OK, so to make a long explanation short:

* I have been Type 1 for more than 20 years; most friends never knew me before diabetes.

* As a kid, for years, I lived a REALLY restricted diabetes life (both in terms of what I ate and when I ate, this being two shots of R+NPH days).

* Then in the mid-2000s I started counting carbohydrates and could suddenly "eat whatever I wanted" as long as I bolused. And you bet I did—I tried things like brownies and milkshakes and countless other goodies I had literally never had before. My friends still find it unbelievable when we come across some common childhood candy that I've never had.

* I went on the pump five years ago. I'm very discreet and don't make a big deal out of counting carbohydrates or bolusing when eating out with friends, so many people meeting me don't even pick up on the fact I have diabetes until some comment comes up, and/or they "know" I'm diabetic but forget.

* I have a severe food allergy and this I DO make a big deal about double-checking ingredients and asking for no side dish, etc. Everyone knows about my allergy since it comes up often.

* Over the past six months I've made major changes to my way of thinking ... specifically, I'm starting to see food as an important aspect of diabetes (in addition to insulin and exercise), and when I'm at home I'm good at sticking to lower-carb stuff and weighing/measuring what I eat.

* I'm also good at not eating out as much and, when I do eat out at restaurants, sticking to generally health stuff (most of the time).

* However, what I am NOT good at are gatherings where the entire group decides to order a meal. Like when I go to a workshop and they order pizza for lunch. Or I'm with friends and everyone spontaneously wants to go for sushi. Or like tonight when I went to a gathering of friends and we ordered Chinese. This is the ONE area I will go ahead and eat the food ... and usually end up with high blood sugar for hours afterward, even though I do massive combo boluses. Tonight I got home to a blood sugar of 19.6 (353 mg/dl) a few hours after eating, and I'm sure that's going to take a many hours to sort out.

* My problem is, I don't know how to deal with this without either a) not eating, or b) making a huge, big deal about it. I know diabetes is common but for some reason at these types of things there are never any other diabetics. I have tried talking to my non-diabetic friends about it, to try and "break them in" to the idea that I would rather not eat that type of food, and their responses tend to be something like, "Oh well, how often do you eat that food? Not like a few hours of high blood sugar will kill you." Well, no, but that's easy for them to say when they aren't the ones having their cells slowly killed ... Part of the problem, too, is that I don't feel unwell or get sick when my blood sugar is high, so they don't get to see any change. Plus, it's not like my food allergy where I would NEVER eat or touch it, because there aren't really any "off-limits" foods with diabetes ... it's not as simple as that.

What do other long-term Type 1s who have changed their eating do? I realize this is something I just need to do myself, but it's hard when I'm with friends who have known me for years and when my diabetes has not really gotten worse, developed complications, or anything like that. I'm just really wanting to do everything I can to get tight control, because tight control is extremely hard for me under the best of circumstances so if I can avoid foods that I *know* will make me spike high for hours it would make sense to do so. But it's hard when, for years, I've told people I can "eat anything" as long as I bolus for it, and it's not like anything has changed diabetes-wise to change that philosophy other than my mindset. It's also hard because, no matter how much I try to explain it, most friends still do not understand the difference between carbohydrates and sugar nor how my blood sugar can still go super high even if I take insulin to cover something like Chinese food, or why " a few hours" of high blood sugar matters even though it won't kill me. My friends are absolutely NOT "food police" but a large part of that is because I've gone on and on in the past about how I can eat anything ... and now I'm suddenly trying to backtrack and contradict that at these types of events.

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Well, I don't really have as good control as I would like. I don't know if stuff like this contributes much but I figure every bit helps, and spending 8-12 hours with high BG from one night of Chinese food can't be helping very much.

I find that portion control and eating slow as molasses helps me the best. My parents don't quite understand diabetes because when I was diagnosed you had to have carbs at every meal and snack. Yesterday they bought me lunch at the ski lodge and the special was spaghetti with sauce, garlic bread, bread pudding and a side salad! Ack, I just pushed the food around my plate for 30 min, My BG went up a little bit but it was tempered by the snowboarding I did later.

I hope that helps, it's just there is just a lot of discipline involved with everything.

It took my parents forever to understand carbohydrate counting and that I don't need to eat exactly on time. Eating slowly is a good idea and something I am good at when I'm alone (maybe to a fault!) but I tend to speed up when I'm eating with people.

I have gotten to taking a stock amount in these meals: 1/2 to 1/3 of the starch portion.
I made a list of 10 starches and their carbs: breading, flour, tiramisu, penne.
With Chinese, I revert to the 1/2 of 1 serving. If I eliminate rice, entirely, I can eat more.
And I made a list of what I had eaten that had real numbers with "hours later" at the top. My friends laughed. But they seem to tolerate my quirks better now.

I'm in a similar situation because when I'm at home and can control what and how much I eat, I do pretty well, but in party or restaurant situations, I fall apart. I really need to learn to be smarter about those situations. One idea I haven't tried yet, but seems more reasonable than eating a whole entree (once I start, I DON'T stop) is to just order an appetizer and iced tea, where I can use artificial sweetener. Also to kick myself in the solar plexus if anyone even mentions dessert. Dessert is my worst downfall -- a friend of mine had a birthday party last Friday, and there was lentil soup, salad, an appetizer of avocado and walnuts and other stuff, and a large chicken breast with a fruit sauce, Thai curried rice, candied carrots, and a HUGE piece of cake with ice cream. It would have been marginally acceptable if I had refused the dessert (who can refuse birthday cake???), and skipped the lentil soup, candied carrots and Thai rice -- I would have done a lot better on just the chicken and the salad. But it's REALLY hard to say no to the majority of the meal, that this lady worked hard over all day. And ironically, she has T2, and didn't test at all, and I wonder what HER BG was!! Mine went up to 311, and I spent all night and much of the next day correcting, and my belly didn't feel empty for 15 hours. And my BG WON'T come down until my belly is empty. I need to remember that next time I'm tempted to pig out!

I think we need to revert to being 2-year-olds, and just say NO!!!!!!

I dunno if you *have* to say "no" but you have to be willing to evaluate monster food correctly and not be too shy about saying "well, that looks like about 120G of carbs, maybe 130 to be on the safe side" and blasting away with both barrels of your pump or syringes or pens or whatever?

I think the "good" vs. "evil" characterizations of stuff like cake doesn't exactly help as I "think" I'll blow it off but then it's there in front of me and I'll eat it, or check the CGM (which will still be low, as dinner hasn't quite hit yet...) and forgo the obvious "take enough to cover another 30G of carbs..." solution to run higher. I'd be a lot better off to pre-plan the cake but I don't do it all the time.

If someone works hard on a fabulous feast, you can still eat it but just cut the portions, leave the rice down to a minium, like an absurdly small portion to taste it. In my head, I do ok if I use those "happy meal" light and lively microwave food trays as a model for what an appropriate serving size is. Not the "Hungry Man" round tray-sized ones but the 200 calorie versions. It's not just endocrinologically sound to cut back. I always razz people posting pictures of heaps of fried garbage on facebook by saying *your cardiologist likes this* but you could extend it to nephrologists, orthopedists, podiatrists, GPs, risk managers at hospitals, etc. will ALL benefit from getting carried away. They are cutting back on that though as several of them have hopped on the P90X bandwagon and are eating much more sensibly than I ever do...

I am a social butterfly, and go out from time to time with friends. I will not eat the stuff I know will spike me and end up hours later trying to "reign in" the terrible 250's and the thirsty 300s. At the Chinese buffet, for example, I try to do a lot of veggies and protein, no rice.. and I use a dual wave bolus( square weave portion for up to 6-7 hours)..But yes. I may give in to the fresh fruit cup and a couple crab ragoons and just one more egg roll. then I watch the CGM even more vigourouslyy, and test and bolus as necessary But this is not something mI do ( the piggy-mout at a restaurant) more than once a week.. It is just too hard to get back on schedule, in range , and have the energy I need.
My friends have never questioned me about my food choices or lack of choosing to eat what they eat.They know that I do not care for pizza or ANY tomato-based oregano-flavored (Yuck!) Italian dish/pasta/pizza... They know I will never eat them, so they make other arrangememtds if it is at someone's home.I just get soup no (bread sticks) and salad at an Italian restaurant. I choose what I want to eat and eat it; not really worrying about what anybody else is eating.Nor do they really pay attention to my plate.Like Acid, I try to go for the smaller portions and get a teeny taste if it looks just too good to pass up.
Holger and Super Sally have excellent explanations. I am sure your friends will understand when you "re-educate" them" You are young and maybe they have not seen persons with the consequences/complications of out-of-control diabetes. Many of my same-age peers have, among their friends and relatives.: Not pretty. Not pretty at all. I do not get hounded, nor is anyone concenrend when I eat "to take good care" of myself. I bet your friends, after you tell them a little bit more, will feel the same way, Jen!

God Bless,

I love appies at restaurants. I will usually get that as a meal with a salad and skip dessert. I used to have problems with high blood sugar whenever I ate out, but now it's mostly only when I eat stuff like burgers, Chinese, sushi, pizza, etc.

Luckily I don't have the problem with my stomach emptying ... I left at 8:00 and continued doing corrections till about midnight, at which point I just went to bed with my blood sugar still at 17.0 (306 mg/dl). I woke up at 2:30 to test and was 7.9 (142 mg/dl) which I probably should have corrected but just left. This morning I was 9.2 (166 mg/dl). So not horrible, but not sure it's worth the "already reduced" (or at least I thought so ...) portion of Chinese food that I had.

I think this is a difficult situation for many diabetics. I would use one of three approaches.

1. I am not hungry. If it is your choice not to eat or not eat much then others will not likely say much. You will just have to change your schedule around to accomidat your choice.

2. Tell friends something like while current standards say T1s can eat whatever they want; I am able to maintain better control and a better life by following these rules (or recent studies have shown doing this (X and Y) helps even more). Also throw in that current standards do not lead to the long term outcomes and healthy life that you want to achieve.

3. Lastly I would educate. I know I should educate more, but I feel like I am talking to a brick wall most of the time. If someone earnestly cares or wants to learn than I am happy to share.

I also think that you may be thinking that people are paying attention to what you are eating more than you think. IMO most people don't pay attention or take notice to what you will be eating if you do not make a big deal of it (or maybe I am too dumb to notice).

I have actually tried very hard not to alter my diet as best as I can, though obviously you have to for some things. I was diagnosed at 18 years old, and before that I didn't really go out to dine often, so my dining experience has been with diabetes from the get go. There is a bit of guess work involved with how much insulin you will need for your meal, but I try not to go for something that looks like it has a huge amount of carbs.

Yep, I have been in the same boat. To be honest, I had to just develop the attitude that what I eat or don't eat is my business and not really the concern of anyone else's. I always make sure I have snacks/food with me and I just try to avoid work-related events where there is food with uncountable amounts of carbs. I do sometimes try to explain to people who are willing to listen that T1D doesn't always play by the same rules. There are some days where, if I'm already low, I know I can be a little more lenient. And there are some days where I have to be really careful because I know I'm running a bit higher than normal. I explain that it's not something that is predictable and, for the most part, it doesn't bother me (what bothers me more is feeling crummy from a high or low BG).

Some folks understand this, some don't. But at the end of the day, I'm responsible for what goes into my mouth and no one can force me to eat anything I don't want to or shouldn't.

I don't have any special words of wisdom on this, Jen, but do what to give you kudos for going from the "I can eat anything" to making some choices and watching what you eat. When I started a Type 1 Women's Group in my old town I found there was something of a difference in diet attitudes between those who were diagnosed years ago and those, like me, who were diagnosed more recently (since the DOC).
It isn't easy to make a change from a lifelong habit!

Since your friends seem open and interested, rather than trying to explain or "justify" each decision I would do a sit down with them to explain, like others said that you are going for tighter control, and what that means. Also, that it isn't cut and dry like "I never eat...." or "I always eat". Maybe just some of the major issues like pizza, pasta or Chinese food (by the way the better the Chinese restaurant the less problem you will have).

To avoid last minute freak outs I'm pretty compulsive about finding out what food will be offered. So if it's pizza, maybe I can order a salad, or Chinese food I can order a simple vegie dish without sauces, etc. Or I check menus on line to find out what I can eat. (I am lucky, though, that I think I have an easier time of it bolusing for things like pasta. I'm a vegetarian so that's often the only option for me on the menu. I actually find combo boluses too iffy unless it's something I eat regularly and know how to bolus for. I just over-bolus a bit and correct if necessary later.) Or worse comes to worse bringing food with me or eating before or after if the food will be something I really don't want to eat. Since I eat later than many people, this is often the choice I make anyway. But truth be told, I really don't like not having control of my food . I used to eat out a lot for the love of fine food, but now only do so occasionally as a social thing.

Again, congrats on your dedication to making healthy changes!




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