Nourish Your Body: What can I eat with Type 2 diabetes?


One of the most common questions I hear when someone finds out that I am diabetic is, “Wow, what can you eat?” I generally say that I try to limit processed foods, foods made primarily from sugar or flour, and white starches (white potatoes, white rice, white pasta) while eating reasonable amounts of fruits, vegetables, healthy fats like avocado, olive oil, and almonds, and lean meats. Of course, that’s not the whole story, but that’s what fits into the average person’s attention span.

The truth is that there is not a single “diabetes diet” because everyone’s body reacts differently to different food. For me, most fruits are fine, even pineapple and bananas, both of which are fairly high in sugar, but that’s not the case for many diabetics. I love black beans but I have to be careful not to eat more than 1/4 cup at a time because they will most certainly raise my blood sugar; others might not have that problem or might not be able to eat even a small amount.

How can you tell which foods work well for your body? By testing before and after meals every time you try a new food, to see what effect it will have on your blood sugar. Testing “in pairs” (both before you eat and two hours after you start eating) is the only sure way to know which foods your body will tolerate without spiking your blood sugar and that is the name of the game when it comes to diabetes self management.

There are some foods that seem pretty universally well tolerated in terms of blood sugar maintenance and those foods tend to be low-to-no carbohydrate foods. Lean meats, healthy fats, some fruits and non-starchy vegetables all fall into that category.

Which fruits and vegetables are unlikely to raise your blood sugar? Specifically:

  • Cherries, grapefruit, plums, peaches, prunes, apples, dried apricots (unsweetened), pears, and grapes*
  • Broccoli, cabbage, lettuce, onions, bell peppers, green beans, tomatoes, cauliflower, eggplant, and raw carrots

*Important note about fruit: keep in mind the serving size when making your choice – generally, one cup constitutes a serving of fruit but one grapefruit is 2 servings of fruit, while two plums are one serving, and one peach or one apple or one pear is one serving; paying attention to how much you’re eating is as important as what you choose to eat.

Are there specific questions you’d like me to answer about food, eating well with diabetes, and how to make good nutritional choices for your body? Leave a comment on this post or send an email so that I can cover your questions in a future post.

Project Me: December and 2013 reviewed

My only goal for December was to make an appointment with my therapist to deal with my anxiety and the binge eating, binge shopping, and horrible obsessive/compulsive behaviors that accompany it. I saw my therapist at the beginning of December and just talking to her made things inside my head a lot more calm. She asked me to keep track of my moods, particularly when I’m feeling more anxious than usual, so that we can isolate any common triggers. We also talked about letting things just be and challenging my constant need for order with the thought, “What would happen if I just left that mess over there? Will anyone be hurt? Why do I care what others think?” I’m doing more of both of those behaviors and definitely feel less anxious than I was before our appointment. I’d like to follow up with her next month but my work schedule is a little insane in January, so we’ll have to see.

This being the last day of the year, I’m also going to take this opportunity to review how I did with my goals for 2013, which were:

  • fasting blood sugar reading below 130 mg/dL – done and dusted; my fasting blood sugar readings this time last year were hovering near 200 (very dangerous) and now they are consistently below 100 and usually closer to 90. [Clinical recommendation for diabetics is fasting/pre-meal readings between 70 and 130, so I’m right in the middle.]
  • triglycerides reading less than 150 mg/dL – done; last time I had blood work done, my triglycerides were below 100 without any medication, so I’m thrilled by that. [Clinical recommendation for diabetics is triglycerides of under 100, so I’m in the clear here.]
  • body weight at or below 169 pounds (putting me into the Overweight category on BMI scale)  – as of this morning, I weigh 167 pounds with 37% body fat, for a BMI of 29.6, officially Overweight. I weighed in on February 1st of this year at 244 with 49% body fat and a BMI of 43.2, officially Morbidly Obese. [I still have 27 pounds to lose in order to be within the Normal weight range for my height.]
  • waist measurement of not more than 39 inches – this was the goal I was most concerned about. At the beginning of the month I still had 1-1/2 inches to go and that just didn’t seem achievable to me. I wrapped the tape measure around me this morning and told myself it would be OK if it wasn’t 39 inches or less. I mean, seriously, look at eveyrthing I’ve achieved this year, so if I miss on one out of five, that’s not too bad. I checked in the mirror to make sure the tape was straight, squeezed my eyes shut while I exhaled deeply, then looked down to see the tape end directly below the big “39”, and I cried – I hit it perfectly. I have lost 14 inches from my waist since February. I know it shouldn’t matter so much to me, but it does. It really, really does. So damn proud. [Clinical recommendation for a healthy woman is a waistline measurement of less than 32-1/2 inches, so I’ve got quite a way to go to get there but I am SO MUCH CLOSER than this time last year.]
  • an improved quality of life as perceived by me – this was my “wild card” goal for the year. There is no quantitative measure to show how much my life overall has improved but here are some important (to me) data points:
    • I’ve made it a point to schedule time with my parents every other month in 2013 and have already set up monthly get-togethers for the first four months of 2014. My life is better when I stay connected with my family.
    • TCB and I have taken more vacations together this year than in any previous year of our relationship. While it’s nice to be able to travel on my own, when we do things together, everything just feels more “right”. We have both scaled back on our volunteer obligations and spend more time together being active every day instead of running around like crazy people trying to fit everything and everyone else in. If it doesn’t tie back to our goal of making and maintaining a happy, healthy family then it goes to the bottom of the list. (And we’re OK when we don’t get anywhere close to the bottom of the list most weeks.) We have subscriptions to two local theater companies and have attended five live productions since October, including one last Sunday.
    • I still fight with my depression but not as much as in the past. I recognize it when it comes much faster than I used to so that I can start to deal with it, and once that’s happened it’s well on its way out.
    • I stopped ignoring my dental problems, had 15 teeth extracted (that’s half of them), and am now on a schedule of regular dental exams and cleanings.
    • I walk a 5K before breakfast, five days a week. I take Pilates Reformer classes twice a week. This year I completed a Sprint Duathlon, Couch to 5K, at least one 5K event every month, and I started a group at work that walks two miles every afternoon.
This is the face of a happy, healthy woman!
This is the face of a happy, healthy woman!

Twenty-thirteen has been an amazing year of becoming happier and growing stronger, and for the first time since 1998 I won’t start the new year with dread and the knowledge that I still need to do something about my weight. It’s funny: once I stopped worrying about the weight and put the focus on my health, everything in my life improved.

I’m going to get off of the computer very soon until next year, so I’ll share my Project Me goals for 2014 in a separate post. Tell me, though, how did you do in 2013 with your healthy living goals and what will you do more of or differently in 2014?

Happy Veterans Day & Diabetes Awareness Month

I borrowed this from the Lilly Pulitzer blog – it perfectly blends my love of all things bright and floral with my patriotic spirit!

Today I’d like to thank every member of the United States armed services for their service and sacrifice. Similarly, I would also like to acknowledge and thank the sacrifices made by the families of service members, too. (Believe me, they also serve.) Less than 1% of the families in this country have a member currently serving in the military. Less than 1%. Please take time every day to thank those in your life who put service ahead of self.

November is National Diabetes Awareness Month, the aim of which is to increase knowledge and understanding of this disease. Most of you know that I am diabetic, as are about 26 million other Americans. The type of diabetes that I have is called Type II – which used to be called “adult onset” until children under 18 began being diagnosed, too – and I am fortunate that my condition is currently well controlled with diet, exercise, and oral medication (Metformin). At the beginning of the year, I was injecting the maximum dose of long-acting insulin, a non-insulin injectible medication (Victoza), taking a pill to make my body produce more insulin on its own (Glipizide) plus a prescription-strength Omega-3 pill (Lovaza) and cholesterol medication (Tricor) to lower my triglycerides, AND double my current dose of Metformin – to absolutely no avail. I was a virtual walking pharmacy and none of it could get my numbers (blood sugar and triglycerides) into the recommended ranges.

I have made a lot of changes to my eating and exercise routines since then and have been fortunate to see drastic, positive changes in my health, but lifestyle changes such as the ones I’ve made this year don’t work for everyone – certainly not for Type I diabetics, who must inject insulin with every meal in order to allow their bodies to process the food that they eat – and so more must be done to spread awareness of ways to avoid diabetes as well as funding critical research to find new and better medical therapies for both Type I and Type II diabetics.

Last month, I was approached to participate in an online diabetes awareness-raising activity. The results of the project can be seen here and I’m very proud to be part of such a great group of bloggers with diabetes. Please take a moment to check it out and let me know if you have any questions about diabetes that I can help with. Knowledge is always powerful and it’s one of the best weapons against diabetes, too.

The 13 minute catch-up post

I have 13 minutes before the next discussion session starts at Fitbloggin, so let’s see what I can tell you about my life in that amount of time.

"empty downtown offices on a Saturday"
my view through the hotel window
  • I’ve done so-so with my June goals. I worked out most days this month but not a single strength training session and I never made an appointment with a trainer. I’ll do a real June Project Me review coming up soon but expect to see “work in some strength training” on my July goal list.
  • My blood sugar is fabulously under control. In fact, I’ve begun slowly reducing my nightly dose of insulin because I kept having yucky low blood sugar readings after (or worse, in the midst of) exercising in the mornings.
  • I’ve started an eight-week Learn to Crochet course and am looking forward to making loads of wooly things!
  • I hit the big four-oh. Forty pounds lost since February 1st. I don’t see it in the mirror but other people have started to notice, for what that’s worth. (I’ve also lost three dress sizes which is both gratifying and frustrating. Gratifying because I can wear clothes I’ve had stuffed into a box for three or so years. Frustrating because I forgot about those clothes for so long that they are now too large and have to go to the tailor. (Yes, too large is a nice problem to have.)

That’s all of the good stuff. For the not-so-good stuff…

  • Still battling the depression. It’s not going away but I’m still working out and still eating properly – I just do it with a piss-poor attitude and lots more whinging.
  • I will be having 15 – yes, really, 15 – teeth removed surgically on Monday. Turns out that diabetics have a much greater chance of developing periodontal disease, which would have been good to know when I was diagnosed in 1996 but whatever, and also that both my mother and grandmother have had major gum problems. So I have to have 15 teeth removed and I will have a temporary partial (aka a “flipper”) for 6-9 months that will look acceptable in normal life but cannot, under any circumstances, chew food. In other words, I will  not be able to chew food in public until after Christmas. I’ll pause a moment to let that sink in. OK, so now I have to figure out how to keep myself moving forward with my diabetes self management while I can’t eat food in public. Or chew meat at all, really. Definitely will give this more thought and words here.

How was your June? Any big plans for the upcoming Independence Day holiday (if you’re in the US)?

Project Me: Goals for June

When last we chatted, I was telling you all about what a pleasant and productive April and May I had. OK, perhaps that wasn’t exactly how it went, but I got through April and May, Project Me is still going strong, and I’m ready to set some goals for June.

Let’s first look back at my bigger goals for 2013, which are

  • fasting blood sugar reading below 130 mg/dL
  • triglycerides reading less than 150 mg/dL
  • body weight at or below 220 pounds,
  • and an improved quality of life as perceived by me

Turns out that I’d blown away all four of those goals before the end of April, so I’ll need to think about new, challenging/inspirational goals to work on between now and December 31st. (Look for that post Coming Soon.) That being said, I know the general direction I want to head, so let’s look at how I can make progress in the next 30 days.

Goals for June:

  1. Get a minimum of 150 minutes of moderate intensity cardio activity PLUS two strength training* sessions each week
    • *Make an appointment with a trainer at the gym!
  2. Have fun: incorporate at least one fun activity into each week (sewing, knitting, crochet, lunch with a friend, bike ride, pedicure, get hair done) – it’s sad that I have to be so serious & focused about having fun but that just seems to be the way it works for me!
  3. At least one fruit or veggie with each meal
  4. Eat at least 25 grams of fiber every day
  5. Don’t buy any clothes for a month – believe it or not, this one is definitely going to be the most difficult for me since I’ve become quite the clothes-a-holic since I stopped using food to numb my feelings.
fun by hodgers, via Flickr

So that’s what I’m going to be working on for June – what will you accomplish in the next 30 days?

Project Me: April retrospective and review

My goals for April were:

  1. Make appointments with my optometrist and a periodontist – DONE. My eye appointment was on May 15 and my periodontal appointment was on May 22.
  2. Take 10,000 steps per day at least 5 days a week – DONE. (Note that this was before The Depression kicked in.)
  3. Cook one meal at home in April – if I can’t manage that, I might just give up on cooking entirely. I think I’m ready to call Uncle on this one. The problem, as far as I can tell, is that I don’t really want to cook at home. I have been successfully improving key areas of health and happiness in my life for three months now without cooking at home, so I don’t really have enough motivation to overcome my dislike for all of the hassle, planning, and MESS that comes with cooking, either. So I’m officially stating for the record that I am no longer beating myself up for not cooking at home because I am making great food and eating choices while eating out and I can afford it, too.
  4. Make an appointment with my hair stylist for highlights – DONE. My appointment was on April 19 and I just love the sunny look of my hair now. (You almost can’t see the gray at my temples. Almost.)
  5. Do something fun at least once a week – I might have accidentally had some fun every week in April but I didn’t really concentrate on it, as I’d intended to do when I set up my goals. This definitely requires more focus!

You might have noticed the date on this post – May 30 – and wondered to yourself, “Why has it taken Denise an entire month to update us on her progress?,” or even, “What happened to May???”

What happened indeed!

The short and simple answer is that I have been fighting with a major depressive episode for roughly the last six weeks. This is not the usual blip on the radar that passes through my universe every month and then goes away without doing much damage, rather this is a terrible beastly thing that devours my happiness, my self-esteem, and any desire I might have to be creative and clever.

Lots of good things happened in April/May, too, especially in regards to my health. I was able to tick off several of my overall health goals for the year before the end of the first third of 2013, and I’m so happy & proud to be able to say that. (Related Note: Look for a reassessment of my 2013 Project Me goals coming soon!) The scale was kind, too, and although I am trying very hard not to let that be the primary barometer of “how I’m doing”, it’s hard to miss the fact that I’ve donated five large trash bags of clothing and shoes to charity since February 1 because things keep falling off of me.

I truly hope that I’m turning the corner and am on my way out of the worst of the depression, so I ought to have my Goals for June up by the weekend. Bless your hearts if you’re still here and still reading!

Project Me March retrospective plus my April goals

How did I do this month? Not bad, honestly. My blood sugar is consistently in recommended ranges, my mood has been mostly good with a few blips that I rode out with some deep breathing and less harsh self-judgment than in the past – all good. I’ve lost some weight, too, which certainly never hurts although it’s not the prime focus of this project.

So let’s get specific. My goals for March were:

  1. Make appointments with my endocrinologist (Diabetes doctor), my general practitioner (for my annual exam), and my optometrist – Never did make that appointment with the eye doctor so that needs to be my first priority tomorrow morning at work.
  2. Work out at gym five or six times a week, 45 minutes each visit – Done and done. Whether I go to the gym five or six times in a week generally depends on what else I’ve got going on, not whether or not I want to work out. The girl at the front desk at the gym knows me now and told a newbie there that I was “a regular” – me, a regular at the gym? Who’d have thunk it???
  3. Eat at least two servings of fruit and three servings of vegetables on three days a week – Big improvements here. On workdays in particular, I always have veggies with my lunch and dinner, and I’ve been making an effort to squeeze in a piece of fruit at least once a day during the week, too. Not doing as well on weekends but my calories are still in line with expectations, so I’m giving myself some slack. Besides, I said I’d do it three days a week and I’m definitely in line with that goal.
  4. Cook dinner at home at least twice a week – Nope. Not once. I have subscribed to a meal planning service and yet still nothing. This is a continuing source of frustration. I am eating well and getting in the nutrients I need but I really want to be able to cook at home and I’m not.
  5. Schedule an anti-aging facial and make it a monthly thing – Didn’t get to this one, either.

Alright then, so what will I be working on for April?

Let’s first look back at my bigger goals for 2013, which are

  • fasting blood sugar reading below 130 mg/dL
  • triglycerides reading less than 150 mg/dL
  • body weight at or below 220 pounds,
  • and an improved quality of life as perceived by me

Goals for April:

  1. Make appointments with my optometrist and a periodontist – The eye doctor is more of a preventative measure (to make sure diabetes isn’t damaging my vision) but the periodontist is something I’ve been putting off dealing with for five years. I have very bad gum disease – turns out that’s probably due to my diabetes – and I haven’t done anything about it since I had costly and painful root scaling surgeries in 2008. Once the doctor told me I’d need a further four surgeries after that and that EACH ONE would cost about $5,000 (none of which was covered by insurance), I just sort of gave up on trying to get better and decided just to wait until my teeth fell out. (Yes, I know how insane that sounds.) That philosophy is not in line with improving the quality of my life – how does hating my teeth fit in with a healthy lifestyle??? – and I need to do something about it, now.
  2. Take 10,000 steps per day at least 5 days a week – right now I’m averaging about 9,000 so this will be a bit more work but not unreasonable.
  3. Cook one meal at home in April – if I can’t manage that, I might just give up on cooking entirely.
  4. Make an appointment with my hair stylist for highlights – the gray in my hair is making me feel old and sad. I’m thinking honey blonde and auburn but I’ll let the expert decide!
fun by hodgers via Flickr
  1. Do something fun at least once a week – I spend so much time doing what has to be done (work, volunteering, parenting an adult former foster child) and almost none actually having fun. I feel as though I’m always running after something elusive, just in front of me, that will make everything perfect and right so that I can relax and just enjoy my life. But I’ve come to realize that there is never going to be a perfect and right time in my life but if I don’t start to have some fun then what is the point? One of my big goals for Project Me is to improve the quality of my life, and I cannot think of anything more important for attaining that goal than having fun!

So those are my goals for April, now you: What will you accomplish in the next 30 days?

How am I doing? (a check in)

Things are going well here at Lottalatte Central, at least health-wise. My blood sugar readings are consistently good, I’m at the gym at least five mornings a week for 45 minutes a go, and I’m eating nearly no white carbs while adding loads more beans, fruits, and veggies to my meals. TCB is also monitoring his food intake and is incredibly supportive of my need to get a grip on my health; we have honestly never been happier.

Balanced rocks
Balanced rocks by gr8what via Flickr

On the other side of the equation, our 20 year old house guest – Alcott’s 20 year old sister – disappeared for 28 days with nary a word then when I inquired as to when she planned to come and get her things (and her cat), got very offended, stomped up and down the stairs in silence for 90 minutes while moving out, and has been ignoring us ever since. I suppose it’s silly of me to expect some kind of “thank you” for the nine months we let her stay with us rent and household expense free but I’m still bothered by her behavior. Still, it’s for the best and her leaving has given me the time I’ve needed to focus on working out and eating properly, so all’s well that ends well.

While my blood sugar has been responding beautifully to the changes in diet and exercise, the scale has not been as ready to drop. Not to say that I’m not losing weight, it’s just that when your mind has already shifted into “I’m living a healthy lifestyle and I’m a healthy, fit person” mode, it’s disconcerting to realize that it’s not that simple when it comes to losing weight. I didn’t gain 100 pounds overnight – although it sometimes feels like it! – and it’s not going to come off that way, either. I keep catching myself day dreaming about all of the gorgeous clothes I’m going to wear “soon”, when I can fit into normal clothing sizes instead of being stuck with the few items of plus sized clothing that don’t look like they were made by Omar the Tent Maker. The problem arises when I realize with a thud that I’m still MILES and MILES from anywhere near being out of plus sizes. “But I’m ready now,” wails my poor, confused brain, while my body just goes about the difficult business of shedding over 100 pounds in a safe and sane manner.

It’s a difficult business, this healthy living gig.

A little bit of motivation

I mentioned in an earlier post that I’m using a Fitbit One activity monitor along with a Fitbit Aria wi-fi enabled scale. In case you’re not familiar with these devices, let me give you a little run down on what they do and why I’m excited to have them in my arsenal.

Fitbit One activity monitor

I’ve used a lot of pedometers/activity monitors through the years and they all work in basically the same way: you wear them at your waist and they keep track of your steps throughout the day. The One is a little different because it not only keeps track of my steps but also how many flights of stairs I take and how much sleep I get every day. The idea is to give you a picture of your whole life so that you can work on areas that aren’t where you’d like them to be. All of that information is sent wirelessly to a web portal/iPhone app where it joins up with information from the available scale (see below) and other information you can manually input such as water consumption and what you’ve eaten all day. I got bored by manually entering my food after a day so I started using the MyFitnessPal application, which talks with Fitbit so it knows how many extra calories I can eat based on my activity level for the day. (Hooray for extra calories!)

Since one of my long-term goals for this year is to lose 10% of my body weight, I’m going to be weighing every week. (I’ve added a countdown widget from MyFitnessPal to the sidebar so you can all follow along at home.)

Fitbit Aria wi-fi smart scale

I love our Aria scale because not only is it an accurate and consistent way to see how my weight is coming along but it sends all of my data to the Fitbit website and app without me doing anything other than standing there on Sunday mornings and praying. (Not sure the prayer helps with weight loss but it can’t hurt, right?)

Anyway, I think part of the allure of my Fitbit paraphernalia is that it makes this whole “eat less, move more” thing a bit like a game, and I do like games, particularly those that come with prizes. (Did I mention I’ve gotten several badges for my walking now?) Shiny objects and silly badges – who knew that was all I needed to get me motivated to take better care of myself.

Are any of you on Fitbit and/or MyFitnessPal? If so, please add me as a friend so that we can share in the fun together.

…and then I had a completely crazy thought

Updates since last time:

  • Went to the gym all seven days last week
  • Tracked every morsel of food that went into my mouth using MyFitnessPal
  • Made it through a mild episode of depression without turning to food. I wanted to eat, I thought a lot about eating, but instead of eating I tried to figure out what it was that I really wanted and how to get there without food. Very interesting
  • I tested my blood sugar seven times in less than a week including my pre-breakfast blood sugars every day. I haven’t tested my blood sugar since I started on insulin injections and the readings were so high that they upset me, so I put my meter away. I committed to my Making Peace With Food group – all Type 1 and Type 2 diabetics – that I would test at least once before our next class, and then when the number wasn’t too bad, I just kept going. I’m treating it like an experiment: “if it’s this number now, what will it look like right after I finish on the treadmill?” or “I wonder what my blood sugar is this morning after I had more carbs for dinner than usual?”
Peonies by Linda N. via Flickr

So many good things are going on in my life right now and it’s wonderful but also scary. Scary because I remember what it feels like when it all goes sideways, so I’m putting in the effort now, while it’s all good, to learn how to be OK with not being 100% perfect all the time – basically learning to fail and bounce back.

Part of my strategy is to not let the scale be the sole determinant of whether or not I’m “successful”. I need to lose a LOT of weight just to be considered “overweight” (as opposed to Morbidly Obese, my current designation based on BMI) but I can’t focus on that because it’s too overwhelming, so I’m staying focused on what’s really important – my blood sugar. Good things are happening on that front, friends, and it’s very exciting! When I took my blood sugar for the first time in months last week it was 171 mg/dL which was about 40 points less than my fasting test last time I saw my endocrinologist two months ago. Target ranges for diabetics with good control are between 70 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, so I knew I was a little high but was heading in the right direction. And I’ll be darned if my reading this morning before breakfast wasn’t 131 mg/dL – down 40 points in less than a week!

I also lost seven pounds this week.

And I had this crazy thought about what I can use for my long-term motivation but that will have to wait until next time. In the meantime, though, tell me how you deal with the “all or nothing”/”must be perfect in all ways” syndrome of healthy eating and exercise? Am I the only one who feels like there’s a light switch somewhere that controls my desire to eat well and exercise every day???