Thursday, May 13, 2010

To Carb or Not To Carb

Day four of Diabetes Blog Week has arrived and our assignment is to discuss what we eat.  There are two general schools of thought:  eat what you want and just bolus for it or limit your carbs to better maintain glycemic homeostasis.  Truthfully, I see both sides of the debate.  However, I was also raised in a household where the meals provided were wholesome, home-cooked and had carbs aplenty.  My mother is a fantastic cook and made nutritious meals from scratch, with love and on a shoestring budget.   Desserts were almost always part of our Sunday menu and were always homemade.  It’s what I lived so it’s what I learned and for the most part it’s what I practice now raising my own family.
Initially, after Jenna’s diagnosis, I tried to limit our carb intake.  I had been given a meal plan by our dietician which specified how many carbs Jenna could have at each meal and snack.  To stray from that would mean Jenna would suffer either a high or a low since she was on multiple daily injections and her insulin dosing was given long before her actual meal or snack.  So it was in her best interest to try to adhere as closely as possible to the plan. 
But Jenna was two at the time and if you’ve ever raised a two year old you can imagine just how difficult this task was for us.  Some days Jenna was super hungry and wanted more than just her 35-40 carb allotment for breakfast.  Other days she wasn’t as hungry and I would be pleading with her to eat her 20 carb morning snack that she had been dosed for before breakfast.  This clearly wasn’t working for us.  So after three months of MDI’s  we started Jenna on an insulin pump and began enjoying food again.  REAL food.  GOOD food.  Without quantity restrictions.  
Now, I can’t say that things have gone right back to the way they were before Jenna’s diagnosis.  But the changes that remain in play are good changes.  More careful thought is given to each and every meal and snack I prepare now.  Like most people affected by diabetes I have become an avid label reader.  Carb counts are crucial but so are other nutritional components.  I pay very close attention to fat and fibre content as these influence the glycemic index of foods which is important in determining how the carbs will be absorbed by Jenna.  I try to limit high fat foods and those foods that are notorious for messing with blood sugars like pizza and pasta.  Because these foods are commonly eaten for supper, they tend to creep up on a person with diabetes when they are in their most vulnerable state - sleeping.  Waking up in the middle of the night to the sound of Jenna chugging an entire sippy of water after a pizza supper means she is likely in the mid to high teens and the fatty, high protein, high carb pizza is to blame.  I won’t lie to you, I feel tremendous guilt when this happens.   It sucks.  
However, Jenna loves pizza and so does her sister.  So while I limit it, I don’t eliminate it from our diet completely.  I don’t want to make certain foods forbidden and leave Jenna feeling deprived.  I mean, what childhood is without the occasional pizza and movie night or spaghetti dinner with loads of parmesan cheese?  So we figure out how to make it work.  And if combo boluses and raised basals don’t take care of the inevitable blood sugar spike, we just correct the crap out of it until we stamp it back down into submission again.  In a perfect world the boluses would match Jenna’s needs and she wouldn’t have any episodes of hyper or hypoglycemia taxing her four year old body.  But then, in a perfect world there would be no such thing as diabetes.
So, as cliché as it sounds, for us moderation is the key.  Food is a huge part of how we socialize and experience life and Jenna deserves to live her life as fully as the next person.  So we do the very best we can.  The rest is beyond our control.
To find links to other awesome blogs writing about this very subject today visit Bitter-Sweet.

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