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January 3, 2008

Last week when I was in California visiting my family, I was getting ready for breakfast and my mother came into the room to check in on me. I told her I was getting ready to go and have breakfast. We had had a large dinner the night before, and my mother asked me if I was hungry. I have never liked being asked about my eating habits and I was very defensive. The truth is, I was a little hungry, but probably not hungry enough to have breakfast right at that time.

My mother observed that it seemed that most of the time I eat because “it’s time” not necessarily because I’m hungry. I remember when I first went on the insulin pump when I was 15 years old that I had a very difficult times giving up snacks. The reason, I think, is snacks had become so ingrained into my daily schedule that giving them up seemed like an interruption to my day. My day was built around the meals and taking them out was like taking out my structure. It made me very anxious.

I just read a post by Mel and she said that her goal is to focus on eating when she is hungry, not because it’s lunchtime or dinnertime. It’s one of those habitual patterns that sneak into our lives when we’re not looking because we have diabetes. I know it seems like people with type 1 diabetes shouldn’t have to worry so much about being overweight because being overweight is not why we were diagnosed with diabetes. But I think being overweight could almost being considered one of the complications – or perhaps just a side effect – of having type 1 diabetes. My mother and I have often discussed whether I would have the food and weight issues that I do if I didn’t have diabetes. Because I was diagnosed in the mid-90s (it will be fourteen years on January 27), I was on a fixed dose of NPH and Regular insulin, and then NPH and Humalog, for six years. The fixed dose meant that I was forced to eat regardless of whether I was hungry or not or I would risk having a low blood sugar. Then when I actually had a low blood sugar, that meant more food – juice or crackers – even if I had a full meal already. Granted, when I’m low I usually crave food so that’s never an issue, but I was adding 100 or 200 calories to an already full plate. How many extra calories have I added to my diet over the year? Of course, I have never enjoyed exercise, so most of these calories were never burned off through activity. When I am at the gym and I have a low blood sugar, my juice box adds in another hundred calories that I just burned off. They were extra calories that I had to consume.

Even though I have an insulin pump, the expectation of eating on a fixed time and dealing with hypoglycemia leads to this constant pattern of consuming extra calories. I think the best way to work on this is to focus on eating healthy meals combined with exercise so that when we do have to consume extra calories it has less of an impact on our weight.

While we were in California, my mother also showed me an article in Good Housekeeping which said that the absolute best way to lose weight is to keep a food journal. I think this is why Weight Watchers works so well because it forces you to write down what you eat and how much. When you reflect back on it at the end of the day or at the end of the week, you can see all of your different food choices and make decisions about when you are slipping up or what a better option could have been so you can prepare better the next time you go to the grocery store. This is the same theory that goes into tracking your blood sugars. You really can’t see the patterns in eating unless you have a record of different days that you can compare. Keeping a food journal is one of my goals for the next 1,001 days, at least for part of the time. My hope is that by keeping a food journal, I can start isolating spots where I’m consuming extra calories during the day (such as that Starbucks Mocha I had with a co-worker this afternoon) so that when I overbolus for dinner and have to add an extra hundred calories of orange juice, I’m not ruining my chances of losing weight (which is another one of my goals for the next 1,001 days.

Once again, adding diabetes into the mix just makes whatever you want to do even harder.

  1. January 3, 2008 8:48 PM

    I’m sure having type 1 diabetes for so long has had an effect on my weight. It is so difficult to get out of the old habits you mentioned. I did the same things. And I’m not much of a fan of exercise so that doesn’t help either. (I definitely need to work on that.) I’ve been keeping a log of what I eat on the same spreadsheet I use to keep track of my BGs. Then I add up the carbs I have eaten each day. That has helped some. It shows that I eat way too many carbs on the weekends, etc.

    Here’s to getting out of old habits & into better habits in 2008! Good luck with your goals!

  2. January 3, 2008 9:03 PM

    Thanks for this post, Allison. I was just talking to my mom about how I want to lose weight and she told me “Well, I thought that type 1 diabetics are normally skinny” and then she reminded me that I didn’t used to have a weight issue. It really irked me. She also told me she forgets that I “need to revolve my life around food” and that she just doesn’t do that so it is hard for her to remember.

    It irked me. A lot.

  3. January 3, 2008 9:27 PM

    From a mom…
    We worry about you, we care about you, we want only the very best for you. We are not perfect, but we want you to be better than us. We try not to nag, but, we worry and so, we nag. Your moms love you and want to help – really…
    I can still remember the first time my mom looked at me, carefully, and said, “Gee, you’ve gained some weight.” I was soooooo ticked off.
    I now have a son who could lose some weight. I try to be careful and I try to be encouraging, “How was the gym today?”, not, “Did you go to the gym today?” I know he sees through my comment and thinks I’m being critical. Know that your moms are trying to be supportive, really!

  4. January 3, 2008 10:55 PM

    I agree!!! I remember the first time I felt hungry… truly hungry after getting my pump. I also attribute some other unhealthy eating issues to the whole NPH thing!

  5. January 3, 2008 11:25 PM

    Food, guilt, and diabetes. It just seems all of these are mixed up together is a weird and wacky relationship. And I especially hear what you say about guzzling down calories when you’re treating a low. It’s not as if the stuff is even enjoyable at that stage. What a PITA that is.

    Here’s another thing to think about. When I first tried Symlin, I realized that I’d forgotten what it felt like to be full after a normal meal. Type 1 diabetes meant that I was no longer full after eating. Symlin gave that back to me. And that’s made a big difference to my (bad) eating habits.

    One day (I hope) we’ll look back at all of this and laugh. I can’t wait.

  6. January 4, 2008 10:49 AM

    Diabetes is almost an eating disorder. When you think about the effects of food as much as we do, it’s bound to end badly. I remember making the decision to cut out my snacks when I was on fixed doses/sliding scale, but not because of weight gain. Just because I didn’t want to eat in the back of class everyday. It had no change on my blood sugars, which is not typical. I just had horrible doctors who didn’t really help us a lot. Enough about me, I wish you luck in your quest to strike a balance between healthy eating habits and managing type 1 diabetes.

  7. January 4, 2008 11:32 AM

    I’ve been a Type 1 for 25 years now and during the days of NPH I gained a few pounds but not enough to worry me then in 2000 I had two heart attacks and needed bypass surgery. I decided then to cut way back on my food intake especially carbs and fats. I also had six weeks in an exercise program to get back in shape after the surgery. I managed to lose nearly 30 pounds which made everyone nervous because I was a little too thin. My wife and I often had different meals and it was getting to be a pain maintaining my weight with the changes in my lifestyle. Nine months after the surgery I started feeling discomfort in my chest after exercising so I went to hospital and they found two of the three bypasses completely blocked. I needed a stent for one of the bypassed arteries but my vessels were actually in better shape, there was less blockage. Because of all this I know I can lose weight and I felt better because the new diet meant less insulin and fewer lows but it meant a serious commitment. I’ve added more carbs to my diet and gained 20 pounds which tells me that I just need to accept that my intake needs to be significantly reduced for the rest of my life. It’s just another thing we have to live with. Imagine how boring life would be without diabetes.

  8. January 4, 2008 11:59 AM

    I actually think it’s healthier to eat regularly. If I don’t, I tend to skip meals and throw myself into some sort of unhealthy cycle where I end up eating more in the end. I’m actually considering getting back into a habit of eating every 3 hours to stave of cravings.

  9. Katie I. permalink
    January 12, 2008 6:04 PM

    I have struggled with weight gain due to hypos, too. I am nodding my head in agreement with your post and all these comments, because I completely agree!! Diabetes definitely forces you to think about food differently, and it’s always on your mind; I’m sure people with diabetes probably have a higher risk of developing an eating disorder.
    I lost over 20 lbs two years ago by (carefully) lowering my basals and exercising, and by thinking about everything before I ate. But it was such a challenge, because every time I had ever been at my ideal weight (or lower), my A1C’s were higher, whereas whenever I was a little overweight, my A1C’s were lower (and I had quite a few lows and was “feeding the insulin” pretty frequently). Thankfully, I finally achieved both a favorable A1C and a favorable weight, but it did not come easily. I lost the weight very slowly, and what really helped me was not thinking about the number on the scale, but just telling myself every day that I was going to be GOOD to my body and make healthy choices, with regard to everything (exercising, eating high-fiber and high-protein lean foods and lots of produce, etc.). An article I’d read about Laura Bush before I started exercising regularly helped me with that mindset– she said her New Year’s resolution was not to lose weight, but just to be healthy. Thinking of it that way changed my perspective.
    I am confident that you WILL achieve your goal– after all, we T1’s have a great work ethic and quite a bit of tenacity! 🙂 I wish you the best.
    P.S. Have you had your thyroid checked? That also had something to do with my weight.

  10. January 13, 2008 7:15 PM

    I totally have a boatload of food issues. I’m sure a fair amount of them (though probably not all) are because of diabetes.

    It is a very complicated relationship we have with food, that is for sure!

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