Shoot Up or Put Up

And lo! the scales fell from my eyes

During the summer last year we went round to some friends of ours for a dinner party. Yes, a dinner party – now that I have reached my thirties, I no longer have the desire to frequent sweaty nightclubs of a Saturday night, downing expensive, sticky drinks and being much, much too close to the dripping unwashed masses.

So being unrelenting and incurably middle class, I now spend Saturday nights with friends, supping fine wines and discussing the issues of the day (I say that, but this particular dinner party ended up being somewhat rowdy, with broken glasses and minor chaos – we eventually left our host in the early hours with an uncontrollable bout of booze-induced hiccups).

Anyway, I digress. I bring up the whole dinner-party thing because I noticed on that particular evening that our host had a rather fancy-pants set of scales which gave you the various nutritional values of whatever you happened to be weighing. I saw that it did carbohydrates and duly lodged this diabetic-friendly piece of information away in the recesses of my brain.

So it came to pass that when our crappy set of TESCO scales gave up the ghost (thanks TESCO – that was £12 well spent, I think not) I finally fulfilled my ambition and purchased a set of said fancy-pants scales.

As I think I’ve mentioned before, I religiously carb count. I mean religiously in that I strictly carb count about as frequently as I attend church (once on Christmas Eve and the occasional wedding). Most of the time I fly solo and make an educated guess for carb contents and insulin doses. But every once in a while I properly check and log everything for a week or so – sort of like a diabetes refresher course – to check I’m doing things well.

It’s therefore when I’m doing a periodic refresher that these scales really come into their own. Can’t be bothered to work out the carb content of your glass of breakfast orange juice? Easy – just bung the glass on the fancy scales, hit 878 (the code for orange juice), fill up with orange and hey presto! up comes the carb content for that exact amount of fruity juicy goodness. Yum!

Using the internal memory, you can quickly tot up the total carb content of your entire breakfast (which is usually, for me, a pint of heavy claret and a whole roast pheasant and trimmings) and log and inject accordingly.

So while not entirely world-shattering, my new fancy-pants scales are actually quite good with helping me to carb count. More importantly, they look really cool. So – in summary – they’re probably a worthwhile spend of £36. If you care, my Salter “Nutri-weigh Slim” electronic scale can be found on the John Lewis web site; if you don’t care, what technology-of-the-future do you use to help carb count?

I spent an age yesterday searching for a proper blueberry muffin. I could find a low fat, low sugar version, or one made with bran (I know it’s healthy but it’s not meant to take me 10 minutes to chew through a muffin, hence I like mine without the bran) but not a genuine, full fat, full sugar, tasty, scrumptious, delicious, naughty but nice blueberry muffin.

Back in 1983 when I was diagnosed (or the dark ages as Tim likes to call it) you struggled to get sugar free anything in the UK. Diet drinks were as rare as a very rare thing. More often than not water was the only sugar free option in a cafe or restaurant (or now I think about it, were my parents just telling me that to keep the costs down???).

We went on holiday as a family to Florida in 1989 when I was 10. We must have spent half a day in the supermarket. It was amazing, they had sugar free everything. Sugar free chocolate soda, root beer (how do you drink that, its vile), cream soda, muffins, toffees, mints, strawberry flavoured chewing gum (we must have brought back a hundred packs of this stuff). I was literally a diabetic kid in a sugar free sweet shop.

I wanted to try all of it. Sadly all the canned drinks were in packs of 6 which was a bit big when you only wanted to try one, but the shop assistant said we could split the packs. That was a revelation, in the UK they start removing your limbs if you try and split a six pack in a supermarket. It just isn’t done.

Actually, most of the sugar free drinks were a grave disappointment. It was the last time I ever drank chocolate soda, root beer or cream soda, but it was so good to try them and know that I wasn’t really missing out!

Ironically now that the world is full of sugar free stuff I no longer have such a need for it. The wonders of carb counting and insulin adjusting mean that if I want chocolate I have a bit of proper chocolate rather than the crime against taste and the digestive system that is sugar free chocolate.  It actually feels like things are going a bit too far in favour of the healthy life. If I want a healthy snack I have an apple. If I want a naughty snack, I have a proper blueberry muffin. The hybrid low sugar, low fat versions seem to miss the mark on both counts – they’re still full of carbs so diabetes wise I still need to think about it, and they doesn’t taste as good as the orignial. On that thought, I’ll get back to my muffin.

We’re back from our long weekend in Venice, it was all the things they tell you in the guide books – romantic, beautiful, lots of bridges, water, gondolas etc and one thing they don’t tell you – carb heavy.

I’ve thought for years that as well as eating low GI foods reducing the number of carbs I eat gives me better control. When I got my CGMS the data showed that I had much better readings when I ate fewer carbs. This is of course logical, if you’re trying to cope with a massive plate of pasta the margin for error in insulin dosing is far greater than if you’re eating a small green salad. This isn’t rocket science.

I do keep an eye on how many carbs I eat and reduce them wherever I can and overall I do ok. But it’s not easy. I like food that contains carbs. And I now think it is physically impossible to have a low carb weekend in Italy – all that fresh pasta, risotto, pizza, ice cream, tiramisu (yes I know they do delicious grilled fish and marvellous salads and I tried, believe me, but they really do specialise in scrumptious carbs!).

I find pizza in the UK to be the root of all diabetes evil so I rarely eat it. Its high carb and also high fat so it’s absorbed quite slowly into my system. I need buckets of insulin to deal with the carbs but not straight away because the fat slows down how quickly those carbs get in. Since I’ve got the pump, I’ve mastered the dual wave bolus which allows me to put some insulin in at the start of the meal and stagger the rest of it over the next few hours. Bingo, pizza without the immediate low or hours later high.

Thankfully proper Italian pizzas have an incredibly thin base so middle of the night highs following pizza for dinner weren’t a problem last weekend. The first one did catch me out though after I was a bit gung ho with the insulin guessing and it appears I needed half a bucket less than I’d thought. And that brings me to the final great thing about Italy – there’s a very tasty ice cream stall on every corner just waiting to help you deal with that low.

I’ve just emptied the washing machine (stick with me, it does get  marginally more interesting I promise). There’s a nice clean load of  washing ready to be hung out. Except for one small problem. It’s  covered in slime. Every item of clothing has different coloured sticky  goo on it, and there are bits of paper all over the place too.

Sadly this isn’t the first time I’ve had this washing machine slime  issue. It’s a diabetes complication caused by using fruit pastilles as  my preferred “I’m a bit low need something now” treatment. They’re in  most of my pockets and most of my husband’s too. Most of the time we  remember to take them out before we put the clothes in the wash. As I
said, most of the time.

Top diabetes tip readers – fruit pastilles should never be washed at 50 degrees, they can’t take the heat.

This post is an extract (actually an entire copy to be honest) of an article from the About Diabetes page over to the right there. Feel free to add your comments, criticism and general bile at the bottom under the comments.

Anyway, there’s a lot of nonsense talked about what you can and can’t eat as a diabetic. This blog focuses on Type One diabetes and those lucky enough to have Type Two might find their experience differs. But probably not much.

When I was first diagnosed with Type One a few years ago, part of my crash course in diabetes was a session or two (easy there!) with a lovely dietician called Debbie.

By the way, it’s worth noting at this point that “dietician” is a protected term in the UK – much like “solicitor” or “architect”. You can’t call yourself a dietician (or a solicitor or architect) unless you are suitably qualified. However, the same is not true for the term “nutritionist” in the UK (it’s different in other countries though).

Essentially any old snake-oil merchant, quack or loony can call themselves a nutritionist in the UK. This is why pretty much anything written or sold by a “nutritionist” in the UK can almost exclusively be discounted as complete rubbish.

Anyway, that aside, Debbie and I had a lovely time and mainly chatted about my homemade Baileys ice cream and spoke about carbohydrate counting and a diet made up of foods with a low glycaemic index. I’ll talk about carb. counting in another post so ignore that for now, but the glycaemic index thing is worthy of mention as I think it’s possibly the most relevant part of the Type One diet.

Glycaemic index

As you probably know when you eat your deep fried mars bar or delicately sautéed fois gras your digestive system breaks down the foody-goo and releases its various constituent parts. Of interest to us diabetics are the carbohydrates or sugars which are released into our blood stream.

All foods are not equal in terms of the rates at which your body can process them and release them into your ruby-red blood. Essentially, and very broadly, the more pre-processed the food the less your body has to do and therefore the quicker it will be broken down and released in to your bloodstream (and so this food is said to have a high glycaemic index). The less processed it is, the longer it will take to be broken down and released (a low glycaemic index).

So why do we diabetics care about this? While it’s not entirely vital to your well-being, the theory is that low GI food makes managing your food / insulin balance easier. Rapid acting manufactured insulin, like humalog, kicks in pretty quickly – but not as quickly as your own stuff. Therefore if you iron out the peaks and troughs life will be easier.

This wonderful diagram shows the sharp Matterhorn-peak of high GI in red and the low rolling hills of low GI in blue.

There are number of GI-related books and web sites which give you the relative GI values of various foods. But a general and quite useful rule-of-thumb is the colourfulness of foods. The more colourful the better (by better I mean lower) in terms of GI. Though this rules does break down when we get into extremes of lime green and violent orange.

For example, wholemeal pasta (generally nice and brown with bits through it) is lower GI than boring, white pasta. A nice green apple is better than processed, clear apple juice.

Okay, the rule isn’t perfect – but you get the idea.

Eating every day

For the purposes of this article I’m going to assume that you too are not some sort of half-wit who doesn’t know how to boil an egg and lives off deep fried pizzas, so I won’t chat about the basics.

Because my wife and I like cooking we’ve got a load of cookbooks – both general cookbooks and those specifically for diabetics. Having cooked from both, I don’t really notice any significant difference in content between the “diabetic” books and the non-diabetic books, so there’s no point in specifically splashing out them.

Books by people like Nigel Slater or Nigella Lawson are great if you want to show off and Madhur Jaffrey is bloomin’ marvellous if you want to cook for large groups in style.

But we’re more interested in every day normal cooking and I like the following because they have quick and easy recipes for the busy young professional and you can knock ‘em up in twenty minutes or so while swilling back a glass of wine and chatting the day over with your loved one:

* Cool Eating by Louise Pickford
* Good Housekeeping – 1001 Recipes
* BBC Good Food – 101 Meals for Two
* BBC Good Food – Low Fat Feasts

Interestingly enough, as the wife and I are both control and organisation freaks, we organise our food by sitting down on a Sunday evening and working out a menu for the week ahead. This is actually quite fun. No, honestly, it is one of the less-onerous household chores.

What it does mean is that throughout the week every night you know you have something healthy and tasty in the cupboard or fridge and you won’t be tempted to pop down to the chippy for another deep-fried pizza, which can only be a good thing.

Anyway, use and abuse the comments section to tell the world about your favourite cookbooks and your slightly-anal domestic arrangements.

http://en.wikipedia.org/wiki/Nutritionist

http://en.wikipedia.org/wiki/Glycemic

Recently I was delighted to be invited on a weekend away.

I was delighted for two reasons, first it was the stag weekend of my chum Ru and it thus marked the fact that his and HP’s three-hundred year long engagement was finally coming to an end and they would, at last, become man and wife. If that isn’t a source of delight I don’t know what is. Hurrah!

The second reason for my delight was the fact that I would be travelling to a remote Scottish pile with the intention of partying the weekend away with a bunch of like-minded people. Double-hurrah!

I’ll spare you the details of the weekend’s debauchery – there’s nothing duller than hearing people’s puking-in-bucket stories – so I’ll only say that it involved a lot of Guinness, flagons of cider and a veritable lake of sweet Greek red wine. And I woke up extremely hoarse and with a very sore hand from playing the bongos all evening.

Some people like to go away for detox-weekends to get wrapped in honeycomb & seaweed balm and have warm stones needlessly put on their backs. But this weekend was universally agreed to be the polar opposite (and infinitely more fun) and so was duly christened the “retox weekend”.

Sadly, perhaps, I’m not eighteen any more and I have to confess that the weekend did take it out of me. I even managed to fall asleep on the way back in the passenger seat of Brian’s fancy two-seater. With the roof down. In the cold Highland air. With Brian’s not-exactly-pedestrian driving.

So all well and good – a few Alka-Seltzers later and I was feeling fighting fit again.

The day after saw me making my usual pilgrimage up to the Edinburgh Royal Infirmary for my seven-month MOT. After the usual tests I was ushered into the registrar’s room to be congratulated on my Hb1ac of 6.5% (down from 6.1% last time, bah! (yes, I am very smug about it)) and to be told that my urine sample had shown traces of blood.

I’m pissing blood? Oh crap!

My registrar told me this was nothing much to worry about but I couldn’t help fretting about impending liver failure or the imminent and catastrophic destruction of my kidneys (don’t lie, we all do that at 3am). But she suggested we re-did the tests in a fortnight or so just to double-check.

So that’s what we did and, dear readers, you’ll be relieved to hear that all was absolutely fine.

They say that diabetes is one of the healthiest afflictions to have – after all, who else gets very regular hospital check ups and has their eyes checked twice a year? But the weekend made me think of all the damage we do to our bodies every time we have a drink.

Should I stop drinking – or maybe reduce my intake to a small glass of champagne at Christmas and maybe a few liquor chocolates on my birthday? It would be far, far healthier.

But then I though “fuck it”, rang round our friends and organised a piss-up in pub tomorrow night. The evening will probably involve lots and lots of sweet Greek red wine. Cheers!

Ladies and gentlemen this is a live blog update from the Virgin trains service to London Euston

(wireless internet on trains, nice move Virgin).

I was sitting here quietly trying and failing to do something clever with Excel when my ears pricked up, the man opposite me uttered the D word.

As ear wigging on trains is pretty much compulsory, I listened carefully. Whilst simultaneously stirring 3 sugars into his coffee and eating a bacon sandwich the larger, older gentleman opposite me  explained to his friend that his doctor was very worried about “the diabetes” and as the tablets didn’t seem to be working he might have to start taking “the jabs”. There was apparently nothing else he could do about it.

Now, I hate it if people comment on what I eat – I know the impact of food on my diabetes and make my choices accordingly. I know certain foods will raise my blood sugar and I make the decision whether that particular cake is worth the extra insulin or not.

So what dear readers do we learn from such an encounter on a high speed train? For me it reinforces my belief that education and a sense of personal responsibility are the key things when it comes to living successfully with diabetes. My diabetes is my problem and I need to take responsibility for it, rather than see it as an issue for the Dr to deal with. On top of that I need sufficient quality education to understand the consequences of putting 3 sugars in my coffee. At that point I can then decide whether its worth it.

“So what happened next?” I hear you cry. I wrestled with whether I should have a chat with the man, sharing diabetes knowledge etc but by that time his friend had got off at Nuneaton and the man promptly put his iPod on and fell asleep. I’ll get back to my spreadsheet then.