[Mick]

Actually, all other things being equal, a type 1 diabetic can eat anything they want whenever they want, or nothing at all if they wish, and maintain stable blood sugar levels all day and night. I do not use a pump, I'm on the "MDI" routine--"Multiple Daily Injections". Most days I DO tend to eat the exact same thing at the exact same time, just because then I don't have to figure stuff out, count too closely, correct levels, or really worry much. I'm a school teacher, and when I teach I'm on my feet all the time, pacing, running about, writing on the board, never sitting much. I eat a bowl of puffed wheat (12 gr. carb), a sliced banana (26gr. carb) and a half cup of skim milk (7 gr. carb) for breakfast every day. the total amount is 45 grams of carbs, and since my ratio is one unit novolog for every 15 grams of carbs, I inject 3 units every weekday morning and know I will be perfect, neither high nor low. If I wake up with either a high or low number, I can add or subtract insulin to correct for that as well. If I really need a bagel, or a piece of toast, or some other item--for a change, or whatever, even waffles and maple syrup (yes, not a problem...), I add it all up and adjust for the total.

For lunch, I eat a carton of fat-free-sugar free yogurt and a salad. The yogurt is 15 gr. carbs, and although I don't measure the salad, I'm pretty good at getting a 2-cup, 40 gr. carb serving. If I want croutons, or they have something a bit more caloric at the salad bar that day, like garbonzo beans or dried fruits, I calculate and add for that--usually taking between 2.5 and 3.5 units at lunchtime.

Dinner varies night to night--my wife and I enjoy cooking, and we have a large collection of foods we enjoy. It's a bit more difficult to calculate dinner--many ingredients, seldom measured, but I DO add up the main starches and figure them. For instance, a helping of pasta or rice is 30-40 gr. carbs, a slice of bread is 15, etc., so I attempt to figure the number of servings--and figure my 1 unit per 15 grams. I do often figure high or low, but I'm seldom all that far off, and then will correct with either a snack if I'm low, or an extra small correction shot later if I'm high. IF i absolutely will not deny myself the double fudge brownies my son made, I look on the box, figure the carbs, shoot and eat. I do not do that very often, but when I do, I figure it in carefully.

Tonight, for example, I wanted to watch a movie and eat popcorn the whole time--an entire bag of microwave popcorn. It has 26 grams per serving, 2 servings per bag, 52 grams of carbs. I injected 3.5 units and enjoyed the whole bag. But generally, I seldom snack and I eat out at fast foods NEVER. If I do not wish to eat any particular meal, I just don't take any insulin. My glucose levels never change if I don't eat, because my basal dose--the background insulin (Lantus) that I take once a day, is carefully calculated to exactly maintain my blood sugar with no food or insulin added. This is called the "Basal/Bolus" routine--the basal is the long-acting dose which covers metabolic processes and should never be adjusted. The bolus is taken to cover any highs and whatever food is eaten.

The ONLY food that is any good for treating low blood sugars is glucose tablets or glucose gel tubes. Cookies and such contain fats, which slow down the absorption of the sugars and cause you to eat too much, thus overtreating most lows and beginning that yo-yo roller coaster ride. I still have the feeling that it's a ****ed shame to waste a low blood sugar on a yucky glucose tab when I could have one of those fudge brownies, but if you are truly low, the brownie will take too long to act. Plus, the glucose tabs aren't good, so you won't ever be tempted to take too many of them, and they contain an exact anount of glucose so you know exactly how many to take to raise your blood sugar an exact amount. I know that 4 of them contain 16 grams of glucose and that will raise me 50 points, each tab raising me about 12 points. The glucose gel tubes have 30 grams and will raise me 100 points in 10-20 minutes. I have these things--a tube and a bottle of tabs, with me at all times,and in my car, on my desk at work, on my dresser at home. I also keep an emergency glucagon kit at work, with the school nurse, and at home, in case I becose unconscious.

EVERY DIABETIC should have all this knowlegdge and information, and should also have all of these supplies and techniques in place. It's the only smart and safe way to live diabetic.

Michael
T1 since 1965