Mental, emotional, and nutritional challenges of eating with diabetes

Food & Diet Nutrition
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I hope this isn’t too touchy or personal of a topic…I know some people have pretty strong opinions about carbs and various ways of eating. I’m just curious to learn how others feel about eating and nutrition as it relates to how they manage diabetes. I want to eat well and nourish my body properly. I want to feel good, have energy, manage my blood sugar well and avoid complications. I generally stick to pretty nutritionally sound meals, minimal processed stuff, plenty of fresh fruits and veggies, etc. But I also love ice cream and pizza, and miss snacking on milk duds and twizzler nibs from my pre-T1D days.

I started out with diabetes by lowering my carb intake some, cutting down on snacking and things that seem like “junk food”, and feeling like I was really on a roll. As time has gone by, I’ve relaxed my eating habits significantly as I’ve gotten better at blousing properly for what I’m eating and getting decent blood sugar results.

I’m eating more carbs (still less than i once did), have gained a few pounds, and I’m slipping into habits like eating Blue Bunny ice cream pops on a nightly basis, when honestly, they aren’t even all that good. I boredom-ate a packet of peanut butter/cheese crackers yesterday and one cracker in, I realized I totally wasn’t hungry, and they were kinda stale, but I had to finish them anyway because I’d bloused for them :slight_smile: But it got me to thinking that some crummy peanut butter crackers really aren’t “better” for me nutritionally than ice cream or pumpkin bread, so why not just use those carbs/calories on something like that that I can really appreciate and enjoy?? Yet in my head, ice cream SOUNDS like a treat, whereas peanut butter crackers are just peanut butter crackers.

I love that the attitude on this forum is one of “unlimitedness.” I want to feel unlimited and feel like I can find a way to eat what I want and what my body needs, but I also need to not use that mindset as an excuse to eat the wrong things on a very regular basis (unlimited shouldn’t necessarily mean I eat like half a loaf of pumpkin bread in a couple days, should it?, The rest is hiding in the freezer where it can’t tempt me)

I guess I’m not sure if there’s even a question in here anywhere. I’m just feeling discouraged and wondering if finding the right balance is sometimes as hard for others as it has been for me lately? Maybe most people don’t spend this much time thinking about it, but it’s been on my mind…

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There are so many great topics in your post! Many things that can be discussed.

It will take a while to go through all the great subjects, but one thing is about carbs.

I know there is a lot of dietary talk about reducing sugar intake. And there are valid reasons to do that. For non-diabetics, reducing sugar can help with weight. And for diabetics, high sugar content can cause spikes and be hard to manage for BG.

And there are reasons for taking slower (low GI) carbs instead of fast (high GI) foods. For example, being able to get a longer and slower influx of carbs can sustain you longer, instead of a quick spike that leaves you tired later.

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But just as a way of understanding sugar versus complex carbs, something that is often not explained - do you know that every carb ends up as glucose? In turn, that glucose can end up 1) stored as muscle glycogen (stored carbs), 2) stored as fat, or 3) be burned immediately for energy (glycolysis).

So if you want a bit of a mental “That’s okay to eat that, kpanda!”, you can consider that the main difference between twizzlers and a baked potato is only how fast it will be metabolized! Both will end up as glucose, the only difference is speed!

Obviously a diet of noting but twizzlers would suck. And twizzlers can cause more of a spike as it comes in faster. But eventually, glucose is glucose.

So have some twizzlers every once-in-a-while. Reduce some carbs in another portion of the meal. Bolus earlier for the faster carbs. But know that the carbs from twizzlers will end up as glucose just like the potato. So don’t stress about that.

Other topics that come to mind here are weight maintenance, fat intake, heart health, portion-control and self-control for food, balance in your diet, and making sure your body is given what it needs in terms of calorie percentages. Food is a pleasure, but it is also fuel, and you just need to make sure you are fueling properly.

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Great explanation @Eric.

In my food planning, I agree, glucose is glucose. But I also look for nutritional bang for my buck, to focus on choosing food with carbs I enjoy, along with nutrition. And of course a trending low can be perfect timing for a sweet treat.

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@kpanda01, finding the right balance is a very hard thing to do. I think that a lot of T1Ds have a warped relationship with food. It’s hard enough for a non-T1D to figure out what to eat. Our struggles with carbs make it harder.

I have a very big sweet tooth and because of that I avoid all junk food. I eat a moderate carb diet with mostly fruit, veggies, nuts, and whole grains, which works well for me. But whenever I go on vacation I relax my ‘rules’ and that gives me permission to indulge. I tend to go crazy and my BGs are all over the place and I don’t feel well. Because of that I end up not enjoying vacations (especially cruises where you can eat continuously). Sounds crazy right? To tell you the truth, I am not sure how to solve this problem. It has to be all or nothing for me - there is no in between.

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Every single day… and sometimes all day long. That’s how often I think about why I eat what I eat and how I can do better. Then I do better right up until I decide to reward myself for doing better… because in my mind, this is safe. I don’t even like this food anymore. And this is how I find myself back wondering the first questions… the why and the how…

I am a fly, and no matter how many times I do it, I can never seem to remember the cycle. Until I’m too deep in again.

Unless someone knows otherwise, I believe they have also linked sugar consumption to cancer. Can’t get much more vague than that statement, but that’s all I can remember at this moment. I sometimes think about THAT as I finish a bag of cookies that don’t even taste that good to begin with…

This can be confusing to me, and that’s the truth. This is one area that the definition of “unlimited” might not translate the same to all. My being able to eat sweets is in no way going to be how I feel “unlimited”. I just don’t ever think that will apply to me. Not needing them… understanding my boundaries— understanding my limits :grimacing: is how I…

I’m not even going to try to finish that. I don’t think it’ll be a popular opinion, BUT the way I see it is you would never tell a recovering alcoholic that the way for them to be unlimited is to drink alcohol. It’s obviously not true. In my case, I understand that my relationship with food is complicated, and although I would never want it to prevent me from doing things I want to do, I also know to be able to eat whatever I want is not my “unlimited”. To have confidence in my choices, the ability to adapt, to accommodate, to enjoy, and just roll with it are more reasonable measures.

It’s that hard for me, yes. But only as long as I do two things: I must be hard on myself and overly judgmental, and I must draw a hard line between acceptable and unacceptable. When I do these things, I can almost guarantee the dance you’re describing. When I take a step back and think about all of the things that are working for me for my health, for my disease, for my mental well being, there stops being so much meaning in those foods. There’s something to that for me, the assigning of meaning to foods. When I cut that out, I eat to satiate hunger rather than whatever else might be lurking in my mind. To have it or not is a temporary choice and not a greater reflection of things. This is not an easy separation, and like everything in life, I go two steps forward, one or so back, and then shuffle to the side before finding my stride again.

I have a feeling I should’ve read others’ responses before writing all of this. I hope I didn’t misunderstand your post… it obviously triggered a little something in me. Food talk does that. :grin:

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Yes, you give a very clear and rational response, but I’ve gotta tell you my brain doesn’t work this way. When I decide to have a treat, instead of my deciding to cut down the carbs elsewhere, just knowing I’m going to have it makes me want to ALSO get extra carbs. And probably before ANd after. If I’m going to have pizza, it will make me want to eat a bunch of crackers while I wait. And then I’ll want cookies afterwards. For me, this is that thinking of things being “off limits” or just bad. So my answer to my myself is, well as long as you’re having this, you might as well also have that. It’s really crappy thinking, and it leaves me with feeling like I can’t touch any of it. It’s a weakness of sorts, but really it’s much more than that. I buckle, I get mad at myself, I vow to do better, I rise to the occasion, I forget about all of the things that have happened and decide I really deserve a piece of cake, and then there I am… again.

Sorry, @kpanda01. You got me all worked up. :roll_eyes:

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You guys are so great. It’s nice to have some understanding folks to bounce these thoughts off of.

These two responses along with @Eric’s got me thinking a bit bigger picture about my eating habits and realizing i do eat pretty well most of the time. I too focus on planning meals with reasonable amounts of carbs, with an all things in moderation approach. I focus on getting my carbs from fruits, veggies, whole grains, beans, etc, If i really look at what i eat in an overarching way, I think it’s pretty well rounded. I suppose tossing some ice cream and pizza on top of a generally well rounded diet isn’t the end of the world, but there’s a complicatedness to that, for some reason. I start to wonder how often pizza is ok, and if I buy that pumpkin bread, how much is it ok to eat and at what point does the rest need to go away? And of course there really are no answers to these questions :slight_smile:

I should clarify what I meant by this because my rambling didn’t explain my thought process well. I would’t necessarily view being unlimited as always eating how and what i want… but instead, not letting diabetes control how and what I eat at all times. It’s not going be good for anybody to sit around and eat candy all day, diabetic or not. But I’d like to feel like i shouldn’t have to stay completely away from certain things because of diabetes, because I didn’t stay away from them before diabetes. All things in moderation, of course.

When I was first diagnosed with diabetes and was in a panic, and was still incredibly uneducated about what it all meant for me, i was so afraid of having to really change my eating habits. It was during that time that i really realized how much food gets woven into socializing, family, friends, self-care, rewarding yourself, etc. I noticed I’m big on the “i earned this” or “i should treat myself to this” thought processes. I should probably work on that :slight_smile:

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Sorry Nicky! :wink: it’s fascinating how food can be such a complicated, emotionally loaded topic for a lot of people!

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@kpanda01 Surely a conundrum between what you can do and what you should do. But it’s one that all people deal with, not just diabetics.

The way I’ve always solved the problem is by allowing my Bg to determine what to eat. I get more than my fair share of candy, donuts, o.j., cookies, etc. But only when I’m low.

I eat the good stuff, like fruit, bread, starchy veggies, etc. when I’m at normal Bg and I bolus. Sometimes I’ll bolus for a treat, but rarely because that doesn’t seem to work very well.

Just think how lucky you are. Most people can’t eat a bag of cookies they don’t like because it’s bad for them. But sometimes it’s the best thing for you to do!

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kpanda,

You’re right, eating is woven into our culture on many levels. I’ve been thru several eating cycles in my 14 years of T1D. Like you, I was diagnosed later, at age 28. I’m grateful I was beyond the teenage years…I ate about a lifetime’s worth of junk food as a teenager, up to diagnosis…I have a really sweet tooth.

After diagnosis, I read Bernstein, and went low carb pretty seriously for a number of years. It worked very well. After some years, I decided I could work a snack cake or candy bar, (or multiples of these at a time) into the mealplan. This was sort of emotionally driven eating, not always necessary, and not managed well on my part, and the result was my A1C increasing by about 2%. Probably related to this, my labs started showing a slight amount of kidney dysfunction. I cleaned up my diet and went modified Bernstein then. The kidney issues disappeared. The candy bars weren’t all that satisfying, in hindsight.

Recently, I’ve increased the carbs to maybe 200g per day (About 25% of diet). Most of these carbs are fruits, whole milk, pastas, corn tortillas, etc. which digest slower for me than sugar based foods. If I eat a candy bar (a milky way a few weeks ago…again the candy bar makes a comeback!), the BG rises for me quicker than the insulin can catch up, and I’m reminded of the long game and how the candy bars arent’ worth it…for now I remember this. I’ll probably need to relearn again in the near future.

So far, I think I’m managing the extra carbs pretty well, due to some of the tricks I’ve learned here (pre-bolusing, IM injections, etc). We’ll see at the next lab, but indication from my meter and diabetes app is around 5.6 A1C.

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We spent a couple days in Milwaukee this summer, my first travels since diabetes, and I was determined to give myself permission to eat and drink what i wanted as well. I enjoyed deep fried cheese curds and way too much beer, and I can’t tell you how much time I spent frustrated with blood sugar instead of enjoying my vacation. I learned a few things from that experience for sure.

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Awesome discussion topic, @kpanda01!

I would say my diet since being diagnosed T1D at 21 years old is better than it was before diagnosis. But I don’t know if my outlook towards food and method of eating is mentally healthier or not. What I mean is that I eat on a schedule. I space my meals to allow for the clutter of digestion and insulin peaks to clear before I add fuel to the fire again. I don’t eat because I’m hungry. I eat on a schedule and snack if my blood sugar allows it. That’s weird.

During both maternity leaves, I always felt trapped between the decision to eat or sleep. Whenever my newborn would nap (90 minutes at a time, tops), new moms are supposed to nap…and could really benefit from napping…but I’d probably already missed a meal by that time and really needed to eat…but pre-bolusing and watching spikes and plummets with all of the unpredictable hormone stuff that was going on…I was in real tears on more than one occasion because I was SO hungry and SO tired. And there’s no benefit to laying down to nap if you’re tanking and have to wake up right away to slam some juice boxes anyway.

Otherwise…my variety in my diet isn’t the greatest. There are certain healthy foods that I just can’t spend the time figuring out how to get the bolusing right at this point in my life. Most food, in my mind, is viewed as Time Allocation. Pizza? I eat it weekly because I refuse to give it up…and I have it pretty well pinned down…but it’s going to require 5-6 hours of watching after I eat it. Ice Cream? Again, I won’t give that up and eat it multiple times a week…but it is a 4-6 hour expenditure on monitoring. Healthier meal composition usually requires much less post-meal watch time…but more preparation up front.

So, for me, food comes down to time. It’s always struck me as odd, but that seems to be the truth of the matter for me.

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Totally agree! At meals I am estimating carbs and timing while my husband just dishes up what looks good. And sometimes I am so tired of this process that I don’t really want to bother eating at all. But…I do look forward to my treat day (Saturday after the farmers market at the European-style coffee shop). I manage any spikes with exercise and/or Afrezza and just cut myself some slack. This week even shared a small pizza with a friend for lunch…and ended up taking a brisk walk to deal with the late spike (yum, pepperoni!!!). Overall, this helps my mood, to be mindful of what I eat and to step back from some of the cultural associations with food that can trip me up.

BTW, at diagnosis (I was DKA), they only wanted me to eat 45-60 grams of carbs per meal, plus 2 snacks of 15 carbs each!! What a roller coaster of spikes and lows. Gah! Then I really started hating diabetes (and food and eating and everybody asking me what I could eat, etc.) and thank goodness found the online community and learned about pre-bolusing and reducing carbs and using a CGM!

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This is such a good topic. To me, unlimited does not mean feel free to eat so much junk that I then become d limited in other ways. We were *never unlimited in terms of our diet before Samson was diagnosed because I personally don’t think it’s great for humans to feel like they have no limits in terms of food. I think humans evolved in a food restricted environment so the all-you-can-eat-buffet that is modern society is sort of problematic inherently.

I want my kids to have a sense of moderation about food and realize that desserts are “treats” and that they shouldn’t eat junk just because it’s there.
I’m obviously VERY far from that as yet (Samson, as I said yesterday, at mac 'n cheese and ice cream for dinner). But that’s the goal.

So to me the idea of being unlimited means that I shouldn’t deny Samson something that I otherwise wouldn’t if he didn’t have T1D. We try really hard to do that and most of the time we succeed. Occasionally we’ll have just our older son with us and realize we’re not quite there yet. For instance, we go to a froyo place with just our older son and let Zane pull the lever a *touch longer than we would if Samson were there.

But in general I think a good strategy is to aim to eat food for a few reasons: For hunger, nutrition and for pleasure, and try to eliminate eating for other reasons (eating out of boredom, obligation, or guilt). If you eat something and then you feel crummy about it later, that’s the main thing I use as a metric for whether I want to try to pare down that kind of eating. A really delicious dessert that I thoroughly enjoyed RARELY makes me feel that way. Eating a bunch of stale cheddar bunnies because I forgot to carve out time for lunch is pretty much never enjoyable.

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You guys are so in my head… I love it. :purple_heart:

@T1Allison your comments about timing meals make total sense to me. I love the concept of intuitive eating/mindful eating, and would love to say I try to incorporate that into my life, but eating around your BG makes it a challenge. Waiting for your BG to be where you want it before eating, eating things you aren’t hungry for because you are dropping, etc. makes your food intake about necessity rather than following your hunger. It’s really interesting. I am making an effort recently to take more of a mindful approach though, and eat when I’m hungry, eat things that taste good AND nourish my body, and enjoy what I’m eating.

And THIS is exactly why I’m working on the mindfulness thing. The stupid peanut butter crackers yesterday really drove home that I need to pay more attention to this. I’m so glad you pointed this out!

And this is where I’m trying to be as well. Before T1d, I never met a soft pretzel with cheese I didn’t like. Is that a nourishing meal? Heck no. Is it really, really tasty on occasion? Yes! But it feels totally off limits to me now. If I really think about it logically, it’s not really much less nutritionally sound than other things I do eat (like pizza, for example). As long as I could manage the spike with insulin reasonably well, there’s probably no harm in trying it occasionally. But it still feels like a total no-no.

There’s a restaurant we frequent with a good appetizer menu. I keep joking with my husband that one day I’m going to bring ALL the insulin and we’re going to share pretzels, fried mac and cheese bites, and nachos. Now that’s something I wouldn’t have even done before diabetes :slight_smile:

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There is so much here that speaks to us. I’ll write more later, when it isn’t bedtime. :slight_smile:

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There is great discussion here. I want to read all of it and respond, but I am away for the weekend (I saw School of Rock last night) and I don’t have time at the moment. Unfortunately, after a family dinner out last night, I had a roller coaster of a night. I enjoyed the meal, but not the aftermath. It didn’t help that I was sitting in a theatre for 3 hours after the meal. As @Nickyghaleb was talking about, now I feel that I have given myself permission to eat badly for the rest of the weekend. We’ll see how today goes…

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I think the problem is that diabetes makes everything harder!

I am non-diabetic, but trust me, I love food and have food issues. If I was to add diabetes to the mix, it would be really rough. It doesn’t help that restricting food makes diabetes management better, but restricting works for some period of time for most people, but usually doesn’t work forever, when life and stress are added to the mix.

Interesting discussion

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Wow. I’ve written not one but two long posts to this topic and deleted both because I got too emotional and upset! So here’s a third try.

It frustrates me that science is unable to tell us what to eat to stay healthy. I grew up with diabetes and serious food allergies, and so had a restricted diet out of necessity. Each year I’d go to Children’s Hospital and get a meal plan with a breakdown of the calories, carbohydrates, proteins, and fats I should eat at each meal and snack, and the “exchanges” that were allowed. But growing up I rarely remember being upset or feeling like I was missing out. My dietary restrictions were just a fact of life and something I had to do to stay healthy.

As an adult, I find myself missing that type of planning. I wish I could see a medical professional each year who would go over that sort of thing. But, so far, doctors freely admit that they know nothing, and the dietitian I was sent to was focused solely on carbohydrate counting and had no knowledge beyond that. I feel like being told in my mid-20s that I could “eat whatever I want” really screwed up my relationship with food, not to mention my weight.

My relationship with food is way more complicated than just diabetes. I have more serious food allergies than I did as a kid, I’m significantly overweight (thanks, “Eat whatever you want!” with no guidance), and I have several other chronic conditions that are triggered by diet. My daily life is seriously impacted by chronic illness. I’m in my mid-30s and sometimes really worry about where my health will be when I’m in my mid-60s, or mid-80s, if my body continues to malfunction at the rate it’s been doing. At times, I worry about whether I’ll even make it that far.

I am good at following rules, but these days no one can tell me what to follow except for groups who say that their way is the only right way (and here I’m not only referring to Bernstein). If someone could just give me a meal plan like I used to have when I was younger, and tell me, “Here, if you follow this you’ll have energy, you won’t have any reactions, your diabetes and weight and heart will be healthy,” I would be able to follow that no problem. But no one is able to provide that rulebook.

I tried a year of very low-carb eating, and I will say this much: as restrictive as it was on top of all the other restrictions I have, that year I had the most stable health and the most energy I have had in years. It’s probably just a coincidence, but my health destabilized as soon as I went off that way of eating. And eating low-carb fostered a new hobby for me (baking) and created a reputation on Facebook of me being “adventurous” in the kitchen, which is a nice stand-in for being able to be adventurous at restaurants. My health is currently at a low point, but when I’m feeling better, I intend to give low-carb eating another run.

I will never be one of those people who can just eat food without a second thought. I will never be someone who can find a random restaurant tucked in a nook on a side street and decide to check it out. I have never had the experience of eating something while wondering what exactly it was. I will never be someone who travels to experience the food. Or who can travel without extensive meal planning and bringing half a kitchen with me. Even without diabetes, I wouldn’t be one of those lucky people. So, for me at least, “unlimited” when it comes to food means finding strategies to live and work and feel comfortable and satisfied eating with restrictions in a social world obsessed with sharing food and being interested in what everyone else is eating.

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I was trying to say just that. It’s not about being able to eat whatever I want. I’ll never be able to do that without destroying myself. As you said, this is about more than diabetes, although it was my development of diabetes that started me on this path. But my not being able to eat whatever I want is not the obstacle to overcome, it is the course. Being able to live my life, to enjoy going and feeling and sharing and losing without feeling I’m at food’s mercy… those are the obstacles that I’m learning how to overcome. I was at the hospital last night with my mom. It was such a scary day. I ended up eating candy. Quite a bit. And cheese. Quite a bit. It’s what I do with fear. I focused on the damage control part of it, reminded myself that I am human, and woke up today to test my blood sugar, have my coffee, and get myself right back to life in progress. @Lisa, I’m not giving myself permission to eat whatever I want today. Yesterday was hard, but today needs not be. I do that in response to my own harsh judgment of my own human actions. No harm, no foul. That’s what I’m trying to learn. Pick up today with what really feels good and move on.

Food is crazy. @Jen, I also deleted a long comment yesterday. I made myself hit “reply” on the one I did post before I could change my mind. I was afraid, even afterwards while watching others’ comments, that I had overshared. That I revealed something shameful in my character. This stuff is hard. I also didn’t say one thing in my comment that is not 100% true. So I either leave it here in writing, or I tuck it down deep inside in an attempt to hide it. That has yet to help. With anything.

It is amazing how fast good food can feel good. If you are in your mid-thirties and your health is unfavorable, then you might also be feeling like the task of setting things right is a beast. And it might be. But the effect of good food is almost immediate, and it’s something we can decide to do at any moment. That’s my task today. Just for today. I’ll worry about tomorrow when I get there. Thank you for trusting and not judging. :cherry_blossom:

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