Food. Itâ€™s probably the biggest challenge for a T1 diabetic. We have to count the carbs in everything we eat so we can make an educated guess of how much insulin to take (called a bolus of insulin). But itâ€™s a VERY complex process.
Take insulin too early, blood sugar (BG) drops low before the carbs you ate finally catch up. Take insulin too late, BG spikes and you can do nothing but wait for the insulin you took to bring it down. I also have digestion struggles which means I donâ€™t always know when the carbs will hit my BG and it is different lengths of time for different foods (for any diabetic, pizza carbs notoriously digest slowly). Protein, fats and fiber can slow down digestion and not always at predictable rates. And you can eat a food one time and get the bolus pretty good and it goes all wacky the next time you try!
I tend to eat from packaged food that has a carb count on it because if I follow a recipe and make something, it can be impossible to figure out the carb count in my one serving! Most T1 diabetics hate potlucks because itâ€™s impossible to figure out the carb count for anything we didnâ€™t make ?. Every T1 diabetic owns a food scale and multiple sets of measuring cups and spoons. To calculate carbs, we need either the weight or the volume and preferably a degree in math to figure out the calculations! Siri has been a wonderful assistant as I try to make some complicated calculations ? If you invite a T1 diabetic over for dinner, please donâ€™t be offended if we bring our own measuring cups or food scale or ask to see the recipe!
Iâ€™ve had to admit to myself that Iâ€™m still scared to eat anything made from â€œscratchâ€ because I have to guesstimate the carbs. And even after all these years, my guessing is never very good. Guess badly and it can take the rest of the day to try to get BG back on track. So although I try to pick the healthiest packaged foods I can (a lot of Whole Foods shopping), Iâ€™m trying to work through my fear of eating something that doesnâ€™t have the carb count clearly marked.
I also have to decide before eating how much I want to eat since ideally I have to give insulin before starting to eat. This also means no eating straight out of the package or â€œsnackingâ€, I have to portion out first what Iâ€™m going to eat. If I start getting full, I have no choice but to finish what I took because I gave myself insulin for everything on my plate. It can be hard to keep eating when full but T1 diabetics have to! And then there is the challenge when a. the food is bad/inedible, b. I donâ€™t like the food and would rather not finish it or c. Iâ€™m eating at a restaurant and I have to wait for them to remake something. Any of those situations leaves me scrambling to find something else to eat that is close enough to the same carbs as what I bolused for and hoping I can finish eating before the insulin BG drop!
T1 diabetics develop eating disorders at a higher rate than the general population. Our relationship with food is already far from normal and we tend to group foods as good or bad based on how they affect our blood sugar. We also have our own eating disorder called diabulimia which I myself have struggled with. When BG is high, one symptom is weight loss. So a diabetic can skip insulin and binge eat making BG spike high enough that the weight just flys off. During my worst episode, I lost over 30 lbs in one month. Yes I felt very sick and I was risking my life but the ability to loose weight quickly was addicting. Thankfully I got some help and I havenâ€™t fallen into it again but the temptation is still there sometimes. Since insulin is a hormone and we have to inject so much of it every day, most T1 diabetics have a really hard time loosing weight and sometimes will gain a little weight even when doing everything right!
So T1 diabetics can eat anything anyone else can (even sugar), itâ€™s just a much more complicated process and always requires planning and being good at guesstimating. But on the meals I get it just right, I feel like I won the lottery! It really is the most wonderful feeling to work hard at getting it right and then be rewarded with a perfect BG. That is enough to keep me working at it â¤ï¸