Two weeks into it: some perspective

I edited the personal details out of this chart, but you can see that the general trend is definitely in the right direction – down. In fact, as of today my average over a little less than two weeks of testing is only 8 points higher than the maximum needed to diagnose. I've still got a lot of work to do, but it's encouraging to see some movement on these numbers.

Some thoughts.

1. My glucometer is my new best friend. I hate needles, and the thought of having to stab myself several times a day really pissed me off at first. It only took me a day or so to get over that, after which my curiosity kicked in and I started testing obsessively to try and figure out exactly what was going on with my blood from one hour to the next during the day. I still don't like the finger stick part, but it's a huge relief to have such an easy, readily available and accurate way to assess the effects of various foods and activities. Everything I've been reading suggests that the complications I'm so terrified of are not necessarily inevitable – they're the result of years of elevated blood glucose (BG) levels, and in most cases, if people keep their BG within a healthy range, there's very little risk of developing those complications. Part of the problem in the past has been that the recommended BG range for diabetics is significantly higher than what's considered normal for a non-diabetic – so, following those guidelines, even someone who's maintaining supposedly "good control" would still have BG levels high enough to cause damage over long periods of time. I'm still researching this, but for now my goal is to do whatever it takes to maintain my BG at non-diabetic levels.

2. I'm no longer afraid of insulin. I'd still rather not have to use it – I really, really hate injections of any kind, and if it ever comes to that for me I'm reserving the right to get pissed off in the extreme all over again. At the same time, it's reassuring to know that if diet, exercise and oral medications aren't enough at some point, there's still a way to keep my BG at what I consider a safe level. I'd rather shoot up than lose my feet!

3. Goodbye snake, hello bird. Getting used to eating differently has been the most challenging part for me so far. For almost 20 years I have employed an eating pattern Mr. A refers to as "the snake" – going long periods of time without eating much of anything, then eating some BIG meal that would supposedly tide me over until the next day. This kind of eating is a disaster for someone with my kind of metabolism, I now know. Now, I'm supposed to eat every 2-3 hours throughout the day, but only very small amounts of food, with the goal of preventing my blood sugar from ever going way up or way down. It's like how birds eat – constantly having a little something, but rarely having very much of anything at any one time. I'm not used to it yet, and I don't like it very much. I resent having to constantly interrupt what I'm doing to go eat something, and I miss that dreamy, druggy feeling I used to get at the end of an especially wonderful meal. Before, I used to eat until I felt full. Now, I only eat until I no longer feel ravenously hungry, then stop.

4. I'm still hungry all the time. Part of this is no doubt because I'm eating less than I used to – but that can't be the only reason. Even when I used to eat a lot, I was always hungry – always! I could finish a whole plate of food and feel my stomach stretching so much I knew it was full, and I would STILL feel hungry. I know I already wrote about the idea that a predisposition to diabetes can contribute to people getting fat by making them hungry all the time ... You're hungry, so you eat more, which makes you fatter, which increases your insulin resistance, which increases your blood sugar, which makes you even hungrier, etc. etc. Or something like that. This week I learned that it apparently works the other way as well – reducing blood sugar helps normalize your appetite, which means you eat less, which means you lose weight, which decreases insulin resistance, which decreases your blood sugar. Getting the blood sugar numbers down isn't easy (and you still have that tendency toward intense hunger), but once you're heading in that direction, all kinds of good things start happening.

I've also read reviews of a few studies that suggest people with diabetes genes may need less food to gain the same amount of weight as regular people do. It's a genetic variation that some people think used to be an advantage back when people had to chase down their own food and sometimes went a long time without much to eat – the better you could do on fewer calories, the more likely you were to survive hard times. These days, at least for someone like me, that adaptation isn't such an advantage. Because it's genetic, chances are if you have relatives who are diabetic, you may be predisposed to it, too. It runs in my family on both sides. Too bad I didn't know that until after I was diagnosed.

Not that I'm trying to deny all responsibility for the situation I'm in. If I had paid more attention and worked this hard a few years ago, back when I was still "normal," I might have been able to avoid or at least postpone this whole thing. But I'm learning that there's more to becoming diabetic than just being overweight and underexercised. Somehow that makes me feel better: at least it's not ALL my own stupid fault.

5. I (heart) my treadmill. The other day, just as an experiment, I ate a half-cup of organic fiber cereal with a half-cup of skim milk. It wasn't very tasty or satisfying, but the dietician had recommended it as an alternative to my usual buttered toast and honey, and I wanted to see how much it would raise my BG in comparison. The carbs were so low I didn't expect much to happen, but when I tested again 40 minutes later my BG had shot up more than 100 points (that's a lot!). Rather than flip out (which I desperately desired to do) I decided to continue the experiment by getting on the treadmill. I watched the first 68 minutes of the Long Goodbye (as recommended by Julie) while strolling at 2.5 miles an hour up a 6-8% incline, and when I tested again I got my first-ever reading in normal range – a 94. I was shocked to find out how well it worked! I've since tested various other forms of exercise, and sure enough – it really does lower my blood sugar dramatically, and quickly. Good to know. (P.S. The toast, strangely, seems to be okay for me to have – just not first thing in the morning anymore.)

6. Food is still good. There are about six million different and conflicting schools of thought about what constitutes the ideal "diabetic diet." Rather than glomming onto someone else's idea of what works, I'm using my meter as my guide. So far, except for the tiny portion sizes, and having to remember to eat constantly, most of what seems to work for me is not that different from what I used to eat before. Even sweet stuff that I might have thought would be off limits seems to be okay, as long as I don't eat too much of it. As an example, two of my favorite little cinnamon crisp cookies have the same carbs and only 2/3 of the calories of half of a nasty-tasting sugar-free fake chocolate South Beach Diet snack bar, but the snack bar raises my BG almost twice as much as the cookies. A lot of the food recommendations I've been seeing start with sentences like, "Take one 100-calorie pack of sugar-free chocolatey crisp cookies, crumble over one sugar-free chocolate pudding cup ..." – which I guess might be helpful for people who are accustomed to eating a lot of sugar-filled pre-packaged snacks they can no longer have. But those suggestions don't do much for me. I've never been in the habit of eating that kind of crap to begin with, and I'm not going to start eating the sugar-free diabetic-friendly versions of it now.

7. I have a new appreciation for Diet Coke. Not that I'm about to start drinking soda every day now, even though diet soda is one of the few things of which you're "allowed" to have as much as you want. I always thought, and still think, that diet soda tastes weird, and especially dislike that slippery, cool, synthetic taste that stays in your mouth after you're done drinking it. Why can't they come up with a diet drink that tastes normal, I wondered. But yesterday between doctor's appointments (see #8) I came to appreciate the difference. I was dying for some way to fill up my starving belly, and had the unprecedented (for me) idea of getting a big Diet Coke from the drive-through at Jack in the Box on my way to my next appointment. So I ordered it, paid for it, and lifted it to my lips as I drove away ... and then it occurred to me, what if that oh-so-easily-distractable teen gave me regular Coke instead of diet? That would be very, very bad for my blood sugar right now! But that slippery synthetic taste is impossible to miss, and I knew from the first mouthful that it would be okay for me to drink the whole jug of it if I really wanted to. That was a relief. Although I am now wondering: since when is a "medium" soda so big you have to use both hands to drink it?

8. Eyes and feet are fine. Yesterday I took another afternoon off work and visited an ophthalmologist and a podiatrist. I haven't had any symptoms of eye or foot problems, but I figure – I don't know how long my blood sugar has been high, and if there's anything wrong with other parts of me I'd rather just get all my bad news at once and figure out how to deal with everything together. Thankfully, there was no bad news to deal with. Everything checked out totally fine and healthy, which means that if I'm relentlessly hardcore about getting my sugar down right away by any means necessary, and diligent about keeping it low for the rest of my life, my fears of blindness, disability, dialysis, amputation and early death will probably never come to pass. And if they do, at least I'll know it wasn't because I was slacking off when I could've done something to prevent it.

9. Losing weight feels good. It's funny that the number on the glucometer has been so successful in keeping me motivated, when the number on the scale has failed to do so for so long. But whatever works, I guess. I've lost several more pounds since last week and am slowly getting used to the idea that I'm not going to have this kind of body anymore – that I really can't have this kind of body anymore. I'm okay with it. The main kind of body I want is the kind that is capable of sustaining life and feeling good. If I have to stay on the lean side of normal to achieve that (as recommended by the diabetes experts I'm coming to respect the most), then that's what I'll do.

10. My self-absorption and obsessive personality are finally coming in handy. I've been reading everything I can find about type 2 diabetes, weighing and logging every gram of food I eat and what time I eat it, testing my blood 8-10 times a day, taking my blood pressure every day, keeping a pedometer in my pocket (with the goal of walking at least 10,000 steps a day), and writing down every minute of exercise. I'm sure eventually I'll be able to lighten up on this rigorous schedule of self-examination, but for now it feels good to be doing something constructive with all my extra energy and anxiety.

Thanks to everyone who's expressed support – it helps! One of these days I really will do a trip report, and write about some other things that have been going on that are semi-interesting, at least to me.