#DIYPS and Pizza, and wondering why we judge people with diabetes for how and what they eat

What’s your reaction if you read that someone with Type 1 diabetes just ate 110 carbs worth of pizza for dinner?

Go ahead, answer the question out loud (or write it down) before continuing.

No, really. Did you say it out loud? Or at least think about it?

Now, what if you find out that their BG never spiked (only rose 10 points) and then glided along in range (80<in range<150) for the rest of the night?

Were they lucky? Was it a fluke? Or was it the way that it (eating food) actually should work?

If you’re like many of us, your initial reaction (the one we asked you to say out loud so you wouldn’t mis-remember it later) was probably something along the lines of “that isn’t very responsible”. It just *makes sense* to judge someone for eating food that is “so obviously bad” for them. But, is the food bad for them? Or is what we’re trying to say (think) that the food is likely to lead to “bad” or out of range BGs, therefore it’s not a good idea to consume (or consume so much)?

Maybe we shouldn’t be blaming people with type 1 diabetes for not eating “right” or “trying hard enough” to get the health outcomes they want (and we all want for them). Maybe we all need to start working on putting together all the technology that already exists, in a way that actually allows people with T1D to live a normal life and worry less about constantly managing their BGs. The way #DIYPS does for me.

We also need to start working on changing the intuitive attitude that the problem is a lack of “compliance” (related – read this great post from Kerri on “compliance”) with diabetes management/treatment. Instead, why don’t we all work with patients to understand what is difficult for them about managing their diabetes, and what changes we might be able to make in the processes, systems, and technology they use to make it easier and more effective to do so.

(You may be wondering where this blog post came from. It’s related to #DIYPS – I tested the system one night by eating several slices of a frozen gluten-free pizza, which while convenient is often higher carb than the already-high-carb food. And, my instinct was not to talk exactly about how much and what I ate, because I’ve experienced so many times over the years a judgement from observers (with or without diabetes) about what I personally choose to consume – whether it’s a bite (or a correctly portioned serving) of dessert, pizza, or whatever someone thinks is not acceptable for someone with diabetes. Scott was surprised by the guarded way I was choosing to document and characterize this test, and this post is the result of our discussion.)

Thanks to #DIYPS, I’ve found (several times, the above scenario has proved not to be a fluke!) that I can eat large meals full of carbohydrates, and have no or minimal spike in my blood glucose. It doesn’t matter if it’s high protein, high fat, a mix, or lots of sugar (like a milkshake). And that’s changed the way I feel about talking about large-carb/”non-diabetes friendly” meals.

There’s a well-known stigma related to food for people with diabetes, but no one seems to know a way to remove the stigma. We’re wondering if tools like #DIYPS (and being able to see the data and more outcomes when someone DOES eat pizza and *is* ok BG-wise) will help change the conversation?

Dana Lewis