Posted by on Tuesday 21 September 2010

Diabetic Once Removed.

I've been otherwise engaged for a while, (summer holidays and change of school for Beth), but Mike's most recent blog, and the response he has had to it, has stirred me into action.

When Mike first mentioned to me, that he'd been coming across more and more people who had not been taught the relationship between what they inject and what they eat, I really believed that there must be a medical reason, some sort of logic wherein that extra bit of effort was now, thankfully, no longer necessary. Our instinct is to trust our doctors.

I said,"But surely they get refered to a dietician." And Mike said, "They do, but they don't all do carb counting." So what do they do? Presumably say, stay off the sweets, eat a low fat high fibre diet. I want to scream.

This diabetic business is a scary one. It is scary for Mike and it is scary for me, Ellen and Beth. It is scary for Mike's Mum and Dad and everyone who supports us. Ignorance makes it even scarier. When incidents like the one which made us begin this blog occur, we need to know why. We need to know what caused it, is it likely to happen again, and what to do if it does, we would like to be prepared. With diabetes, ignorance is not bliss.

Mike read a blog recently, where the writer refered to his immediate family as type 3's. He quite liked that description, though I think of us more as diabetic once removed. We need including in the education that has to happen. Not every diabetic that goes to see a dietician cooks at home, there is often someone else doing that job. I remember very early in our relationship, Mike showing me a glucose injection, and saying that if his blood sugar went really low I may need to use it. He said, "Practise on a grapefruit." I probably looked quite calm and said ok at the time, but it terrified me, and I remember thinking 'I'll just call 999.' I guess as a parent with a child with diabetes, you get some sort of training, but being diagnosed as an adult leaves you very much alone.

The important thing is to know how much carbohydrate is in your meal, we aim for 60grams, because it's easier for me to know what to aim for, and easier for Mike to know automatically what's likely to be in his meal without having to ask every time. It could be whatever suits your appetite I suppose, and can vary from meal to meal.

A quick guide if you're interested: 60grams of carbohydrate in a meal equates to:
75gr rice
100gr pasta
One and a half rafts of noodles
Half of a deep pan pizza, three quarters of a thin based pizza.
Naan breads vary, but often around 70gr carbohydrate each.

Actually all of these things vary, and you have to check the packs, but we find it useful to have a rough idea.

Potatoes are the hardest thing to estimate, we were initially told that a potato the size of an egg is approximately 10gr of carbs. That's useful for roasties, but useless for mash, and new potatoes are an entirely different problem. It's experience that helps with things like that.

You also have to take into account flour added, tinned tomatoes in a sauce adds a small amount, pulses add quite a lot, root veg if that is a large part of your meal can change the calculation, and of course look at the information of any jar or packet that adds to the meal.

If you're cooking for one, the job is then done, if you're cooking for a family, it's only just begun. You have to work out how much of what you've just measured out carefully, needs to be dished up for the diabetic in the house, to ensure that he/she is getting approximately 60gr of carbohydrate on his/her plate. Bear in mind not everyone around the table will have the same size appetite. Again, it's actually pretty easy with experience, but mind boggling to begin with.

I cook pretty much everything from scratch, but it is probably easier to make those calculations if you eat mostly from packets, which is ironic. It can still be healthy if you add lots of fresh veg, which mostly doesn't count at all. Mike can eat strawberries and melon without extra insulin, but all other fruit, including fruit juice, he has to allow for.

Mike mentioned the other day that when he first was diagnosed, he wondered whether he was allowed to replace sugar with honey. All sweet things have their price, we know that now, so we rarely eat puds, but allow ourselves a treat now and then. If it's shop bought Mike goes by the info on the pack, and invariably gets it about right. If I make a pie I use eating apples rather than cookers, so that I don't need to add sugar, if we're being good; but to be honest, so long as it's a treat and not the norm, it's nice to spoil ourselves now and again, and it's enjoyed all the more for it's rarity.

A good diabetic cook book helped me to get the hang of things, I had a small book produced by Sainsbury's, which was simple and clear with pictures, (a must for any cook book) not too many recipes to get overwhelmed by, just a few which looked appetising and manageable for a weekly supper. The same one is no longer available, but there must be similar things around.

I have an overwhelming desire to put my arm around anyone just starting out and say, 'It's going to be fine, you do get used to it, I'll show you what to do.' I suppose that, ultimately, is what we hope happens to anyone who is first diagnosed.


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