Your Cheatin' Heart
Learning to break the rules of diabetes.
March 2006 — Should you eat that? Is it on your diabetes diet? Do you really think that's good for you?
No, no and yes. Or, perhaps, it depends.
Last week, in honor of our twenty-fifth wedding anniversary, my in-laws treated my husband and me to a lavish dinner at the White Dog Caf, a West Philadelphia landmark. My eighty-something father-in-law, who developed type 2 diabetes late in life, arrived equipped for action: insulin, symlin pen, carb counting book, blood glucose tester, and tiny black book where he records every carb and bite.
Seated beside him, having grappled with type 2 diabetes for over twenty years, I grabbed the wine list, flexed my fork wielding fingers, and brandished my knife, ready to go to town.
I was on summer break. I was celebrating a quarter century of marriage. I was out to enjoy myself.
I wanted to be bad. I planned to be bad. I had earned – I believe - the right to be bad.
Let's be honest. After twenty some years of pretty good diabetes control, there are times when I really do think that I deserve a night off, an evening when I can – temporarily - leave my type 2 diabetes behind.
This fact is nothing that would please my endo or internist, but it's a fact of life. And on this particular night, I knew exactly what I craved: fatty lamb, not heart-healthy fish; two (or three) glasses of a bold red wine, hold the spritzer; the dark chocolate cinnamon pot au crme (real whipped cream, not the fake, sugarless, fat free stuff), forget the fruit.
Taking on "bad" choices on special nights (or days) wasn't always my style. Constrained by fear of a high glucose readings the next morning, internal guilt (Should you, would you, could you eat that?) coupled with cautionary glances from friends and loved ones (Should she, would she, could she eat that?), I stuck close to the low-glycemic path: dry broiled salmon, lightly dressed salad, strawberries sans whipped cream.
Behind my slender plates, I radiated willpower, determination, and fierce discipline. As I watched others dig into their steaks and cakes, I speared simple lettuce leaves and pretended not to care.
But all that denial masked a dark secret. Sometimes, I ate my stringent dinner and that was that. But more often, I reached home and downed everything in sight. Chocolate chips, ice cream, icing from a can. Peanut butter straight from the jar, potato chips, anything I might find. A Class A binge, that hardly helped my A1Cs.
My long experience with type 2 diabetes has taught me that on occasional nights (such as my twenty-fifth anniversary), indulging a bit beats an overdose of perfectionism. Time has schooled me in how my body, glucose readings, and tolerance for sugar and stress will react to a bit of a splurge.
So, the questions: Did I expect higher sugars after a trip to White Dog Caf? Well, yes. Could I live with that? Yes, again. And, which was worse: denying myself what I wanted and staying on the stringent side of the menu, only to return home to go off the deep end?
For this night, my answer was clear.
To my father-in-law, still a newbie who is prone to fluctuating lows and highs, diabetes remains an enemy to conquer. He attacks his type 2 diabetes condition with his engineer's intelligence, spurred by a late in life heart valve replacement, calculating and documenting every bite and glucose shift.
I'm not critiquing his approach. Or yours. But one benefit of staying in pretty good control over so many years has been a better sense of my limits – and, in full cognizance of the consequences, stepping outside of them when I decide it's right.
Diabetes never gets easy. Yet having lived with it in relatively good health for many years, I don't consider it my enemy anymore. Instead, I think of type 2 diabetes as a part of who I am, a shadow self, who guides me in certain areas of my life –testing, eating, and exercising.
Diabetes isn't my dictator; it's my teacher, and my job is to understand the lessons it brings.
Of course, it's important that my father-in-law, and I, follow our daily readings, take our medication, and react quickly to lows and highs. But just as there is a time to work out and a time to count carbs carefully, there is also – if you manage it right – a good time to cheat.
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.
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Years before I was diagnosed with type 2 diabetes, The Other Half came out of a doctor's appointment with a diagnosis of "borderline diabetes" and an ADA exchange diet sheet. His health insurance agency followed up on the diagnosis with a glucometer and test strips. After a year or so of trying to follow the diet plan and test his glucose levels, things appeared to be back in "normal" range, and stood there until a couple of years after my own diagnosis. Shortly...