The Man in the Mirror

| Jun 1, 2002

Last night, I woke up a little before 3 a.m. and tested my blood glucose. It was 52. I had to get up and eat. Here I am, going to Weight Watchers, exercising, trying to take off another 15 pounds, and my efforts are being thwarted by diabetes.

It isn't easy to lose weight under any circumstances. If you have diabetes, it can be even more difficult. If you take insulin or an oral medication that can cause your blood-glucose levels to go low, you're often forced to eat—even when you don't want to. (How many people do you know who have to get up at 3 a.m. and eat something?) Last night I probably consumed 500 extra calories that I didn't need, just to get my blood glucose back up.

Many oral medications taken by people with type 2 diabetes actually promote weight gain. And yet we're all told that we need to lose weight or, at least, avoid gaining weight.

When we don't lose, or when we're slow to lose, we feel like failures. At least I do. For example, I've lost only 11 pounds since I started Weight Watchers last October. My wife tells me I am not a failure; instead, because I am still going to the meetings, she says, "You are patient." I like her view better!

As people with diabetes, we're supposed to eat "sensibly"—while being bombarded with billboards, magazine ads and television commercials that attack our senses with mouth-watering examples of (usually) fat-filled foods.

And there's senseless eating. We went to a Cinco de Mayo party where there were candy-filled pinatas for the children to break. On our way home, my daughter, Miranda, would take one bite from each candy and then hand me the rest. I think she wanted to taste them all. My desire for chocolate overrode my commitment to avoid extra calories. I happily ate them.

I also find that I tend to nibble and taste while fixing my children's school lunches and snacks. On the days when they have baseball practice after school, I have to fix double lunches.

Maybe I should be more accepting of myself. Maybe I should realize that I can only do my best and stop berating myself for taking a nibble here and there and for sometimes giving in to my. well, human qualities.

I can identify with many of the comments made by people in our article "Winning or Losing?" on page 32 of this issue. Many of us are told to "lose weight" but aren't told how to lose it.

I think the first key is to realize the challenge—weight loss is tough, and everybody struggles with it.

The second key is to be patient with yourself.

P.S.: When I submitted this column to our clinical adviser, Cindy Onufer, RN, MA, CDE, she sent back a valuable comment that I want to share in its entirety.

Clinical adviser's note: What concerns me is your comment that "…I probably consumed 500 extra calories that I didn't need, just to get my blood glucose back up." Of course, when having a low at the most vulnerable time, the middle of the night, most people consume extra, just to be sure it's safe to go back to sleep—to "carry them over." But for immediate treatment of blood glucose between 50 and 70 mg/dl, the American Diabetes Association recommends eating or drinking 15 grams of carbohydrate, which should raise the blood-glucose level 30 to 45 mg/dl. If blood glucose is near or less than 50 mg/dl, the ADA recommends consuming 20 to 30 grams of carbohydrate. But after 50 minutes, blood-glucose levels start to fall again.

The best action is to test blood glucose again about 15 to 20 minutes after treatment, and if the result is still low (70 mg/dl or less), repeat the treatment even if symptoms have disappeared. The catch is that if a meal or snack is not scheduled within the next hour (we're talking 3 a.m. here!), then a more substantial snack is probably indicated (but not usually 500 calories).

The key is to be a detective and figure out why the low occurred. If it was a late response to exercise, then in the future either lower insulin to compensate for exercise or at least plan a healthy bedtime snack to prevent a low. Other thoughts are to consider whether the basal insulin dose is too high—try planning a 2:30 or 3:00 a.m. blood-glucose check to evaluate. For some people, for example, nighttime lows are related to alcohol intake. Or they might result from a "correction dose" late in the evening with rapid-acting insulin that was an overestimation.

Click Here To View Or Post Comments

Categories: Blood Glucose, Diabetes, Diabetes, Food, Insulin, Losing weight, My Own Injection, Type 2 Issues

Take the Diabetes Health Pump Survey
See What's Inside
Read this FREE issue now
For healthcare professionals only
  • 12th Annual Product Reference Guide
  • Insulin Syringe Chart
  • Insulin Pen Needles Chart
  • Fast-Acting Glucose
  • Sharps Disposal
  • Blood Glucose Meters Chart
  • Insulin Pumps Chart
See the entire table of contents here!

You can view the current or previous issues of Diabetes Health online, in their entirety, anytime you want.
Click Here To View

See if you qualify for our free healthcare professional magazines. Click here to start your application for Pre-Diabetes Health, Diabetes Health Pharmacist and Diabetes Health Professional.

Learn More About the Professional Subscription

Free Diabetes Health e-Newsletter

Top Rated
Print | Email | Share | Comments (0)

You May Also Be Interested In...


Add your comments about this article below. You can add comments as a registered user or anonymously. If you choose to post anonymously your comments will be sent to our moderator for approval before they appear on this page. If you choose to post as a registered user your comments will appear instantly.

When voicing your views via the comment feature, please respect the Diabetes Health community by refraining from comments that could be considered offensive to other people. Diabetes Health reserves the right to remove comments when necessary to maintain the cordial voice of the diabetes community.

For your privacy and protection, we ask that you do not include personal details such as address or telephone number in any comments posted.

Don't have your Diabetes Health Username? Register now and add your comments to all our content.

Have Your Say...

Username: Password:
©1991-2015 Diabetes Health | Home | Privacy | Press | Advertising | Help | Contact Us | Donate | Sitemap

Diabetes Health Medical Disclaimer

The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. Opinions expressed here are the opinions of writers, contributors, and commentators, and are not necessarily those of Diabetes Health. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website.