Living and eating with diabetes

It's been a strange journey, this last 7 months, knowing I had diabetes. There have been lots of ups and down as I've worked on keeping my blood sugar steady. Some predictable issues, others that have taken me by surprise. When I first was diagnosed I didn't really take it in. I just researched and researched how to eat and what to do differently to turn my life around.

My initial decision was that I had to find a way of eating that would work for me, not just long term, but forever. No point in denying myself completely the tastes I most craved, and with such a sweet tooth, that was going to be desserts. But, I had to change. If I carried on eating in the same way as before, I was severely restricting my life expectancy.

It turned out that the diagnosis of diabetes was one of the good things that has happened to me. Obviously not good in the sense that no-one actually wants to have diabetes, but it gave me the shakeup I needed to get my life together a bit more.

I feel daft for this now, but I genuinely thought I understood how diets work, cut back on calories, cut back on fat, eat lots of salads and you should lose weight. I also knew that although I didn't move as much as I should, I also didn't eat that much. Friends who spent any time with me were genuinely shocked by what I ate - about the same as them, maybe less, and yet I was freak show fat.

A lovely friend gave me some pointers to get me on to the low Glycaemic Index (GI) diet to cut my sugars. I knew we were always being told to eat whole-wheat bread, rather than white, and the same with pasta, but I'd thought that was simply a fibre thing. I genuinely hadn't picked up on the links with sugar. I don't really know why now - the advice is out there, but then so is a lot of junk advice that goes on gut instinct or fashions from celebrities and a great deal of this is either utter nonsense or at best, not ideal.

This was different. The big culprits for high GI food are rice, flour, sugar, cooked root veggies, fruit juice and tropical fruit. I decided I could totally (or as near as didn’t really count) cut out the most of these. I’ve had one spoonful of rice when a curry was just too hot one evening, one spring roll wrapped in rice paper and one serving of laap which has dry fried rice powder as one of the ingredients. Of course each ingredient can’t be taken alone. I knew that if I really really wanted rice, then basmati was the one to go for, and if I ate it with a really oily curry, then this would go a long way towards preventing the sugars being absorbed.

It’s confusing and I leap around, thinking I’ve understood the whole concept of low GI one minute, then realising I’ve got something wrong the next. It doesn’t help that anyone can write a blog – me for example, on what low GI food is and just because it’s out there, doesn’t mean they’ve got it right. It’s complex. Processing food changes its GI, so steel cut oats have a lower GI than rolled oats, which have a lower GI than quick cook oats. If you take whole grains and grind them into powder, removing a lot of their chewiness along the way, that seems to massively increase their GI. And then there is the Glycaemic Load (GL) of a food. This takes account of fibre so is considered a better indicator. Many fruits and vegetables with a high GI have a medium or even low GL, making them okay to eat.

How you prepare food makes an impact. Pasta is lowest GI when it’s skinny – like spaghetti, and cooked al-dente. The more you cook it, the higher the GI. As I’ve said, fat slows down the absorption of the sugar into the blood, so if you really want a potato, French fries are better, from a GI standpoint, than a baked potato.

But there is also the added confusion that the impact of a certain food is different from one person to the next. For me flour is a problem. I have had very little flour, a sliver of cake, maybe three or four times, a couple of chicken nuggets coated in breadcrumbs when I was testing a recipe before making them with some kids on a cooking course, and a whole-wheat chapatti for my daal once. I was hopeful that the oils in the daal, and the fact that the chapatti was made with whole-wheat flour would minimise the impact it would have. My blood sugar peaked to its highest since I was first diagnosed. Chapattis were back off my list of foods I can try out. And so was daal. I love daal. It’s low GI. But it just isn’t right without chapattis.

I’ve had about three or four potatoes in the last 7 months. And I’ve savoured every mouthful as I’ve eaten them. I do miss potatoes.

Fruit juices are out. This is ok. Pepsi and Coke are out. This doesn’t bother me either. Beer is out. No problem. Wine is okay, in moderation. That’s great. Vodka, gin, whiskey, brandy, tequila are all fine.  Now that would be good except what I want is a gin and tonic. And tonic is out. Even the sugar free one. Not that you can get hold of sugar free tonic in the obscure part of the world where I live. Seems that it is almost as bad as the sugar loaded stuff for insulin production. I haven’t looked into it in too much depth; just put it into the box of things I can no longer eat. Vodka soda is alright, but there are only so many bubbles you can drink before becoming uncomfortable, or worse. And vodka soda just isn’t gin and tonic. I’ll occasionally go for a bloody Mary. Whizzed up tomatoes, vodka, a grind of pepper, lemon juice and chilli to taste, decorated with celery. It’s not low GI, but it isn’t too bad. My blood sugar doesn’t spike too badly.

Eating out has also had its challenges. When I was first diagnosed, I had planned to keep the diagnosis to myself. This lasted until just before I ordered something for the first time. I couldn’t order normally any longer. I didn’t want food cooked with hidden sugar. I didn’t want rice – and living in Asia that can be challenging. I didn’t want cooked root veggies, or sweet corn or anything particularly sweet. A chef told me he’d prepared something especially for me – it was a total carb fest. I couldn’t eat it. Instantly I realised that the only way I was going to be able to make it through this complete lifestyle change was by telling people and by getting help.

I asked the waiter to give me a simple olive oil dressing on the salad and could I change the dauphine gratinoise for some green veggies? They paused for a moment and I blurted out that I’d been diagnosed with diabetes and couldn’t eat these things any longer. Of course, no problem. In fact restauranteurs have been wonderful. Offering alternatives, or piling on extra of the ‘allowed’ items. But eating out has lost a lot of its charms. I don’t want to be the fussy one with a list of food items I can’t do. And if I cook at home, that won’t happen.

Because I teach cooking, I simply changed a lot of the courses to low GI food. This means that I always have plenty of low GI food easily available. I think this is crucial. Without this I’d have been very tempted to have some toast or a sandwich. So easy and quick to fix. So I do my best to always make sure there is easy food around at all times that is good for me. Most of the time, as well as the leftovers, there is homemade hummus and crudités in the fridge. It’s important that it is homemade as so many shop bought varieties come laden with hidden sugar which somewhat defeats the purpose. There are normally other dips too. Jeows (the smoky, spicy dips from Laos), baba ganoush, nut dips and so on for easy and quick snacks or to accompany a salad, with some cold meats which are also normally in the fridge. I make sure I have plenty of eggs, cheese, fresh veggies in the fridge too as these can be used quickly and easily. I’ve found certain items sneak into my meals a great deal more since changing my eating habits. Limes, capers, and olives all add great flavour. Vanilla essence, cinnamon and nutmeg all lift a dish – yoghurt with vanilla essence seems much sweeter, apples stewed with cinnamon and nutmeg have a much better depth of flavour that helps round off the dessert. Cardamom and turmeric all feature much more, as do cloves and all spice.

Very soon after starting, I found food tasted sweeter than before as my taste buds adjusted to the new flavours. One of my favourite desserts now is cardamom and vanilla panna cotta, made with either no sweetener, or the tiniest touch of honey or brown sugar (generally if I’ve made them for others who aren’t eating a low sugar diet). Berries are great too. Most mornings I’ll grab a handful of frozen berries, some roasted nuts and some thick yoghurt and it leaves me full for hours.

I’ve got into some new habits. If I’m not exactly sure when I’ll next be able to eat, I’ll make sure I have a bag with almonds in, popped in a pocket. If food is delayed, or not low GI, I can just snack on these without spiking my blood sugar.

But aside from the food, there have been a number of other unexpected side effects of diabetes and the subsequent weight loss. I’ve currently lost a little over 30 kilos (or 70 pounds) and it’s impacting in all sorts of ways. 
One of the most remarkable is the amazing support I've had from people all around me. I've had such wonderful help and positive feedback from some amazing people who have really helped me in my journey. It has made a huge difference.
Another is my sleep. I’m generally losing about 0.8 kilos a week and my body shape is changing. I can’t lie the same way as before so I toss and turn every night, trying to get comfortable. I can’t sit still for long any more. If I do, my legs will go to sleep. I guess this is the impact of circulation that is a symptom of diabetes. It goes properly to sleep too. I can’t put my weight on it until it comes back (complete with pins and needles, which isn’t great when it’s every day).

I can’t let myself become over-tired or over-heated any longer. I have no idea why. Maybe it’s the diabetes, maybe the weight loss, maybe something else, but if I do, I physically react.  Either I start to feel very unwell, very quickly or I get very dizzy, sweaty and my lips start to lose colour and have no choice but to sit down. I’m writing this having left a birthday party early because I was just too hot and had had a very tiring week. I would have become unpleasantly ill, had I stayed. It’s a real shame when it impacts on being with friends, of course. I also get dizzy easily if I have a blood sugar spike, but happily this doesn't happen too often.
Oestrogen is fat soluable, so as I've lost weight, my hormones have been on a roller-coaster. I now try not to laugh too much at something; it flips into tears, full on desperate body racking tears stream down my face, leaving me emotionally exhausted and everyone around me confused and unsure what to do. It took me by complete surprise the first couple of times and since then I try to keep more stable. This doesn't always work, of course.

Then there are the other normal results of losing the weight too, of course. My knees don’t hurt all the time. I have energy that I hadn’t had for a long time, and I feel like I have got my spark back. I didn’t plan or try to lose weight. It was all just a side effect of changing how I ate to manage the diabetes. A wonderful, life changing side effect and the reason why it really feels like diabetes probably saved my life, certainly gave me my life back, and has given me a new energy for living. This is why receiving the diagnosis of diabetes is probably one of the good things that has happened to me.

The journey so far - my brother and me a few days before the diagnosis

And seven months later.There is still a long way to go, but definitely on the right track.