A Beginner's Guide to Diabetes

My story starts Labor Day weekend 2021. My partner and I were on vacation in Lake George, NY. It was our first vacation since the pandemic began. We rented a little house all to ourselves on the lake. It was a lovely trip. On our drive home, we picked up an early dinner. When we got home, instead of eating it, I fell asleep for the rest of the day. I didn’t think anything of it, I thought I was just tired.

For the next six weeks, every once in a while, I would have a day where I was just too tired to do anything, and would sleep the whole day. I lost 30lb without changing my diet. I also drank a lot of water. Around 3 liters a day. Besides that, though, I generally felt really good. Whenever I would have a tired spell, I would take a COVID test, and nothing, so I made a doctor’s appointment. I saw the doctor, explained what was going on, had blood drawn, and that was that. That was October 12, 2021.

The next day, I got a frantic (for a doctor) call. I was asked if I was sure if I had fasted before my blood tests. I assured them I had. I was told I needed to come back in as soon as possible. I made an appointment for the next day, Thursday, October 14th, 2021.

If you read the title of the article, you know what my diagnosis was. I was told I was diabetic. Really, really diabetic. My heart absolutely sank. I’ve been overweight my entire life. Up until that point, the only things I really knew about diabetes were it was sugar related, it was stigmatized as being a “fat person disease” that could cause you to loose a foot and lead to death. I knew there were needles involved. And of course, Wilford Brimley’s “diabetus”. I’ve been terrified of this diagnosis since high school. But just how bad was my diagnosis? Well, a here’s the first of many “medical things I’ve learned over the past year”:

  • Diabetes is all about insulin, the main hormone in our bodies that regulate how what we eat becomes energy for our body. It’s a big deal. There are two main kinds of diabetics, Type 1 diabetics, who do not produce insulin (or, as a friend describes, a Type 1.5 diabetic who no longer can due to some other circumstances), and Type 2 diabetics who do produce insulin, but it either isn’t enough, or their body is resistant to the insulin they do produce.
  • There are a number of tests to determine if someone is diabetic and what kind, but from what I’ve been able to understand, there are two main ones: a C-peptide test to determine if the body makes insulin, and a Hemoglobin A1c test to measure the average blood sugar levels over the past 3 months, measured as a percentage. If your body produces insulin, your A1c is the indicator of if you’re considered diabetic.
  • A1c is broken down into three ranges, <5.7 is considered normal or non-diabetic, 5.7-6.4 is considered at risk of becoming diabetic or pre-diabetic, and >=6.5 is considered diabetic. The A1c range for diabetes is usually given from 6-12. The scale stops as 12.

My A1c was 11.3. Probably gallows humor in hindsight, but I remember telling my partner the doctors were probably surprised I felt fine and was able to walk around with an A1c that high. The only good news? I made insulin, so I was Type 2 diabetic, not Type 1.

The endocrinologist who diagnosed me saw me for about 20 minutes.

First up was denial. I don’t eat much sugar! I basically don’t drink! I rarely have soda! I don’t even really do desserts! What I didn’t know was all carbohydrates turn into sugar when digested, so the bagels and apples I was eating were just as bad. I needed to drastically change how I ate and move to a super low-carb diet. To help me navigate this, I was given a piece of paper with about 24 items on it, 12 each of low-carb and high-carb foods, printed from some rando’s website.

I was told I couldn’t walk around barefoot anymore. The nerve endings in the soles of my feet may just stop working and I may wind up scorching the bottom of my feet like some horror story they knew of some guy at a pool. In fact, I could loose my feet entirely. In fact, go make a podiatrist appointment. Here’s a referral. This is where anger set in. I hate shoes. I’ve given talks on international stages barefoot. Needing to be shoed at all times was unthinkable for me.

I also needed to go make an optometrists appointment. Turns out the extra sugar in my blood could build up in my eyes and cause me to go blind.

Finally,I got my meds and my monitor. My endo showed me briefly how to use my blood glucose monitor, the finger prick thing. I was prescribed two medications: Metformin, a drug to help my body better use the insulin it makes, and Jardiance, a drug that blocks extra glucose from being reabsorbed by the kidneys. And that was it! That is how I was told I have a life-altering chronic illness and the instructions I was given to manage it.

I got home, took the rest of the day off, and picked up my meds. I don’t remember what I had for dinner that night, but I do remember being upset that all I had wanted all week was a cheesesteak, and now I didn’t know if I could ever have one again.

The next morning, I started my new routine. I took my blood glucose level, often shortened to blood sugar. It took me pricking my finger 3 time to get a working sample. I wasn’t taught how to fill the strips, or how to prick my finger to make it hurt less. I screamed in frustration, a bloody finger, and no idea how to get it to work, until it did. It was 264 mg/dL. 269 mg/dL is the estimated average for an A1c of 11. I took my meds.

That day, I tried to eat a low-carb diet. The pamphlet I was given wasn’t super helpful. I don’t really remember eating much.

Saturday was fine. Sunday morning, I went to the farmer’s market, and when I came home, I felt like crap. I went to sleep for the rest of the day… Monday, I still felt like crap. I took my blood sugar throughout the day and it was between 144-146 each time; high, but not dangerously so. I stayed in bed all day. I had water, and tried to have some Gatorade, a desperate attempt to have something in my system, not knowing if it was OK or not for me to drink. Tuesday, was the same. I had a telemedicine check-in with my endo. They weren’t able to diagnose anything, and recommended I go to the ER.

So, it turns out I had diabetic ketoacidosis. I was moved to the intensive care unit. I had my finger pricked every few hours and was given regular insulin injections. I didn’t really eat. I was in the ICU for 3 days. On the 3rd day, my partner later told me, she could tell I was feeling better because I had started complaining about the comfort (or lack there of) of the bed. I was finally moved from the ICU down to the general care area.

It took me being hospitalized for a life-threatening complication for me to get any real information about how I could manage my diabetes. I was on day 10 of being diagnosed. I had spent more time having the wonderful hospital staff manage it than I had. By the time Saturday had come around, I was feeling back to my old self and got to really dig into my diagnosis with the specialists who came to visit me:

  • A nutrition team came in and gave me a small book’s worth of information on how to manage my diabetes. They talked with me about different kinds of food and how they affect my blood sugar and gave me a ton of resources. They also set me up with a nutritionist to follow-up with after I left the hospital.
  • I met with a new endocrinologist (endo, for short). She was fabulous. I asked her tons of questions. I learned what insulin resistance means and she confirmed my diagnosis (Type 2). She gave me guidelines for how many carbs I should eat and she even talked me through how she calculated that number. She described the different kinds of insulin, and when each is needed (before that, I didn’t know there were different kinds!). At my request, she drew diagrams for me, wrote out formulas for me, and explained in detail basically every question I had about what was happening and why it was happening, from a biological perspective. Finally, she kicked me off Jardiance, having decided that that’s probably what caused my DKA and said she wouldn’t have started me on two drugs at once to manage my condition.

I was all set to leave, I had seen everyone, but then I had a showdown with who became my hospital arch-nemesis: the general practitioner who had to sign off on my release. I had gone through all of my required stuff to be released, but when I asked if I was going to be released that day, they said “no”, I needed sign-off from the endo who I had met with. I got it, could I be released? Still no. They were concerned that I may have a blood clot in my legs from lying down for a few days, so I needed to go get an ultrasound. That was a multi-hour round-trip. Ok, could I go then? Still no! When you’re in the hospital for DKA, you leave the hospital on insulin. A wonderful nurse came in and taught me how to inject myself with the insulin I’d be getting when I left. This was in the morning. Now, in the late afternoon, I was told I needed me to prove I could give myself my insulin shot. No problem, I thought, until the nurse brought it in for me. I had be taught how to use a home-use, pre-filled auto-injector. They wanted me to use an old-school needle drawing from a vial, which I hadn’t been taught. I told them I absolutely couldn’t do that, I hadn’t been taught that. The GP didn’t care. I was ready to refuse their service and request an new GP when I was told the endo had confidence I would do it at home, and the nurse came and gave me my shot. I was finally released around 6pm Saturday, the 23rd. For those curious, the hospital food wasn’t bad.

Starting that Sunday, for the next two weeks. I stabbed my leg with an insulin shot every morning. Much like my first morning trying to get a blood sugar reading, I cried and yelled and cursed my situation every morning. I hated it. I didn’t want this to be my life. I was deep into the depression stage. My diagnosing endo wanted me to come back in. I refused, and transferred my care to the new hospital endo. Fortunately, I had a 2-week checkup with my endo from the hospital. She saw I was keeping my blood sugar under control, and my final test results from the hospital, and she took me off the insulin and back onto Metformin. With Thanksgiving coming up, she also gave me one last bit of encouraging news: it was OK if my blood sugar got a little high, as long as it didn’t stay high. I could splurge a little for Thanksgiving, as long as it came back in check. And if it didn’t? I had the insulin to get it back in check. That single piece of advice has been the most helpful to me in living with my diabetes.

New diet, who dis?

After being released from the hospital, my endo set a new diet for me: no more than than 60 grams of carbs per day. For reference, the USDA guide recommendation is about 250 grams. For reference, 1 slice of sandwich bread is about 15 grams. Everything I knew about healthy eating? Turned on its head. Veggies? Carbs. Fruit? Lots of carbs! Chicharrones? Just fat and protein! I can have as much of those as I want! Hot sauce? Basically nothing; throw that shit on everything!

For the first time in my life, I had food I was afraid of. I broke down at dinner one night because I had to choose between eating peppers and onions or a tortilla with my fajitas. But I think my love of food actually, and tendency towards savory over sweet, really helped me through here. My first meeting with my nutritionist, I was given a ton of information breaking down lists and lists of ingredients and categorizing them by how much impact they had on my blood sugar. Fortunately, I didn’t need to do other, presumably common, things like cut soda and sweets out of my diet or learn how to cook for myself; I really just had to find bread alternatives. And make sure I had room for onions. I couldn’t cut onions out of my diet. I started putting together recipes in my head; desperation bred innovation here. I wound up making buffalo mac and cheese with cauliflower rice, which became a real comfort food for me. I’ve made breakfast for myself every morning since being diagnosed and have perfected the hotel buffet style omelette and put together an excellent avocado toast hack. We found a food delivery service that had carb counts on everything so I could plan my week’s food out. But then, my partner being the lovely person she is, got me an anniversary present that required me to rethink how I dealt with food.

Before I was diagnosed, knowing that I missed Austin, my partner had ordered me a bunch of sausage, jalapeño, and cheese kolaches. I was so excited to have them! But, they arrived after my return from the hospital. I was crestfallen, neither being able to enjoy a food nor a thoughtful present, all at once. I had been using MyFitnessPal to track my carbs, and I found it lacking. I hated the interface. I hated needing to pay for it to set my goals. I hated that even after paying for it it pushed upsells. And more than anything, I hated that it had a bunch of random user-generated food in there that wasn’t reliable (Where did they get these numbers? What’s 1 carrot compared to my carrot?). I needed something better.

Tracking my health

When I started seriously tracking what I ate, I quickly started obsessing over nutrition labels. I noticed something important; all nutrition labels (in the US anyway) give serving size in either grams (weight) or milliliters (volume). Figuring out how many carbs I ate was a matter of measuring and multiplication! My best friend, a chemistry PhD, recommended I buy a scientific balance for my kitchen (aka a super fancy scale). I got one. This is really where my frustration with MyFitnessPal really manifested itself. I had precise measurements for what I was eating, and I couldn’t properly track it! I started looking for a better way. I found the USDA FoodCentral API. I had an idea. I was going to make my own app.

Starting with the API, I made a simple web app (using Svelte, Vite, Firebase functions, and Firestore, for those interested). Everything in FoodCentral is measured by weight or milliliters, and baselined against either 100 grams or 100 milliliters, letting me accurately scale the nutrition of any food I put in. It was great! With a meal entry system in place, I could start fixing some of the other problems I had with MyFitnessPal. The first thing I cared about, tracking my blood sugar and food together in a timeline view, so I could see how what I ate affected my blood sugar. My nutritionist wanted me to take notes about how I was feeling throughout the day, so I added that. I was told I needed to loose weight, so I added weight tracking. I was told my excess water drinking was a clear sign of diabetes, so I added water consumption. After using it for a few weeks, I found that sometimes, I really just wanted to enter carb, protein, fat, and calorie estimates instead of looking up food. I added that! I now had a way to comprehensively track my health. I did what came naturally to me: take what I’ve learned and turn it into a scalable system. It gave me a safety net, something for me to unload my stress onto; I built something to help me process the trauma I was gone through. I built something to carry the burden of maintaining my health.

Cheat days on a health-critical diet?

Thanksgiving was my first big test. Besides breakfasts, I hadn’t really cooked since being diagnosed, and Thanksgiving’s usually a carb-heavy meal. I went to my parent’s house, brought my scale, planned out my meal using my app, and weighed everything to the tenth of a gram. I made gravy using modernist techniques (xanthan gum and gelatin) instead of flour. I used monkfruit sweetener instead of sugar in my cranberry sauce. I made way too salty cauliflower puree. My family played along, and I really appreciated it. We did make Pillsbury biscuits and my potato bread, brown butter, sage, and mushroom dressing. It’s something my partner likes too much, and I wasn’t prepared to find a replacement for. I went into the day knowing it was going to be tough, but kept my endo’s reminder in the back of my head; it’s OK if my blood sugar got a little high, as long as it didn’t stay high. My insulin shot was ready if I needed it. I had a plate of food, a little of everything, and the next morning, my blood sugar was OK. I trusted my doctor, and it got me through Thanksgiving. It was my first real challenge to my diet, and I came through the other side fine.

The next big challenge came in the middle of December. My partner had a business trip that required us to be in my old neighborhood in NYC. All of my favorite restaurants were there, and I didn’t have my scale. I had a bagel for the first time from Russ & Daughters. I fought through anxiety and fear to order noodles from Momofuku Noodle Bar for dinner. I came out the other end OK again. I was doing well.

I had a follow-up appointment with my endo in mid-January. I had been keeping really precise track of what I had been eating and my blood sugar. I felt good going into it. My A1c came back. 5.4. 5.4. In 4 months, through diet alone, I had managed to bring my A1c down almost 6 points! Not only was I no longer in the diabetic range, I wasn’t even in the pre-diabetic range! I was in a normal range! I had also lost weight! When I was admitted to the hospital, I weighed about 250lb. I now weighed 224lb. I was feeling great. My endo was impressed. She thought, going into the appointment, that she’d need to increase my Metformin dosage but, given where I was, she kept it the same. The system I had put in place was working.

Dealing with diet anxiety

For most of the prior 4 months, I had been sticking really strictly to the low range of my diet, trying to only have around 30 grams of carbs per day, total. I had been doing so well that I started to relax that, letting myself balloon it all the way up to a whopping 60 grams a day! I even added some fruit back into my diet! Salt on watermelon? A+. I had lost so much weight by this point I needed to go buy new pants because neither my pants nor my belts worked! It felt good! Then, disaster struck.

Remember how I said, for the first time in my life, I had foods I was afraid of? Well, throughout these first few months, once a week, sometimes more, sometimes less, when my partner and I were trying to decide on dinner, I’d have an anxiety attack about not being able to eat anything at a restaurant we were looking at. I was like Neo in The Matrix; where he saw code everywhere, I saw carbs. This was probably made worse both because I know how to cook (so know where carbs get hidden) and know that restaurant cooking is usually punched up with what amounts to bonus carbs. I had mostly gotten this under control, I thought, until early February. I had ordered one of my comfort delivery foods from a local restaurant, shawarma over salad, for dinner, but when it arrived, something had gotten crossed in the order, and instead of salad, I had only rice. It broke me. All of my anxiety about food and my diet flooded over me, and I stopped eating dinner. Not that night. At all. I rearranged my eating schedule to have a late lunch every day. I divided my daily calories between the two meals. To this day, thinking about having dinner on weeknights bubbles up feelings of dread. It’s something I’m still working on. All that’s to say, I needed a break.

At the end of February, my partner planned a little weekend trip to Philadelphia for us. We needed to get out of the house, and away from our routine. I used it as an opportunity to try and overcome some of my anxiety around food; I decided to not track what I ate while I was there. We wound up having a great weekend. I finally got the cheesesteak I had been craving since October! We got some big soft pretzels and had some great Chinese noodles and dumplings. We ate indoors for the first (and really only since) time since the start of the pandemic. Per my doctor’s recommendation, I took an extra Metformin pill at night. My blood sugar kept in range.

In March, my partner came through again. We had been craving the ability to go back to the movies, and she found a local drive-in movie theater. I had had a number of successful trips going out of my diet comfort zone, I decided to treat myself, and see what happened. I had a bag of buttered popcorn and Sno-Caps. It was delicious. I had really missed popcorn. The next morning, my blood sugar was fine again.

By April, thanks to these successful attempts at pushing up my carb limit, I decided to go wild and allow myself up to 90 grams of carbs per day! I could now have a full sandwich, on regular bread, for lunch, and not go over my carb limit! It felt freeing.

In a groove

By this time, I had expanded my app. I had added exercise tracking. I had deeply investigated choosing and tracking macros, the ratio of carbs, fat, and protein that make up your daily caloric intake, and added a whole system to manage and update it as your weight changes, including being able to set minimums as well as maximums. I had built in A1c estimation. I had built graphs to show weight and blood sugar trends. I added body fat percentage and BMI tracking. I put in the ability to generate reports! I had as close to a fully-connected view of food, blood sugar, weight, and exercise as I could have hoped for at that point. And the system worked.

On May 10, 2022, I had my second check-in with my endo. I now weighed 196lb. My app had estimated my A1c to be 5.4. It was 5.1. Only taking my blood sugar more would have made it more accurate. I had started wearing a smart watch again to track my resting heart rate. It had gone from around 120 beats per minute in October to around 70. I felt fantastic. My endo told me she talks about me to her other patients as proof that diet can control your diabetes. She reduced my Metformin dosage, even suggesting that if I didn’t want to, I could stop taking it! She didn’t think she needed to see me again until November. I still needed to exercise more. Fair.

By this time, I had my eye set on a weight loss goal: 180lb. Before I started drastically losing weight in September of 2021, I weighed about 285lb. Loosing over 100lb felt like a good, and now reachable, goal for me. By the end of June, I had lost 100lb. We went to a destination wedding mid-July and I overate a little. I hit my goal mid-August. I’ve updated my macro goals from lose weight to maintain it.

This week, I finished the final feature I’ve wanted to build into my app for a long time: routines. Set up checks for logging anything in the app on a reoccurring basis, optionally within a time range, and get a gold star if you complete it. I built it to give me a visual indicator of whether I took my medicine each day. And that bring me to today, writing this for y’all.

What I’ve learned

Throughout this process, I’ve learned a lot about diet, food, and health from talking to friends, specialists, and strangers about this journey. Hopefully some of this is helpful to you.

Diabetic friendly eating

I was explicitly told by my endo that I couldn’t eat less than 30 grams of carbs per day because that may push me into ketosis and she didn’t want to risk that, with me having been hospitalized for DKA once already. But, keto diet branded foods? They’re amazing. As with everything, you need to read the nutrition label and see what a serving actually is, and if the food really is low-carb or just marketing nonsense, but I find that most stuff in the supermarket labeled keto is a great alternative to other versions. I found I particularly liked the Sola brand of bread products, especially their golden wheat bread and hamburger buns. Be wary of “healthy” breads like Dave’s Killer Bread or Ezekiel bread, while whole grains and especially nuts in bread may be considered “healthier”, they also tend to bump up the carb count, so if you’re going to eat them, make sure you’ve got your serving size down right. Believe it or not, good old fashioned nothing in it white Wonder bread is not bad; a single serving is 2 slices and less than 30 carbs! Some potato breads I also found were tasty and lower carb than others around. When looking for a crunchy snack, again turning to Keto goodies worked here, specifically chicharrones. I kind of fell in love with Pork King Good’s Pink Salt & Vinegar chicharrones for a while. In general, though, I’ve found that between having a scale and a goal number of carbs for a snack or meal, I’m mostly able to eat what I’d like.

I’ve also found that natural alternative sugars, like monk fruit, erythritol, allulose, are all excellent substitutes for sweetness in most applications. Even if I wasn’t diabetic, I’d probably continue using these in recipes and applications where I mostly just needed sweetness, like pickled onions (I make so many of these), whipped cream, candied nuts, and the like. They aren’t 1:1 replacements in recipes where sugar’s ingredient function is more than really sweetness, so you’ll need to experiment to get those right. I’ve found Lakanto a great source for monk fruit sweetener, and King Author makes a Keto baking sugar blend (as well as Keto flour) that have both proven at least mildly successful for me.

A common thing, when looking at many “Keto” foods, is the advertisement of “net carbs”. Talking with my endo and nutritionist about this, here’s what I’ve learned: the standard net carb formula is total carbs minus fiber and sugar alcohol (what things like monk fruit, erythritol, and allulose are considered). How much food affects your blood sugar is called their glycemic index, or GI. Sugar alcohols generally have a GI at or near 0, so they can be removed when “counting carbs”. Fiber passes through your body undigested, so it, too, has a GI at or near 0. Both have said counting net carbs instead of total carbs works for some people, and doesn’t work for others. For me, between when I was hospitalized and my first meeting with my endo after that, I was counting total carbs. I now count net carbs.

Tracking blood sugar

First and foremost, unless your doctor tells you to, I wouldn’t recommend tracking your blood sugar “for fun”. For the most accurate reading, you’re suppose to draw blood for a reading at least 4x a day. It’s painful, it can be messy, and it requires a lot of equipment. That said, I did find it really interesting learning about how your body processes food. From my conversations, after you start eat, your body starts to produce insulin to turn your food into energy. About 2 hours after you’ve eaten, your blood sugar will be at its peak from your food. About 4 hours after you’ve eaten, it should have returned to normal. When you sleep, your blood sugar rests, too, and needs to “wake up” again. When taking my blood sugar, I’ve been told to always take it before meals, to get an accurate reading of my baseline. I also found that my blood sugar is constantly a little high in the morning, a combination of it still waking up and it being the tail end of my 24 hour medicine cycle (I take an extended release form of Metformin). Given how well I’ve managed my condition, I was given the OK by my doctor to cut back taking my blood sugar to morning and evening, and then eventually just morning, with the understanding that if it stayed high I’d need to up my dosage or come back in with some insulin. I’ve got two kinds sitting in my fridge: Lantus, long-acting insulin usually taken once per day, and Humalog, rapid-acting insulin taken to help reduce blood sugar spikes from eating.

For those who can’t reduce how many times they take their blood sugar, there’s a whole range of devices called continuous glucose monitors, or CGMs. They’re devices that attach to your body, usually the under arm or stomach, with a little needle sitting just under your skin to read your glucose levels. Some of these are amazingly accurate; a friend of mine who requires an insulin pump has one accurate enough that it’s allowed to control said pump. He’s described it as a game-changer for him. That’s not an introductory CGM, though. I tried the Libre Freestyle 2, a little white button that sat on the back of my arm. In theory it was great! I only needed to prick my finger when I calibrated it, and then it’d work in the background for two weeks. Whenever I needed a reading, I could tab my reader to it and I had it! It didn’t work for me in practice, though. I found the readings were constantly on the low end of their accuracy guarantee (around 80% accurate) and resulted in a lot of false alarms for low blood sugar. It constantly came detached. I had one where blood came up through it. One of mine in December was inaccurate to their standards, so I was sent another one, the next one I used fell off in less than a week, then the next one I put on failed to work after the day’s worth of calibration. 3 monitors in 2 weeks, none of which were super accurate? It wasn’t convenient for me anymore, so I went back to my regular reader, with my updated schedule, after discussing it with my endo. So basically, your mileage may vary with them, but they’re worth trying.

One last thing, if you’re taking your blood sugar by pricking your finger, here are two protips I learned from the ICU nurses: prick your finger on the side of your finger instead of the pad of your finger (it’ll hurt less), and ratchet down the force just enough for it to draw blood and no more (no need for extra pain, and you really only need a drop of blood).

Losing weight

If you came here from my Twitter, you probably weren’t expecting over 6k words on diabetes for how I lost weight, but the truth of the matter is, the only reason I lost this weight is I had a very strong motivating factor to do so. I’ve tried to lose weight since literally high school, and the fact that I now weigh less than I did then is a testament to that motivation. Not to sound dramatic, but being overweight basically became an existential threat. That was my motivation. For the first few months, I didn’t even really care how many calories I was eating, it was all about carbs, but the funny thing about being hospitalized and not eating for a few days is it reset my hunger levels. For the first few months, I probably ate between 1100 and 1500 calories a day through a combination of not being hungry, not being able to mindlessly eat carbs, and not wanting to just eat meat when my carb limit was expended. I found in that time that I wound up eating, by grams, roughly the same amount of fat and protein, so when I started to actively care about macros and losing weight, I used that as my baseline instead of trying to fit into a specific diet. With my current weight and weight maintenance goals, I look to eat about 1900 calories a day, with about 100 grams of carbs, 119 grams of fat, or about 70% of my remaining calories, and 115 grams of protein, or about 30% of my remaining calories. But finding the right ratio for you is personal and based on a number of factors. There are only two constants I’ve seen in this journey: energy in needs to be less than energy used, and sustainable weight loss is a long-term game, not a short-term one. I don’t stress if my weight goes up or down a few pounds day-to-day, or if I have a cheat day, or week. The long-term trends, and the strategy for safely losing weight (less in than used, but don’t go hungry) is what’s important.

Diabetic health care

Finally, I’ve had the opportunity to reflect on the health care I received when I was diagnosed, and have been able to talk to others, some of whom were recently diagnosed, some diagnosed a long time ago, and I’ve seen one common thread emerge: no one seems to get good advice. Everyone I’ve talked to had more or less the same story I had; they were given a blood glucose monitor, told to eat fewer carbs, told to get some follow-ups, then shoved out. It doesn’t seem to matter what your health insurance is or where in the country you are, everyone really seems to be more-or-less left to figure it out, and cope with it, on their own. The first website I went to look for help was the American Diabetic Association. Most of the content on their website wasn’t more helpful than what I had been given. Their diabetes food hub immediately served me a wall of Splenda sponsored recipes, which caused me to immediately check out. Even with the great team I’ve got now, I had to piece a number of things together myself. If I were to guess, it’s probably a combination of nuance is hard, an information dump on top of the diagnosis would be overwhelming, prioritizing getting it under control, and time is short. I’m really thankful I had a friend to reach out to who had gone through this already who was able to reassure me that things got easier, and that I was able to do that for someone else, too, but we shouldn’t rely on an ad-hoc network for these things. This is such a prevalent disease I’d have assumed support networks and reliable information would be easy to come by, but it’s really not. Anything beyond surface-level advice is glaringly absent, or devoid of much other than opinion. My hope with sharing my story is that someone will read this and take from it what I got from my friend, and hopefully find something useful to help them on their journey, too.

Thanks for reading. Love y’all!