Wednesday, February 27, 2013

Work out buddies...

I was reading a blurb recently from Real Simple Magazine about how thin people stay thin and I was particularly struck by one point the article made: thin people have thin parents.  Citing that only 30% of this is genetic, the rest is environmental factors I am hopeful that HB and I are on the right track to keep our kids within healthy BMI ranges.

By modeling healthy choices and an active lifestyle, GW and GV are growing up with exercise as a regular, normal thing rather than something they'll have to learn about after possibly accumulating excess weight.   HB and I constantly take them out with us when we go for runs and they both seem to take their role in the process quite seriously - GW always yells "go go GO!" and GV wails whenever we slow down or stop, so it's definitely a family event.  Ultimately, when they're big enough, I fully plan to take them out jogging with us but for the time being their motivation is enough participation to keep us all satisfied.

Course, now that we are four days into Insanity both little ones are figuring out just how to be involved in our new exercise routine.  GW has decided that he's big enough to get his interval training groove started and, GV, well, as long as she's within arms distance (if not actually in arms) she's happy.  Perhaps it is not exactly the best way for us to do the work out and perhaps they're both trying to run before they can crawl (figuratively for one, literally for the other), but hey, they're at least starting down the road of a good habit and it's time together.    



Saturday, February 23, 2013

Insanity!

Alright, people, the time has come... Sean T has officially re-entered the building!

For the first time since Fall 2011, HB and I restarted the Insanity work out routine today and, seriously, there is a reason the program is named what it is!  For those who aren't familiar with it, this 60 day program combines plyometrics, body-weight lifting and cardio interval training in a way that would make even the most fit, manly, stoic marine cry.  Constantly encouraging quicker speed and therefore more reps, Sean T makes a 30 minute work out feel like a three hour lifting session... it's insane!

The first day of the program is a fit test that is comprised of eight exercises lasting one minute each.  So along with before pictures (over my post-pregnancy body will those be posted until I have after shots to post as well!), this is a way to track your physical improvement as you progress week by week through the program.  While I am not exactly happy with my initial results here they are --

Switch Kicks: 84
Power Jacks: 49
Power Knees: 99
Power Jumps: 35
Globe Jumps:  8
Suicide Jumps:  15
Push-ups Jacks:  33
Low Plank Obliques:  53

The last time we did Insanity, we made it about four weeks into the program before we were worn out and in need of a much needed break (which we took as running a half marathon).  I'm really hoping that we can physically last longer this go around and get the same - if not better - trimming and toning results as before. Starting with a BMI of 20.3 and body fat reading of 18.3%, I have 6 lbs to go to get back to my pre-pregnancy weight and 14 lbs left before I am back to my ideal weight.  We'll see how long this takes.

That said, I am disconnecting my pump, putting on three bras (so not kidding), rolling up the living room rug, and cursing Sean T for the ridiculous awesomeness that is INSANITY!


Friday, February 22, 2013

Lent Recipe #2: Mushroom Tart

So it seems like there is this misconception in pop culture that whatever you forgo or alter for Lent must make you miserable in order to be a true expression of piety -- almost as if we socially expect Catholics to desperately stand in the pouring rain outside of the local bakery and lustfully gape at the shelves of tantalizing, seductive cupcakes until Easter when the poor, starving soul can finally be rewarded with dessert.  And while I readily acknowledge that it is difficult to give up a worldly comfort for the sake of spirituality (and no, I will never give up sugar), I fully reject the connection of misery with the practice of abstinence. 

You see, at just about two weeks into Lent, I am feeling like my family isn't necessarily missing anything in our lives by eschewing restaurants.  Don't get me wrong, I've thoroughly screwed up dinner a couple times and the other nights certainly aren't five star quality, but I am finding the experience to be a worthwhile exercise of "plan B" -- which, admittedly, is something I am not very good at.  It seems to me that the value of Lent is in recognizing something tangible or excess that we place far too much value in and essentially resetting our lives in a bigger context.  By using the opportunity as a learning experience to better ourselves, we are attempting to find "... glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope" (Romans 5: 3-4). 

By giving up restaurants and any form of prepared food, HB and I are without the convenience of just grabbing a bite wherever, but we're starting to recognizing the superfluous nature of going out.  We can make what we like at home and, frankly, the cost of only eating what can be purchased at the grocery store seems to be more time together... and I like those prices. 

So... the recipe for this week is for an awesome mushroom tart.  I originally got the recipe from Bon Appètit magazine, but I've been tweaking it over the years and I think I've finally found the combination of ingredients that I think is easiest, healthier and tastes better than the original (whatever you do, don't skip the Cognac or change the chesse!).  I typically make my own pastry crust, but for convenience sake I've listed a store bought crust to save you precious weeknight time:  

Single pie crust 
1 roughly chopped maitake mushroom (AKA "Hen of the Woods")
1/4 cup minced shallots
2 Tablespoons Cognac
2 Tablesppons chopped fresh rosemary and thyme
2/3 cup grated Gruyère cheese
3/4 cup milk
2 egg whites
1 whole egg 

Melt butter in heavy large skillet over high heat. Add chopped maitake mushrooms. Season with salt; sauté until deep golden, about ten minutes. Add shallots and sauté for two minutes. Add Cognac and boil until absorbed, about three minutes. Mix in 1 tablespoon of the herbs. Cool.

Preheat oven to 375° F. Line crust with foil. Fill with dried beans; bake until golden, about 15 minutes. Maintain oven temperature.

Sprinkle 1/3 cup cheese in crust. Cover with mushrooms. Whisk cream, yolks, egg and remaining herbs in bowl. Pour custard over mushrooms. Top with remaining cheese. Bake until filling is set and top is golden, about 30 minutes. Cool on rack 15 minutes and serve. 


Tuesday, February 19, 2013

12 Weeks

I cannot believe that GV is twelve weeks old already, time is just flying by.  She's growing beautifully (up to 14 lbs 6 oz) and is a gorgeous roly poly, chubby baby who is full of big smiles, adorable "ah-goos" and, in her opinion, all too many hiccups.  Although she has her moments, I feel thoroughly blessed that she is such a sweet, happy baby!

The last couple weeks have been rough on her though -- all of us actually -- because each of us have had the winter scuzz.  Despite our best efforts, we've played hot potato with these germs and, considering her tiny immune system, it seems like GV is bearing the brunt of it with a significantly congested nose.  She hasn't been running a fever or anything super serious, but when your three month old baby sounds like a snuffleupagous and develops a previously undiscovered knack for screaming you're justified in excess concern.

So with this in mind and hearing GW's wet cough, I took both the kids up to the pediatrician this past Friday to make sure that they weren't developing something more serious than whatever this blah started out as.  Reassuring me that it hadn't gone to their lungs and that their ears still looked fine, the doctor suggested I give GW honey for his cough and that I try a Nosefrida on GV.  Well, as you can imagine, the spoon full of sugar went down smoothly with GW but I struggled with the "snotsucker."  This thing is designed so that you place the end of a tube against your infant's nose and use a mouth piece to suck out whatever is blocking their nasal passageways.  Well, I must not have much in the way of lung capacity or something because I found that sucker to be extremely difficult to use.  I think it'd probably work well for a simple runny nose, but for the full on congestion GV has going I am having to rely on the good ol' bulb syringe.

Course I am sure most parents out there are familiar with the screaming, unhappy baby that goes along with the use of an aspirator -- but for those who don't have first hand knowledge, just imagine snot being forcibly sucked from your nose and the disgusting tugging feeling that must accompany it (there's a reason we don't remember these things from our own childhoods).  Well, oddly enough, my beautiful little weirdo here likes it.  She gets all sorts of excited when she see me pull out the aspirator and, although I know she's not developmentally there yet, it's almost like she already rationalizes that it's good for her and that the discomfort is a temporary solution to her problems.  Granted she gets annoyed after a while and gives a good "waaaaaaaah" to let you know she's done, but the picture says it all folks.

Weird, right?  I'll take it, but that is absolutely bizarre.

You know, in a lot of ways, GV reminds me of her brother when he was a little guy.  He wasn't a fan of having his nose cleaned like she is, but otherwise they have a very similar temperament -- and given that he is turning out to be a very kind, thoughtful child I am over the moon about this!  He's adjusted to his big brother role so well, I am very proud and grateful that he is who he is.  (Yes you, GW.)

Of course, I must say, he's shocking the heck out of me right now with his growth spurts.  Since the beginning of January, this kid has grown half an inch (42" tall now) and he's officially out grown toddler size shoes.  Now wearing a boy's size one there is only a four centimeter difference between the size of his feet and mine.  He is three. I am two weeks shy of 27 years old.  How ridiculous is that?!

Whenever we look at height predictors that estimate how tall your child will be when full grown as an adult, the math comes back that GW will be somewhere around 6' 6" give or take two inches for a margin of error! Can you imagine trying to feed a teenage boy who will likely be between 6' 4" and 6' 8"?!  I can't... perhaps I should just purchase a supermarket.

They are great kids.  I wish there was something more I could do to make them feel better right now, but I'll admit I appreciate the scuzz induced extra snuggles.  Some day they'll be too big and they wont want their Mommy to dote on them or stick an aspirator up their nose when they're sick... but even with as big as they're getting, that day isn't today and, for that, thanks be to God.


Monday, February 18, 2013

Postprandial Hyperglycemia Continues...

Much to my disappointment, I guess my endocrinologist had a point when she said high glycemic index food is out.   I'd initially hoped such a food restriction would be a fluke suggestion for my recent hyperglycemia, but it is unfortunately turning out to be something I actually need to consider.  Bummer.

As per our usual weekend morning tradition, yesterday before mass HB got up and made the family his famous pancake breakfast with a side of bacon and - hallelujah - coffee.  It's not often that I willingly hand over the reigns to my kitchen, but if he offers I always take him up on making this breakfast because it's just so darn good!  I think the special trick to his recipe is the 50-50 split of white flour to wheat flour and his inclusion of melted butter and cinnamon right in the batter... they are so amazing.

Anyway, after HB finished slaving away at his new griddle, he put the plate of gorgeous golden brown pancakes and our three maple syrup variants on the table and lead us in grace.  I set GW up with two pancakes and once they were cut into toddler sized pieces, I turned back to my own plate for calculation.  Taking three pancakes (20 g each), about 1/4 cup of sugar free maple syrup (10 g) and my coffee (20 g) into account, I bolused 5 units of insulin to cover the 100 grams of carbs in front of me (20 g carb per 1 unit insulin).   Back when I was first diagnosed, I remembered thinking that 100 grams sounded like an embarrassing amount of carbohydrates to eat in one sitting, but now that I have a better idea of the composition of food it really isn't difficult to rack up carbs quickly with a couple pancakes or a simple glass of juice.  So eating just barely more than my 3 year old, I finished breakfast and off we went to Sunday Mass.

Returning home an hour later, I checked my blood sugar at the two hour post breakfast mark: 202 mg/dL.  Requiring only 0.90 units for a correction, HB and I were thoroughly agitated to see I still had 3.4 active units in my system.  Sighing deeply, I waited another two hours before checking again and my glucose at that point was down to 71 mg/dL -- which as I have said before, is slightly on the low side but within the correct range of where I want it.

I'd peaked early, again.  I'd calculated my carbs correctly, I'd eaten what I intended to eat and my glucose was eventually were it ought to have been, but not without a cost.  Going up into the 200s isn't healthy and regardless of the temporary nature of it, I cannot afford to go high if I want my HgA1C to stay under tight control in a "normal" person range.  I need it to be normal -- and not just for me and my sanity, but for any unplanned children we may possibly have. I mean I trust God to be looking out for us and our current & future children, but that doesn't mean I should take his care for granted and disregard my responsibility and role in the process.

It's frustrating that after two years of a steep learning curve with diabetes management that things are changing all over again.  My body is responding entirely different to carbohydrates now at three months postpartum than it ever did before or during the pregnancy and, despite my irritation with the idea of the glycemic index, I capitulate that it is completely necessary.  And while my e-whining about cream of wheat and pancakes may indicate otherwise, I think the fact of the matter is that I am more emotionally attached to the luxury of choice than I am to the specific carbs I'm losing... my world is shrinking even further because of diabetes and the reality of my new condition and its limitations causes me great sadness.

Completely unintended.  You'd think it is smiling because it knows...
sick sense of humor pancake, just sick. 

Friday, February 15, 2013

Lent Recipe #1: Israeli Skillet


So it is the first Friday of Lent today and, as a practicing, soon-to-be baptized Catholic, that means fasting and abstinence (no meat).  Since HB and I have decided to abstain from eating at restaurants for the next 40 days - which, if I may say, is not only a oblation of convenience but a sincere sacrifice of worldly foodie indulgence - I've resorted to the HB-tested, GW-approved bag of home cooking tricks I've built up over the last couple years.  Most of my recipes are for things like slow cooked lamb shanks, pesto-steak sandwiches or veal bolognese, which clearly are not vegetarian or fish options, but I've got a few Lent appropriate meals up my sleeve that will satisfy even these picky eaters. 

The thing is, although fasting cuts out the main source of protein in meals by restricting meat, as a diabetic I don't exactly relish the idea of serving up a big plate of plain old carbs.  Plus, if you tie in my desperate attempts to loose the extra baby weight and my interest in actually have something tasty on the table, creativity and nutritional research become key... because, let's face it, cereal has never exactly been my forte.

So in an attempt to share the work I've done to combine these food-factors, I'm going to post the recipes for our Friday night dinners throughout Lent in case something strikes your fancy.  Tonight's was an "Israeli Skillet" recipe from Bon Appetit magazine that I've tweeked a bit.  It's got chickpeas, tomatoes, feta and eggs -- and, if I've never raved the value of the garbanzo bean before, let me do it now! Not only does this recipe have phenomenal flavor and come together in a jiff, but the chickpea has a stellar carb:protein ratio that beefs up (ha) its substantive quality in this dish - I mean one 4 ounce serving size has 15 grams of carbs and 5 grams of protein! And to top it all off, HB - the meat and potatoes, corn fed, muscle man from MN - says he loves it...  

Alright, enough preamble, here ya go:

Ingredients

1/4 cup olive oil
1 medium onion, finely chopped
2 garlic cloves, coarsely chopped
1 can chopped green chilies
1 15-ounce can chickpeas, drained
2 tsp Hungarian sweet paprika
1 tsp ground cumin
1 tsp lemon peel; 1 Tbsp lemon juice
Dash ground cinnamon
1 28-ounce can diced tomatoes
Kosher salt and freshly ground black pepper
1 cup coarsely crumbled Israeli feta
8 large eggs
1 tablespoon chopped flat-leaf parsley
Warm pita bread with honey (watch the carbs in pita, it's higher than you'd think at roughly 36 g per slice)

Directions

Place souffle dishes on a cookie sheet and preheat them in oven to 425°F.

Heat oil in a large ovenproof skillet over medium-high heat. Add onion, garlic, and jalapeños; cook, stirring occasionally, until onion is soft, about 8 minutes. Add chickpeas, paprika, and cumin and cook for 2 minutes longer.

Add crushed tomatoes and their juices. Bring to a boil, reduce heat to medium-low, and simmer, stirring occasionally, until sauce thickens slightly, about 15 minutes. Season to taste with pepper.

Pull souffle dishes from oven and evenly separate the tomato sauce between the dishes. Sprinkle feta evenly over sauce. Crack eggs one at a time and place over sauce, spacing evenly apart (two per souffle dish).

Transfer dishes back to oven and bake until whites are just set but yolks are still runny, 8 - 10 minutes. Garnish with parsley.

Serve with pita for dipping, honey on the side.

Thursday, February 14, 2013




"Doubt the stars are fire;
Doubt that the sun doth move;
Doubt truth to be a liar;
But never doubt I love."
~ Shakespeare's Hamlet

You're my everything, HB. 
I love you. 

Happy Valentines Day!

Breast Milk, part two

So you know my last post on breast feeding? Thought I was done? Well, guess what? There's more!

Now that I've explained the complexity of breast feeding as a diabetic and how the balancing act is more a matter of self-care than baby-care, it's about time that I move onto the real impetus for getting around to writing these posts: Downton Abbey.  For those of you who watch the show, I've tried to give you all a few weeks to catch up on the fourth episode so as to not inadvertently spoil the plot for you, but seeing as this topic has been eating me up inside I just cannot wait any longer to vent about it.  Several Sundays ago, Lady Sybil died from eclampsia after giving birth to a beautiful, healthy baby girl.  I wept my freaking eyes out.  I simply couldn't believe that Julian Fellowes (the writer) would do something so horrible to the most wonderful character on the show... I mean for God's sake man, kill Bates if you have to, but not Sybil!


Many of you might find this to be completely random and not at all relevant to a diabetes related post about breast milk, but bear with me -- you see, when Mr. Carson, Mrs. Hughes and Mrs. Patmore began talking about the baby's need for a wet nurse I got to thinking.  While breast feeding is an extremely personal choice for mother's now a days and there are definitely social stigmas that go along with not just nursing, but sharing breast milk, the reality still exists that there are babies out there that need to be fed by other means than their own mothers.  Clearly formula is the go-to option now a days for such situations, but I'd heard tell about the practice of breast milk donation and wanted to check it out.

So off to Mr. Google I go to look into what organizations are out there and what it takes to become a breast milk donor (face it, with the image of Sybil Branson's baby fresh in mind who wouldn't want to help out?).  The search engine pops up with several different groups that collect donations for families in need and I delve into the mission statements, success stories and finally into the requirements pages... logically, the organizations insist that a donor have her own baby's feeding covered before considering donating extra milk; they also mandate that a donor's freezer be capable of reaching - 4 degrees Fahrenheit; and, oh yeah, donors under no circumstances can be diabetic.

Putting diabetes under the same category of disqualifying diseases as HIV (SERIOUSLY?!), using artificial insulin on a regular basis classifies me an "unhealthy" mother...  ouch.  Now I am not so irrational as to deny these organizations consideration of liability reduction in making this decision, but likening my milk quality to that of a disease that is actually transmittable from person to person and actually communicable through breast milk is just insulting.   Women with HIV cannot safely breast feed without taking antiretroviral medication to prevent transference of the disease to their babies, but women with diabetes - as I said earlier - are not only capable of breast feeding safely, but they are encouraged to do it!

Having the past several weeks to stew on this topic, I'm not angry with these groups because I cannot donate something I willing would under different circumstances, but I am furious with diabetes that it has taken something important away from me.  It never crossed my mind to donate milk while breast feeding GW, but now that I'm actively feeding GV and am in a physical position to do so now, it really stings to know what opportunity I missed and what difference I'll never be allowed to make for another mother.  Don't get me wrong, I know mothers today who can't or don't breast feed have alternative options with formula, but it's the principle of the thing...

While I understand that I have a disease I work tirelessly to manage it and make it as irrelevant as possible.  But, being of spiteful character, diabetes seems to take pleasure in continuously adding insult to injury -- making me wear a battery operated computer 24/7 was just selfish; forcing me to cut out cream of wheat was just rude; making candy a thing of necessity rather than pleasure was sick and twisted; and, worst of all, having my milk practically labeled as carcinogenic is just unforgivable.

Screw you, diabetes. And the horse you rode in on.

Wednesday, February 13, 2013

Breast Feeding and Diabetes

For months now I've been saying that I'd write a blog post about breast feeding as a diabetic.  I'd skipped the topic while still pregnant since it wasn't quite relevant at the time and for the past 11 weeks since GV was born I just haven't made a priority of writing about it since doing it seemed more important.  But seeing as she's happily asleep in her swing chair and GW is at least pretending to nap in his room, I'm going to take this opportunity to tell you about it since I know you all must have been anxiously loosing sleep over it since I first mentioned I'd write about the topic back in 2012.

No? Just me? Ah well, c'est la vie.

According to the American Diabetes Association, the best thing that a diabetic mother can do for her new born child is to breast feed.  Citing multiple research studies, the ADA explains that babies that are exposed to diabetes in utero and are breast fed for upwards of six months after delivery have a decreased incidence of respiratory infections, a lower risk of asthma and atopy, tend to have lower blood pressure and are less likely to develop childhood obesity.   All great things, right?  Well, combining these medical benefits with the fact that the disease is not transmittable, that there have been research studies connecting certain types of baby formula containing bovine protein to the development of autoimmune diseases like diabetes and that I thoroughly enjoyed breast feeding GW, the choice was easy for me.  The practice of breast feeding with diabetes, however, is not so easy.

Blood sugar affects everything we do in our daily lives because it provides us with energy, so it seems only logical that there be some relationship between blood glucose and the natural formation of breast milk.  While you've probably heard that breast feeding burns calories, you may not have taken the next mental step to connect that with blood sugar... Essentially, in a similar way to how our bodies burn both calories and glucose when we exercise, a mother's body burns both fuels to create milk for her infant. So while a non-diabetic mother can singularly reap the weight loss benefits of nursing her little one due to her self-regulation of glucagon and insulin, a diabetic mother needs to monitor her blood sugar with extreme caution so as to not put herself (and by extension her baby) in danger of hypoglycemia.

To prevent this and to keep blood sugar stable, it's important that I eat before, during and sometimes after feeding GV.  But that brings me to the next topic of difficulty: weight gain and nursing.  Because of my sugars I need to eat more to keep my blood sugar up to be able to safely nurse -- but then that means that although I am burning calories while nursing I am required to ingest more calories to nurse which means any weight loss I should have with breast feeding is replaced with weight maintenance, if not additional weight gain.  Obviously this creates a source of stress for someone as physically self-conscious as me, but to take it to a less superficial level, weight gain can change a diabetic's chemistry enough to change the body's response to glucose and therefore its artificial insulin requirements.  So... to keep this complicated... that means that I need to eat more to nurse more and that I must exercise more to compensate for not only remaining pregnancy weight (15 lbs to go) but the extra calories necessary to nurse (and exercise) all in order to keep my sugars stable enough to nurse in the first place.

Furthermore (because why, really, would it end there?) not only should my blood sugar be kept from going low while breast feeding, but they should not be permitted to go high either.  While the majority of perinatologists, pediatricians, obstetricians and diabetes organizations insist that there is no connection between a mother's in-the-moment blood sugar and the quality of her breast milk, there is a school of thought out of the Sansum Diabetes Research Institute in Santa Barbara, CA that believes the value of a mother's breast milk decreases when her bg is over 150 mg/dL.  According to these researchers, such deficient breast milk can cause infants to have "reactive hyperglycemia" which causes them to vomit, be excessively irritable and require more milk to satisfy their nutritional needs.  While there aren't additional studies to backup these claims and I've never seen such negative effects in GV's behavior when I have nursed her while high, a lack of evidence doesn't necessarily refute the possibility and I've decided to play it safe rather than sorry.  Admittedly it voluntarily adds another level of complication to breast feeding, but what does it really cost me?  If it is no big deal, then oh well.  If it actually matters, then it's worth the effort.

The bottom line is, I am thrilled to be nursing; it's a very personal choice and I find it completely satisfying. But breast feeding and diabetes take a lot of conscientious thought -- and at 3 o'clock in the morning when GV wants to nurse that is a lot to ask for.  Don't get me wrong, glucose control is definitely less critical and requires far less attention to minutia now than in pregnancy, but it's still exhausting to continuously consider.  I could let it go and give myself an easy DKA-sponsored trip back to my skinny jeans, but I cannot justify cutting myself any self-satisfying slack on my sugar control since a lax take on it would imply irresponsible parenting at best.

Seeing as I take my vocation as wife and mother extremely seriously, I guess this is just another one of those necessary "diabetes says this is how it is going to be" horse pills to swallow and get over it... now if only they made that in a gummy I'd be happier.

Why take a horse pill when you can have a gummy?  

Monday, February 11, 2013

Farewell, my beloved breakfast.

This past Saturday at just before 9:00 in the morning, two hours after my breakfast, my jaw hit the floor when my blood glucose meter read 312 mg/dL.  Having calculated the carbohydrates in my breakfast precisely and then failed to drink my coffee my blood sugar should have dropped low, but like so many early day meals lately my glucose was off the charts.  I'd adjusted my pump settings last week in an attempt to self-correct my post-breakfast hyperglycemia, but seeing my meter read a clearly unhealthy, wholly intolerable number in the three hundreds (THE THREE HUNDREDS!!) I placed a call to my endocrinologist on Monday morning for some much needed help.

Since my two hour postprandial numbers have been high, but my four hour postprandial numbers have been low/almost low she didn't recommend changing my morning bolus ratio and, because my breakfast isn't always at the same time, she said my basal rates shouldn't be the issue.  I inquired about whether I should go back on the symlin injections, but because I am breast feeding she insisted that I do not since there isn't any information about whether or not artificial amylin is transmitted in breast milk and, if it is, it'd create an unsafe situation for GV.

Removing all the "simple solutions" to the issue and still without a clear path forward, Dr. Rogacz inquired about what I usually eat for breakfast.  Telling her that my everyday (yes, the same thing, everyday) go to breakfast is a bowl of cream of wheat and a cup of coffee, she made an "ah ha" sound and proceeded to break my heart by saying "your problem is probably the cream of wheat."  Citing the high glycemic index of wheat, as we loving call it in this house, she instructed me to drop it and similar "dense" carbs out of my diet in order to keep my sugars under better control.

(Insert mopey, pouty face here)

So what is the glycemic index (GI)?  The GI is a measurement of how much each gram of carbohydrate in a certain type of food raises a person's blood glucose level once it is consumed.  Foods that breakdown quickly in digestion and rapidly release glucose into the bloodstream are "high" (over 70) on the GI scale, where as foods that break down more slowly will gradually release sugar into the bloodstream and therefore are considered to be "low" (under 55).   Here are some examples for you:

High:  Rice, plain white bread, potatoes, breakfast cereal and watermelon.
Medium: Sweet corn, bananas, raw pineapple, raisins, pita bread and regular ice cream.
Low:  Raw carrots, peanuts, raw apple, grapefruit, peas, skim milk, kidney beans and lentils.

Because a lower glycemic response usually means less insulin is required to maintain a healthy HgA1C, foods that are low on the GI tend to improve long-term blood sugar control and cause less spikes in sugar like I am currently seeing at my two hour postprandial.  So, you see, on top of needing to be carbohydrate conscious on the basic this is bread that is pork level, my body has decided for the first time since becoming diabetic that it cares what carbohydrates I am eating and is forcing me to forfeit the lusciously dense carbs I emotionally love.

I know my doctor is right in making this recommendation and I'm only just beginning my research on what this actually means as a lifestyle choice, but my first response is that I am thoroughly peeved.  I am annoyed with my diabetes for messing with me again and on something so indulgent as my favorite breakfast.  I mean at least the doc didn't tell me to give up coffee (Lord knows THAT would have been impossible) so I at least still have that, but what to have with it will take some time.  I expect after an adequate period of mourning that I'll come up with something else to whip together in half sleepy delirium, but for the time being, in a state of melodramatic protest I refuse to replace it with something sub-satisfactory.