I am finally making significant changes. For years, I have been trying to counteract the effects of an event that knocked me off my diabetes regimen by going back to the routine that worked before. But things aren’t the same as they were then. Primarily, I have gained a significant amount of weight. It’s so simple, so common. But so harmful.
Since my weight finally plateaued a few months ago, I can feel how much harder my body has to work to function. I move more slowly, sleep comes harder and isn’t as restful, all the bad habits I conquered have returned. I have had to quadruple my blood pressure medication, and it’s still the high end of normal. I have had to more than double my daily dose of insulin and four months ago I surpassed the high end of normal. Since then, my numbers have dropped slightly, but not enough to put me in the accepted safe range.
Apparently my 20-year stability was rather fragile. It couldn’t weather its first major challenge.
The fact that I understand what’s happening helps me not panic too much. But the fact that I know what’s happening makes me afraid for the future if I don’t clean it up now.
The three pillars of diabetes care are medication, food, and exercise. If I can master the twin keys of food and exercise, the medication will fall into place.
Exercise
The exercise part is actually pretty straightforward. If I wait until after work, I will 100% talk my way out of exercise. The narrative goes something like this:
I deserve a short break after work before I start. I’ll start at 5:00.
[Sit down and turn on the TV.]
[The clock strikes 5.] As long as I start before 7:00, I’ll still be able to go to sleep on time.
[7:00 rolls around.] 8:00 should be fine.
[8:00 comes and goes.] I really don’t want to change into workout clothes. I’ll do it tomorrow.
Sound familiar?
So, I have to get my butt out of bed before 5:00 a.m. to get cardio in before work. And it’s just cardio right now, which is fine. It has the positive effect on blood sugar that I want and I can add in weights in once my habits are more settled. It’s a baby habit, but I go every morning my blood sugar isn’t too high or too low.
Food
The food part is much more complicated. A diabetic’s relationship with food is always complicated. The healthy approach is “eat to live” and not “live to eat”. And yet, in order to live, we have to eat. If it’s too little, blood sugar will drop too low; if it’s too much, blood sugar will go too high. It’s a balancing act and you can’t often just skip a meal because you’re not hungry. Delay for a while, maybe, but more than that can be dangerous, even for those of us with the flexibility afforded us by an insulin pump (variable automatic infusion as opposed to multiple daily injections).
As I started overhauling everything to create a new regimen, I had to study the numbers. The numbers said that processed carbs – pasta, bread, white rice, etc. – is poison right now. Worse than candy since you never eat them by themselves or in portions equivalent to a piece or two. Or five. Because of the insulin resistance that results from weight gain, my blood sugar will be ok for an hour or so after I eat it, but then it will start climbing and climbing and climbing and it’s really hard to calculate how much it will take to stop the upswing and bring it back down.
It breaks my heart to give up my favorite foods – is it really eating your feelings if the food doesn’t bring comfort? – but it’s just easier to cut them out and go to unprocessed carbs like potatoes, farro for rice, or just replace them completely with vegetables. The latter comes with the added bonus that it cuts the overall number of carbs I eat a day. If I don’t try to “make it up” with something else.
It’s not fun getting up at 4:40 or 4:45, and my office has two candy dishes, plus always some kind of leftover dessert platter from the latest meeting. My apartment building has a deli with a good number of my trigger foods just a 45 second elevator ride away (I counted).
It’s going to be really hard. But I can’t go back and I can’t stay here.
*(It’s the food. It’s always the food.)