Commitment

Type 1 and LADA
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Commitment

In the 1945-1988 years I had only one rule to follow. Don’t eat foods containing sugar. My doctors never mentioned carbs. I was very committed to following that rule. I became so used to using artificial sweeteners, that a teensy taste of something containing a lot of sugar was too sweet, and I did not like it. Having only one rule to follow made it easier.

In 1988 I read an article in a magazine saying that diabetics should restrict the number of carbs they ate to help keep their blood tests lower, and more stable. Why didn’t my doctors tell me that? That was my first exposure to carbs. Then I found that some carbs acted faster, and others more slowly. I started eating smaller portions of the foods
with faster acting carbs, and I stopped eating some foods. There were more rules to follow, and things became more complicated. Then there was using my first meter in the 1980s, basal and bolus insulins with carb counting in the 1990s, and my insulin pump in 2007. Things were very complicated then. It was so much simpler in my early years to just avoid sugar. It was hard to be committed to having tight control with all these newer rules, and devices to follow. I sometimes wanted to just drop everything, and go back to the old ways. I had no complications despite all the high blood sugar I must have had during my first 40+ years, so convincing myself to follow all the new rules and use the new devices was difficult.

I did not know any other diabetics until I joined some diabetes websites in 2006-2007. That was 61 years after my diagnosis. That turned things around for me. I met so many diabetics like me, and saw they were struggling with the same problems I was having, or had previously experienced. There were so many not taking good care of themselves, and having diabetes related complications. I could feel myself becoming more and more committed to having really great control. I had always worked hard to have good control, but my online experience made me more committed than ever before.

My commitment has led to my having 71 years of type 1 with no complications except some neuropathy, and other minor nerve damage. I do not need any medication for that, and I am very fortunate that having only the “no sugar” rule for so many years has not caused me any major problems.
I am definitely committed to being committed. Perhaps diabetics who are not committed should be committed to online diabetes support groups! :wink:

What does commitment mean to you?

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Not exactly responsive to your question, but that “no sugar” rule that sounds so naïve and unsophisticated may actually have a factual underpinning after all. In Gary Taubes’s recent book The Case Against Sugar, he argues—with a great deal of circumstantial research—that sugar may, indeed, be the villain it used to be looked upon as, not because it’s a carbohydrate but because its specific chemical nature and behavior set it apart from other foods, including other carbohydrates. Whether you agree with his conclusions or not, there’s a lot of thought-provoking material there.

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I agree wholeheartedly, @Richard157! Your story traces a nice evolution of how your thinking changed over the years. You were wise to not look at your lack of complications in your initial 40+ years as evidence that you didn’t need to change your ways.

Willingness to change, especially eating habits, is an essential trait of living well with diabetes. It took me 28 years to take that leap; I was a reluctant learner. We also must accept the fact that some people can do everything right and yield poor results, but in general it is worth the effort to keep blood glucose levels as close to normal as possible.

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Wow @Richard157 that has so many resonances for me. I was on the old R/NPH thing and came to Basal-Bolus MDI after 20 years of the pre carb-counting, “exchange diets” regime. I too spent all that time religiously avoiding sugary foods of all kinds but absolutely clueless about all the other kinds of carbs–starches, grains and the like.

In terms of commitment, that initial 20 years of sugar avoidance gave me a strong resistance to sweets similar to yours. Sugar avoidance was a big part of the deal back then and we were indoctrinated in it pretty heavily. Nowadays the rule is you can have anything as long as you bolus for it, but I think for us old-school T1s that’s still kind of alien and just not something I’m ever going to feel comfortable with. When I was finally introduced to carb counting it was more the other way around: I tended to expand the category of “stuff to minimize or avoid” to other high glycemic-index stuff, so eating a low carb diet isn’t as hard as it might be for some.

I also share that experience of not really knowing any other T1s for decades until the DOC and sites like this one came along. It was only a chance meeting of another guy with it–the ex-husband of a friend who I happened to meet at a party–that put me on to the whole basal-bolus MDI thing back around 2000; I’d never heard of it because I’d never had access to a specialist. With sites like this one, now I’m surrounded by people who are trying different things and sharing their experiences. Without that I probably wouldn’t have taken the leap to switching to a pump four years ago and more recently getting a CGM. It’s made a huge difference in commitment to maintaining control and the tools available to do it

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What a wonderful testimony and history Richard. I’m always inspired by those who have dealt with the evolution of treatment and technology. I’m so thankful for what we have today.

Having numerous complications when I was diagnosed (long story) what my commitment means to me is life. Saving my vision (or what is left of it) and reversing all the other issues created by my pre-diagnosis neglect. From the beginning I chose to look at this commitment to control as the only option and consider it nonnegotiable.

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[quote=“Richard157, post:1, topic:59428, full:true”]
What does commitment mean to you?
[/quote]Hi Richard! It’s me, Karen :slight_smile: Commitment means so many different things for me depending on the idea or thing that is in front of me. I am committed to staying well and living happy. I am committed to helping advocate for diabetes of all types, certainly in the young. And I am committed to fighting for the supplies we need to live well and happy with this and any other condition we may wear.
One more thing…I am committed to Beating The Odds (like you) and hope you don’t mind me dropping your book in here.

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P.S. Depending on your present attitude toward the ADA as an advisor on nutrition, your opinion after reading the book will be either the same or worse. It definitely won’t get better.

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I had a similar ‘No Sugar rule’, when diagnosed in 1965. But back then, was ‘easy’ to identify the off limits foods. Candies, cakes, cookies, donuts, etc. There weren’t vending machines and convenient stores around every corner. We had home cooked meals, often with food from our garden, and rarely had dessert or sweets except on special occasions. Made our lunches to bring to school and I had to get white milk while siblings enjoyed chocolate. Today ‘sugar’ is hidden in just about everything.

I started on one injection of Lente each morning, and then usually ate eggs with toast, or cereal. Since my morning ‘urine’ checks were often ++, my post breakfast BG must have been sky high, even though I had not eaten ‘sugar’. That continued for almost 15 years. Every 4-6 months, I would go to pediatrician (not an endo), and would review my urine test logs. All they did was tell me to increase dosage by 1 unit, and see ya next time. I don’t recall ever having to ‘call in’ logs between visits. Dr told my Mom I was lucky, since many of his other patients ended up in DKA or experienced serious hypos. I then went on to college, continuing 1 injection of Lente /day, rarely testing urine, and seeing endo once. I didn’t feel ill, and life seemed normal.

I’m curious about what your insulin regime was. In 1945 was Lente available ? Or were you doing multiple injections of R ?

In 1984, I started NPH+R ‘MDI’, and started BG testing. But again, it was only to log the numbers, and at the next visit with doctor, they would increase dosage. The only adjustment was +1 unit at meal time if I was above 200, which I usually was. No carb counting, just using the Exchange system. Oh how I wish I knew more back then. Commitment is one thing, but knowledge is also important. I didn’t know what I didn’t know.

My Commitments were to try to live a ‘normal’ life, and expected that complications would come sooner or later, regardless of what I did. Doctors told me ‘we don’t know why’ some get more complications than others, and in those days, doctors had all the answers, no place else to turn. It was a question of when, not if. And in 1985-6, I learned about eye complications, and lost partial vision in one eye. Right on target, about 20 years after diagnosis.

The biggest change for me came when I started MM CGMS in 2007. Even though I struggled with it, it led me to support groups, and eventually online DOCs. When starting MM pump, I replaced the exchange diet with carb counting, but a carb was a carb (NOT so said my cgms). By this time, A1Cs were also tested frequently and the DCCT study results were hung over my head at every doctor’s appt. (A1C goal was 9, and I could be in the ‘special’ Nines club.) So my commitments were influenced by that, along with goal of preventing any further eye complications. New goals were to keep my BGs as close to ‘normal’ as I possibly could, and I adopted the ‘eat to your meter’ philosophy instead of listening to the CDE and dietitian.

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Excuse me, but why did this P.S. get dropped in here? When I was dx’d long after Richard but well before the DOC and all the books, the ADA and JDRF were amazing. That “nutritional adviser” crap that gets tossed out that the ADA gives to diabetics is not even true. In fact, we were advised to eat a balanced diet even way back when, and my own recommendation was a list of exchanges to go with my likes/dislikes/weight/ and the old fashioned insulin regime so that we always had something for our peak and valley life to work with. I still use the exchanges to count my plate sometimes. Glad I learned it because not every choice I make has a label.

Hopefully we have moved long and far from getting diet advice from books. The only book I am committed to is the OLD Betty Crocker Christmas Cookie one, so I can make stuff for my loved ones. Oh and an old Healthy Choice Vegetarian Book. LOL

I think the T1 tribe are pretty capable regarding getting nutrition from our diet choices. For anyone who believes the BS regarding ADA advice please know that what they actually say is “Living with diabetes doesn’t have to mean feeling deprived. We’ll help you learn to balance your meals and make the healthiest food choices.” and the food advisor goes on to say “Can I eat this? . . . Meal Planning and Tips - Managing diabetes is a challenge that requires finding the right balance among food, physical activity, and medicine, if needed. Healthful food is key to managing diabetes. Only you can decide what to eat and using a meal plan as a guide can make it easier.” And yes, they want to sell you a book but you don’t have to buy it!

Those monsters, suggesting we can enjoy healthy eating! I have a new commitment and it is to defend the ADA for what they do for diabetics. Food advice is the least of it!

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I, too, remember the “sugar-free” days. Growing up, I spent 13 years on NPH avoiding all sugary treats. In some ways, diabetes was so much more simple back then: four tests a day, two or three shots a day, avoid sugary things, make sure your meal roughly matched your meal plan from the exchange list, and that was about it, largely forget about diabetes the rest of the time (except for the severe, dramatic lows that hit once or twice a year). My control was about as good as you could expect on such a regimen, but I was a “model patient” in that my A1c was typically around 7% on two shots a day due largely to being very strict about my diet. I rarely “cheated” growing up.

I was quite unfortunate to be 23 years old and in university when I switched to Lantus and was suddenly told that I could eat whatever I wanted as long as I bolused for it. I think if I’d been ten years older, I would have just stuck with my old ways. But instead, at that age of course I went out and ate dessert at every single restaurant, I tried everything I’d never experienced as a child like candies and eating a sundae and milkshake and brownie for the first time ever, ordered baked goods and lattes at coffee shops, and ate treats whenever they were offered to me, because my doctor said I could. And, unfortunately, I believe I developed a sweet tooth and somewhat of an addiction to sugar. It was very, very, very hard (and still is) for me to stick with eating a more LCHF diet. These days I’ve developed food allergies that fortunately prevent me from eating most sugary things spontaneously, but I still eat too much of them at home, and the years of “eating whatever I wanted” led me to gain a significant amount of weight. I wish that, instead of suddenly being told I could eat whatever I wanted, I was instead told that rather than getting an A1c of 7.5% I could get an A1c of 6.5% with this new carbohydrate counting method and keeping my det the same.

I remain very committed to diabetes. I think the majority of people are. But I think these days things have become a lot more complex and there are a lot more mixed messages, and we are aiming for much, much tighter control, which makes things challenging.

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Thanks, Karen! I agre with everything you have said! :slight_smile:

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When originally diagnosed in 1973 that was the exact information I received in addition to calorie counting. :blue_heart::blue_heart::blue_heart::blue_heart:Technology has come along way & now my pump & CGM are my security blanket.

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Randy5 experiencing some of the many complications than can unfortunately launch an attack may or may not be due to poor habits but instead the weaknesses of your body. The same as how diseases affect different individuals differently due to weaknesses ofor their body very seldom text book. I understand your concern with vision loss because I too am there. Thankful that I don’t have the neuropathy of the feet or hands. Best of luck. Each day is a new day to tackle.

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