Welcome back to T1 Talk, a series of conversations between myself and Bec of Sweet and Sour Diabetes. The aim of these conversations is to highlight how type 1 diabetes affects two people of a similar age, diagnosed at slightly different stages of life (Bec was a 14 year old high school student, I was a 17 year old freshman uni student).
Haven’t caught up yet?
Today, we’re tackling the not so technical side of our management – namely food, exercise and emotions. The first half of the chat is here, and the second half follows on Bec’s blog here.
In order to remain healthy, people with and without diabetes often consider food as a fundamental part of maintaining their wellbeing. What are your views on nutrition? How do you include this in your management?
Frank: Food is a really tough one for me. Being Italian, there’s a pretty big emphasis on food. It’s ingrained into our culture. If I don’t eat, my parents notice pretty quickly. If they didn’t see me prepare lunch this morning, they will ask me what I ate. When I go to visit Nonna, it’s almost expected that I’ll have an espresso and biscotti. When we hosted Mum’s family for Easter this year, I spent three days trying to reassure her she had prepared more than enough food.
I love food, and we do have some of the best. Pasta, cannoli, amaretti, cottolette, lasagne….I could go on for days. However, we are talking about diabetes here.
I feel that I eat fairly well. I prepare my own breakfast and lunch most days, and we usually have a cooked meal in the evenings. I drink three milky coffees a day, and usually find myself most peckish in the afternoons and caving in to my sweet tooth.
While nothing is off limits for me, diabetes has certainly made me more mindful of what I’m eating. I’ve cut back on a lot of the sugar laden foods I once ate – cereals, muesli bars, stir through yoghurt pots, and the sugar in my tea and coffee – as well as foods that I realised I didn’t truly enjoy. I am more mindful of the carbs I eat today, and try to balance them out with proteins, fruit and veggies. I would typically eat between 100-150g of carbs a day, which is less than what’s recommended but certainly not low carb.
I feel I have a pretty good idea of what different foods will do to my blood sugars. I’m quite diligent with my carb counting at home, and weigh most of my food on kitchen scales. Even if I don’t know the carb content, simply weighing the cookie and guessing a carb factor of 60% is extremely helpful. I try to pre-bolus by 15-20 minutes if I’m having a higher carb or higher GI meal, but I don’t do this all the time. If I’m having a bit of a cruisier day of eating, I’ll simply set a temp basal rate of 100% on my pump to help me cruise through a little easier.
Bec: I think the idea of tying food into culture is actually lovely, and I definitely don’t experience it. In some ways that’s a good thing considering I’m gluten intolerant and a lot of things would be off the menu if I were Italian!
Eating isn’t my favourite thing. I get a lot of strange looks for this, but I don’t get particularly hungry. I wish I could live off tea and coffee. It’s just a long boring task for me to find something to eat that’s gluten free, work out the carbs, take the insulin and then eat it. That being said there are some foods I actually do enjoy eating, like chocolate, cake, thai food, and risotto.
I think I have the same goal of being a little more organised. I need to increase my carb intake for medical reasons, but it’s hard when you’re not hungry. I also don’t think about food very much in terms of GI and what it does to my sugars. For now though, I’m just focusing on 1) increasing my intake and 2) attempting to count carbs accurately.
Frank: I feel like this gif is relevant in response to eating not being your favourite thing…
Well, I could easily live off coffee (decent coffee, of course), so at least we have some common ground there.
I want to say that maybe you just haven’t found enough of those foods that you enjoy. Keep searching! You don’t need to be European or have a big family to tie food into culture, either. Does your family not have a special dish that brings you together? A meal that you all simply rave about?
Bec: That gif perfectly represents everyone’s thoughts, often followed by measuring the circumference of my wrist…
Well, Mum’s Christmas lunch is pretty great but unfortunately only occurs once a year. My Nan used to make an amazing meal fondly named porcupine rissoles which no one has since replicated to perfection. But hey, I’m always keen to try new food to find something I actually enjoy.
What are your views on exercise?
Frank: I’ve never been the biggest sports person, and that dates back to well before diabetes came along. Our culture has too much of an emphasis on sport and on winning, rather than on just having a good time and doing what makes us happy. I never felt comfortable or encouraged playing sport because I wasn’t the best, while being on the debating team in Year 10 earned me a great deal of sniggers.
Most of my physical activity would be incidental or recreational activity. Fortunately my job as a Warehouse attendant keeps me fairly active. I do dread the day that I get a job sitting behind a desk, because then I’ll probably have to start doing some form of exercise. I also enjoy going for walks in the afternoon, and keeping this little man entertained when he comes to stay with us.
Bec: Ugh. Exercise. I get it to an extent, when I go on walks I do get that adrenalin rush, and it is a good way of staying present. But organised sport is a recipe for disaster. I hated it because I wasn’t perfect at it. You might have gotten sniggers for debating, but I WISH I could have done that at school! It was just so sport focused the only outlet I had was choir (a sequined experience involving dodgy dance moves that I’d rather forget).
I agree we are heavily focused on sport as a culture. I don’t mind it in some ways, after all I do follow the NRL off and on. But it’s not a core part of my life. I also agree that it’s important not to be so focused on winning. It has no appeal to me because I’m too uncoordinated to be perfect at it. Really though, perhaps I should be thinking about shifting the focus off perfect and on to fun.
But taking it back to diabetes, exercise makes me hypo. Very hypo. But I try to keep up the walking in spite of it, because I don’t have as much incidental exercise as I would like. Then again, I make up for it on hospital placements. So. Many. Stairs.
Aw, you certainly have a good motivator there! How can you resist walking that little guy?
Frank: I’ll never truly understand how Australia came to have two different footy codes. Clearly, AFL is where it’s at. I had my hopes up for Freo a few years back, but it’s looking very unlikely nowadays…
Urgh. Exercise hypos. Such a pain, moreso with the insulin pump. You even have to remember to adjust your basal rate for housework!
I’d be keen to hear more about managing diabetes on placement…would make a great blog post.