Ask D’Mine: Battling Snark + Surviving Starbucks

It’s a Holiday weekend, but the surviving-diabetes-train never stops. Our Ask D’Mine weekly advice column host Wil Dubois is workin’ overtime to answer your every query.

This week, he’s taking on online commenters who bite, and coffee drinks that hopefully don’t. 

{Need help navigating life with diabetes? AskDMine@diabetesmine.com}

Chad from Illinois, type 1, writes: When I put up positive messages on some diabetic chat sites I’ve gotten replies to my posts stating that I must be in denial, or that my “eyes are closed.”  I’m starting to think that maybe there are people out there who feel it’s impossible for someone to be so at peace with a disease like diabetes, and not be full of anger. I’m focused on my family, community and faith. In no way do I feel that I am better or worse than anyone else. I am just different, and I am A-OK with that. What upsets me is when people complain anonymously. I don’t want to cause a ruckus with anyone. What would you do to let people know that this is just my own philosophy?

Wil@Ask D’Mine answers:  Oh boy, where to start… Well, I don’t think you’re in denial. I don’t think your eyes are closed. And don’t worry, you’re not the only one at peace with having diabetes. I feel the same way. So at least there’s the two of us! But yes, there’re a lot of people who cannot conceive of any feeling towards diabetes other than anger. So why the anger?

Well…

People are tired. People are broke. People are scared about the future. And that’s just garden-variety people. Add a pesky chronic illness to the mix and ya’ gotta great recipe for anger.

But that’s only half the story.

Because it gets more complicated.

Because there are no diabetes facts. None of our experts can even agree on something as simple as what the hell we should eat. Hey, medicine is an art not a science, and your mileage will vary. No one wants to admit it, but really all we have is theories. Ideas. Beliefs. Diabetes is more like a religion than a science. And people are pretty sensitive when it comes to their religion.

Now, add all that up and then remember that people are territorial creatures. So we’ve got an environment with an abundance of anger, a dearth of facts, and very deep personal feelings. Trust me on this: I’m speaking from experience, you can’t say anything about diabetes without stepping on someone’s toes.

So it’s really easy to set people off. Even when you didn’t intend too. And to make matters worse, written communication on the web suffers from a lack of visual and auditory cues that help smooth over miscommunication in the face-to-face world. Oh, and on top of that, most people don’t read carefully and thoughtfully anymore because they are tired, broke, and scared. And most people don’t re-read what they wrote online before they post it. Most people don’t even realize how they “sound” online. Some are being rude. Others just sound that way.

But as to ruckus avoidance (and personally, I like causing a good ruckus) I have some advice for you. Bear in mind that except for the absolutely most crazy amongst us… and members of Congress… most people respect your right to have an opinion—even if it’s different from their own. Where folks get upset is if they misinterpret you giving your opinion as arguing about their “facts” with them. Or worse yet, trashing their beliefs.

To avoid a ruckus, you just need to make it clear you’re speaking for yourself, not proselytizing to them. And you can best do that by just prefacing every comment you leave with the letters “IMO” or “IMHO.” That’s internet slang for “In My (Humble) Opinion.” It’s simply a way of flagging to folks when you know you’re editorializing. It can go a long way towards avoiding miscommunication with tired, broke and scared people; while also not setting off those the-world-is-carved-in-stone freaks out there who believe that anyone who believes anything differently from them is stupid and wrong. A few simple letters stake out some safe ground for you.

Oh, and about those anonymous folks: They’re just a bunch of  lily-livered chicken-shit spineless cowards who don’t have the frickin’ guts to stand up and say what they think in the light of day. I say screw ‘em. If they won’t say who they are, we shouldn’t pay any attention to what they say.

But that’s just my opinion… Let the ruckus begin!

Kayla, from Alabama, type 2, writes: I love coffee drinks and Starbucks, but I have stayed away since I was diagnosed. The other day I finally did the big No-No and had a Latte …I will NEVER do that again. My sugar spiked way up!  That really scared me.  But who likes black coffee? Is there a certain coffee choice that won’t cause such a high glucose rise?

Wil@Ask D’Mine answers: IMO, Starbucks rocks! Oh, and just speaking for myself, I not only like black coffee, I love it. So the answer to your first question is: Me. That’s who likes black coffee. (See, Chad, it is possible to have a civilized disagreement in the diabetes social media space!) As to your second question, not all Starbucks Lattes are created equal.

The low-down on Lattes can be found at the Starbucks homepage’s most excellent nutrition guide here. Did you know that Starbucks has 14 different species of Lattes on the menu? And the blood sugar impact of each one couldn’t be more different.

You know what a carb is, right? Technically, carbs are organic compounds made up of carbon, hydrogen, and oxygen atoms, but we can use the carb content of foods and drinks as a proxy measure for how much a given food or drink will impact our blood sugar. We T1s use carb counts to determine how much insulin we need to take to keep each meal from killing us. Although it rarely works out this way, in theory, we T1s could eat anything we wanted so long as we take enough insulin for it. As a type 2, your meds most likely don’t give you as much flexibility, but you can count on the fact that the higher the carb count of a food item, the more impact it’s likely to have on your blood sugar; the lower the carb count, the less the impact it’s likely to have on your blood sugar.

So, at the low end of the carb scale is Starbuck’s Tall Skinny Flavored Latte, tipping the carb scale at only 8 grams of carbs. For perspective, that’s about the same carb count as a snack-sized bag of baby carrots. I very much doubt that this drink would spike you “way up.” At the other end of the spectrum is the Venti Caramel Brulée Latte at a whopping 88 carbs, almost twice the recommended carb count of an entire meal for a woman with diabetes. That’s like chugging your breakfast and lunch in one sitting. I’d place money on that drink being “spiky” for you.

Now some folks are saying that the Tall Skinnies taste pretty much like puréed baby carrots, and aren’t worth drinking; while others find them pretty yummy. I haven’t tried one, so I can’t say. ‘Cause… you know… I drink black coffee. But that’s not the point. The point is, there’s a whole lot of variation in the carb count of Starbucks Lattes.

So what’s going on here? Well, Lattes are basically espresso coffee (carb-free) and milk (not carb-free) and flavorings (maybe carb free and maybe not). Sometimes the milk is whipped up, like in a hot Latte, and other times it’s just poured in, like in an iced Latte. Whipped milk is effectively lower in carb ‘cause it’s foamy and a given amount of ‘milk space’ is taken up by air. I also cheated. The “Tall” is Starbucks smallest size and the “Venti” is their largest. So I’m comparing apples to oranges. But, hey, you can cheat too. What size was the Latte that screwed up your blood sugar? Wouldn’t it be better to have a smaller one than none at all?

I’ve been doing a lot of experimenting with smaller portions lately and have found that for me at least, I’m happier with less than none.

So, is there a coffee choice that won’t cause such a high glucose rise? Yeah. I bet there is. Look up the Latte that punched you in the blood sugar. Find out its carb count. Then scan the menu for something else that sounds yummy with a lower carb count. Maybe a different kind of Latte. Maybe a different size. Try it and see what happens. It may take some trial and error, but it’s worth it.

Kayla, your Latte is waiting for you. Go find it. Life is too short to live without Starbucks, IMHO.

Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.