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type2diabetestreatments-blog · 7 years

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Ask D'Mine: Easter Candy Edition

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Ask D'Mine: Easter Candy Edition

Welcome back to our weekly diabetes advice column, Ask D’Mine — with your host veteran type 1 and diabetes author Wil Dubois. This weekend is Easter, so it just stands to reason that Wil's fielding a question about how to choose the "least offensive" sugary treats for someone with diabetes.

Hop on in for details...

Got your own questions? Email us at [email protected]

Nicki, type 3 from Oklahoma, writes: Hi Wil! My niece was diagnosed with type 1 last year and I'm at a loss for what to get her for Easter. I've always given her a basket of candies. I talked to my brother (my niece's father) and he says I should go ahead just as I always have, that as long as she takes the right amount of insulin and doesn't eat too much at one time, she can have candy. Still, I don't want to be the cause of any trouble, so I guess my question is: What Easter candies have the least amount of sugar?

Wil@AskD'Mine answers: Good for you for checking in with her father first thing! It always amazes me how many people are hesitant to go to the source of the best information on the planet when it comes to D-kiddos -- their parents!

This forward thinking automatically puts you in the running for the Diabetes Aunt of the Year award. You'll be happy to know the award includes an all-expense-paid luxury trip for two to Aruba.

OK, I hope everybody knows I totally made all that up. The part about the Aruba trip, that is. She still gets my vote for Diabetes Aunt of the Year.

Anyway, moving on. As you've been granted permission to give candy, do so. And I'm here to help you figure out the most D-friendly type of Easter candy, which I grant you, is oxymoronic.

In thinking about Easter candy, there are pretty much eggs, bunnies, and chicks. The chicks and eggs make sense. How the bunnies got into the mix, I have no clue. And I don't even want to think about why bunnies are delivering the eggs. But I digress. All three basic Easter candy forms are available as solid chocolate, filled chocolate, or generally larger hollow chocolate. Chicks and bunnies also come in various marshmallow-like creations, and finally, eggs also come as jelly beans.

Which is higher in sugar? I'll bet most people are placing bets on either the nearly solid sugar jelly bean or the infamous whipped sugar marshmallow Peep (which we addressed in depth last year.) But guess what? On a carb-to-weight basis, all Easter candy is about the same, more or less 22 carbs per ounce.

So if they are all the same, does it matter what you give? As a matter of fact, it does. Because sugar per ounce is only one-third of the diabetes/candy equation.

The next third of the equation is serving size. Because while all Easter candy is the same on a carb-to-weight basis, they vary a great deal in their density, which means one ounce of Peeps looks a lot larger than one ounce of jelly beans. Said another way, which is more satisfying: Ten jelly beans or four Peeps? The carbs are the same. Or you could eat one Cadbury caramel egg. Of course, there's no universal answer to the question of what's more satisfying, so you need to think about your niece's personality. Is she one of those kids who will graze on Easter candy until Halloween, and then finally throw out the rock-hard leftovers? Or is she one of those kids who will eat everything in the basket within 48 hours? If she's a grazer, I think it would be OK to give more sugar-dense candies, if she's a binger, the lighter, fluffier options will be better for her. Also, be sure to consider how her recent diabetes diagnosis might have affected her relationship with food, especially sweets.

The last leg of our Easter triumvirate is, for lack of a better word, the Glycemic Index. I doubt that the index folks have worked out all the numbers on Easter candy, but the fact is that not all sugars are created equal. Candies with chocolate, especially milk chocolate, have more fat than candies that don't have chocolate. The fat has the effect of slowing down the absorption of the carbs in the sugar. This is why chocolate is a bad choice for trying to fix hypoglycemia -- it's too slow-acting -- but it's an excellent choice for sweets for D-folks, as it's less likely to put us into a coma. Most of us will see a slower, lower blood sugar excursion from eating milk chocolate eggs than from eating jelly beans.

For that reason, I'd lean towards a diabetes Easter basket heavy on chocolate, unless of course, your niece is one of those strange kids who doesn't care for chocolate (scientists on Easter Island are researching this rare genetic disorder and say a cure is less than five years away). Be sure to look for high-quality hollow chocolate bunnies and the like. They don't have less sugar per ounce, but being full of air, they take up more room in the basket, making it look fuller than it is.

But the most important factor in all of this is something you probably already know. Does she have a favorite Easter candy? My father loved the Fruit & Nut Egg. It was a one-pound football-sized candy egg that dominated our Easter baskets when I was a kid. I hated them, and I just picked the chocolate coating off. (My pleas to the Easter Bunny went unanswered as I got confused and addressed them all to the North Pole). My point? Don't project what you love on others. I'm not saying you shouldn't expose family kiddos to things you think are awesome, but be sure to observe and pay attention to their preferences over time, and then cater to them on special occasions like this.

So if your niece loves watermelon jelly beans, don't forgo them and just give her chocolate, because I said it's the "healthier" option. Because really, the differences between candies are just shades of grey in a sea of green (fake) grass in the Easter Basket.

Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

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type2diabetestreatments-blog · 8 years

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D-Teens and Alcohol: No Bull from Uncle Wil

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D-Teens and Alcohol: No Bull from Uncle Wil

Today, we bring you a special edition of our weekly advice column, Ask D'Mine. Your host, type 1 diabetes author and educator Wil Dubois has a few things to say about drinking with diabetes.

Got questions? As usual, email us at [email protected]

Uncle Wil on Alcohol Consumption

One of my type 1 patients is in jail today. Something involving a firearm and a bottle of whiskey downtown. He was so drunk he was shooting into the air.

He's 15 years old.

Before this happened, his mother had specifically asked me not to talk to him about diabetes and alcohol. He wasn't that kind of boy, you see. She was afraid I might put ideas in his head. Ideas that were apparently very much there already. Ideas with no facts and information to balance them.

So today, instead of our usual Q&A format, I'm writing today's Ask D'Mine as an open letter to all my little brothers and sisters. To tell you what I should have told him.

Dear Type 1 Teens and College-types:

Today I'm going to teach you how to get wasted safely. I'm not saying you should. I'm not saying I want you to. But if you are going to, I want you to know the dangers, and I want you to know how to do it right.

Why? Because no one else will frickin' tell you. Your parents won't. Your grandparents won't. Your doctors won't. Your educators won't. Your teachers won't. Your priests won't. But I will.

I call all young type 1s my little brothers or sisters, but I today I'm thinking of you as my nieces and nephews. Yep, I'm the Uncle your mother really wishes would just join the Merchant Marines and never visit until after you're all grown up. I'm the perceived bad influence. The tattooed guy who swears, smokes, drinks, flirts with all the women in the room, and makes politically incorrect jokes.

But God puts people into families for a reason. And the black-sheep uncle has an important role to fill: the adult who cares but does not judge.

To drink safely you need to first understand how alcohol affects you and me differently than it does the sugar-normals. Do you know anything about your liver? It does all kinds of things for your body. It has more than 500 different functions, actually. But most importantly to our discussion today: It's a blood filter. It removes toxins from your blood. Toxins like alcohol.

But the liver only does one thing at a time. Everyone and everything else just has to take a number and stand in line until it's finished the job at hand. And on that list of 500 jobs is "remove excess insulin." Unless, of course, alcohol is in line first. Then the insulin just builds up in your blood while your liver is dealing with the alcohol. It takes hours for the liver to "clear" a good binge, and all that time the insulin stays in your system. It's like taking an extra shot of basal. Big-time hypos hit 8-10 hours downstream from last call, when you're sleeping it off.

Oh, and when you've been drinking, your body will respond more sluggishly to the treatment of those lows. The rebound will be a lot slower than you're used to. So don't panic, just be prepared for a 2-3 times longer "recovery" than you'd experience with sober lows. Booze also reduces your awareness of lows overall, and sometimes even triggers a temporary state of hypoglycemia unawareness. So be aware that you may not be aware, OK?

If you want to learn more about the biology of booze, check this out. But the important message is that booze screws with your diabetic body differently than it does for all your non-D friends. And you need to plan for that fact.

So Uncle Wil, you ask, how do I get totally shit-faced drunk off my ass safely? Look, the only way to play Russian Roulette safely is with an empty gun. Oh dear. Now I've gone and introduced your impressionable little minds to Russian Roulette, too. Your mother is going to throw me out of the house.

The stone cold sober truth: for people with type 1 diabetes, there is no safe way to get four sheets to the wind. Hang on! Keep reading! I know that sounds like a typical "adult" cop-out answer. But it's true, and it's why most adults just throw in the towel at this point and say "Just don't drink!" But I'm a realist. I know you will still get wasted, no matter what the risks.

I don't have any magic bullets, or secret formulas to let you binge in safety. No two young type 1s are alike, and no two binges are alike. That said, here are my tips for making this dangerous undertaking as safe as possible. Three things to consider before the first sip -

One: To bolus or not to bolus? Should you bolus for beer or mixers? Both have carbs. Sometimes a lot of carbs. Logically, you should cover those carbs. But the alcohol in the drink will supersize the insulin downstream, remember? What to do? There's no right answer here, and the drunker you get, the worse you'll count carbs, the worse you'll calculate the bolus, and the less you'll care. I suggest cutting your bolus down. Should you take half what you normally would? A third? Sorry, I don't know. But some amount less should be in your game plan.

Two: To eat drink and be merry requires eating. If you're not throwing up, and even if you are, I think you should eat a snack before you sleep it off. Something high in fat so that it takes a long time to work through your system. That slice of cold pizza on the floor will do the trick. Don't cover it with insulin unless you are insanely high at bedtime. You'll want carbs in your system to soak up the insulin that the liver isn't filtering away.

Three: No alcohol and heavy machinery. If you're wasted, can you drive a forklift safely? No? Then what makes you think you can drive an insulin pump safely? Or a glucometer, for that matter? If you are really out of it, can you make good treatment decisions? Smart adults choose a designated driver when they go out drinking in packs. Is there anyone in your group who can serve in that role? If so, does that person understand diabetes well enough to help? Is that person reliable? Is he or she the kind of person that'll wipe the vomit off your hands and check your blood sugar at 3 a.m. while you're sleeping it off? Or will they be passed out on the other side of the room?

Well, that's it. Alcohol supersizes your insulin and sets you up for epic lows hours later when you're likely to be asleep. It blunts your ability to feel those lows, and slows down your recovery if you do feel them and are sober enough to deal with it. But you can lower your risk of all of those scary things by thinking and planning ahead and...Oh, crap! I forgot to tell you about the Zombies.

My tattoo artist has a glass case in his studio with a faux chainsaw in it. Stenciled in bold red letters on the case is: BREAK GLASS IN CASE OF ZOMBIE ATTACK. So let's pretend there's been a Zombie attack. Steps behind you is a shuffling, stinking, moaning mob of the undead intent on tearing you to shreds, drinking your blood, and feasting on your flesh. You barely make it to the case in time, grab the hammer, and... Crap! The case is empty.

This doesn't look good for the home team.

You know what? If you drink too many Tactical Nuclear Penguins, your glucagon emergency kit case might just as well be empty, too.

I bet your endo never told you, but, glucagon does not work when you are drunk.

A drunk liver won't dump its stores of sugar on demand. I'm not saying your peers shouldn't try giving you a shot if you have a seizure, but realistically, it won't work. When you're drunk, the break-glass-in-case-of-emergency cabinet is empty.

The only way to save your life if you have a severe hypo when plastered is to get an IV of dextrose in the back of an ambulance or at the hospital ER. So wear your damn medic alert when you go drinking—if the paramedics smell booze on your passed out carcass, they probably won't think to check your blood sugar.

The lesson here, my dear nieces and nephews, is don't let your drinking get to the Zombie attack point. Plan ahead the best you can. If you drink to get drunk—or find you're way well down that road—please get the carbs in and get the insulin out. If you're pumping, turn down the basal or take the pump off. If you shoot up and you haven't taken your basal yet, take less, or maybe even skip it. If you've already taken your basal, skip the fast-acting insulin and eat a snack.

Can you get drunk safely? No. Not really. But now you have the tools to do it as safely as possible, because I want each of you to grow up and become a black-sheep uncle or aunt for the next generation.

Much love,

Uncle Wil

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

Type 2 Diabetes Treatment Type 2 Diabetes Diet Diabetes Destroyer Reviews Original Article

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