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Re: [IPk] Food and diet

In message <email @ redacted>, email @ redacted writes
>I just wondered whether the pump makes your diet more restricted or have I 
>been reading things wrong?

Certainly wrong, in my case.  On mdi, I ate pretty much the same diet as
I do now, but with abysmal results (I now get ok results).

What I do do differently now is feel much more in control of what I eat
- no more deciding before a Chinese meal that I will be eating 80g CHO -
instead, I bolus each and every time I finish a little bowl.  When I've
had enough, I've had enough.  So, sometimes I end up having bolused very
little, other times, a lot.  Also at the end of such a meal (or grazing
on 'nibbles'), I make a judgement about the fat content - if it seems to
me to be particularly high, I will take a couple of extra units over the
next 6 hours.

Also, I bolus now for _everything_.  Before, I would not bolus for 'a
few crisps' or 'a few strawberries', and faced with an awful expresso,
would grin and bear it.  Now I add half a teaspoon of sugar, and bolus
(I am talking about bolusing for under 5 g CHO, which would raise my bg
by only a couple of points).

There is swings and roundabouts in this: not having to decide before
hand how much I want to eat means that in meals, I often end up eating
fewer calories than I used to.  On the other hand, particularly faced
with the 10g biscuit or apple, where in the past I would have thought
'it's not worth the trip to the bathroom', I now just eat.  Some people
find these swings and roundabouts end up in weight gain, others in
weight loss.  I lost weight over the first year, but put it all back on
(and then some) when I hurt my back, and in order to take all the pain
management drugs, ended up on 8 meals a day (and even if some of those
meals were only a muller rice, when one is not exercising, those
calories soon mount up!)

Having been type 1 for over 30 years, it still feels really, really
weird having low carbohydrate meals.  My mdi friends still don't believe
it is possible to eat steak and salad and not to have chips.  But on a
pump I have found that a lunch with around 20g CHO, representing perhaps
25% of calories is what I actually prefer (the fat and protein is
largely there as cheese).  

As with all things, you have to strike a balance between what you want
to do and what happens.  You will find that eating whatever you want to
will result in a certain level of diabetic control, and a certain health
risk.  If you are lucky, you and your diabetes team will agree that the
level of control and risk are acceptable.  Or you may feel that by
slightly, somewhat, or greatly limiting what you do, diet-wise, achieves
significantly better control and/or risk.

The uncertainties in this are:
a) everyone is different: you may have a body that really can't cope all
that well with more than 30g CHO at a sitting, or a body that can get to
between 4 and 6 after a restaurant pizza, a little sushi or a glass of
water ...

b) what you are prepared to do is very personal.  Some people are not
prepared to give up the social necessity of mcdonalds.  Some people are
prepared to live on lettuce and the occasional prawn.  Most of us have
lines somewhere between the two.  

c) where you are comfortable with, in terms of control and risk is very

Plus, on one day, most of us are happy with a given, but on the next,
want something completely different (so one day, for example, we are
happy to steer clear of toffee, and on another we don't).  This is
nothing to be worried about!  The diet of a diabetic is not like a
religious belief of choosing a sexual partner: changing your mind, hour
by hour is perfectly normal and acceptable.  Studies of people who eat
healthily (natturally healthily, not people who try to eat healthily)
show that actually they do vary what the eat!

Best wishes,

(dm 30+, 508 2+, pretty happy with control, fairly happy with risk)

Pat Reynolds
email @ redacted
   "It might look a bit messy now, 
                    but just you come back in 500 years time" 
   (T. Pratchett)
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