Bagel Hell

April 23, 2012By 0 Comments

What is it about that gooey bready goodness that draws us in?  Comfort foods that are so tempting, only to make you feel like a dead weight afterward.  Bagels, pizza and doughnuts, are the three ultimate Satan foods for people with diabetes.  It’s as if that cute little chunky bagel or cheese-dripping pizza coos and smiles at me before I put it in my mouth and then it takes a knife to my pancreas once inside.  I do not eat these foods often, if ever at all.  However, there is the occasion of a sporting event or a birthday party or breakfast at a friend’s where these food devils are the only option.  Then there is the once-in-a blue moon decision to just give-in when I’m standing in line at Panera on a Saturday morning and I’m torn between the cheese soufflé or the Asiago bagel with horns sticking out of its head.

People with diabetes are in a constant battle with these types of foods.  We have tried everything: We don’t eat the crust on the pizza, we hollow out the bagel with a plastic knife, and we even just eat the frosting off the doughnut.  But in the end, they almost always win.  Not in hour one, not even in hour two, but more towards the third hour after consuming one of these big bullies we see the spike on our blood glucose meter.  After it’s all said and done, you’re on the floor, knocked down by the doughy punch to the gut.  What does it, and how can this cycle be stopped once and for all?

If an average person eats 2000 calories a day (which does not include every shape and size, especially for women), you should be consuming between 50-60% of your calories from carbohydrates (which equals about 250 g of carbs total).  For someone with diabetes, they should aim for the lower end, and even try to consume less than 50% from carbs, so about 600-800 cals or 150-200 g from carbs.  That Asiago bagel with cream cheese that I mentioned kicks 560 calories and 60 grams of carb at you!!  Remember from my earlier posts, a significant portion of these carbs should come from whole grains, fruits, and veggies.  So, this leaves little room for those mean grains, like white-flour filled bagels, pizza and doughnuts.  The size of the grain particles in such foods are heavy and wide, not like the strong and lean size of the particles in healthy proteins or whole grains.  Combine this with the fat from the yummy cream cheese on a bagel, or cheese on pizza, and you get blood sugar hell.

It takes a lot of trial and error to figure out how these foods affect your blood sugar individually, and what kind of insulin requirements will help arm you with the best defense against blood sugar spikes.  For me, I am constantly playing with my dual-wave bolus on my pump.  Often, I find that if I give 30% of my bolus up front and 70% over a 1.5-2 hr period, I am able to contain my blood sugar so that it at least doesn’t go above 200.  These times and percentages are different for everyone.  Luckily, this is one of the major advantages of wearing a pump, you can program it to ‘think like a pancreas’ and slowly release insulin over time.  For people on injections, it’s almost impossible to figure out how you could spread shots over a two-hour period, but I’m sure there are some out there who have figured it out.  I would ask your CDE or Endo for advice on this before experimenting.

Now imagine if you don’t have diabetes, what these kinds of foods are doing to your poor little pancreas!  Those little insulin making cells, the ‘Islet Gang’, they are sweating and working on over-drive in the insulin mill to keep your blood sugars from spiking.  This is often thought to be a reason that people who eat very poor diets and have other risk factors like genetics, obesity and metabolic syndrome actually may ‘burn out’ their own pancreas.   If I had Islet cells that worked, I would want them to be lounging around drinking Pina Coladas on the beach.

Next time you may want to sell your soul to any of those little flour-filled devils, make an effort to work with your blood sugars and figure out what doses help to keep those high spikes at bay, or just pass on the dough and go for a piece of Angel food cake instead!

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