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.
