Every endo visit is an adventure, in my book. Last week when I went in, proudly displaying my latest A1c result of 6.2 (!), the whole session turned out to be about my fiber intake and (nonexistent) vitamin regime. Aaargh! Can’t a PWD rest on their laurels for just a day or two?
First off, we decided I needed more fiber in my diet (don’t ask). So how much fruit do I eat? Um, next to none, I had to admit. Of course I miss the stuff, but it’s just not worth the glucose spikes, I thought. Well, my endo instructed me to try a new strategy: add in a little bit of fruit at the end of one meal each day. So for example, half an apple or a few slices or orange after I’ve ingested some other foods, preferably heavy on the protein. With the other foodstuffs in there to help absorb the glucose shock, this shouldn’t cause too much BG havoc. And if it goes well, I can try adding another fruit portion after another meal. Hooray for doctor’s orders!
Secondly, we talked about vegetables. I do OK here, although I ought to expand my horizons beyond salad, broccoli and carrots. Liquid form seemed like a good idea until I had enough of those mega-green smoothies, and that tomato/veggie juice I was supposed to choke down for breakfast during the South Beach diet. (The first bottle’s still standing on my refrigerator door, with the thick red residue clinging to the sides of the clear plastic jug — shudder.)
All right, so what about a daily multi-vitamin? And baby aspirin (81 mg)? And am I taking a daily dose of Vitamin D? My problem is that I don’t tolerate this stuff very well. A while back I was feeling pretty nauseous every morning, which I cannot stand (pregnancies notwithstanding), so I stopped taking all of those supplements. But now I’m instructed to get back on ‘em.
I’m starting out with a One-A-Day Women’s Multivitamin, and hoping the coating they add on the outside to make the pill go down easier won’t make me feel ill. Sometimes the red dye in the coating, or gluten ingredients in my case, can cause a yucky feeling in your gut.
Finally, my endo insisted that I start taking a daily Vitamin D. “We’re all a little Vitamin D deficient in this country,” she said. What the heck?! I grew up in Los Angeles, where the sun almost never doesn’t shine. I grew up believing that people in California were never in need of extra Vitamin D, although your body has only a limited capacity to store it. Furthermore, in all the years I spent in Europe (where people get about 95% less sun), I never heard anyone talking about taking Vitamin D supplements.
Still, no reason to argue with my endo. We Americans are a bit vitamin-happy, but as long as I can tolerate it, why not? So of course I went home and starting looking into what Vitamin D actually does:
* it promotes the body’s absorption of calcium, which is essential for the normal development of healthy teeth and bones
* It also helps maintain adequate blood levels of the minerals calcium and phosphorus
* it affects the immune system by promoting a process called phagocytosis, which controls inflammation by transporting cells into the blood
Vitamin D is something of a super-vitamin, I read, because it “behaves like a hormone in the body, relaying chemical messages — something no other vitamin does. For example, Vitamin D signals the intestines to absorb calcium from foods and to regulate its uptake by bone cells.”
I’m guessing my endo is aiming to help me avoid osteoporosis, that softening of the bones that is a special concern for women over 40 (which my aerobics’ instructor is always shouting at us about – ugh).
Not only that, but apparently Vitamin D is hot stuff right now! It’s good to keep in mind that vitamins are as trendy as anything else sold to consumers. And hey, back in the I Love Lucy days, the vitamin tonic primarily consisted of alcohol. The motto being: If it makes you feel good, it must be good for you?
For fiber, try adding beans and lentils (buy the dry beans and soak/cook them yourself). VERY high in fiber, relatively high in protein (for a vegetal source and/or starch), and as long as they’ve not been frozen after cooking, the carbs should not spike you.
Regarding single vitamins and minerals, check your dietary sources. Often you’ll do better to add the appropriate food into your diet than to take a supplement. And many of the vitamin pills say they are better tolerated when taken with meals.
Hi Amy,
As someone who has had Type I diabetes for 28 years (since I was 7 years old), I love your blog. Thanks for all the good work you do.
About multivitamins, which I have taken my whole life, I find that taking them in the evening with dinner eliminates the nausea. You might give that a try.
Cheers!
Michelle
You’ve been a victimized by the pseudo-science of Nutritionism.
Highly recommend reading, In Defense of Eating by Michael Pollan
Read it, Snowflake. Thanks!
I take a suppliment called “PGX Daily” at least once a day, which has a side effect of helping stablize BG levels and it is primarily a fiber pill. I think that it was developed by the University of Toronto. It seems to work for me.
I have been a type 1 for around 35 years and have a 6.3 A1C also, and have to maintain that control if I am to keep the Kidney function from failing.
I was going to suggest the vitamins after dinner as well that is when I take them, if I remember
I justed added Vit D as well as it was on ABC National News, how important it is. The aspirin I forget to take as well, but was suggested by my endo. It sounds to me like you have an excellent and caring MD.
Oooooo before we all forget, GREAT A1C, I know how much hard work goes into getting a great number like that!!!!
Thanks, Karen. I needed that.
Vitamin pills are activism to me. They give you the feeling to have done something good for your body and this feeling was very easy to achieve. I think people should be concerned more about the quality and balance of their daily food. One vitamin pill will not change that. Some scientists even argue that cells have effective defense and repair mechanisms when they are short of vitamins. These strategies will only be triggered when the vitamin levels go below the treshhold. Living with always sufficient vitamin levels is like to live your life without ever having any fever attack. But fever will trigger a high alert immune reaction that can kill even cancer cells. These cancer cells would have survived without the fever strategy. An argument pro vitamin pills could be that todays agricultural conditions do not allow the fruit to build up sufficient vitamin levels. I would agree but the right answer should be to eat more fruit (do not suppose that I am a role model for this).
So as a T1 I would say: you have a pump, you have a meter, pick one food and try to figure out how to handle it, how many carbs, distribution strategy to catch fructose later (multiwave or delayed), log the reactions. Try that for some days to learn how to handle the fruit. In my opinion it is worth the efford to get a grip on that.
See you on TuDiabetes.com
Apparently if you are Vitamin D deficient, your body doesn’t produce enough of a peptide called cathelicidin, which helps protect your skin from infection, leading to eczema. (http://www.sciencedaily.com/releases/2008/10/081006130503.htm) I’m wondering if there is a correlation between all the skin rashes from adhesives in PWDs and the vitamin D deficiency inherent in T1 diabetes. It is certainly worth a home experiment — cheap and easy! We will be trying it at our house, and will keep you posted.
Regarding your multivitamin — most multivitamins contain a form of iron humans can’t easily digest and can upset your stomach. You may want to switch to a vitamin without iron. Humans really only digest heme iron well, found in red meat. Only a small percentage of non-heme iron (found in grains, vegetables, and most vitamins) is absorbed, so you have to eat a lot more of it to get the same benefit. So get a vitamin without iron and treat yourself to a steak instead! : )
Kashi Rolls are a great source of fiber and are “optimized for glycemic response.” They are way better than any other protein bar I’ve ever had, too!
Ah, Vitamin D. It’s all the rage. Actually I’ve up my dose also. It’s hard to get it all from the diet and you know you have to limit the sunshine. Still, about 15 minutes a day is all you need. Dermatologists, don’t scream.
I have read many articles in the various diabetes publications about the 6 to 8 most essential vitamins, minerals, and supplements for PWD. I take most of them every day plus a few others. Amy, I am curious to know what will be on your list when you finally make one up so lets revist this again sometime. Thanks
Seriously, congrats on the A1c. My last one was 6.3, and I know I called up everyone I know to brag about it–even if I had to explain what an A1c was first.