Diabetes and Food

‘Seedy’ Crackers.

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I’ve been wanting to try my hand at seed crackers for ages. I’ve seen them shared by he likes of low carbers and health kick programs, but how could I justify buying a whole bunch of foreign ingredients for a recipe that might not even turn out?

But with a bunch of leftover seeds in the pantry from a lapsed health kick in my house, I finally had the perfect opportunity to do so over the weekend.

These are as easy as combining 1/4 cup chia seeds, 2 cups of LSA (Linseed, Sunflower Seed and Almond Mix), 1/2 cup of buckwheat, 1 1/2 cups warm water and rosemary flakes in a bowl. Then spread it out in a nice thin layer over two baking trays lined with greaseproof paper. I would suggest seasoning them generously with salt and pepper before placing them in the oven. Then simply bake on 180C for 1 hour or until golden and crispy.

I had to adapt this recipe to deplete some of the ingredients in my cupboard, but you could definitely mix this up with whatever seeds and seasonings that take your fancy. Just make sure that you don’t leave out the Chia, as this is what binds it all together.

The irony here is that when I began making them, I just assumed they were low carb. By the time they were in the oven and I was looking up the ingredients in my Calorie King app, I realised that they were far from it. But hey, still better than anything you’ll find out of a packet…

The verdict? They tasted similar to Ryvita crackers, minus that sandy stuff on the outside. They did taste plain, but then again they are crackers and best eaten with something. I think more generous seasoning, and some whole seeds rather than the ground LSA, would have added some more flavour and less carbs to these.

I would definitely tweak the recipe and make these again.

Diabetes Brigades.

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I was trawling through my Facebook feed yesterday when I was distracted by one post in particular. It wasn’t the content that caught my attention however, but rather the brigade of comments that accompanied it.

With many schools going back this week after a leisurely six weeks off (one can only dream), the post was providing some suggestions for school lunchbox snacks.

I didn’t think there was anything particularly bad about the items suggested. Most of the suggestions were only small snack sized portions, and obviously not every item on the list would go into the lunchbox at one time.

I knew that if I were a kid, these would sound like pretty popular options to me. In fact two of these suggestions were in my own lunch box earlier that day, which I had carb counted and given insulin for. I imagine that I would feel very comfortable among my friends in the school yard with suggested snacks such as an apple or a yoghurt.

The aggressive comments, however, told a very different story. People felt the need to begin picking these suggestions apart for a number of different reasons, and linking them to all sorts of horrible diabetes end games. These comments were a pretty poor reflection on the community that I have come to know and cherish.

Yet I couldn’t help but come back to the bit about two of those very suggestions being in my own lunch box earlier that day. Put yourself in the shoes of a parent, or any person with diabetes for that matter, who is packing some of these very typical school food items into their lunchbox. How would you feel, reading a brigade of comments shaming your food choices and your parenting?

Now imagine that the person reading these comments isn’t in as comfortable a place as you are with diabetes. Where could that potentially lead you to? Feelings of guilt? Depression? Diabetes burnout? Disordered eating?

Despite how much of myself I’ve shared with you on these pages, it is not my place to give you advice, tell you how you should be managing your diabetes, or be making you feel guilty if your approach to diabetes doesn’t agree with mine.

Diabetes management is a very individual issue, and I truly believe that the foundation should be built on the needs and preferences of the individual. If that means letting a kid be a kid and eat a muesli bar or a handful of popcorn, then so be it. But hey, that’s only my two cents. 

If the suggestion you see online doesn’t suit your individual needs, then you’re certainly not obliged to take it next time.

P.S. I think Diabetes Australia have done an outstanding job on the resource Mastering Diabetes in Preschools and Schools, and I strongly encourage you to check it out here.

Some Insights into Fat and Protein Bolusing

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One of the most frustrating things that I often read (or hear) is that a low carb diet produces seemingly perfect blood glucose levels.

I certainly don’t have a problem with anyone who chooses to follow a low carb diet, and I can definitely see the benefits to being more mindful of my carbohydrate intake.

However, I find it incredibly frustrating that nobody ever talks about how they manage their blood glucose levels around fat and protein. Because, with the exeption of a few ‘free’ foods (non starchy vegetables, anyone?) the major trade off to carbohydrates is eating more fat and protein.

I’ve sort of conceived this idea that if one chose to contantly fuel their body with fat and protein, you could just offset their effects with a higher basal insulin dose. But what about those who just want to enjoy steak or pizza night without the spike?

Other than monitor your blood sugar levels closely and see how your body responds because everyone is different, Dr Google was very little help in this regard. I get that this topic is very individual in nature, but the information out there is scarce.

My first useful insight into this topic came from Gary Scheiner’s book Think Like a Pancreas. Suggesting that many restaurant and take out meals are naturally higher in fat, he suggests employing a temporary basal rate of 50% as a starting point to combat insulin resistance.

Gary also suggests that protein is only converted to glucose when the carbohydrate content in a meal is insignificant, and therefore only recommends making adjustments for protein when consumed in low or no carb meals. As a starting point, he suggests counting 50% of the protein in a meal as carbohydrate and delivering insulin through either an extended bolus on a pump or a delayed insulin dose when blood glucose starts to rise.

My second valuable insight came from meeting Dr Kirstie Bell, a researcher from the University of Sydney at the ADS-ADEA conference last year. I was absolutely engrossed in her research into fat and protein bolusing, and managed to catch up with her in Perth earlier this month.

Unlike conventional thinking, Dr Bell’s research suggests that fat and protein alone don’t impact blood glucose levels. It’s the lack of sufficient insulin that does. In people without diabetes who produce insulin, the impact of slowly digested fats and proteins is minimal. For people with diabetes who don’t produce insulin however, the impact is quite the opposite.

Ever had one of those nights where you’re correcting a high blood sugar level over and over with very little effect? Dr Bell also suggested that higher fat meals pushed the blood glucose peak of a meal out later, and caused a sustained blood glucose response due to insulin resistance caused by saturated fat.

Protein also produced a noticeable blood glucose response within 2 hours of being consumed. Research findings suggested that protein required adjustments in both mixed and no carbohydrate meals, with mixed meals having a greater degree of impact on blood glucose levels.

The most interesting point for me was hearing the concept of finding a ‘sweet spot’ in insulin dosing for higher fat and protein meals. Research suggested that if insulin was given too early, participants went hypo. But if insulin was given too late and insulin resistance had already set in, finding an optimal blood glucose result was too difficult.

For me, this is one of the things that makes diabetes so difficult to manage. I truly wish that all food was created equal. I wish that I could count the carbs, give insulin and it would produce the same effect on my levels each time.

At the moment I definitely need to put more effort my fat and protein bolusing, because I am definitely seeing a lot of slow and unwanted spikes after my meals.

Want to know more? Check out the resource website www.ibolus4t1d.com, and you can find @drkirstiebell on Twitter.

Festive Isolation

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Diabetes is an extremely isolating condition to live with. I think I’ve dealt with that isolation quite well over the past couple of years, both by building good support networks around me and simply acknowledging that it exists. Diabetes is not normal, and I feel more normal just by saying that out loud.

But there’s still something about this time of year, where that isolation feels a little greater.

It’s hard being surrounded by loved ones who don’t have diabetes, or don’t seem to care about diabetes, at this time of the year. Watching others being all merry and carefree and sometimes living like there’s no tomorrow, can make that isolation feel somewhat greater.

Hey, that’s fine. I don’t expect extended family members who I see a few times a year to remember about diabetes. I don’t expect, nor do I want special treatment just because I have diabetes.

But I also find it extremely insulting to be asked about diabetes the minute I’m sitting down with my helping of dessert.

“How do you manage sweets with your diabetes?”

“Do you have to be careful?”

“It’s not too much sugar?”

I manage my diabetes 24 hours a day, seven days a week, 365 days a year. 366 in a leap year. Diabetes extends far beyond dessert time. It extends into my nights. Into my weekends. Into my physical activity. Into my work. Even into my sleep. Misconceptions like these do me a great injustice.

As someone who actually has to live with this condition every day for the rest of his life, it’s ludicrous to suggest that I don’t know what’s best for me. Or that I would, you know, be tipping poison into my mouth if I knew it would kill me.

I don’t think anyone takes pleasure in inflicting feelings of guilt and shame, and yet ill timed comments like these do just that. In fact, feelings of guilt and shame can spiral even further into anxiety, depression and even disordered eating.

So if you are planning on seeing a loved one with diabetes during this festive season, here’s a better way that you can support them and help reduce those feelings of isolation.

Check in. Say hi. Ask them how they’re doing. Genuinely, and not just in passing. Show them that you care. Ask us about day to day life with diabetes, because hell, it’s a bloody big part of our lives!

However when it comes to dessert time, the only question a person with diabetes should be asked is how delicious it is.

While I’m at it, check out these pearls of wisdom on best supporting a loved one with diabetes from My Therapy App!

Navigating My Way Through a Food Heavy Culture

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There’s a new column up over at Diabetes Daily, all about the challenges of learning to manage diabetes among a very food heavy culture.

“Growing up in an Italian family, there has always been a big emphasis on food.

Our cupboards, fridges and freezers at home are always well stocked. Every Friday, I receive a reminder from Mum and Dad to add whatever I want to the weekly shopping list. If I haven’t taken any lunch to work with me, my parents are usually quick to notice. When I go to Nonna’s house, the cafeteria comes out and she motions for me to have some of the biscotti or chocolates on the table. If I’m the first to finish eating at a family get together, the host soon tells me to go up for seconds.

Food is at the center of family gatherings, visits to peoples homes and day to day life. Bringing the family together over a dish of pasta or Nonna’s cannoli is a lovely thing. Yet it has also proven to be one of the greatest challenges I have faced since being diagnosed with type 1 diabetes. I have been conditioned to eat for as long as I can remember and diabetes has really challenged me to break away from this.”

You can check out the full column over at Diabetes Daily here.

(Also, can’t help but be reminded of this GIF…)