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Credit: Catherine Willemse

The Never-Ending Math Magic You Do in the Kitchen as a Type 1 Diabetic

updated Jul 31, 2019
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When I was 11 years old, I was diagnosed with Type 1 diabetes, a chronic condition where the pancreas stops producing insulin. I was hospitalized for several days due to diabetic ketoacidosis, a complication of undiagnosed diabetes. I wasn’t allowed to leave the hospital until I learned how to inject myself with insulin and how to count carbohydrates.

While in the hospital, I met with a nutritionist daily who taught me — to my absolute shock — that a banana has twice as many carbohydrates (30) as an apple (15), along with several other numbers that remain ingrained in my brain. For instance, one cup of cooked spaghetti has approximately 45 grams of carbohydrates, a third cup of rice is 15 grams, a Jamba Juice smoothie is “approximately” one million grams (that’s my super-scientific estimation). 

You get the picture.

Type 1 diabetes is a complicated chronic illness that can make eating as complex as an algebraic equation. Through this disease, though, I’ve learned to enjoy food in a deeper, more nuanced way; it just takes a little bit of math. At this point, I’ve had diabetes for 18 years, so I could essentially weigh a cup of cooked spaghetti in my hands with closed eyes. Still, eating out as a Type 1 diabetic can be a nightmarish hell, particularly when it comes to sauces. It seems as though every sauce is thickened with flour, and sugar hides in everything from tomato sauce to rice. 

That’s why I love cooking for myself. When I’m at home in my own kitchen, I know exactly what I’m putting into each meal. My favorite meals to cook tend to be pretty simple, and I’m known to rely on a few standby recipes. It’s easier for me, because I know the exact carbohydrate count, therefore I know how much insulin to take.

This is where diets for people with Type 1 diabetes gets controversial. Some people advocate low-carbohydrate lifestyles, as your blood sugar may fluctuate less, and you’ll ultimately have better control of your numbers. I’ve figured out a way to maintain a “normal” and healthy lifestyle filled with fruits, vegetables, protein, and healthy whole grains. My blood sugar averages are as close to a non-diabetic as possible, and I’m living a full, productive life. Plus, I’ve gone extended periods without eating carbohydrates in the past, and my body hates it. I need fuel, and that includes some bread now and then.

Now, down to the food.

There’s nothing like a bowl of steel-cut oats with apples, chia seeds, and flax seeds first thing in the morning, topped off with unsweetened almond milk and cinnamon. It’s exactly 35 grams of carbohydrates. Each morning, I check my blood sugar, take my insulin, make coffee, warm up my oatmeal (I make it in large batches in my slow cooker), wash my face, and take my dog outside. By that time, it’s been about 10 to 15 minutes since I’ve taken my insulin — the perfect amount of time so my insulin has just started to kick in, and I can avoid a drastic blood sugar spike.

For lunch, one of my favorites is brown rice topped with kale sautéed in olive oil, salt, and pepper, then two eggs over-easy with goat cheese and Sriracha. Once everything is piled into a bowl, I mix it all together and call it 25 grams of carbohydrates. The tanginess of the goat cheese paired with the heat and sweetness of the hot sauce always leaves me wanting more. I’ve even fantasized about making a Sriracha and goat cheese ice cream. I know it sounds bizarre, but I personally think I could get rich off of it. (Send me your pre-orders now.)

Dinners tends to be incredibly simple; chicken thighs with roasted potatoes and a salad, maybe some soup. I live in Minnesota, where the summers reach up to 100 degrees and the winters deliver wind chills in the negative 50s (no joke). Because that’s the case, my diet drastically changes throughout the year, and I’m all about a good homemade chicken soup in the winter. I tend to add more vegetables to my soup than the average person; it’s a great way for me to fill up without eating too many carbohydrates. I’ve been known to stretch out a batch of chicken soup for a week by adding handfuls of dinosaur kale.

I’m also a huge snacker, particularly around bedtime. I know that’s not optimal for many people and that Oprah doesn’t eat past 7 p.m. or something, but it’s a habit from when I was diagnosed with diabetes, and I just can’t quit it. Ever since I was a kid, I’d eat 30 grams of carbohydrates along with 7 or 8 grams of protein before bed — maybe a banana and string cheese, or two pieces of peanut butter toast. These days, I love making banana “nice cream” — I blend a frozen banana in my blender along with a splash of unsweetened vanilla almond milk, then top it with some pistachios. I get my protein and my carbohydrates — perfectly the same amount as my childhood bedtime snacks. 

Bedtime snacks aren’t really necessary these days, but like I said, old habits die hard. Back when I was first diagnosed, that was the normal routine for a person with diabetes, as it was believed that it would help you maintain a steady blood sugar overnight. We now have incredible technology that helps you avoid having low blood sugar in the middle of the night, such as a continuous glucose monitor (CGM), which checks your blood sugar every five minutes and updates your phone. If you go too low or high, it will alarm you. My CGM has woken me up plenty of times in the middle of the night, and I’ll roll over with one eye open to drink a box of apple juice with 15 grams of carbohydrates. 

As I mentioned, eating out can be a bit challenging, but I tend to have a few favorite restaurants where I order the same menu item. My partner and I love walking to Black Sheep Pizza, which makes coal-fired pizzas with thin crusts and delectable toppings. We always split the house salad and a small Persian beef, tomato, feta, and harissa pizza; I’ve estimated that my share is about 45 grams of carbohydrates. Pizza’s a tricky food because you tend to go low then spike a few hours after eating it due to the large amounts of fat and protein in it. With that in mind, I tend to do what’s called an “extended basal,” where I take 20 percent of my insulin upfront, then I get the remaining 80 percent in an hour. It works especially well because the walk is about a half-mile each way; I avoid any spikes in my blood sugar, and I don’t go low later.

While eating as a Type 1 diabetic can be challenging, it also makes me appreciate food in unique ways. For instance, I’ll never know the pleasure of mindlessly eating a bag of potato chips; I have to count how many I’m going to eat, then take insulin for it. I have a special affinity for salami, though, which doesn’t have any carbohydrates; just spiced meaty goodness. That and cheese. Whenever I eat salami and cheese, I don’t have to think about my blood sugar spiking. I can just enjoy eating food without endless calculations.

Still, these endless calculations have become a constant companion. My endocrinologist recently told me that there likely won’t be a cure for Type 1 diabetes in my lifetime. While I obviously felt devastated by that news, there was a weird sense of relief as well; what would I do if I wasn’t constantly checking my blood sugar, adding up carbohydrates, and calculating insulin dosages? I don’t think that part of my brain would ever shut down. While the whirring of numbers in my brain can be exhausting, it’s also the familiar hum that accompanies me every time I step into the kitchen.