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Treating type 2 diabetes with compassion

June 3, 2014

Weight LossFat HealthMy Boring-Ass LifeDiet Talk

My grandfather is 86 years old, so when he gets sick I have to carefully watch him to make sure his health doesn’t get any worse. Sure enough, last Wednesday when he complained of not feeling well and coughing during my phone call to him from work, I texted my mom and asked her to check on him since I wasn’t able to leave work. He still has his mind and is a very stubborn man, and doesn’t like going to the doctor unless he absolutely has to.

She went to our house to see him and decided to take him to the emergency room. He was shaking, sweating like crazy and was pale as a ghost. It was a very good decision because it turned out he had pneumonia. He was admitted to the hospital that night and came home the Saturday before Memorial Day.

The illness weakened his already-suppressed immune system and the hospital ordered home care for him. Last Sunday, the weekend nurse came to see him. She was concerned because his blood sugar levels were high while hospitalized. Pop has type 2 diabetes (you know, the “fat person’s disease”) and manages it with metformin. His numbers are usually in 80-120 range and it rarely goes over that. DiabetesThe infection jumped those numbers up to the 190s and low 200s. The nurse wanted him to start watching his carbs.

Let me tell you, trying to lessen the number of carbs in a diet is extremely difficult. I can’t think of a single food or drink that doesn’t have carbs in it apart from water. If anyone has experience with cutting carbs due to medical reasons, please let me know what you do and what things you eat. It would make my life a lot easier when I grocery shop, as this is the first time Pop has really ever had to change how he eats!

The good news was that Pop’s weight was never mentioned. He is 6’3″ and weighs anywhere between 260 and 270 lbs. His last current BMI reading was 35, which puts him in the “obese” range but, due to his height and age, doctors don’t give him grief for it. So these dietary changes are just to get his blood sugars back to what they need to be, not for weight loss.

Too often people who are visibly fat who have type 2 diabetes get shamed for developing the disease and are accused of eating their way into it, with weight loss and restrictive dieting prescribed as the only treatment for it, instead of making small dietary changes and/or taking medicine to manage blood sugar levels. Celebrity chef Paula Deen faced harsh criticism for not disclosing she had it.

I’m glad that Pop didn’t get the “fat talk.” His response to those who try to get him to make major lifestyle changes is “I’m 86 years old, I’ve come this far, I want to be left alone.” He’s a tough old bird and has survived heart bypass surgery, a pacemaker operation, emergency gall bladder surgery, sepsis and two prostate operations. I think a little chunk is the last thing he or anyone else needs to worry about.

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11 Comments leave one →
  1. Twistie permalink
    June 3, 2014 10:05 am

    Ah yes, the joy of managing diabetes.

    If your grandfather’s blood sugar is usually in the 80 – 120 range and he’s recovering nicely from the pneumonia, then a few meals focussing more on proteins and low-glycemic veggies should put him back on track fairly quickly. As long as he’s not eating huge mounds of potatoes or entire pots of rice with nothing else, chances are his sugars will go back to normal pretty quickly.

    The key isn’t to cut out carbs. As you’ve discovered, carbs are in pretty much everything. The key is to make sure that they are balanced with other things (such as protein), and to use as many complex (as opposed to simple) carbs as you can because the complex ones take longer to break down, so they don’t cause a major sugar dump in the system.

    Find a copy of the glycemic index on line. Feed him primarily from the foods with a low score. They have less carbs to begin with and/or are ones that break down more slowly, helping to regulate sugar levels. So whole grain bread rather than white, brown rice is better than white, sweet potatoes are lower on the scale than russets, etc. Hummus is brilliant because it fills up a stomach without raising blood sugar significantly.

    Here’s a list that you may find helpful: http://www.glycemicedge.com/glycemic-index-chart/

    Most of all, remember that this is his body and his decision. If he refuses to eat brown bread or can’t stand the thought of eating less potatoes, well, he gets to make that call for himself. He’s eighty-six and stubborn and you don’t want to alienate him for what time he has left.

    That’s the tack I’ve taken in trying to help Mr. Twistie manage his sugar for the twenty-plus years since he was diagnosed with Type II diabetes. He’s not eighty-six, but he’s stubborn, and I want to have him around and wanting me around as long as possible.

  2. June 3, 2014 10:09 am

    I am one of those death!fat folks with type 2 diabetes. I am fortunate that my doctor did not tell me I brought this on myself, and focused instead on finding the right mix of medications to help me get it under control while prescribing a diabetes management class as well. I was also very happily surprised when I took the diabetes management class and heard the instructors state that the majority of the type 2 diabetics came by it genetically. (My biological father is a type 2 diabetic alcoholic. Yeah, I’ve got some great DNA built in.)

    I won’t say that my doctor hasn’t brought up weight loss and how that could potentially help my health, but she didn’t bring that up as the very first thing that needed to be addressed. She took over a year to get to the point of bringing it up and has been understanding, if somewhat frustrated from time to time with me. But I know I’m blessed with a doctor who doesn’t trot fat shaming out each time I’m there, telling me that everything I’m dealing with will get better if only I’d stop being a fat person.

  3. Vic permalink
    June 3, 2014 10:45 am

    I don’t usually enter these discussions as they can become heated, so keeping in mind that every single on of us is “a special snowflake” I can share what I do. I have T2 and was finding it increasingly difficult to manage even with meds. I started restricting carbs, and even a modest lowering helped. Then started having side effects from the metformin(UGH!) so I restricted carbs until I had normal sugars without the drugs. I eat eggs and sausage or ham for breakfast, no toast for me, but if he can tolerate the medications a nice piece of toast would be great. Lunch is a home made chef salad with full fat dressing. Dinner is just the usual meal I make for my family, I just limit or avoid, for myself, things like potatoes and pasta and rice. Other root veggies, like carrots, beets, turnips etc are OK for me, but others find it will spike their sugars. I have found that eating a higher fat diet makes it easier to restrict my carbs as much as I need to. So no “fat free” anything, plus if it says fat free, it is probably higher in carbs. I find if I eat meat, fish, poultry, eggs, and real whole fat dairy, seeds/nuts, plus all the veggies I want, my blood glucose doesn’t spike out of control. I am 60 and have been eating this way for a few years, no meds for nearly 2 and my last a1c was 5.7 (American.) It works well for me, but mileage may vary, as they say.

  4. June 3, 2014 1:22 pm

    I don’t have full blown T2 but only because doctors caught my high blood sugar early enough that with a change if diet and added exercise I’m managing my fasting blood sugar levels to be between 80 and 98. Some days it’s in the 70s. They started me on metformin but I’m a stubborn jackass that didn’t like the idea of taking a pill every day if I could manage my BS myself

    The one thing doctors told me was not cutting carbs but cutting refined carbs and starches so white bread white rice, potatoes, etc… And replacing them with while grains. Not to worry about the carbs found in fruit so much. Also the way to construct a dinner plate: half full of greens (like a salad) then 1/4 of protein and 1/4 of a starch.

    That’s helped me. But also that’s me. Different bodies react differently.

  5. lifeonfats permalink
    June 3, 2014 6:06 pm

    Right before this went to “print” so to speak, another nurse came out and talked to Pop and I about his diet. She said he was doing pretty good but wanted him to make some not-so-restrictive changes and he doesn’t have to cut as many carbs as previously thought. She left us a list of what to include and what to avoid for blood sugar spikes. His levels have been better this week, with readings between 109-135, but I suspect it will go down to what it was as the illness subsides and he weans off the prednisone burst, which can cause blood sugar to spike.

  6. esinger893 permalink
    June 3, 2014 6:17 pm

    My Grandmother was diagnosed as a Type 2 Diabetic in the 40s when they did not have anything but diet and exercise to control their sugar. This diet is the best diet for anyone who wants to control their blood sugar and not be hungry:
    http://www.glycemic.com/DiabeticExchange/The%20Diabetic%20Exchange%20List.pdf

  7. Vic permalink
    June 3, 2014 8:21 pm

    Good News!

  8. gingeroid permalink
    June 3, 2014 8:33 pm

    The easiest way for me to stick to low carb is to do a lot of my own cooking so that I know exactly what I’m eating. I take the easy way out by not having a lot of bread, pasta, rice, etc. at home. My big splurge is an English muffin in the morning and I might have a small portion of rice after a workout.

    I got a huge slow cooker with a removeable pot for Christmas and I use it frequently. Typically I’ll take some kind of meat and combine it with whatever vegetable/sauce combination is in the fridge and seems good. I’ll assemble the pot Sunday night, put it in the fridge overnight, set up the slow cooker Monday morning, and come home to dinner that night. That’ll last for at least a week. Then if my meat has bones, I’ll save them for soup after I’ve finished the meat. I’ll usually shop for veggies and seasonings specifically for the soup I’m envisioning. Again, bones + veggies + water + time = dinners,

    Eating out I tend to go for a burger wrapped in lettuce and swap the fries for something lower carb. There are also salads, but those get boring fast and some places randomly sugar/wheat things you wouldn’t expect them to. In social settings I try to scout the menu and nutrition information beforehand so that I can see what the best options are. If I want to spend more money, there’s sashimi and some places do rice-less rolls.

  9. Jennifer Hansen permalink
    June 4, 2014 9:02 pm

    I am currently trying to drop a particular sugar-filled item from my diet because I do have a family history of diabetes and my sugars are getting up there. I’ve noticed that what I use it for often is a quick sensation of well-being to get me going. So far I’ve found the following items that replace it (YMMV):

    *Two hard-cooked eggs. Quick to eat, long-lasting energy, soothe the itch of hunger.
    * A mug of hot, thick soup. A mug because a whole bowl is a settle-in kind of meal and I need a boost, not a break.
    * About an ounce, maybe a little less, of very dark chocolate (85 percent if possible, but 70 percent will do). Not that this is a low-carb item exactly, but it’s lower in carbs than what I’m trying to kick and cheaper too! Chased with a glass of full-fat milk if I am very hungry. If I am ravenous I add two pears.
    *Brie and apples. Not cheap but oh-so-satisfying and packed with energy.

    • Happy Spider permalink
      June 6, 2014 4:07 am

      What type of soup specifically?

      • Jennifer Hansen permalink
        June 6, 2014 5:57 pm

        Beefy-with-tomato-and-veggies-and-barley; cream-of-chicken-with-chicken-chunks (not homemade, so it’s very salty, but a little goes a long way and it’s easy to sip as I do chores with one hand); so-many-beans-you-can-mash-some-up-to-thicken-the-soup-and-still-have-beans; any permutation of broccoli, ham, and potato.

        Oh! And a whole baking potato, skin and all, split, with a little butter or cheese and some pepper and salt. With a microwave, it’s a quick meal.

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