Bolus Deserving Desserts

When choosing dessert, there are some sweet things that I consider to be bolus deserving and some that are not. Ice cream, especially when of the chocolate peanut butter type, is always deserving of an extra bolus. Flan is not. Carrot cake cupcakes with cream cheese frosting definitely get a yes vote from me, white cake with crunchy frosting, no  An oatmeal cookie with chocolate chips, yes. An oatmeal cookie with raisins, no. Cheesecake takes some serious consideration. Crust is important. Graham cracker is favorable. Flavor is also important. Mint can be passed up. Strawberry, maybe. Chocolate, bolus deserving.

There are also some desserts that I am reconsidering. Pie is an example. I have politely refused pie for many years now, so much so, that I had convinced myself that I didn't like pie. It was not a difficult refusal. Would you like some peach pie? No thanks. However, after riding my bicycle across the state of Iowa and being lured by roadside signs such as Grandma's Homemade Pies- 5 miles, I think I might love pie. Grandma Sue's homemade dutch apple. Mama's homemade peach. What was once not worthy of a bolus, has now become the dessert that makes my mouth water. Pies made by grandma-Bolus Deserving.

What's in a Number?

If you are a type 1 diabetic like myself, you know that Hemoglobin A1c is a measure of your average glucose over the past 2-3 months. It is presented to you multiple times a year in the form of a percentage. The higher your glucose levels, the higher the percentage and vice versa. If you happen to meet another T1 you might discuss HA1c, however you would never have the guts to ask. It's a taboo subject. It's synonymous with asking how much they weigh or how old they are. It's off limits. Because it is a way of comparison, a way of telling how well you are managing your disease compared to others. And since this number is controllable (for the most part) by you, it becomes a competition. How low can I go? How am I doing compared to others?

At one of our first meet ups for Young and Type 1, I was introduced to Jacob, a 21 year old male with T1. He sat down on the sofa with his coffee, introduced himself and proclaimed, to prove to all of you that I am diabetic, I'm going to measure my glucose right now. He then proceeded to whip his meter out of his backpack and take his blood sugar. Since you are all wondering what it is I'll show you. He then flipped around his meter and to reveal his result of 96. And thing is, we did want to know. Badly. We all wanted to know.
So what does Hemoglobin A1c really mean for us diabetics?

This is THE number that determines whether we are in control or out of control.  It is the primary tool we have to measure our success or failure. It is the number that every physician wants to know.  It is the number we measure ourselves by or try not to measure ourselves by. It is the number no one wants to reveal.  It is the number we feel self-conscious about and the number we strive to have lower and lower. It is the number we celebrate and the number that can cause tears.  If you want to become pregnant, like myself, it is the bane of your existence for months. It determines whether or not your womb is safe to be occupied. Everything weighs on this number. Which is why I am happy to report most recent result of  6.0% that I thought was impossible to achieve.

Yet, does everything really weigh on this number? My current targets are 70-100 before meals, 140 one hour post meal, 120 two hours post meal. That's a narrow range I have to keep. If I am able to maintain these targets consistently, my average would be 105 which is the equivalent of an HA1c of 5.3%. However if I maintain a range of 30-180, my average is also 105 or 5.3%. The latter is not necessarily a place I want to be in, yet would I be satisfied with a number of 5.3% even if I was bouncing from 30 to 180 each day? While I strive to have my number lower and lower and wait in anticipation for each result, I try to remember that this number is not flawless. It is simple math, an AVERAGE, which might not always tell the whole story. It is not the bane of my existence nor the sole measure of how well I am managing my diabetes. Nonetheless, with my number of 6.0%, I've been cleared to put a bun in the oven and it's not going to get burnt. I feel good about that.

Smoothie in a Blender

I love 'em. You can basically put anything you want into a blender and

call it a smoothie. Yogurt, frozen fruit, eggs, peanut butter, honey, bananas, cottage cheese, agave nectar, mint, tofu, peaches, the list goes on and on and I haven't even ventured into the vegetable side. The possibilities are endless! On a hot and humid summer morning when the temperature has surpassed 91 degrees by 7:00a.m. a smoothie is cool, refreshing and tasty.

My most recent favorite:

1c. plain yogurt (whatever fat content you like)

1/2 banana

1 tsp honey (from Katie's honey bee farm)

2Tbsp unsalted natural peanut butter (I prefer the Trader Joe's type)

Margarita + Beach Volleyball = Disaster

It all started out because of poor planning. My office mates and I had rescheduled our after work margarita night multiple times and had finally decided on last evening. I was also simultaneously scheduling an evening league with my beach volleyball partner. It all happened to coincide last night and I was faced with a decision. To margarita or to not margarita? I didn't want to force my office mates to reschedule yet again and I definitely did not want to miss volleyball. I love playing volleyball. So I decided to try both.

I should tell you that a margarita is not a normal drink for me, so I wasn't sure how to handle it. So I guessed. I bolused 1.5 units, probably a little on the low side, but a double-header on the beach was immediately to follow so I thought I would need the extra sugar. After 45 minutes and chips with guacamole the cacophony began. Beep. 185 and upwards. Crap. I hopped on my bike before I could be convinced of another margarita and rode to the beach. Beep. Vibrate. 256. The first game didn't go so well. Lucky for me, my partner had also consumed a glass of wine before game time, so we were both a little sluggish and slow on our feet. By the end of the match I had come down to 114 and felt much better. I drank some Gatorade and played another match. Beep. 139. I cycled 6 miles to my house. Vibrations. 67. I ate an ice cream sandwich and snuggled up in bed to read a book. By midnight, I was hearing that high-pitched shrilled, the last resort one, when you've missed all of the vibrations because you are SLEEPING. Beeeeeeeep(high-pitched and shrill-like) 59. ugh. I desperately wanted to go back to sleep, but decided against it and went to the kitchen for M&Ms. At 2am, beep. 56. To the kitchen I stumble! At 4am, vibrate. METER BG NOW. Are you kidding? 104. Sigh of relief. When 5am hit and I was 59 again I started to complain while half asleep. Why didn't I just bring the giant bag of M&M's with me to bed? After the third time of going to the kitchen last night, I was delirious and mumbling about having poor dental hygiene from all of the sugar consumed. My husband seemed concerned and all I could utter from my subconscious was, Typical Type 1 doesn't brush her teeth in the middle of the night.

Diabetic Housewives: A Fantasy

I'm going to visit my endocrinologist on Monday with the hope that she will tell me my womb is now safe to be occupied. I am optimistic that I have lowered my A1C over the last three months and that she will give me the green light. She is located across the hall from the maternal fetal high risk OB clinic where I will be transitioning to once I have a bun in the oven. They have "diabetic" Friday clinic days when all pregnant T1 diabetics show up for their battery of tests and adjustments.

I have this fantasy. I am pregnant, diabetic and visiting this clinic every other Friday to make sure that the growing fetus is not living in a toxic environment. I see myself in the small-ish waiting room. The walls are painted a sterile white and there are paintings with calming colors. On the tables, magazines are stacked with covers featuring healthy babies. A mother is holding her shapely child above her head and there is a lovely park in the background. She is happy with her healthy baby. There are only women in this waiting room. Pregnant women with little bumps and swelling bellies. Type 1 women with insulin pumps attached to their hips.  Because it is Diabetic Friday. I strike up a conversation with them and we find out that we have everything in common. We are all pregnant AND diabetic. We see each other every two weeks in this waiting room. Five of us become friends. We have fancy lunches in downtown Chicago when the drone of non-stress tests, ultrasounds and tweaking of basal rates are finished. We order our mid-day meal. Could I have 1 cup of a tasty low-sodium, vegetable soup with extra vegetables. Two ounces of lean protein. A slice of whole wheat bread, preferably with a low glycemic index.  And a non-alcoholic, sugar free margarita please.  We discuss our latest A1C's, how much our insulin requirements have increased, what doctor we saw that day and what he told me that was different from you. We discuss how often and when the fetus is kicking, how our husbands are talking to our bellies and whether or not we will return to work. We discuss the nurses we LOVE and the one's who drive us crazy. We lament about our challenges and celebrate our triumphs. 

D-Feast Friday with a Little Gravy on the Side

I've decided to join D-Feast celebrations on Fridays. The reasons for doing so are tri-fold. The first being that I love food!! Talking about it, reading about it, thinking about it, cooking it, eating it....  The original thought behind D-Feast Friday is to share diabetic-friendly recipes, but I'm going to add a little variation. I will feature recipes, but also dicussion, a link to an article I find interesting, some new food thingy (very open ended here), maybe a photo or whatever I fancy. The second is that food is so central to living with Type 1 that it becomes the center of my universe some days. I like to try and keep it fun and yummy and not obsess. And lastly, I'm jumping on to the D-Feast Friday to keep me on task and keep my blog updated regularly.

I have two rules 1) as long as it is related to food, it counts and 2) EVERY Friday-this is the hard one. Stay tuned...

Let the Sun Shine In

As many of you have recently seen, vitamin D seems to be making a star appearance in the diabetes world. The reason your endocrinologist is now ordering lab tests to measure vitamin D and recommending that you take it is probably a result of this study published in Diabetes Educator. The study states things such as "persons with diabetes are at significant risk for vitamin D insufficiency or deficiency. Reasons for this include diet, lack of sun exposure, obesity, renal impairment, and genetic predisposition." It claims that added vitamin D may reduce complications associated with diabetes such as cardiovascular disease. Also, it states that having adequate intake of vitamin D daily may delay the onset of diabetes. What is adequate, you ask? It has not been determined.  Do you all remember the blood sugar lowering capabilities of cinnamon? Sound familiar?

If you think I sound skeptical, I am. I was surprised when my endo started recommending that I take 1000mg of vitamin D daily and then followed up to make sure I was taking it. I was also surprised that she ordered labs to confirm.  The explanation for this unexpected inclusion into my daily routine was brief. There was this study. You should take vitamin D. It's good for you. You probably don't get enough sun.  What? We had never discussed my sun exposure while determining basal rates.

While I respect and trust my endocrinologist and appreciate that she is keeping current with science, I just don't think that vitamin D is really going to decrease the likelihood of complications or delay the onset of diabetes for those of you that don't have it. If I have an A1C of 13.1% and take vitamin D daily, will I decrease the chances of kidney failure? probably not. I don't mean to sound all pessimistic. I'm not saying that's its a BAD thing to take some extra Vitamin D with breakfast.  I like a more realistic approach, such as this.  I just think that this is a simple solution for such a complicated disease.

For the record: I'm taking vitamin D daily and I top off my oatmeal with cinnamon each morning.