DIABETES DIAGNOSIS

The other day I called an old friend to catch up. We hadn’t talked in a few months. She began to tell me how hard of a time that she and her husband were having since he had been diagnosed with diabetes.

Boy, did this sound familiar. A few years ago when I was diagnosed I had gone through the same things. The doctor tells you how high your glucose count is and gives you a prescription and sends you home. You were in shock, no matter how much you actually know, or don’t know, about diabetes, your blood sugar is high and you can’t think. Even though I had worked in dietary kitchens, taken dietary courses, nutrition classes, I could not remember anything. So you think, if I just don’t eat, it has to come down, forget just not eating anything with sugar, you mean eat NOTHING. You check your blood sugar levels way more than is necessary because nothing is happening, and you don’t understand, you are starving, still drinking gallons of water, and the glucose count is still way too high. After a couple of days you decide you have to eat, so you eat only meat, but of course you are still hungry, you have no energy and you are still SOOO thirsty. You call the doctor back, and the nurse tells you to come back in, they check your glucose, it’s still high. But this time you ask “what can I eat?” Only to be told you will need to go to a class to learn how to handle your disease, and to eat six small meals a day and avoid sweets. Your mind is screaming “SIX meals a day, of WHAT?” But, you still are not thinking clearly and leave. You head to the grocery store to look for foods you can eat. You don’t know what you are looking for but ask directions to the diabetic section. Obviously this must be wrong, the only things here are sugar free “sweets”, things that would normally have added sugar. OK, so does that mean anything that isn’t sweet you can eat? No, that’s not what it means and you have a few weeks before that class begins, now what do you do?

I got lucky, and met a woman who saw me looking at the ingredients on packages and was kind enough to tell me she had to do that too, because she was a diabetic. I think I almost grabbed her and kissed her. I explained I was recently diagnosed and I had not been able to get my glucose below 300mg/dl yet. Her eyes got wide, so I knew this was worse than I had thought. She asked if I was on insulin, “no” I replied. She asked what I had been eating, I told her. She slowly smiled. She said “let me take you through the store, and I will help you shop.” She put her frozen food back in the freezer and off we went, me saying I didn’t want to be such a bother, while nearly hanging on to this woman who seemed like my salvation. We went back to the fresh produce section, and she began explaining to me that I should avoid ‘white’ foods except cauliflower. I asked if that meant the skins or the inside of the foods? She laughed. She explained that she meant things like white potatoes, bleached grains, and processed foods. She said that eating six small meals meant just eating smaller portions at regular meals of normal foods like fresh meat, fruits and vegetables, and even whole grain breads, and to have snacks in between and at bedtime that always consisted of a balance of protein and carbohydrates. So we shopped and she showed me the hidden sugars on the ingredient lists like fructose, dextrose, corn syrup, honey, and more. Then she showed me the whole grain breads and how some said whole grain, but not all had the first ingredient listed as whole wheat flour, but rather enriched flour, those were no good. It had to be whole grain flour, or whole wheat flour as the first ingredient. She then told me to watch carefully the packages that said “low fat” because most added sugar to make up for the flavor lost when they removed the fat, don’t buy them. Once she established I knew how to cook, she was able to explain that everything but meat turns into a carbohydrate, or sugar. So when making a meal be sure there is some kind of protein at every one of the six meals, it didn’t have to be from meat, it could come from fish, dairy, eggs, beans, nuts, or legumes. But that the last three also contained carbohydrates. I knew that, but it just wasn’t registering in my sugar brain fog. But I left the store, with foods I felt safe eating and thanking her over and over again. She had also told me to avoid that section labeled “diabetic”, it all tasted bad anyhow.

So I began my routine, and ate healthier, yet still was having trouble with the snack part and always being hungry. A week later when my blood sugars were still way up there, the doctor put me on insulin. I freaked. I had given shots to animals and people before, but right now my eyes were so bad everything was blurry, and when I picked up the prescription I couldn’t understand the dosing instructions, they made no sense. I couldn't see the needles to read the increments. High blood sugar also changes your eyes so they will not focus while it is high, a major problem when you are sitting there with a needle and tiny vial of insulin. It was after the pharmacy had closed, I sat there crying until I looked up and saw the magnet from my insurance company on the refrigerator with a 24 hour nurse help line in big bold numbers. I called. By the time I was finally able to read my insurance number from my card the frustration was too much and I was crying when the nurse came on the line. She was so patient, kind and helpful, I can’t tell you how valuable she was. She first asked how high my blood sugar was, when I was diagnosed and all about my medications. She talked me through feeling the marks on the needle and how to fill it and give myself my insulin. She then began telling me about how and why I needed to eat what, and when. It turns out not eating now while taking the insulin could kill me as much as not taking the insulin. Oh, goody here come the tears again. She asked me to get a piece of paper and pen, and she began to give me a diet plan asking what foods I had in the house, and was happy with most of my choices. (Thank you again lady in the grocery store.) After we did one day worth of meals, the nurse explained that my main meals, breakfast, lunch and dinner should be about 30 to 45 grams of carbohydrates per meal with about 4oz. of protein. My snacks were to be 15-20 grams of carbohydrate and 1-2 ounces of protein. If I was still hungry between meals, she told me to eat protein until we could get the blood sugar down. She suggested soy nuts, or another nut, because it would also satisfy my craving for crunchy snacks, but not to eat salted ones because that would only make me want more sweets. She called me back every evening that week to ask what my numbers were, what I had eaten and to see if I had any questions or were having any problems giving myself the insulin. I was having a problem with the insulin, because I just couldn’t see, but my husband was able to give me the shots.

That nurse called me twice a week the following week, and once a week after that. When I was able to get my blood sugar down to 100 and was slowly taken off the insulin, she still called me once a month. They sent me so much information, and when my eyes got so I could see, I really began doing research online. I discovered many of my online friends also were diabetic and they helped me a lot too.

The nurse also suggested I purchase a week’s worth of ready-made meals, of the healthy kind, in the frozen food section where I could read how many carbohydrates were in each one, and I could learn to see portion sizes. This actually did help me, because I needed to lose some weight.

So, the point of this week’s blog is to help the next person diagnosed, who is lost, and to remind you it is nothing to be ashamed of. Not just fat people but skinny people get diagnosed with diabetes. The signs are constant thirst, blurred vision, frequent urination, a sudden drop in weight, or being hungry all the time, always being tired, irritability, and other seemingly minor symptoms that alone would seem like nothing. If you have any doubts, check with your doctor. Then remember to ask for information.

There are hundreds of websites now dedicated to teaching you about your disease, there are social networks where you can ask your friends for help, even get a buddy to work with you the way the nurse did with me, the companies that make the glucose meters all have excellent information and will send you free meters with a few test strips to try them out. The test strips are expensive, and do have expiration dates, so if you are low on money make sure you spread these requests out so not to have the test strips expire before you can use them. I discovered when I didn’t have insurance that Accu-Chek, my favorite meter company, had a program for those who were low income and had no insurance to help with the cost of the strips. So call your meter company and explain the situation! There is help when you ask for it.

The reason I like the Accu-Chek meter is because it takes a drum of test strips instead of placing them in individually. The arthritis in my hands often made me drop the single test strip and ruin it because I couldn’t hang on to it. It worked best for me, other meters work fine too. Ask you pharmacist which ones are the cheapest to buy the test strips for if you do not have insurance.

Please feel free to pass around this information; each of us needs help when we are diagnosed no matter how much experience we have had with helping others with the disease. If you see someone struggling to read ingredients in the grocery store, you might just offer to help them.