Hi! I am Kristen O’Dell, Registered Dietitian, Certified Diabetes Care and Education Specialist, and I have had type 1 diabetes for over two decades. My relationship with food and diabetes has changed over the years and below are some key concepts that guide me when it comes to maintaining a healthy relationship with food and living a healthy lifestyle with diabetes. These points also help me in my work as a registered dietitian and diabetes educator.
Food is a fundamental part of life. From the clichés, “An apple a day keeps the doctor away” or “You are what you eat,” to the traditions every culture has around food (like Thanksgiving, Passover, or Eid al-Fitr). The true purpose of food is to fuel the body with calories to sustain life. You literally eat to live, whether you have diabetes or not.
One of the first things I think about in the morning, as I’m smelling my freshly brewed coffee, is “Hmm, what does my day look like today, what is my blood sugar, and what am I going to eat for breakfast?” Then my stomach begins to rumble as if the thought itself reminded my stomach that it was empty. Sometimes food can be easier to navigate, especially when there is a plan or if it was prepped beforehand, other times it’s laborious to have to figure out what to eat and if it’s a healthy choice. Not to mention the added challenges of counting the carbohydrates accurately and timing the meal-time bolus appropriately for people with diabetes.
As the type A planner that I am, when it comes to any unknowns around food, I can feel overwhelmed. Things that should be enjoyable, such as going to a friend’s house for dinner, can be hard when I don’t know what food is being served. Sometimes I also feel concerned about managing my blood sugars or bringing attention to myself due to diabetes. Other occasions, like a football game or carnival can be just as challenging with navigating the extra activity and finding a healthy food option among the typical choices at these events. Balancing the joy that comes from life events with the difficulties in caring for diabetes takes experience and resilience.
With all of the decisions that revolve around food on a daily basis, and the extra layer that diabetes management adds, it can be very stressful and difficult to consistently make healthy choices. I want to remind anyone and everyone that perfection is not the goal with healthy eating OR diabetes management, moderation is…
You can not walk the stage, graduating with a degree in nutrition or dietetics without having the motto: “Everything in moderation, even moderation,” by Oscar Wilde, ingrained in your thinking. As I have counseled people in nutrition and lived with type 1 diabetes, I truly believe there is room for ANY food in a healthy diet.
Do you love ice cream and can’t imagine life without it? Well then let’s find a healthy balance to incorporate ice cream into your life. What about chocolate, sweet cereal, processed meats, or French fries? There is room for those too. What about cotton candy? There is even room for cotton candy, I promise. The key to incorporating these foods into your life is portion size and frequency.
Eating ice cream every night for dessert can be done with some adjustments, such as trying frozen yogurt, only having one serving and eating it at the right time with appropriate insulin to achieve target blood sugars. A huge bowl of sweet cereal daily isn’t going to be healthy for anyone, but one serving of sweet cereal every other week is much more reasonable, and the appropriate amount and timing of insulin are key. Cotton candy once a month might not be a healthy choice but once or twice a year at a sporting event or fair is something that could work. I can not promise there will not be a blood sugar spike after eating cotton candy, so maybe timing with a low blood sugar is ideal. Everything in moderation, even moderation.
It all comes down to moderation while having the skills, knowledge, and resources to make healthy decisions.
Nutrition is a vast subject; food groups, nutrition labels, serving sizes, macro nutrients, micro nutrients, fat-soluble vitamins, water-soluble vitamins, minerals, essential nutrients, the list goes on and on. These nutrition terms are the building blocks of healthy eating. It can be very overwhelming learning how to apply these concepts to your life, and that is where your health care professionals can help, especially Registered Dietitians. You don’t have to learn and apply everything all at once. It is a process, where learning and applying the basics is the beginning and you can continue to build off that, incorporating new things when you’re ready.
These nutrition concepts don’t even begin to touch on disease-specific knowledge that is essential, especially with diabetes: blood sugar goals, ketones, rapid or long-acting insulin, oral medications, technology (CGMs, pumps), etc. Learning diabetes-specific knowledge on top of nutrition knowledge can make someone’s head spin. Quite honestly, there is no possible way to learn the concepts of diabetes and nutrition all at once and apply them to a healthy and active lifestyle effectively. Much of this learning is a lifelong experiment full of trial and error, and everyone’s experience with diabetes is unique.
A Certified Diabetes Care and Education Specialist can help you navigate through all the information. And slowly, as you learn more about nutrition and diabetes, you can apply it to your life to achieve and maintain a healthy lifestyle.
Keep in mind this process is continual. I am always learning new things within the field of nutrition, professional diabetes management, and personal diabetes management. Even though I am a RD, CDCES, and have lived with T1D for over two decades, I still have fluctuations in blood sugars all the time. It’s not something that anyone gets perfect, not even those of us that are literally paid to help teach people about diabetes. It’s not about perfection, it’s about effort.
The definition of the word adjustment is “a small alteration made to achieve a desired result; the process of adapting to a new situation.” Adjustment is an important skill to have in life. Did your flight get cancelled? Did your car get a flat tire? Did your child wake up sick? Did your coworker call in sick? These are all things in life that cause us to adjust. When it comes to living a healthy lifestyle or diabetes management, adjustment is even more important. Embracing adjustment with the right mindset and having the capacity to do so is very important.
Within a healthy lifestyle, if you find yourself in a situation where there aren’t healthy food choices to make, you make the best choice you can and then decide to do a harder workout than intended or choose healthier food options the rest of the day to offset the original choice.
With diabetes, when your blood sugar is high, you adjust by drinking some water, choosing to do something active, or giving additional insulin (per HCP recommendations) to help bring your blood sugar down. When your blood sugar is low, you would adjust what you’re doing and decide the best thing to eat at that given moment. Sometimes your adjustment can be super inconvenient and it’s all about being resilient, and moving forward after.
This isn’t always what happens, I FULLY understand that and have many of my own moments, but it is so important to be able to give yourself some compassion, pick yourself up, and lean on a support system. It takes a village, as the saying goes, and finding your diabetes support system can make a huge difference in your lifelong diabetes journey.
In any stage of life, support can be found in many different venues. It can be family that is understanding and helpful. It can be coaches or teachers that listen. It can be a significant other that is going through life with you. It can be a healthcare team that is understanding. It can be an online community that responds to your issues with one click. There are so many different types of support out there and it is important to remember to lean on this support when things get overwhelming.
There is a woman I follow on Facebook who said it very well, “We weren’t meant to do life alone. We weren’t meant to figure things out on our own. We weren’t meant to have all the answers… We were meant to do life together. We were meant to be in community with others.” (Jaclyn E. Turner).
I truly believe that and if I can be part of your community, it would be my absolute pleasure!
For more information in CWD’s upcoming events for the diabetes community, check out cwd.is/community.
Written and reviewed by Kristen O’Dell, MS, RD, CDCES