I'm not nervous. I'm just hungry.

[Fresser]

The nausea kicks me in the stomach, doubling me over like a spring-loaded pocket ruler. Cue the racing heart and rivulets of sweat that make me resemble a human lawn sprinkler. At this point I’ll check my hands, which may tremble like a person suffering from delirium tremens. At times like this, my best friend is a loaf of whole-grain bread.

My name is Steve and I’m diabetic. The drama which I just described—one all too familiar to insulin fiends—is known as hypoglycemia, or low blood sugar. It’s a discomfiting and dangerous condition, but one readily remedied by food.

The glucose gas-tank

Sugar is often seen as the bête noire of diabetics, but this isn’t entirely accurate. Diabetics can’t metabolize sugar and other foods into glucose, which is fuel for the body’s cells. So we take insulin (orally or by injection) to help convert that mid-day nosh into glucose. We just can’t handle large infusions of sugar such as you’ll find in cakes, chocolate and my once-beloved Haagen-Dasz.

However, since our bodies cannot store excess fuel and sugar as glycogen, calling on these reserves as needed, our blood glucose levels can, if not monitored, drop to dangerously low levels. That’s when I run—or stagger—to my bread stash.

Basta Pasta

So what can (or can’t) diabetics eat? To paraphrase a diabetic friend, diabetics eat the way most people should eat. We can eat whole grain breads, lots of vegetables, lean meats and a modest amount of fruits.

What most diabetic-friendly foods share is the tendency to raise blood sugar slowly. Dieticians measure the effects of individual foods on blood sugar on something called the glycemic index. Low G.I. foods such as oatmeal, vegetables and lean meats keep a diabetic’s glucose levels relatively steady.

On the dangerous side of the index are refined starches such as pasty white bread (once beloved by schoolchildren everywhere), sweets and most pastas. An innocuous-looking bowl of spaghetti with marinara sauce is off-limits to me. No more trips to Olive Garden for the Never-Ending Pasta Bowl—which, depending on your perspective, might be more a blessing than a curse.

Alarm Clock

Given this vast knowledge of how to control blood sugar, you would think that I never suffer from hypoglycemia.

Gee, that would be nice.

I remember one bout of hypoglycemia a little too vividly. It was summer, and my cycling regimen was in full swing. I had ridden a 30-miler that day, snacking judiciously throughout the ride. Then I had dinner, took my dose of oral insulin and went to sleep.

Until.

I woke up as if I had heard a gunshot. My chest was pounding like a sledgehammer. Something was VERY wrong.

When you’re diabetic and you feel sick, your first instinct is to check your blood sugar. Keep in mind that normal resting blood sugar is 100 mg/dl.

I staggered to the bathroom and fumbled with a blood test strip and my lancet, nicknamed “Harpoon.” Then I inserted the test strip into the glucose meter and tried to remain upright while waiting for my glucose reading. The result: a Jack Benny-esque 39.

I dashed to the fridge for the diabetic’s fix: orange juice. I guzzled some and waited for my chest to stop pounding.

It didn’t.

So I started wolfing down slices of oatmeal bread at a rate that would put the Coney Island Bun-Eating champion to shame. My trick is to submerge the bread in Diet Coke before inhaling—ah, eating it.

I wish I could say the bread worked instantly. It didn’t. It seemed like 20 minutes elapsed between when I checked my blood glucose and when it normalized. I had never prayed to hard before.

Listen to your Mother

Mom had cautioned me against exercising too hard. Sure, that’s what mothers do. But I’m actually most cautious about my blood sugars when cycling.

A 30-mile jaunt burns up a tremendous amount of glucose, so I always eat before a ride and bring prunes and bananas with me on the ride itself. A leafy bike bath is the last place I want to find myself when hypoglycemia strikes.

But I love cycling—the health benefits and oxygen rush can’t be beat. Plus cycling works wonders to control blood sugars. I just have to be careful.

So if you’re driving along one day and see a pack of cyclists whirring along the road, honk and wave. You’ll recognize me—I’ll be the cyclist with a baguette strapped to my back.

[racheld]

Great piece, Fresser, and so true. When I miss Chris in the middle of the night, he can always be found in the kitchen, crackers and milk in hand.

And for day, he carries those disgusting huge pastel glucose tablets, like Sweet-Tarts, but just tooth-achingly SWEET. He's headed out for a long drive today, and his luggage includes a big apple, several diet drinks, and crackers and cheese.

[judiu]

As a fairly new diabetic, I was advised by the wife of an insulin dependant diabetic to keep a tube of icing gel (the stuff you buy to write on cakes with) because if I was to black out, it could be squirted under my tongue, and it's a hell of a lot cheaper than the "medical" version of the product, which is just not colored.

I seem to be having the opposite problem, though. My sugar is always WAY too high. Eventually I'll get it right, hopefully before it causes any other problems.

[Kim Shook]

I am a diet controlled diabetic. I was on orals until I lost 100 lbs. I start to get the shakes at anything below 80. I had a nurse tell me once to handle the low sugar with a double method - 1st something very sweet (oj, sugar candy, etc.) and then to have a bit of protein (a cube of cheese, a bit of chicken, etc.) - is this still good advice?

[Badiane]

Ah yes...I remember when I was first diagnosed and keeled over at yoga. Boy have I learned a lot since then.

Kim...I handle my lows the same way...a fast acting sugar followed up with a slow acting sugar...so it's a Coke or some candy and then some cheese or meat or nuts - if it works for you, go with it. If you aren't getting good results, research another solution.

Now if I could just get people to stop inviting me for dinner at 6 only to find out the meal will not be served until 8...

[Fresser]

I am a diet controlled diabetic.  I was on orals until I lost 100 lbs.  I start to get the shakes at anything below 80.  I had a nurse tell me once to handle the low sugar with a double method - 1st something very sweet (oj, sugar candy, etc.) and then to have a bit of protein (a cube of cheese, a bit of chicken, etc.) - is this still good advice?

←

When mixed with high-G.I. foods, fats and proteins act as a buffer against your blood sugar spiking. So this nurse probably wanted to raise your blood sugar quickly (away from dangerously low levels) without raising it TOO much.

But for me, when I get the low-sugar shakes, I avoid protein. I just tear through a loaf bread like the Tasmanian Devil....

[Whirling dust cloud]Chomp chomp chomp![/whirling dust cloud]

Edited May 18, 2006 by Fresser (log)

[thegreatdane]

What chocolates can diabetics eat?

[judiu]

What chocolates can diabetics eat?

←

I like the Hershey's Sugar Free mini bars, and Russell Stover makes some decent sugar free stuff. Hershey's has milk choclate, milk with soy crunchies (not bad at all) and Dark Choclate Candy. The taste is good, the texture not as good as real, but they answer a need.

[thegreatdane]

What chocolates can diabetics eat?

←

I like the Hershey's Sugar Free mini bars, and Russell Stover makes some decent sugar free stuff. Hershey's has milk choclate, milk with soy crunchies (not bad at all) and Dark Choclate Candy. The taste is good, the texture not as good as real, but they answer a need.

←

How about cocoa nibs? I know they're not sweet.

[Fresser]

How about cocoa nibs?  I know they're not sweet.

←

I tried eating a brick of unsweetened chocolate once. It tasted like dirt.

[SuzySushi]

Actually, diabetic hypoglycemia causes ravenous carb-craving, which is as it should be because your body's saying "Give me glucose NOW!"

The by-the-books advice is to ingest 15 grams of fast-acting carbohydrates: 1/2 cup of fruit juice or regular soda pop OR 1 cup of milk (yes, milk's counted as a carbohydrate, folks, not as a protein) OR 15 grams of sugar candy (not chocolate, where the fat slows down the action) OR 2 to 3 glucose tablets. Wait 15 minutes, test your blood sugar again. Repeat the 15 grams of carbohydrates if your blood sugar reading hasn't risen enough. Follow this up with a small snack of slower-acting carbohydrates (such as 2 crackers) and some protein and fat, like an ounce of cheese or a spoonful of peanut butter.

In practice, I know of few people with diabetes who can restrain themselves to 15 grams of carbohydrates and wait 15 minutes before testing again. When my husband has hypoglycemia, his routine, before I can stop him, is usually 2 to 3 glucose tablets, a full glass of orange juice, another glass of orange juice, then raid the refrigerator for whatever isn't nailed down (cookies, candy, ice cream, anything "regular" that's not no-sugar-added). By the time he tests his blood sugar again, it can be over 300! But such over-compensation isn't uncommon.

[thegreatdane]

How about cocoa nibs?  I know they're not sweet.

←

I tried eating a brick of unsweetened chocolate once. It tasted like dirt.

←

The nibs, really good quality ones, taste like nuts, wine, and chocolate. Can you have any sugar with that?

[SuzySushi]

What chocolates can diabetics eat?

←

Actually, people with diabetes can eat any food as long as it's worked into their diet and medication plan. It's preferable to stay away from foods that are concentrated sources of "empty calories" from added sugar because they must be factored into the day's total carbohydrate count, and take away from eating those carbohydrates as more nutritious foods.

So... my husband and daughter (who both have diabetes) will eat small portions of high-quality "real" chocolate as a treat. On an everyday basis, they snack on the new generation of "sugar-free" chocolates that are made with sugar substitutes (such as Splenda) and sugar alcohols (such as sorbitol) that are metabolized slowly and are less likely to cause a blood sugar spike. They still count the total carbs in their diet plan, though.

Of the readily available sugar-free chocolates, we've found the best-tasting ones to be Hershey's candy bar lookalikes, Nestle sugar-free Crunch, and Russell Stover's individually wrapped filled bonbons (we especially like the French mint and raspberry varieties).

Note that excess consumption of sugar alcohols can cause gastric distress (cramps and a laxative effect), so overeating sugar-free candies is generally self-limiting!

[Kouign Aman]

I recently read an article stating that vinegar effectively lowers the glycemic index of some carbs. The study administered it a few minutes before a meal (~ 2 T). I'm wondering if adding vinegar instead of ketchup to one's fish'n'chips makes them more diabetic-friendly.

[SuzySushi]

I recently read an article stating that vinegar effectively lowers the glycemic index of some carbs. The study administered it a few minutes before a meal (~ 2 T). I'm wondering if adding vinegar instead of ketchup to one's fish'n'chips makes them more diabetic-friendly.

←

Interesting hypothesis, but the two studies I've read about were exceedingly small (12 subjects in one study, 13 in another) and were done on patients with "insulin resistance" or "insulin sensitivity" who were NOT taking medications for diabetes. No research has actually been done on patients who have diabetes and are taking medication for diabetes, particularly insulin!

[Kim Shook]

As to chocolate, I can recommend the York peppermint patty sugar-free. They are amazingly good actually. You can hardly tell the difference and that is the only sugar free candy that I have EVER said that about.

[tejon]

My sister has hypoglycemia, so I've gotten to know her reactions really well. Now, if I tell her to eat something, she does it without asking - since I can often tell that her blood sugar is low when she can't. She usually does a fast acting carb and a protein as well, so I make sure there are always quick options at my house for her. She carries trail mix and other quick foods for when it's been too long in between meals as well.

I find *I* feel a lot better when I eat more frequent, smaller meals with a better balance of protein and carbs. You're right - this is the diet we really all should be following.

[Fresser]

In practice, I know of few people with diabetes who can restrain themselves to 15 grams of carbohydrates and wait 15 minutes before testing again.

←

L-rd, isn't this the truth.

When I get the nightime shakes, I'll tear through five slices of whole grain bread without blinking. Truly.

Hypoglycemia feels like a Pentagon-level alarm sounding off in my body. The only thing that will quell that alarm is massive quantities of carbohydrates, ingested before I tip out of my kitchen chair. I'll just keep snarfing down bread dunked in Diet Coke until my jackhammer heartbeat calms down, then I stagger back to bed. Once I've quelled my hypoglycemia, checking my blood sugar is the furthest thing from my mind.

[andiesenji]

I have Type II diabetes, diagnosed a couple of years ago and usually in good control, except when I have an infection, the flu or am excessively fatigued. I take Avandia, which works well for me but I do watch my diet carefully. I have other problems that cause my electrolytes to go haywire and keeping everything in balance is tricky. I have some of the Pedialyte freezer pops in the freezer because they replace electrolytes as well as dextrose and fructose and in a form that is rapidly absorbed. I have a couple of bottles in my tote bag that goes everywhere with me (along with my backup Epipens). It doesn't require refrigeration until opened. We get samples at the office, however I have also printed out coupons from an online site which give a dollar off on a 4-bottle pack. It also tastes better than the diabetic stuff.

I also can't exercise a lot because my joints are damaged by arthritis. However, I have discovered that I can exercise on a "glider-type" of machine, not an elliptical, and found one that works well. I have it in the den so I can watch TV while exercising. My blood glucose will drop after a certain level of exercise but never to the point that I am hypoglycemic.

[Fresser]

I am a diet-controlled diabetic.  I was on orals until I lost 100 lbs.  I start to get the shakes at anything below 80.

←

Lately I'm seeing my diabetes as a great indicator of when I need to eat. I can handle blood sugars in the 50's before I get violently ill, but if my moods ever start to swing, I check my sugars and eat something if my below glucose reads below 90 or so.

[Kouign Aman]

My mom has type II diabetes, diagnosed in the past few years. Although she generally does a very good job of managing her blood sugar, I've noticed that her logic gets wonky if she puts off eating too long (trying to match a grandbaby's schedule, perhaps).

When mom's logic is off due to low blood sugar, it takes her ability to make the logical connection with it. So she will refuse to eat. And it gets worse.... Even guests at our house have noticed it in 'advanced' stages. Unfortunately, I dont have mom as well trained as Tejon's got her sister trained. Something to work on

What is funny, is that she can spot low bloodsugar in me from a mile off.

[Allura]

I have PCOS (and lyme...), which gives me the "insulin resistance" problem. I'm on oral meds and watching my diet. I'm very slowly getting the hang of it, and probably taking longer since I don't measure my glucose. The lyme tends to mean that when the blood sugar drops, so too does the energy to go get anything. However, I've learned to LOVE milk; it's got carbs and protein in it, and for me, it does a good job at bringing my blood sugar back up quickly without me going overboard and eating everything in sight. Sometimes, though, I do that too, all the carbs I can find. I pay for it later with a massive headache when the spike hits.