About a month ago I learned something disconcerting from the doctor. Since then I've been coming to terms with the fact that I have an incurable disease (one unlikely to be cured any time in future, as long as Type 2 diabetes is perceived as "a disease you brought on yourself by overeating," which the most recent research refutes, and as long as so many groups stand to profit more from "diabetic maintenance" than from finding a real cure. At least I'm less bitter about this than I was a month ago) and the things I need to do to take care of myself. Some days are easy, others less so.
A few friends have asked me what I can and cannot eat now. It's a good question. I can't presume to answer this question for all diabetics, as different people have different levels of pancreatic function, metabolize foods at a different rate, etc. Personally, I've chosen to keep my blood glucose within normal, non-diabetic ranges at all times (about 80-130 mg/dl) by eating a low-carbohydrate diet. By "low-carbohydrate" I mean always less than 100 grams of carbs per day, and usually less than 60 grams of carbs per day. This and metformin have helped me bring my sugars down to normal ranges within 2 weeks of being diagnosed. Staying in this zone is most likely to reduce my chances of developing complications later in life.
So, for those who really wanna know, my recommendations:
1. PLEASE IGNORE THE DIABETIC DIET RECOMMENDATIONS OF THE AMERICAN DIABETES ASSOCIATION. Based on its recommendations, the name is either a grave misnomer or this is an association whose secret aim is to promote diabetes. As I've mentioned elsewhere, I've started to think of carbohydrates as though they were measured doses of radiation -- my body can handle small amounts spread out over time, but too much too quickly will create serious health consequences. The ADA recommends a much higher-carbohydrate diet than is healthy for most diabetics; to extend the analogy, it would be like suggesting the best way to treat radiation sickness is by bathing people in more radiation. But then, the ADA claims that blood glucose levels anywhere below 180 mg/dl are "well-controlled," when numerous studies have suggested that 140 mg/dl is the upper limit threshold beyond which complications like retinopathy (uncontrolled bleeding in the eyes), neuropathy (nerve damage in the hands and feet) and nephropathy (kidney damage) are likely to occur. Already seen that happen with other people, don't care to have that happen to me, thanks.
OK, rant over, you can come back now.
2. Zero-carb or low-carb foods are very welcome. I've started obsessively reading the Nutrition Facts labels at the grocery store; I try to pick items that are either carb-free or have less than 10 grams of net carbohydrate per serving. Examples of these include every type of cheese, most lunchmeats, sugar-free Jello, plain yogurt, beef jerky, smoked salmon, nuts, hummus, and a wide variety of non-starchy vegetables. I try to stick to only the lowest-carb fruits for now. You can estimate the net-carb status of a food by looking at the total grams of carbohydrates per serving and subtracting the grams of fiber per serving.
3. I drink a lot... of water. I also sometimes drink unsweetened almond milk (lower in carbs than regular milk, and I like the taste much better than soy milk) and the occasional sugar-free soda (hel-loooo Root Beer Store, it's me again!). I've discovered that not all sugar-free sodas are created equal. Also that not all "diet" sodas are sugar-free, so read those labels.
4. Alternative sweeteners such as granulated sucralose, DaVinci sugar-free syrups, erythritol and stevia are very welcome once in a while when the sweet tooth hits. I try to avoid the other sugar alcohols such as xylitol and maltitol because, well, frankly, they bring on diarrhea. I'm also cautious about ingesting a lot of aspartame (aka NutraSweet) because it contains phenylalanine -- and although there's currently no indication why this is, diabetics tend to have unusually high amounts of certain amino acids circulating in their blood, including phenylalanine. (Incidentally, clearing up these amino acids in the blood -- usually through gastric bypass surgery -- seems to "cure" diabetes, or at least put it into remission.)
5. I have cut starches and high-sugar foods out of my diet. These include potatoes, rice, corn, oatmeal, beans, grains, many fruits, sugar, honey, and anything made with more than trace amounts of these ingredients. Yes, I know some of these foods are "good for you," but they're not good for me based on what they do to my blood sugar -- especially rice. I love rice, and I miss it, but I'm not willing to go blind or lose my kidney function for a plate of pilaf. Brown rice and whole wheat bread/pasta raise my blood sugars just as much as white rice and white bread/pasta do -- the spike just arrives a few hours later.
6. "Gluten-free" foods are not necessarily good for diabetics. (I, for one, have no problem digesting gluten -- my trouble is too many carbs.) You can also safely ignore the "low glycemic index" foods, as the glycemic index is determined by testing the blood sugar rise caused by specific foods on people with normal pancreatic function, which diabetics, by definition, do not have. For us it's all about the carbs, people.
7. Sometimes I'd rather have a tiny bit of the real thing than gobs and gobs of an ersatz approximation. This is especially true of dark chocolate. One small square of real dark chocolate, dissolving slowly on my tongue, is better than a whole bar of most sugar-free chocolates on the market. Oh. Yeah. Baby.
8. Argonauts. They're low in carbs.
Now, you might think that my food options are pretty limited, but it's not as bad as it looks. The Internet is a great resource for general information about diabetes, recipes that work with low-carb eating, and free sites to track weight loss and exercise targets. The world is full of brilliant creative people who have not only figured out how to make truly diabetic-friendly recipes from soup to nuts, but who are kind enough to share their know-how with others. More and more restaurants are providing nutrition information on request, and although the accuracy of this information sometimes comes into question, at least it allows Type 2 diabetics like me to make a ballpark estimate of how many carbs they're eating.
All told, it's a good time to be sick.