How to Stay on Your Diabetes Diet Forever
In the sections below you'll read about some of the many tricks and tips people have found have helped them stick with a carbohydrate restricted diet, with a particular emphasis on the strategies most helpful to people who are eating a lower carbohydrate diet to achieve normal blood sugars. However, some of these tips will be equally helpful to people who have adopted low carb diets just for weight loss.
Eliminate "Habit Carbs" and Concentrate on "Value Carbs"
When people think about restricting their carb intake they assume this means never eating any of their favorite foods again.
But for many of us, this doesn't have to be true. Why? Because a quick look at your daily carb intake will often reveal that the bulk of the carbohydrates you are eating are what I call "habit carbs." These are the carbs you eat without a second thought because they are there. Not because they taste good. Not because you couldn't live without them. Just because you're in the habit of eating them. Here is a list of some prime "habit carbs."
Steam table mashed potatoes
Limp french fries
Squashy hamburger buns
Cold home fries
Stale boxed cookies
How many of these flavorless, starchy foods are you consuming everyday just because they're there? Probably more than you realize. So before you lift that fork-full to your mouth, ask yourself, "Is this food thrilling me?" If not, put it down. This should go a long way towards getting your carb intake down.
What I'd call "value carbs" are those carb-rich foods that really do mean something to you. I'm not going to lie to you. You are not going to be able to make them the mainstays of your diabetes diet. But by using the strategies describe below, you should be able to eat enough of these foods to keep yourself from feeling deprived--without destroying your health.
Don't Create "Forbidden Foods!"
If you are one of those people who could live happily on Purina People Chow, you can skip what follows. But if food has been important to you, and if you have hitherto had a long and emotionally satisfying relationship with food, or if, like me, baking from scratch was one of your favorite ways to show love and express creativity, restricting your carbohydrate input will mean that a whole lot of what you've been eating (and baking) up until now is suddenly, completely, off limits. I can't eat cake and get a healthy blood sugar level. Even with two different diabetes drugs in my system. I can't eat cake. I love cake but there is no way I can eat more than a bite or two without seeing very high blood sugars and there is no way I can eat only two bites of cake and be happy. The same goes for french fries and Thai noodles.
During the first enthusiastic weeks and months of exploring carb restriction most people deal with this kind of discovery by coming up with new recipes and finding new, delicious and healthy things they can substitute for old, high carb standards. They appreciate the way cutting way back on carbohydrates curbs their hunger and makes food much more manageable. This is good and it is why many people choose to stick to carbohydrate restricted diets. But the appeal of your favorite foods does not go away that easily.
If you decide that some food you have been eating and enjoying all your life will never again cross your lips, it is almost 100% guaranteed that you'll end up pigging out on that very same food at some time in the future, hating yourself, and even beginning a binge that can throw you completely off your diet for months.
It might not happen the first month you are restricting your carb intake or even the first year. It took me three years of eating a strict ketogenic low carb diet to get to where I crashed off it. But eventually it happens to most of us. After eighteen years of counting my carbs I've learned that I will never lose my love for certain foods that don't love me, But I've also learned that it is possible to find a way of limiting my carb intake in a way that avoids the buildup of the feelings of deprivation that eventually lead to long periods of unwise eating.
The key, for me, has been to build safety valves into my diet. I don't call eating these high carb foods them "cheats" or label them "bad foods" for reasons I'll get into later. I call them "off plan" foods, because they are not foods I can make an ongoing part of my every day food plan. But because my goal is life-long blood sugar control, and because feeling deprived does not contribute to my ability to do that, I accept that I will occasional eat "off plan" and that it is perfectly okay to do this as long as I am meeting my blood sugar targets mostof the time. "Good enough" control that I can adhere to year in and year out beats a few months of perfection followed by crashing off the diet entirely and ruining my health.
Here is one way to approach doing this:
Do the Diet Straight for a Month or Two Before You Try Off-Plan Goodies
If you are going to follow a more moderate, flexible approach, it's important to keep a few things in mind. The first is that you can only relax your diet after you've gotten yourself firmly on that diet. You will need to lower your blood sugar to normal levels for a month or more to begin to experience the huge benefits, including greatly reduced insulin resistance, that will make it possible to be more flexible about what you eat. Going on and off a carbohydrate restricted diet, early on, will only make you more hungry, which will make it harder to get your diet under control. So during the first couple of months while you are learning how to get your blood sugar under control and finding what foods will let you achieve normal blood sugars you will have to accept that you can only eat those foods that don't cause spikes.
After a few months, when you've gotten your blood sugar under control, nothing horrible will happen if you make room for a small portion of some high carb treat every now and then.
How Often Can You Eat Off-Plan?
How often you have an off-plan food once you have brought your blood sugar under control depends a lot on your dietary goals, how high your blood sugar is before you eat carbs, and whether you are willing to exercise after eating. It also depends greatly on what medications you are taking for your diabetes. Forty minutes of cardiovascular exercise will burn off a lot of extra carbs, so if you exercise regularly, try to eat your high carb treat before you head for the gym.
If you're trying to lose weight, you may have to keep off plan treats few and far between. It is easier on your system to eat an occasional high carb item here and there--adding, say an additional 20-50 grams to your daily intake than it is to eat a blockbuster all carb meal, with 100 grams or more all at once. Almost certainly you will feel terrible after eating a huge amount of carbs all at once and you may find yourself struggling with ravenous hunger for a day or two after surprising your system that way.
But adding a slice of bread to your breakfast, or a half a potato to dinner every few days may work well for you. And if you do find yourself in a situation where a high carbohydrate pig out is required, enjoy it. Just don't do it more than once a month. You'll find out how to recover from the impact of a sudden high carb overindulgence HERE
Throw Away the Vocabulary of Self-Destructive Dieting
When you eat something with carbs in it, don't think of it as a "cheat." Cheating is what you do when faced with an authority figure--your 9th grade math teacher or the IRS. But you are the one in control of what you eat. So when you eat something that is off-plan, you should stop thinking of it as "getting away with something" and treat it instead as something you've decided to do--for a reason that should be clear to you while you do it.
If you keep eating things that were not what you had intended, rather than beating yourself up, it's time to reconsider your food plan and figure out why it isn't working. Are you having trouble finding foods in restaurants that don't raise your blood sugar? Maybe it's time to bring your lunch along to work for a while, or to find new place to dine.
Are you bored with what you have been eating? Google for good low carb recipes you can try at home. There are thousands of them. If you use the Google Groups search and look for messages in alt.support.diet.low-carb that start with "REC" you'll find a treasure trove of ideas to try.
Keep the vocabulary of sin and guilt for the confessional. You're going to eat a lot of things in the years to come that will mess up your blood sugar. But if you are kind to yourself and dust yourself off after you mess up and keep on going, doing the best you can to hit your blood sugar targets, even if you miss them quite frquently you may very well stillend up healthier than many people who do not have diabetes diagnoses who eat those very unhealthy meals every single day.
The important thing is to keep at it, doing the best you can and forgiving yourself when the best you can do isn't as good as you wish it was.
Know Your Limits
I've learned the hard way I can't eat half a blueberry muffin, so I don't even try portion control for that particular food. I know blueberry muffins are trouble and I also know that I will eventually eat one. That's just how it is, so every blue moon or so I eat a blueberry muffin, experience the miserable high blood sugars that follow, and then remember why I don't eat muffins every day any more. What I don't do is fool myself that I can buy a muffin and only eat half. Everyone has a few foods that fall into this category. Treat them with caution!
Eat Off-Plan Foods Out of the House
I've learned the hard way that if a big box of something full of carbs is in the fridge, bad things are going to happen. So I try to eat my off-plan foods away from home. I eat my muffins or cookies at a coffee house. I have a slice of pizza at a pizzeria. I don't buy a box of muffins or a whole pizza and bring them home.
Getting this strategy to work requires that your whole family understand what's at stake. It took me a couple years of harping on what "complications" means, but by now, my family understands that if my blood sugar is too high, I'm damaging my body. They want to keep me around for a while, so they understand that there are some foods that shouldn't be brought into the house--ever.
When other family members want to have treats at home, they are kind enough to buy things I don't like. For example, if someone wants Ben & Jerry's they buy the Chunky Monkey flavor that I find revolting, not the New York Fudge. By the same token, when my kids lived at home, I didn't buy them the brands of cookies I can't resist. There are plenty of others cookies they liked that don't tempt me at all, and those were the ones in the cupboard.
Over the years the nondiabetic members of my family learned that no one is doing themselves a favor scarfing down 300 grams of fast acting carbohydrate every day--particularly not people with a family history of diabetes and heart disease!
Medications Can Help
I'm not a big fan of medications because I've learned the hard way that drug companies lie about side effects and some of these side effects are permanent and can ruin your life. But I learned the hard way, too, that some of us (like, say me) can't get normal blood sugars no matter how low our carb intake. For us, adding a diabetic drug or two to our daily regimen may be the only way we can get normal blood sugars without a life of tormenting self-denial.
Drugs I have found useful over the years include metformin, acarbose, repaglinide and, for quite a few years, post-meal insulin shots, which I no longer need. Even with all these drugs I've never been able to eat more than 120 grams of carbohydrates a day and keep good control, but after many years of eating an extremely low carb diet--which was the only diet that would control my blood sugars before I was given insulin--120 grams of carbs a day feels to me like a completely normal diet.
Intense Insulin Resistance or Insulin Deficiency May Require Drug Help
Some people may find that eating a low carb diet is not enough to control their blood sugar because they are very insulin resistant. Perhaps they have been diagnosed with PCOS, or have to take a drug, like Prednisone that increases insulin resistance. The book, Dr. Bernstein's Diabetes Solution by Dr. Richard K. Bernstein, the distinguished diabetes doctor, recommends Metformin as an appropriate drug for patients on a low carb diet whose blood sugars are still not completely controlled. It isn't a cure by any means, just one more tool you can use to keep blood sugars under control, and if you limit your insulin resistance you may solve both weight and hunger problems that otherwise can derail your diet. If it isn't enough, you may need supplementary insulin which you can read about in its own post.