Yes, She CAN Have That

Last weekend was Halloween. Like all the other holidays at school, there is always a party or some sort of acknowledgment which often includes the passing around of goody bags by some overachieving well-meaning mom kid. Ava came home from school on Friday upset about something. Someone handed out goody bags for Halloween and said, “this one is Ava’s.” Ava’s goody bag contained no candy, just stickers, a pencil, and eraser, etc. It was the only bag with a name on it, so it would be clearly designated as hers.

This isn’t the first time we’ve encountered ignorance and misconceptions around Type One diabetes. Back in our old school, one little girl – a real sweetheart and true friend to Ava – would always give her sugar-free candy. Now, I didn’t blame her. I knew that she most likely went home and told her mom who, in an honest effort to be caring and considerate, went out to a local candy store and bought her a special bag of sugar-free gummie bears just for her. I considered writing her a thank-you note and gently explaining why it wasn’t necessary, but I never did get around to it. And, in case you’ve never heard about the gastrointestinal apocalypse that occurs after eating too many of these sugar-free gummies, trust me when I implore you to just throw them away. (If you must – Google it or click here for the Amazon review.)

Many Type 2s are managing their diabetes with medication, diet, and exercise (read: NOT insulin) – translating to low-carbohydrate intake and definitely reduced sugar intake, which is the primary reason for the plethora of sugar-free food options on the market shelves today. You may recall me saying previously that Type 1s inject insulin to cover all foods they eat (the few exceptions being food without carbs - perhaps for a later post). This is called an insulin-to-carb ratio. Type 1s add up the carbohydrates in the foods they plan to eat and use this ratio to determine how much insulin to inject. This is called a bolus, by the way.

Anyway, did you know that sugar-free foods contain carbohydrates? Well, they do. This means that those sugar-free candies still require a bolus for a Type 1. Now – you’re the parent: Would you rather feed your T1 chemically sweetened candy that she’ll need to bolus slightly less for, or give her full-on real-sugar candy? This one is a no-brainer for me.

Misunderstandings about what Type 1s can and cannot eat abound. There’s a meme circulating in the DOC (Diabetes Online Community): “Things T1 diabetics cannot eat: 1. Poison. 2. Cookies with poison.”

So, what can people with Type 1 diabetes eat? The uncomplicated answer is – Anything that you can eat.

Now, that’s not to say that they don’t have “issues” with foods high on the glycemic index (Google it), and high-fat foods. We in the Type 1 community frequently lament the after-effects of pizza, pasta, cake, and ice cream on blood sugars. Does Ava eat this stuff? Yes. Do I spend the entire night awake and correcting her high blood sugars SIX to EIGHT HOURS after she’s eaten pizza? Yes. Do we eat pizza often? No. Why? Because I need my sleep…duh. (Not to mention the harm of high blood sugars.)

Oh – and chocolate too. Ava loves chocolate as much as her momma does. And she eats it – but again – not too often. Ava eats everything. Because a) I want her to live a normal life, and b) because I give her insulin for it anyway. Chocolate, however – much to Ava’s disappointment – is NOT helpful for lows (low blood sugars). Why, you ask? Because chocolate contains fat – which actually slows down the body’s response to sugar (translation: lows can continue to go lower). Lows need a fast-acting sugar… think Smarties, hard candies, juice.

Sure, there are foods – including those already mentioned – that I’d prefer to limit or avoid. But shouldn’t every parent want to limit their child’s intake of fat and excess sugar? I can tell you that we already know that Ava’s cholesterol is on the high end of the range, and we’ve known this since she was 3 years old. And so – she’s on a heart-healthy diet. But again – shouldn’t EVERY child be on a heart-healthy diet?

Okay, all that being said, I do appreciate everyone’s heartfelt gestures. I sometimes use those moments to educate, and sometimes I’m just too tired. But the love is felt, you can be sure. Ava – she’s ten – so she takes it a bit harder…but I have told her it’s a two-sided equation. If she wants the candy (literally and figuratively), she has to dispel the myths. She needs to learn to advocate, if only for herself. Needless to say, she’s still very private about her diabetes and probably always will be. I’ve offered to come talk to her class and, just as in every year before, the answer is always no.

So –what did we learn today?

Yes – She can have that.

And - She takes insulin for all her food intake. (For all intents and purposes, for the novice and unbaptized person to understand.)

Thanks for reading. And do please share. Knowledge is power.