An Extra Unit

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Craig: From Beta Cell, this is Thicker Than Water. I'm Craig Stubing.

When I was diagnosed with type 1 Diabetes in 2001, my long-acting insulin was called Lente. While it lasted all day, it peaked six hours after you took it, which means that three hours after I took my morning shot, I had to have a snack. Then three hours after that, I had to eat lunch. Then three hours after that, I had to eat another snack again. If you were late, your blood sugar went low.

Since I was taking this long-acting insulin in the morning, instead of before I ate, I was on a strict meal plan where I could only have a certain amount of carbs each of those times that I ate. I don't remember exactly what it was, but at some point, I made the connection that I could just take more short-acting insulin to eat more.

While it seems pretty obvious now, at the time, no one told me that. Maybe it was because I was newly diagnosed and they didn't want me messing with the insulin too much and going low. This discovery changed everything.

[music]

Craig: Suddenly, I had my freedom back. I could eat the whole box of fries with my burger, good ice cream after if I wanted, or have a real Thanksgiving dinner with my family. Now, anyone who knows my aunt Laura knows that she loves to bake. Every holiday, she would always have a huge assortment of different treats to try. Since she's been diagnosed, she's been on a meal plan too. Sure, she could have a cookie for dinner, but that only leaves a few grams of carbs for the rest of her meal.

While there isn't anyone saying she can't eat something, it always comes with a price to something else she would eat instead. I know that at holidays and parties, she's been sad that she couldn't enjoy the food the way she had for the first 60 years of her life. I've been anxiously awaiting the day she takes that first extra unit of insulin and gets a bit of her freedom back too.

Aunt Laura: Now, my big deal that I did the other night, which I've never done, is I took one unit of insulin outside of my normal insulin because we were at our friend's house watching the Bucs game. I brought some lower carb desserts. I brought the avocado truffle.

Craig: The ones I sent?

Aunt Laura: Yes.

Craig: Wow.

Aunt Laura: Everybody loved them. Then I made a peanut butter chocolate chip bar, which was okay. I'm experimenting, so I was like, “Uh." It was all right. The third thing I did was the store had huge strawberries on sale, the dipping strawberries. I made those dipped in chocolate. My friend had pound cake, which is really high. I took one unit, and I took a third of a piece of the pound cake. I took an avocado truffle, and I think I ate a strawberry.

My friend said, “Don't feel like you have to.” I said, “No, I need to try to do this. When I want to do it, I'm okay with doing it.” In giving myself a shot, people think, “It's a shot." I'm like, [chuckles] “It's really not that bad.” You feel funny with one for one unit. Every morning for breakfast, I only take one unit because she has me on that because it seems to work for me. I'm like, “What's the big deal taking another shot?” [chuckles]

I think I pretty much covered it. I might have went a little bit high. I guess that's good.

Craig: It didn't make you want to just have 30 grams of carbs and get two units?

Aunt Laura: No, you know what, because I had enough, and I didn't want to get into guessing. Pound cake recipes I've looked at, if I had a piece of pound cake, I would probably need to take five units [laughs]. I'm not going to do that. I'm just not ready to do that. I'm at least willing to start trying to do something just a little bit out of the ordinary than what I normally would do. We could talk about, I don't know when you want to talk about it now or talk about later about the frustration with cookbooks.

Craig: Tell me.

Aunt Laura: I went on this quest for diabetes cookbooks. The two I found, they were Betty Crocker Diabetes Cookbooks, were written in combination with the International Diabetes Center, which is in Minneapolis. It looks like they're the same doctor and dietitians who wrote it. Let's see. This one was written in 2012, and then there was an older edition that was written in 2003.

The 2003, is using carbohydrate choices, which they still do. Each recipe tells you how many you'll have. One and a half, a half, two. That was nice. It has a whole section where they talk about the differences between type 1, type 2, carbohydrate choices, reading labels. It's nice. It has all the info you need. It's got uses of food pyramid, which is now obsolete [laughs]. Because it's made by Betty Crocker, that recipes use, they have ingredients, you'll find normal ingredients and all that other stuff. That was nice.

Then I found this book on Amazon that I ordered. It's The Type 1 Diabetes Cookbook. It's written by a dietitian. It's easy recipes for balanced meals and healthy living, and as she just centers on type 1. She has a whole chapter on getting to know type 1, and she talks about all the insulin, delivery methods, treating, highs and lows, the role of a healthy diet, how do you count your carbohydrates, glycemic index, everything.

Then she talks about how you prepare yourself to make the change and what you need to do. Then she has her recipes. She has the number of servings, and it will give you the calories and the carbohydrates. She doesn't do the exchange thing. She just tells you, “30 carbs are in this.” Or, “16 carbs are in this.” or, “Three carbs are in this.” Again, hers were a little more of a modern day kind of recipes.

I don't make smoothies, but she is almond milk, nut butters, mocha smoothie, bait Parmesan chips, buffalo chicken, celery sticks, kale chips, noodles, carbonate era. Anyway, I just want to say I thought this was a pretty nice starter book, especially if you don't understand type 1 diabetes. I thought she wrote it pretty well, that you could understand it without it being too medical. Anyway, I was giving a shout out to her.

There are books out there. I think it's just a matter of you have to find them. I know chef Talbot wrote a cookbook. Now I heard the second cookbook doesn't have exchanges in it though. [laughs]

Craig: Really?

Aunt Laura: That's what I heard, so I don't know. Then also when you have friends, if you have friends over and they're not type 1, I don't want all my desserts to be all this low carby stuff. They're willing to try stuff. I'll bring stuff and they're okay with that. They're my experimental group. These friends, I've tried new recipes on them before, so they were fine with it. I still make my chocolate chip toffee cookies. I take the unit and I'll have a cookie.

My other frustration is, [chuckles] and I know the younger generation doesn't get magazines, but I still get magazines, but I also check them out. You can check them out through your library online, so you can get all kinds of magazines without subscribing. There's so many magazines that don't tell you any nutritional information. There were some that I subscribed to, and I don't subscribe anymore. I'm like, “I'm done with you.”

Even before when I was watching what I would make, as a dietitian, I could look at a recipe and I would know it's high fat. I would know it's going to have a lot of calories. I would know. I really didn't need that little information, but when you need that information, I need to know how many carbs. I'm not going to try to figure that out for every recipe that I want to try. It's just too much. I don't know if you and your friends just make stuff and then you just estimate, or do you make simpler stuff?

Craig: There's definitely a little bit of guessing. I can look at a plate of food and guess pretty close how many carbs are in it. Then if I have to, then just fix it later.

Aunt Laura: When you travel to foreign countries, then what do you do?

Craig: I can look at a bowl of rice and know how much rice that is, but the kryptonite I think for everyone is sauce. Everything is just mixed together. You have no idea how much of that is sugar. That's the stuff that it's hard to-- Like your salad dressing, you don't know how much sugar sweet is in that salad dressing. If you can put less of it on it, that's a less of a chance that it's going to go bad. You can take a bite of something and you'll know, “This is pretty sweet.”

In terms of the things I cook, I think most of my meals tend to be ones I make myself. I don't know how much type one plays in it, that's obviously I'm a little more aware of what I'm eating and my health, but just wanting to be healthier. I'm not eating a lot of things where I don't necessarily know what's in it or where it comes from. I also get to know the carbs, which is an added benefit.

Aunt Laura: People don't realize, I buy dressings with low carb, they're pretty high in fat because-

Craig: They have to add flavor somehow.

Aunt Laura: -they have to add flavor somehow. Then when you have a low-fat item, it's probably the opposite. They're adding some kind of sweeteners in order to make it taste better or salt or something.

Craig: That's why I don't like pre-made things, especially frozen things, because there's just a ton of salt. I think as type ones, we tend to focus so much on just the carbs that we almost ignore fat, calories, protein, salt, cholesterol, because we're just looking at that one number on the nutrition fact.

Aunt Laura: That's my point in the fact that like these magazines don't put it in. I'm not just talking about diabetics, if you're a heart patient, you should be looking at the fat. If you have high blood pressure, you should be looking at the sodium. If you don't have any of those things to stay healthy, you should be looking at that. I wasn't totally against processed foods per se because sometimes I don't mind convenience, but I try to limit it because it is a lot of stuff that you don't know where it came from. There's a lot of issues about what you're eating, or stuff that's just weird made stuff.

When I worked for the school district, I banned pop-tarts. Pop-tarts are not-- it's not food. If you're going to have a pastry, have a good pastry. [laughs] You're better off eating a piece of whole wheat bread. Then if you put a little jelly on it, okay, that's better than a pop-tart because at least you're getting the whole wheat. I wouldn't waste a carb on it. If I'm going to have used my carbs then give me a really good Danish pastry from a bakery. [laughs] That's good, like croissant. Give me that and I'll take the carbs, but not on a pop-tart, I'm not going to do it.

Craig: In the next episode of Thicker Than Water, Aunt Laura reflects on six months of living with type one diabetes.

Thicker Than Water is a production of Beta Cell. As always, a very special thanks to my Aunt Laura. This amazing theme song is by Nina Ragonese. Do you want even more Beta Cell in your life? Support us on Patreon and you'll get access to bonus clips, outtakes and our Patreon exclusive show, Out of range after dark. Visit patreon.com/betacell to sign up.

I'm Craig, and this is Thicker Than Water.