Food choice flexibility often depends on the individual
April 2013 — Upon diagnosis, the list of foods I wasn't "allowed" to eat could be unfurled and circle the globe's circumference at least twice over. Sugar-coated cereals like Golden Grahams and Lucky Charms, and pasta, and full-fat cheeses, and whole milk, and any kind of juice (other than with the intention of treating a low) … it was a very daunting list of don'ts.
But these food yays and nays were driven by the peaks and valleys of my insulin, which at the time, was NPH and required sticking to a predictable timetable. Now, with the benefit of fast-acting insulin and an insulin pump for precision dosing, my food choices have way more flexibility. If I can carb count it, I can dose for it.
So why do I still have a list of forbidden foods?
After twenty-six years with type 1 diabetes, my "no way!" food list is self-imposed, and with good reason. Trial-and-error is the name of the game (when the game is diabetes, anyway), and over the last few decades, my body has been clear about what foods it can tolerate, blood-sugar wise, and which foods make everything bounce out of control.
So many people with diabetes have pizza on their forbidden food list, but for me, it's never been that much of an issue. If I bolus at least 30 minutes ahead of time, and I take the high-fat content of the meal into account, my blood sugars don't go berserk. But Chinese food? Holy moly, that stuff will wreck my numbers up properly, and for days. Even pre-bolusing and taking a follow-up bolus two hours later can't ward off the highs that come as a result of fried rice, noodles, and the mysterious sauces that are served with these dishes.
Pineapple is another food that is hard for me to make sense of, diabetes-wise. For whatever reason, my body doesn't break pineapple down at the same rate as other fruits, so I actually end up going low, and then spiking up, as a result of not being able to predict the timing of the absorption. Because this happens nine out of ten attempts, I've crossed pineapple off my "go for it" food list.
(Note: Let's just be real for a minute, shall we? I'll stuff my face with a cupcake when I want to, or go out for fondue with my friends, or eat a pile of stuff that's off "the list." Life happens, and I'm all in. But I don't like having crap blood sugars for days on end, so this is where I need to take what I'm learning from all this trial-and-error nonsense and actually make good use of that information. /note)
Conversely, there are foods that react quietly, and predictably, which makes me love them a whole lot. And yes, many of them are lower in carbohydrate, but that seems to be what works best for avoiding insanely spiky post-prandials for me. Like hard-boiled eggs and avocado (which my daughter calls, simply, "Ew!" but then she steals bites from the bowl when she thinks I'm not looking). Or fresh green beans. Or grilled chicken with broccoli and rice. (Yes – rice! For whatever reason, rice breaks down predictably for me, and ends up on the "acceptable" list.) And of course, when I revisit the "free foods" lists from my childhood, they all behave as well: pickles, sugar-free Jell-O and popsicles, and cucumber slices. (Upon reviewing that list, I can see why no one wanted to switch snacks with me in school.)
I don't think there are any real "forbidden foods" when it comes to diabetes, but I do think that there are foods that are easier, and make my diabetes simpler to manage. So even though I don't have a formal list of foods I avoid, I do have a mental one, and sticking with it makes for smoother numbers.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
Joe Weaver's Seasoned Greens Family Favorite Chicken Soup Frappacino Pork with Pineapple and Coconut Curry Welsh Rarebit Carne Guisada Cucumber, Tomato, and Green Pepper Salad Sake Marinated Vegetable Salad Red Bell Pepper Sauce La Genovese
Occasionally my mailbox or follow-the-link browsing will come up with something discussing whether (and if so, when) to ease the restrictions on treatment goals when the patient is elderly, arguing either to favor a higher quality of remaining life (lifestyle choices less limited by chronic illness) or to take into consideration geriatric cognitive decline (aka "senility") and simplify, as much as possible, the regimen. While the goal of medicine is, obviously, not to...