carbohydrate count; after all, a few handfuls of an unknown number of Skittles have far more carbs than a single serving of 15 Skittles.
Be picky about the types of treats kept in the house. My kryptonite is most definitely Reese’s cups…I love the salty/sweet combination of peanut butter and chocolate almost as much as I love my dog. So I recognized that a bad habit was forming when I kept a little bowl out in my living room filled to the brim with mini cups. I was breaking every single one of the above rules with this practice! After I realized this, I put the bowl away and stopped buying Reese’s every time I went to the grocery store. I still have other things around the house that will satisfy my sweet tooth (before Easter, I bought a package of dark chocolate Oreos that I’ve easily kept around for the last 6 weeks because they don’t tempt me in the same way that Reese’s cups do), so I’m really not depriving myself at all.
Temptation can be tricky to navigate when you have T1Ds and love sugary treats as much as I do…but as long as you can come up with ways to cope with temptation like I did, then you don’t have to feel guilty for giving in to your cravings every now and then. I sure don’t!
I guess I’m hopping on the “what I eat in a day” bandwagon.
This trend has existed long before the TikTok videos and Instagram reels in which vloggers share what they typically eat on any given day of the week – it’s also been something that tons of celebrities have been asked to share in interviews. And while I’m far from a celeb (especially Gwyneth Paltrow, who allegedly is sustained by a cup of coffee, bone broth, and steamed veggies on a day-to-day basis), I do have a certain meal routine that’s centered around my diabetes. Nobody asked me about it, but I figured, why not share it on the blog? After all, so many of the “what I eat in a day” videos and articles I’ve viewed sound a little too perfect. I often wonder how realistic folks are when they’re covering this topic, so I’m going to be pretty matter-of-fact when going through my “meal plan”, and cover how it varies on a weekday versus a weekend. So here we go:
Breakfast on a weekday: I am usually eating breakfast between 7:30 A.M. and 8:30 A.M. I love all breakfast foods, but lately my go-to has been a baked oatmeal. I prep this myself on Sundays and it makes enough servings for 6, so I’m covered for breakfast for the week. I add a couple of scoops of protein powder to it and top it with berries so that I make sure I’m getting a nice balance of carbs, fruits, and protein. One serving is roughly 30-35 grams of carbs, and I’ve found that my blood sugar fares well whenever I eat this meal, maybe spiking a bit in the hour after consuming it but settling back down nicely in no time.
Breakfast on a weekend: Anything goes! My wake-up time could be as early as 8 or as late as 10:30 or even 11 (though I don’t like sleeping my mornings away). Depending on when I wake up, I might want a breakfast sandwich or a protein smoothie, but there are other times that my partner will make me a breakfast consisting of something like hash browns, eggs, bacon, and salsa – no matter what we do, I try to keep breakfast no more than 30-40 carbs because that feels like a sweet spot for my blood sugar levels, whether I’ll be exercising in the hours after eating or even if I’m just lounging around until the afternoon.
Lunch on a weekday: I almost always have a salad or a sandwich. I like to load up my salads with lots of extras – tons of veggies, feta, bacon bits, croutons – and always top them with a protein like hardboiled eggs or chicken. If I’m having a sandwich, I’ll almost always eat it with a side of baby carrots or veggie straws (and if I’m in the office, I might indulge in a buffalo chicken wrap which comes with house-made chips – so yummy but much higher carb compared to what I’d make at home). I will eat an apple or any other fruit I have on hand for something sweet. My blood sugar is usually good after lunch, but if I see it going up too quickly or if it stays higher than I’d like it to for an extended period of time, I’ll combat that with a walk in my neighborhood or around my office suite.
Lunch on a weekend: Admittedly, it’s almost non-existent. If I have leftovers from the night before, I’ll eat that, or maybe my partner and I will split a box of frozen samosas or share a cheese plate so we’re not totally starving by dinnertime. It’s just what works best for me since all of my weekends are totally different in terms of our plans.
Dinner on a weeknight: I like to either meal prep on a Sunday night and have whatever I make carry me through the first few days of the week, or I’ll make something on a Monday evening that will produce my dinners for the next few nights. I’m a semi-lazy cook, so I like tossing veggies, starches, and proteins on a sheet pan and roast everything up (I love recipes from this website). And I have a sweet tooth, so dinner is often followed by a single serving of ice cream or a chocolate-covered frozen banana. My carb intake at dinner hovers around 45-60 grams of carbs, which I find works well because I get busy in the evenings catching up on chores around the house or running errands. The extra carbs help me stay level (and full).
Dinner on a weekend: I enjoy whenever my partner and I have a chance to make food together, because he’s a great cook and very conscientious of my diabetes when making something to eat. He helps me carb count and if we’re going out somewhere to eat/ordering takeout, he’ll offer to split higher-carb dishes with me so I can still have them without totally wrecking my blood sugar. I don’t really place limits on my carb intake for meals out because I love getting sushi, flatbread, and other high-carb menu items – I just try to keep an eye on my blood sugar levels in the hours after a meal out so I can stay on top of highs.
Snacks: I’m a grazer through and through, meaning that it’s hard for me to resist the temptation to snack on foods in my pantry throughout any given day. So I try not to keep bottomless bags of anything in my home, though I do keep things like bags of light kettle corn and single-serving snack bars on hand. But I’m also a sucker for a bowl filled with chocolates like Reese’s or Ghirardelli squares which I will shamelessly help myself to, never having more than a couple in one day because ~*balance*~ matters. Grazing can really screw up my blood sugar, though, so I try to be smart and time it so any snacks coincide with periods of higher activity (such as before I vacuum or head out to run errands).
Drinks: I try to stay hydrated on a daily basis. Besides plain water, I drink Powerade Zero to get in extra electrolytes and I’m an absolute sucker for fizzy and carbonated drinks as long as they are carb-free. I do drink beer/wine/cocktails from time to time that definitely have extra carbs, but I have learned over the years how my blood sugar will respond to a given alcohol and plan accordingly around that.
So, that’s it – an honest explanation of what I eat in a day as a person with diabetes. Some days I am more balanced and “healthy” than others, and some days I just go to town and whatever I like. My relationship with food will never be perfect because my diabetes undoubtedly influenced it, but that’s a post for a different day. For now, I’m off to have a snack to keep my blood sugar (which is 113 mg/dL as I write this) steady throughout my evening workout routine.
As an ardent lover of all types of carbohydrate-packed foods, I can say with almost 100% certainty that I could never commit to a keto diet.
Before I dare to delve even deeper into that train of thought, let me just say that I know plenty of people with diabetes who do follow a keto diet successfully. It’s what works for them. And that’s wonderful! Truly, I know firsthand how difficult it can be to find a nutrition plan that cooperates with diabetes, and that just because one plan works well for one individual does not mean that it will work the same for others. In a nutshell? You do you, and I support that.
Okay, now that I’ve got that out of the way – let’s get to the root of the matter.
It’s not just my utter adoration of carbs that would cause me to struggle on a keto diet. Absolutely not. In my years of relatively light research on the keto diet (which consists of many conversations I’ve had with strict followers of it, as well as my social media lurking on pages plugging keto), I’ve learned that just about all carbs can be replaced by a keto version: You just have to get creative and have keto-friendly ingredients in your kitchen cabinets. So I’d find solace in knowing that I could always bake low-carb muffins, bagels, pizzas, cakes, and the like as long as I had a good recipe and the proper ingredients on hand.
The real reason that I’d totally fail at a keto diet is that I have a hard time with self-control when it comes to 0 or minimal-carb treats. I actually go to town on them. Since I know that I don’t have to bolus for something with low or no carbohydrates, it’s like they become “free” foods to me, meaning that I can eat as much as I want without having to worry about the consequences…which may or may not impact my blood sugar, but which definitely could affect my waistline.
In other words, I have a difficult time remembering that just because something has 0 carbs, it doesn’t mean it has 0 calories.
During the short-lived (think 3 days at a time) keto phases of my life, I found myself eating more and more. Since I was deprived of carbs, I felt entitled to consume more keto foods than I actually needed. My blood sugar may have benefited overall, but it was not at all necessary to be mowing down on all the keto-friendly treats (think keto ice cream, keto cookies, keto bread) that are out there and available to me. I didn’t recognize it right away, but when I did, I realized it came down to my lack of ability to exercise restraint as well as acknowledge the difference between carbs and calories as both a person with diabetes and a person who aims to maintain a particular caloric intake.
So when it comes to keto, it’s a no-go because I finally understand how it impacts my relationship with carbs and calories. I’ll stick to what has generally worked best for me in my 25 years of diabetes, which is a classic: everything in moderation.
I have a confession to make: I’m a bit of a perfectionist. I know that perfectionism can be my own worst enemy and hinder me from accomplishing goals, but it’s just the way I am in some situations – particularly, with my own diabetes.
My diabetes perfectionism means that there is very little room for error when it comes to dosing insulin properly for the foods that I eat. Like many people with diabetes, I strive to bolus as accurately as possible to ensure better blood sugar outcomes, but I don’t always succeed at this.
That’s why I try to reduce the amount of possible error by being very specific about the number of carbs I consume at mealtimes. In fact, I have a self-imposed carbohydrate limit of about 60 grams of carbs per meal. I don’t know where this number came from, and I definitely exceed that from time to time, but for some reason I never input a number greater than 60 carbs into my PDM even when I know I’m probably eating more carbohydrates than that.
This is because of my fear of the room for error, and the potential consequence being a severe hypoglycemic event.
In other words, even when I may be exceeding my “comfort carb count”, I know that the room for error grows with the amount of carbs that I consume. More carbohydrates = more insulin = a greater room for error, something that freaks me out and that I attempt to control by only bolusing for what I feel is an agreeable amount. I’ve written about this phenomenon of mine before and my desire to get over it, but as I continue to work through it, I think it can only be done if I change my thinking about the margin of error that I’m willing to tolerate.
This is where it all comes full circle and I begin to understand how perfectionism, the room for error, and my diabetes management all play off one another…which is to say, they don’t fare well together whatsoever. Because my room for error is low, I don’t dose correctly for some meals, which drives my inner perfectionist crazy because it’s at conflict with my inner scaredy-cat who’s afraid to dose the right amount because I don’t want to deal with any negative outcomes. I’m literally in conflict with myself, which is a wild thing to realize as I write this blog post, but it’s the truth and I’m glad I’m uncovering it.
It will absolutely take time, but as I begin to let go of some of my perfectionist tendencies, I’d like to learn how to also usher in a greater comfortability with the room for error. I’m looking forward to exploring this and hope that I can reconcile the two so me and my diabetes can live in better harmony.
This post is adapted from something I wrote and published on Hugging the Cactus on October 1, 2018. I decided to revisit it as a reminder of the many ways pumpkin spice can be enjoyed this time of year that won’t wind up making my blood sugar spike!
Since pumpkin spice manifests itself in many carb-laden treats this time of year, you might be wondering exactly how I can get away with enjoying a mass quantity of the stuff. And no, my method doesn’t involve dosing tons of insulin so I can down endless amounts of pumpkin spice M&Ms, ice cream, Oreos, yogurt, muffins, or any other kind of pumpkin-spicy product you can imagine (including the dearly beloved pumpkin spice latte).
It’s much simpler than that – all that I do is make it my mission each year, right around mid-August, to find as many carb-free or low-carb pumpkin spice products as possible, buy them, and revel in them for the following three months. I’ve been a bit behind this year, but I’m stoked to stock up on favorites from the last few years which includes… gum, tea, coffee, butter (yes, pumpkin spice BUTTER), peanut butter (with pumpkin spice literally swirled in it), English muffins…the list can go on and on, and it does, considering that the gamut of pumpkin spice offerings only increases year after year.
I’ve hunted down foods that have both pumpkin spice and a lower carb count, like Halo Top Pumpkin Pie ice cream or FiberOne bars (ugh, they’re so good it’s not fair). I’ve even mixed it up by combining pumpkin spice with some more manageable carbs, such as plain oatmeal. I just can’t get enough, especially since this is a seasonal offering that plays pretty nicely with my diabetes.
I have strong opinions about ice cream. Potentially controversial ones:
Chocolate ice cream is the weakest flavor out there.
My ratio of ice cream to mix-ins is…gimme ALL the mix-ins. The more chopped-up chunks of goodness, whether it be cookie dough or candy, the better.
Ice cream tastes best when it’s a little softened – like, almost to the point of being soft-serve consistency. I used to microwave my ice cream for about 20 seconds when I was a kid before eating it and loved every drop of my ice cream “soup”.
See? I warned you. Those are some triggering statements I just made about my personal ice cream preferences. But one not on that list, that I think most people would happen to agree with me on, is that sugar-free ice cream just ain’t it.
“Oooh, Molly, look! They have sugar-free ice cream on the menu, are you going to get some?” One of my truly well-meaning girlfriends asked me this, ever-so innocently, on a recent ice cream outing.
I remember raising my eyebrows incredulously as my eyes scanned the regular list of ice cream compared to the sugar-free options. There were dozens of delectable-sounding regular ice cream flavors: all the traditional ones, plus more exotic ones like cotton candy, blueberry pie, s’mores, German chocolate cake, coffee kahlua cream…and then in direct opposition to that were TWO, yes TWO meagerly sugar-free choices: black raspberry and coffee.
I turned to my friend and, as non-condescendingly as I possibly could say it, told her that those “choices” had to be a joke and that furthermore, sugar-free ice cream just ain’t it for me. If I’m going to eat ice cream (and I’ve consumed LOTS of it this summer, let alone throughout my lifetime), then I’m going for the real stuff – no question about it. So with the air cleared on that particular matter, we both got matching ice creams (the blueberry pie flavor with blueberry and graham cracker swirled in a vanilla cream base) and enjoyed the heck out of them.
Would you believe me if I told you that last weekend, I ate mostly carbs for 36 hours straight and totally avoided high blood sugars the whole time?
It sounds wild, but it’s the truth! I went on my annual weekend getaway with my college besties and it was the loveliest time filled with sunshine, conversation, and tons of delicious food. I can’t remember the last time I ate that much in such a short window of time, but it was all worth it, especially because my blood sugars didn’t pay the price for it for once.
Here’s the breakdown of what I ate:
2 slices of Mediterranean-style pizza and 3 chicken tenders for dinner, the first official meal of the weekend trip
2 glasses of wine
Handfuls of crackers and cheese because who doesn’t love that with wine
1 blueberry bagel accompanied by 1 fried egg for breakfast
Salad and heaping scoop of ice cream for lunch
Pita chips for a snack
Panko-crusted haddock with jasmine rice and veggies for dinner
2 cans of cider (and maybeeeee a glass or two of bubbly)
1 everything bagel slathered in goat cheese plus 1 fried egg for breakfast
2 slices of leftover pizza for lunch, which is also when I arrived home from the trip
It definitely wasn’t my healthiest, most balanced weekend of eating, but I’m more than okay with that because it was about enjoying my time with my friends and indulging a little rather than stressing the whole time about bolusing and blood sugars. And you know what, I think that my laidback, let’s-just-savor-this approach is partially the reason why I had such stellar weekend blood sugar levels. That, coupled with extended boluses for most of my meals (you know that pizza and bagels contain alllll the slow-acting carbohydrates), really helped me achieve the relaxing weekend that I wanted.
Now if only I could get away with this on a regular basis – as I write this, my blood sugar is coasting from a peak of 248 back into the low 190s after I dared to consume a bagel at lunch in the middle of my busy workweek. But it’s all good, and maybe just evidence that I should try to remember to live in the moment on weekends of fun like this one and prevent diabetes/blood sugar from taking center stage. Perhaps that’s the key to more stable numbers.
If nothing else, this serves as a reminder to me that even with diabetes, I can still enjoy a sh*t ton of carbs every now and then.