Monday, April 14, 2008

Injecting some common sense along with the insulin…

My husband is diabetic. He’s been struggling with it for about six years now, never seeming to be able to get the upper hand even with privation so extreme that he simply cannot keep it up. Some of us would rather trade quality of life for quantity, and a life lived eating tasteless cardboard food washed down with nothing but water just seems to lack some essential element for joy.

Curiously, even when he was being religious about his diet, his blood sugar would go up during the night when, in fact, it should be dropping (the morning meal is not called “break fast without reason, after all). After five years of struggling with diet and pills as a means of control, Hubby was finally put on insulin. That first night taking the long-acting insulin at bedtime was one of great anticipation. Imagine our disappointment when, in the morning, the blood sugar was still elevated. After more months of struggle and ever-increasing dosages of the bedtime insulin…and no improvement in his glucose control…he was prescribed a moderate dose of short acting insulin before each meal in addition to his normal pills and long-acting insulin doses.

His instructions from his doctors, both when he was just taking tablets and later, when the insulin was added, was the same: test on rising and again two hours after each meal. For the longest time this made no sense to me but, being neither diabetic nor a doctor, I didn’t make much of it. But when Hubby was put onto the insulin injections before meals, I spoke up.

“Why not,” I asked him, “check your glucose level before you eat…that can help you choose what to eat if we are out, it can help me plan meal preparation. If I know your blood sugar is low, I can cook a meal with more carbs, like spaghetti, but if it is high, I can go for a higher protein, lower carb meal.”

At first he demurred. The doctors were very clear that he should test two hours after eating and write down the results. But I persisted. What was to stop him from testing before and after? He agreed to try it...and the results have been nothing short of astonishing.

In the past he would choose his food rather blindly, going by his appetite, tastebuds, and a vague sense of what was ok to eat and in what quantities. Two hours later the finger prick would tell him if he had chose well or not…usually not. It was always a case of finding out just how incorrectly he had chosen, but without knowing what his blood sugar was going into the meal, failure was practically inevitable.

Now, he tests 30 to 60 minutes before dinner is ready to be served, usually as I go out to the kitchen to prepare it. If his sugar is above a certain level, I increase the amount of veg in the meal and decrease the amount of carbs. If it is below a certain level, then more carbs can go into it. He can make choices knowing high sugar means no potatoes, lower sugar dictates how many (baby) potatoes he can put on his plate. And not only has his glucose remained within acceptable bounds during the day, his morning readings are now approximately half of what they were before he started this before-meal testing.

So if you or anyone you know is diabetic and struggling with blood sugar levels, stop shooting in the dark. Take a blood sugar reading immediately before a meal and then choose both your foods and their quantities according to that reading. It won’t cure your diabetes, but it can give you so much more control over it!

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