I have spent another week helping my patients manage their diabetes, and I want to share some interesting gems. Hopefully reading about these specific problems may save you from some similar daily life situations.
This concerns a stay at home dad, age 50, who for the last 15 years prepares all the food for the family including dinner. He recently developed type 2 diabetes; he weighs over 350 pounds and his blood sugars are out of control. After our initial interview and food intake history it was apparent what was happening to this gentleman especially during dinner preparation. He also admitted early on that he was a stress and emotional eater. He started making dinner at 5 PM and the family actually sat down to eat at 6:30 PM. Basically during preparation he was eating an entire dinner while chopping, sautéing and watching TV and then sitting down with the family for his real meal. The biggest problem was he did not even realize this was happening until we actually started to talk about it. Another issue was he was finishing the remainder of food on everyone’s plate (3 other plates) during kitchen cleanup since it wasn’t quite enough for left over’s but too good to just throw away. This was realistically a third mini meal most nights. He literally was horrified when he began to see how much food he was eating basically within a 2 hour period. He also told me he barely ate during the day and usually skipped lunch entirely. Obviously he was starving! He soon learned that it’s a terrible way to eat when you have diabetes. Hunger catches up with you later and people with diabetes should never get to an intense state of hunger. It generally sets you up for failure at the next meal. Luckily he is on diabetes pills that do not induce hypoglycemia and is not on any basal insulin.
Gem – A recent trend and catch phrase in the field of psychology is “mindfulness.” Although the origins began in Eastern philosophy, its real meaning is just being more aware. I spoke to him about actually being present and in the moment to see how food tastes, if he feels hungry or full, how fast or slow he is eating and if he chews his food in 2, 10, or 20 bites. This is all part of mindful eating. Mindfulness requires you eat with no distractions such as TV, e-mails, phone calls or other interruptions except for the family and food. He immediately acknowledged that he has never heard of mindfulness and was not a “mindful eater.” Studies done at Duke University in North Carolina as well as Indiana State University have shown that mindful eating can aid in properly controlling your weight. Even without the guarantee of weight control, mindful eating may help you make better food choices as well as take realistic food quantities. Mindful eating is eating with less emotion and more present reality. For someone with diabetes, with a need for controlling their weight, nothing can be more exciting than being aware and paying attention to what goes into your mouth. Some ways to refine mindful eating is to see how long it takes you to naturally eat a meal and then set a timer for 20 minutes for the next meal; stretch out the meal without finishing it until the buzzer goes off. Another trick is to eat with your non-dominant hand to slow you down or even use chop sticks. Place your fork down between bites and cut each bite separately by placing the knife down with each use. Plan to chew your food carefully and eat slowly. See how many times you actually chew and then double that amount. Try to be in a calm mood and focus on the present not worry about the thousand things you must do later. Never show up starving for the next meal. Think about the taste, texture and aroma of the food before starting to eat. If you are able, put time into the food preparation and make it visually appealing; set the table to enjoy the experience. This tends to slow you down. Visualize how your food was grown, how it got from the farm to store to table. Try to imagine the entire process which will make you more appreciative of the meal. Drink a glass of water before you even start to eat. Try to start journaling about your food intake. Include what, when, where and how much you have eaten. This will definitely make you more mindful of what you are eating.
Food can certainly be an addiction, stress reliever, emotional support and huge trouble spot for people with diabetes. Try to capture the moment and slow down. It can hopefully make a difference in your over all food intake, weight and more important blood sugar control!
NOTE: Consult your Doctor first to make sure my recommendations fit your special health needs.
She is a member of the American Diabetes Association as well as the South Florida Association of Diabetes Educators. She worked with the education department of NBMC to help educate the hospital's in-patient nurses about diabetes. She practices a healthy lifestyle and has worked as a personal fitness trainer in the past.
She was one of the initiators of the North Broward Diabetes Center (NBMC) which started in 1990 and was one of the first American Diabetes Association (ADA) certified programs in Broward County, Florida for nearly two decades. Robbie has educated patients to care for themselves and has counseled them on healthy eating, heart disease, high lipids, use of glucometers, insulin and many other aspects of diabetes care. The NBMC Diabetes Center received the Valor Award from the American Diabetes Center for excellent care to their patients. Robbie has volunteered over the years as leader of many diabetes support groups.