Diabetes and the Food Conversation: Embracing Teachable-Moments


Diabetes and the Food Conversation: Embracing Teachable-Moments

Anyone who has lived with diabetes for any length of time knows that every day is a teachable moment when inquisitive strangers, co-workers or family members ask questions (or make assumptions) about what we can and cannot eat.  A lot of the misunderstandings come from the fact that most people only know very little about diabetes from either the news media or from a friend/family member that may be living with any type of diabetes.  With this casual relationship between the general public and diabetes knowledge, in most cases, comes a lack of in-depth understanding to what goes into a day in the life of a person with diabetes, including decisions around food. 

Sometimes, it may come up around the nicely set holiday dinner table when a relative says, “Oh no, don’t pass the bread to her she can’t eat it.”, or at a loud restaurant over a drink, “Wait, aren’t you not supposed to drink Margaritas because of the sugar’?”, your friend of over a decade says to you.  It doesn’t mean they haven’t been paying attention when you have tried to embrace all the teachable moments when someone hones in on your button pressing on your pump while you are holding a sandwich between your teeth, it just means they can’t absorb all the information we tell them because they don’t live with this disease everyday! 

It is sometimes a delicate topic, that can often frustrate those of us who have lived with diabetes for much of our lives and still are surrounded by people that just don’t quite understand how or why we do anything we do with our food and insulin management but continue to assume, often out loud.  We may want to start spouting off facts, showing them reputable books or websites, or even start drawing diagrams, but this only fuels the fire in which those of us already having a difficult enough time remembering to bolus for a meal can’t be burdened with. 

Here are some tips I have learned over the years in regards to communicating your food choices and diabetes related decisions to anyone who is pestering you with questions or even trying to tell you what to do or eat…even if it’s for the hundredth time and they mean well:

  1. Smile and take deep breaths:  First and foremost, listen.  Whoever is asking you about your food choices is either eager to learn more because they care, are nosey, or want to scold you.  Try and understand their point of view and what their knowledge base is about diabetes in general and then answer accordingly.  If they want to know why you are able to eat the cheesecake because their grandmother could never eat it when she had diabetes thirty years ago, explain that you wear an insulin pump or that you count your carbohydrates to take the correct injection of insulin.  Explain it briefly, and simply.  If they want to understand more, then you can get into as much information as you want. 

  2. Come up with a Mantra to say: “Yes, I have diabetes, but today’s technology and medicine allow me to be more flexible with my food choices, and while I still have to be careful, I am able to enjoy the foods I love with some proper planning….thank you for your interest though!”

  3. Food decisions change:  Sometimes, I have a difficult time explaining why I can freely eat fruit (and bolus for it) as long as my blood sugars are good, but if I am very high that adding any kind of sugar or carbohydrates to my body before my correction doses starts working is only going to take it longer to bring my blood sugar down.  Again, try summarizes it in terms like “Depending on what my blood sugar is, I am sometimes able to be more lenient with the amount and type of foods I eat, and other times I have to have a little more restraint in order to feel the best I can today.”

  4. Choosing carbs that are worth it to you at that moment:  If you are having a three course meal, which may include carb-dense pasta as the main course, you know you probably shouldn’t gorge yourself with both breadsticks and tiramisu, as it will require more insulin and a longer stretch of time for your blood sugars to come back down.  Also, portions and food choices impact more than just your diabetes!  Often those I am dining with may ask, “Now, why could you eat the dessert but not the bread?”  This is another teachable moment to come up with a simple summary statement such as: “Even though I have the luxury of wearing an insulin pump, I still need to make smart choices with my food, as anyone without diabetes may also do the same”. 

  5. Finally, portions portions portions!  We’ve all been there; over a family members house, or at a dinner put on by friends or a boss.  The courses keep coming, all already pre-portioned plates with much larger mounds of food then you would normally like to load up on all at once.  You don’t want to be rude, your mother taught you to clean your plate…whatever the reason, its okay to NOT eat everything!  If the people serving you don’t already know you have diabetes, you don’t need to tell them unless you want to (sometimes this runs the risk of hurting their feelings that they didn’t consider asking you about your food choices prior to serving the meal).  Just try to consume what you feel comfortable eating depending on what your blood sugar is, or if you don’t want to finish the giant pile of mashed potatoes, ask for a second helping of green beans so that they know you are enjoying the meal they prepared for you!

One other idea is to bring everyone into your world of food preparation.  If you enjoy cooking, and you have adapted to a healthier lifestyle since you have had diabetes, include others in your love of cooking by recipe sharing and having people over to try some of your healthy and tasty meals.  This is yet another great teachable moment to openly share why you cook the way you do and why it benefits not only your diabetes but your overall health!