It’s popular knowledge now in America that the obesity epidemic has given rise to an epidemic of metabolic syndrome and type 2 diabetes. In other words, (with the right genetic predisposition) being fat can make you a diabetic.
What is less appreciated is that being a diabetic can make you fat.
If I were to characterize my diabetes care, I would say I aggressively treat to range. If I see my blood glucose (BG) start to rise, I bolus early, rather than waiting until I am actually high and correcting. I admit it– I prefer to run a little low rather than a little high.
The benefit of this aggressive treatment is that I can prevent some degree of hyperglycemia. The downside? I frequently have to correct on the other end– eating to bring my BG back up because I too aggressively treated a high. I correct usually with 5 – 10 grams of carbohydrates, in the form of dry crackers, or straight sugar if I’m below 60 mg/dL. (I don’t like glucose tabs much, and I try not to correct with foods I actually like because, as a diabetic, my relationship with food is screwed up enough as it is.)
I am fairly insulin and exercise sensitive at this point in my life, so I end up needing to correct frequently. On average, I end up eating about 40 grams of corrective carbohydrates per day. That’s 160 extra calories (ignoring for simplicity any extra non-carb calories the crackers contain) a day.
One hundred and forty extra, totally non-nutritive calories. And not enjoyed, either– it’s medicine, not food. Ugh.
To gain one pound, on average, a person needs to eat an extra 3,500 calories. At 160 extra calories per day, I will gain a pound about every three weeks. Over the course of a year, I will gain 17 pounds.
The way I treat my diabetes is making me fat.
So what are my options? The first and most obvious is to use less insulin, treat less aggressively, correct less. I’ve tried that, and apparently I’m not patient enough or clever enough to do that and not be high too frequently for my liking.
The second is to cut the excess calories out of what I would normally be eating to maintain my weight. That’s what I do, and it works, but it’s lame. That means I eat less real food, and get far too much of my daily caloric intake in crackers.
Of course, complaining that I dislike my source of calories is pretty clearly a case of First World Problems. But I live in the first world, and I care about my health, and eating tons of carbs in sugar is not the best thing for me, I know.
So what’s the solution, other than a cure and/or artificial pancreas that takes the burden of insulin dosing out of my hands? I’ll take suggestions.
In the meantime, my diabetes and I will continue to lock horns, as it tries to make me blind and fat, and I do my best to resist. I hate that bitch.