Is it Possible to Eat Pizza Without Encountering Blood Sugar Problems?

My short answer to that question is YES. Yes, it’s absolutely possible to eat pizza – and just about any food, in my opinion – without experiencing turbulent blood sugars.

It all just comes down to serving size, timing, and method of insulin delivery. Piece of cake, right? (Or should I say, piece of pizza?)

Have a slice!

Well, it really isn’t THAT simple. Other factors include the exact type of pizza (Is it gluten-free? Are there toppings? Is the crust thick or thin?), whether or not other food/drink is being consumed with it, whether exercise or inaction will follow in the hours after eating it…truly, there’s all that (and more) that people with diabetes need to think about when eating any type of food.

But what’s different about pizza is that it has a particular combination of fat and carbohydrates that can make it a tricky food for people with diabetes to figure out how much insulin to take and when to take it. It’s a little easier for those of us who have insulin pumps, because we can utilize the extended bolus (or square wave) feature that allows us to give a certain percentage of a mealtime bolus at once, and select a time later on to receive the rest of the bolus.

If that last sentence didn’t make any sense, here’s an example of what I mean:

It’s dinnertime – 5:30 P.M. I have two slices of pizza that I plan on eating. One’s plain, the other has BBQ chicken on it. I figure that there’s 50 grams total of carbohydrates in the two slices of pizza. My blood sugar before eating the pizza is 130 mg/dL. I put that number into my pump, and also input 50 grams of carbs. My pump wants me to take 8 units of insulin to cover the pizza. Instead of administering the full 8 units at once, I hit the “extend” option and opt to take 75% of the dose now, and the remaining 25% an hour and a half from now. So I get 6 units of insulin at 5:30, and 2 units at 7:00. This extended bolus typically has the power to prevent my blood sugar from crashing and spiking hours after eating said pizza, and in turns, saves me from dealing with a massive headache and questioning why I ever ate pizza in the first place.

Granted, an extended bolus isn’t the end-all, be-all. It relies heavily on me and my ability to count carbs correctly and time my boluses perfectly. But I have had fantastic success using it, particularly in a recent situation in which I ate two large slices of whole wheat pizza, a side salad, and a bit of pita bread without spiking beyond 160. I can’t say whether it was the whole wheat crust that helped me out (maybe it has a lower carb count compared to regular crust?), or if it was just supremely accurate calculations on my end, but it really doesn’t matter to me in the end…because I know that I can eat and enjoy pizza – and again, virtually any food – without my diabetes ruining it for me.

 

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Memory Monday: Carb Counting and the Calorie King

One Monday per month, I’ll take a trip down memory lane and reflect on how much my diabetes thoughts, feelings, and experiences have unfolded over the years. Today, I remember…

…discussing carb counting and the role of The Calorie King with a nutritionist.

I’ve met with a nutritionist as part of my diabetes care a few times in my life. During my last visit, maybe six or seven years ago, the nutritionist gifted me with a book entitled The Calorie King. “It’s really going to help you with your carb counting,” she told me.

I remember staring at the book dubiously. It was a compact little thing adorned with bright, bold colors. A bearded man wearing a crown was the cover image, and I couldn’t help but think that it looked totally dorky. I was skeptical: How was a book about calorie counting supposed to help me with my carb counting?

Fresh and Organic
Have you ever heard of The Calorie King or used it yourself for dietary or nutritional purposes?

As it turned out, it could help me a lot.

The Calorie King wasn’t just a list of the calorie content of different foods – it was a comprehensive guide that told me everything about the nutritional content of food. It was like having a manual of nutritional labels, except it was in an easier-to-digest format. And it gave me something that I’d never had access to before: Carbohydrate counts of food that you can get at fast food places, sit-down restaurants, and the like. It gave me a better sense of just how ridiculous some restaurants’ portions can be, as well as how serving size is one of the most critical factors in determining a food’s carb count. My mind marveled at that silly little book’s treasure trove of information, which would be key in helping me determine how much insulin I should take for food in just about any situation.

These days, I use apps on my phone whenever I’m unsure about a given meal or food item. They’re far more convenient than lugging around a copy of The Calorie King. But it turns out my nutritionist kinda knew what she was talking about when she told me that it would open my eyes up to the world of more precise carb counting. And for that, I’m grateful.

 

Diabetes, Diets, and Holidays are Naughty, Not Nice

Ahh, the holiday season…it’s been in full swing for just about a month now, and with that arrived a bevy of parties, potlucks, and poor dietary decisions. In a week, the new year will be here and it’ll bring a fresh start with it, but for now…I’m trying to find a way to make peace with all the indulgences I’ve enjoyed in the last several weeks.

Takeout Chinese food, pizza, homemade roasts, and baked goods galore are among the gamut of glutinous grub responsible for transforming me into a guilty gourmand over the course of the holidays. (Can I get a round of applause for that alliterative sentence?) I wish I could say that I had the willpower to resist the temptation of these foods that have been provided at the various holiday parties I’ve attended; alas, I couldn’t stop myself from noshing on them just as much as the other guests at these gatherings. A fair share of my fellow party attendees commiserated with me about diets flying out the window this time of year, but very few of them could understand that the fattening fare impacts more than just my waistline.

My blood sugars, of course, have been a victim of holiday feasting just as much as my size six jeans.

Feel the joy!
Instead of sugarplums, I’ve got visions of wacky blood sugars and too-tight pants dancing in my head. Fun!!!

Truthfully, they’re not as terrible as they’ve been during past holiday seasons. But that doesn’t mean I’m satisfied with them, or okay with the fact that they tend to rise and crash at equally rapid paces when I eat too much of the carb-y stuff and correct accordingly with insulin. The roller coaster ride combined with the feeling that I’m turning into the Pillsbury dough girl is what I’m fed up with, and I’m trying to figure out a way to stop punishing myself for it. After all, a new year IS right around the corner, and like many others in the world, I can and should use it as a reason to start eating more mindfully and healthfully, leaving the dietary mistakes of 2018 in the past.

It’s definitely cliche, but I’ve got to get back into the routine and replace all the cookies and fancy chocolates I’ve been consuming with leafy veggies and lean proteins. It won’t be easy, but I know that it’ll be worth the improved blood sugars and looser pants that are bound to follow.

 

Yes, I Can Eat Those Christmas Cookies

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Check out that spread. You’re looking at an assortment of nine different kinds of Christmas cookies, all baked fresh by my mom, aunts, and cousins for our annual cookie swap this past weekend. And I can attest to the fact that each of them were effing delicious.

Now, if you’re thinking that people with diabetes can’t or shouldn’t eat cookies, sweets, or carbs in general…I’m here to (gently) tell you that you’re wrong. It’s a myth, a grain of utmost untruth, that people with diabetes cannot have carbohydrates of the sugary or starchy varieties. It’s fake news, y’all!!!

The FACT of the matter is that people with diabetes don’t have limits on what foods they’re able to eat. But there are matters of condition and preference to take into consideration here. First and foremost, carbs MUST be counted before they’re consumed. This is crucial because it determines how much insulin a T1D must inject. And then things like personal taste, diet, and comfort levels come into play that account for the variations in eating habits among people with diabetes. And that is the reason why you’ll meet some who are low carb, high fat followers, some who do not consume gluten, and others who do not exclude any particular food group from their diet.

I’ve written a bit about this before, so why am I repeating it again? Because it’s worth knowing and accepting that everyone is different. Bodies respond differently to different stimuli, including the foods and insulin we put into them. And whatever works best for someone should be unconditionally tolerated, not judged, by others.

So if I want to eat a bunch of Christmas cookies as part of my Christmastime celebrations, then here’s my friendly reminder that I can – and you bet your bottom dollar that I did, and was very grateful for insulin after doing so.

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Why I Decided to do a 3-Day Cleanse (and How it Impacted my Blood Sugars)

No carbs. No dairy. No meat. No processed foods. Strictly vegetables, fruits, and shakes for the next three days. 72 hours – I could do it, right?

Last week, I completed a 3-Day Cleanse. My goal was that it would help me feel a little bit refreshed after a couple weeks of nonstop gluttony. I figured it’d help reset my system and make me feel less bloated and tired. I didn’t want to do a typical “cleanse” though, the kind that forces you to stop eating any and all food and stick with juices. That’s why I did this particular program – I would be eating real foods on a regular basis throughout all three days. The bonus was that it would be foods I’m familiar with and are generally low carb, which could only mean good things for my blood sugar.

My routine for all three days would follow this format: Wake up, drink a glass of water, blend a shake together with one serving size of fruit. I’d have a cup of herbal tea one hour after breakfast, and one hour after that, I’d have a fiber-filled drink. Lunch would consist of another shake, one serving of vegetables, one serving of fruit, and one spoonful of hummus. I’d have an afternoon snack of baby carrots and one spoonful of almond butter with another cup of herbal tea an hour after consuming the snack. Dinner would be one last shake, one cup of vegetable broth, and a spinach salad with olive oil and lemon juice drizzled on top. I could have a final cup of herbal tea any time in the evening.

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I didn’t expect to learn as much as I did throughout the program, but those three days taught me a lot about how the things I put into my body impact not just my blood sugar, but my state of mind. Here’s what happened during my cleanse:

  • Day 1 – This day was by far the easiest to complete. Despite dialing back the amounts and types of foods I was consuming, I didn’t feel hungry at all – everything sated me. I was really enjoying watching my Dexcom CGM graph because it barely budged. I stayed right around 90-110 mg/dL for most of the day, probably because I was eating minimal carbs. Fewer carbs means less room for error, and this concept was definitely cemented into my mind by the end of the cleanse. I went to bed with a slight headache at the end of day 1, but a smile on my face. This would be a breeze!
  • Day 2 – My CGM sensor went kaput by mid-morning, and I was PISSED about it. I wanted the ability to continue tracking my blood sugars on this cleanse, and suddenly it was no longer available to me (because oh-so-conveniently, it was my last sensor in stock). Fuming over my CGM situation, I started feeling slight pangs of hunger shortly after having my fiber drink. I ate lunch as soon as I could after that, and spent much of the rest of the afternoon fighting a headache and dreading going home to see – not eat – my mom’s delicious home cooking. On the brighter side of things, my digestion seemed to be improving already and I felt a bit less bloated.
  • Day 3 – I went from “Oh, this cleanse will be a breeze!” to “OMG THESE ARE THE LONGEST THREE DAYS OF MY LIFE GIMME REAL FOOD AGAIN BEFORE I HAVE A MELTDOWN” in less than 48 hours. That’s gotta be a new record. I distracted myself as much as I could from my misery by burying myself in my work, which helped to a degree. But I couldn’t fight the lightheaded sensation that seemed to grip my entire body. I was confused by that – I though only eating real, plant-based foods would eliminate crummy feelings. Maybe I was experiencing a sort of withdrawal as my body got used to this new diet? I can’t confirm that, but I suspect that after a few more days, I likely would’ve felt much better…or hungrier. I’ll leave it to speculation because there is no way I’m doing this again any time soon. But MAN, am I proud of myself for completing the cleanse without cheating, not even once.

So if I felt THAT miserable toward the end of the cleanse, then why am I glad that I did it? Mainly, I’m astonished at how much easier it was to maintain my diabetes and “desirable” blood sugar levels in that three-day time period. Even without my CGM, I was still getting great results. It reinforced something that I already knew: that the body will react accordingly to the quantity and quality of foods that are used to nourish it. It made me realize that perhaps I should toy with cutting down my daily carb intake and upping my veggie/fruit/protein consumption to find out whether that positively impacts my blood sugar in the way that I think it will. This doesn’t mean I’m starting a low-carb or keto diet; rather, I’m simply going to follow a more thoughtful one.

To sum it up, this three-day cleanse/torture act/lesson (whatever you want to call it) helped make my understanding and appreciation of food much stronger, which makes it worth it in my book.

 

Memory Monday: The Diabetes Diet, 100 Years Ago

One Monday per month, I’ll take a trip down memory lane and reflect on how much diabetes technology, education, and stigma has changed over the years. Remember when…

…insulin had yet to be discovered? Of course you don’t actually remember it, unless you were born in or prior to 1921 (and if you were, wow!!! Thanks for checking out the blog!).

Anyway, prior to the groundbreaking discovery of insulin, people with diabetes lived difficult – rather miserable, actually – lives. I started reading a book called Breakthrough: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle a little while ago. This book has made me realize just how fortunate I am to live during a time when insulin is around (even if it is grossly overpriced).

Many parts of this book have surprised, horrified, and downright depressed me. One of the more shocking things that I’ve learned from it, though, is the diabetes diet that was prescribed to patients in the early 1900s. Patients like Elizabeth Hughes, the T1D daughter of a U.S. politician, were expected to follow a strict meal plan upon admission to the Physiatric Institute in Morristown, New Jersey. Imagine following an eating plan like this every day:

Breakfast – One egg with two and one-quarter tablespoons of string beans boiled three times, and one tablespoon each of cream and coffee.

10 A.M. – Half a small orange for a snack.

12 P.M. – Two and a half tablespoons of cod with two heaping tablespoons of Brussels sprouts boiled three times, as well as five small olives and a half pat of butter…with a cup of tea to wash it all down.

Dinner – One egg and one egg white, 2 tablespoons of spinach (yes, boiled three times), with a half pat of butter.

Oh, scratch that part about following this diet every single day – patients had to fast one day each week. No food was permitted, at all.

Does that not sound vile?

I mean, I love eggs, and I happily eat veggies on a daily basis. But I’m certain I’d get sick of them no matter how they were prepared. And veggies boiled THREE times? I would think that they’d be reduced to mush, which, according to the book, is the point. Boiling them so many times would ensure minimal carbohydrate consumption since the nutrients would basically be cooked out of the vegetable. Plus, with portions so tiny, it’s hard to imagine that anyone ever felt full after consuming a “meal”.

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For context, one egg is about the same size as one tablespoon, meaning that portions on this diet plan were miniscule.

This extremely restrictive diet left patients yearning for pictures of food they saw in magazines, as well as severely undernourished. Following this meal plan practically guaranteed that patients would become emaciated. In fact, by the time 15-year-old Elizabeth Hughes left the Physiatric Institute, she weighed a mere 45 pounds – less than half what a healthy girl that age should weigh.

Even though I haven’t finished the book yet, it already serves as a reminder to be grateful for what I’ve got in this day in age: not just insulin, but amazing technology, wonderful doctors, and radical ongoing research in the diabetes field.

All of today’s advancements make me hopeful for the possibility of the eradication of diabetes, maybe not too far after the 100-year anniversary of the discovery of insulin.

Why I Refuse to Quit Carbs

Recently, a random person on the Internet criticized my choice to incorporate carbohydrates in my daily diet. Thanks for the unnecessary judgment, stranger!!!

I’m not really upset about the comment, though, because it prompted me to reflect on why I consume carbs.

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I LOVE CARBS. But of course, everything in moderation! So as much as I’d like to eat this mountain of nachos – a serving will do just fine & works better for me.

For me, it’s about more than just enjoying (relishing, adoring) the taste of carb-heavy substances both starchy and sweet. Carbs also help me achieve balance in my blood sugars. For instance, I find that consuming a serving of carbohydrates at dinnertime keeps me steady as I move through the evening hours. Say that I’m eating grilled chicken with a side salad for dinner. That’s a good meal by itself, but I like to complement it with a carb like half a cup of mashed potatoes or brown rice. I’ve noticed that the carbs kick in more slowly when they’re consumed with minimal or zero-carb foods, thanks to the power of the glycemic index.

The glycemic index is, in short, a measure of how quickly the carbohydrate content of foods will affect blood sugar levels. Since learning about it in college and subsequently researching the glycemic indices of various foods I eat, it’s been an immensely useful tool in determining the makeup of my meals throughout the day. Knowing the glycemic index of a wide array of foods also helps me figure out the timing of my insulin doses; in turn, preventing crazy spikes or crashes after eating.

I can’t shortchange carbs for the fact that they literally save my butt sometimes, too. When I’m experiencing a low blood sugar, nothing BUT carbs will bring me back up to a normal level. Whether it’s carbohydrates from healthy fruits or straight-up candy, it’s giving my blood sugar the surge it needs to keep me going. Like many things in life, it’s a matter of moderation – making sure I don’t consume TOO many carbs when I’m experiencing a low.

If you’re someone who thrives on low carb, high fat diets, that’s great! I know that many people find this to be a successful method in achieving target blood sugars. But for me, my tried-and-true technique of balancing carbs, fats, and proteins is always going to be my ideal strategy. Just because that’s what works for me doesn’t give anyone a right to criticize me for it. I’m here to live my best life, as we all should try to do. Shouldn’t we encourage one another to thrive, instead of judging?

The answer, if you didn’t realize, is YES.