Not long ago, a friend invited me over for coffee. I remember sitting at her kitchen counter when I started feeling light-headed, so I checked my blood sugar. Sure enough, I was low--52 mg/dL.
“Here, have a slice of pie,” she offered trying to be helpful.
“Oh, no thank you,” I declined as I rummaged through my purse and popped five Skittles into my mouth.
She was confused. “Wait, I don’t get it…you can eat candy, but not apple pie?” she asked.
That’s when I went into diabetes educator mode:
“That slice of homemade pie is over 50 grams of carbohydrate I’m sure but all I need to treat this low is 10 grams,” I explained. “If I ate the pie, I’d have to cover most of it with insulin because it’s way more carbs than I need right now. Plus, since I’m not sure of the exact carb-count of the slice of pie, I’d be guessing about my insulin dose and I might end up high or low …”
Yada. Yada. Yada.
This is how having type 1 diabetes can make you seem like a picky—or, dare I say rude--dinner guest.
Unwanted carbs can really be challenging for people living with type 1 diabetes. Here are some other reasons why we turn down certain foods:
Being polite can be hazardous to your blood sugars. Just ask Sysy Morales.
“I used to say yes in order not to offend anyone,” explains the writer with type 1 diabetes and 8-year-old twins, “and then my blood sugars would later remind me to show myself a little more respect.”
Having a plan and sticking to it is a big part of a successful day of blood sugars for most type 1s. This, of course, is often easier said than done—especially during holidays, parties, and simple outings with friends.
Constantly justifying your food choices to family/friends is exhausting. If you don’t want to eat the cakes and cookies being dished out at a family gathering--but you also don’t want to call a lot of attention to it—Sysy has some suggestions.
“I just stress that I have specific dietary needs,” she explains. “Or I say the food looks and smells very nice, I’ll eat what I can, and to please not be offended if I whip a protein bar out of my purse.”
Offering to help serve can be an easy out. “When dessert time comes around, be one of the people carrying the goodies and offering them to others,” Sysy says with a laugh. “That way you aren’t in the position of refusing it when it’s offered to you.” Plus, Sysy points out, others will be less likely to notice you aren’t eating any “won’t give you a hard time about being health conscious.”
“Politely and firmly refusing to eat food offered to us by well-meaning people is a necessary act of true self-care throughout our lives with diabetes,” says Daniele Hargenrader, health coach of DiabetesDominator. “We must understand that not eating food offered to us is in no way rude or disrespectful to the person offering. However, it is both rude and disrespectful to ourselves if we truly do not want the food.”
It really comes down to simply knowing what you need for your own health and well-being, and not concerning yourselves with the manners.
“Prioritizing our own health needs over our perceived fear of hurting others' feelings is a real act of self-respect,” says Daniele.
Planning is essential when you live with type 1 diabetes and sometimes the food being offered does not fit that plan.
“Since I’m on MDI (multiple daily injections), I can’t easily go for a walk if I have a boatload of IOB (insulin-on-board),” explains Christel Oreum, a health coach at DiabetesStrong who also lives with type 1.
A pump can help you compensate for that IOB by suspending your basal rate, but with injections, you’ve got to be even more sure that the amount of insulin you’re taking fits the plan.
“Gotta love it when dinner is announced but not actually served for another hour,” adds Christel with frustration.
Having type 1 diabetes inevitably brings a need to control as much around us as possible. And food is #1 on that list of things.
“It’s also challenging when stuff like honey is added to salad dressing,” Christel explains. “Nothing wrong with honey, but I’d just rather eat my carbs. Instead, I get my own side salads—without dressing—at family gatherings.”
Perhaps the most interesting part is what works well for one particular type 1 doesn’t necessarily work for another person living with type 1.
For example, I prefer to skip carbs at dinner if it means I can enjoy some of the dessert and still feel like I’m well within my ideal carb-consumption range for the day. Others might prefer the bread and butter over the homemade chocolate fudge!
“Most people don't understand the complexities of type 1 diabetes, and they understand even less that each person’s diabetes’ management style is unique,” explains Asha Brown, founder of WeAreDiabetes. “There is no ‘one size fits all’ way to manage your diabetes.”
“Unfortunately this can mean when you kindly decline a second helping of your host’s potato salad, because it’s not worth the extra bolus and the potential post-meal spike, she may point out that her ‘other friend with diabetes just takes more insulin,’ leaving you in the awkward position of trying to defend why that isn't the way you choose to manage your health."
Personally, it probably confuses my family and friends when I decline to eat the gluten-free birthday cake at one event, but I’m happy to eat it at another.
Inside my head, I’m just deciding whether I have the patience and diligence that day to make sure I take the additional doses of insulin I’ll need 3 and 5 hours after eating that cake in order to keep my blood sugar from spiking wildly high. (Gotta love cake with buttercream frosting but it takes forever to digest!)
"Managing your diabetes while also trying to live like a ‘normal person’ can feel like walking on a tightrope at times,” says Asha who also lives with type 1. “Engaging in social events surrounding food can be downright stressful!”
In the end, the simplest approach might be to remind yourself that you’re not being rude, you’re just doing the best you can with a very high-maintenance, tedious disease that can fluctuate easily and wildly. Every bite you take has the potential to make your day easier or more complicated. The choices is yours, and no one else’s.