Apropos to Halloween last week, a doctor I know — who happens to be an endocrinologist — recently offered me a piece of hard candy. Casually. Without hesitation. When I smiled and noted that my “condition” keeps me off that stuff, he insisted I was being “obsessive.”
Surely one piece of hard candy won’t do much to your blood sugar, right?
Ummm, that’s what I take when I’m low. For me it’s a treatment, you know…?
The whole thing made me feel validated in my prejudice that most doctors — even those who treat diabetes for a living — really have no idea what it means to live with type 1.
But then I second-guessed myself.
Maybe he was right… maybe one piece of candy wouldn’t spoil a happy blood sugar day after all (not that we humans can ever stick to just one piece!)
Anyway, there was only one way to find out. I’d have to do the empirical research. I decided on a three-time N of 1 trial.
On the First Day, I was at a delightful 115 before lunch (the kind of #BGnow that makes food seem more evil than ever, ya know?). While picking up some cottage cheese for lunch, I grabbed one of those strawberry-looking wrapped hard candies off the store counter and popped it in my mouth. Sugar and all. Just like that. No hypo even.
Fifteen minutes later, I clocked in at 132. So a jump of just 17 points. Hmmm.
The Second Time around, I began at a lovely 120 at 10:55 am on a Monday. I very much enjoyed a Werther’s Original (after failing to find my all-time favorite hard candy, Coffee Nips). Fifteen minutes later I was at 136, so a 16-point jump. Ironically, at 11:36 am, I was back down to 129 mg/dL — if you have faith in glucose meter accuracy, that is.
In Session Three, I woke up at a perfect round 100 mg/dL. For the sake of science, I popped another Werther’s and waited 20 minutes. This time I clocked in at 126, so nearly a 30-point gain from one little sucker.
OK, so my barely-even-close-to-scientific study shows that one hard candy raises my blood sugar by 16-26 points.
Well, that tells me that if I want to use these suckers to treat a low, I probably need 2-3 of them.
It also tells me that if something so tiny (and therefore unfulfilling) raises my blood sugar by that much, it’s better off avoided when I am not low.
So what’s gotten into endos these days? Are you trying to make me feel normal or something?!
)
I guess just one of the pieces missing in your N x 1 experiment is what was your BG trend at the time?
“It’s only one candy” belies what it is like to be PWD and constantly aware that bg matters. My concern-o-meter never turns off!
This just proves how finely balanced the blood glucose level is when we are “in control.” It doesn’t take much to tip the balance and then it’s off to the roller coaster races!
Hardly a roller coaster. 16-26 points is within +/- 20 pt meter accuracy. Mike has a point about trends. This one piece of candy wasn’t all Amy had all day, I’d guess, or the only factor in the equation.
3 options: 1. Save the candy for 1/3 of treating upcoming low. 2. Bolus for the 4 grams. 3. Realize it is possible to savor one small moment of sweetness without compulsively eating a huge amount or obsessing over a tiny rise (which could also be caused by the worrying).
This is not a bad endo and good ones are rare. Not everyone has access to any endo. He didn’t give Amy a huge candy bar or decide she didn’t need insulin or test strips.
This feeds into the myths we constantly fight: that diabetes is caused by eating candy and diabetics can’t have sweets. I expected better from you, Amy.
Huh, Mary….? Who ever said anything about candy CAUSING diabetes? Not me.
I’m just a typical insulin-dependent gal struggling to keep my sugars in check, is all. I’m actually disappointed to hear that you’re disappointed just ’cause I try not to eat candy regularly.
I don’t see this post as feeding into any myths. I think it’s a hard fact that a piece of candy will tip the blood sugar balance and either we give insulin for it or suffer a rise in blood sugar which is against health. If there is no rise in blood sugar than there is activity going on or too much basal insulin or something else like that. I don’t eat candy at all because I find that once my blood sugar goes over 120, it rises naturally, albeit slowly from there for the next few hours whereas if my blood sugar is 100, it won’t rise for the next few hours, it remains stable and slowly drops. It’s as if the body is telling me what blood sugar it likes.
Anyway, what diabetics can and can’t do is irrelevant here because the issue is that a piece of candy does something to blood sugar when there isn’t insulin. It’s science. It’s just biology.
Frankly, this is a post by someone who clearly enjoys tight control of blood sugars and I appreciate it.
Interesting post. I’m a type 2 trying to control my blood sugars with metformin and Dr. Bernstein’s regimen of very low carbs and fairly low protein and moderate exercise. It is working, but it takes a lot of effort. I’d like to try your experiment, but it would take mean using 20% of my daily carb allowance.
I have type 2 because of a (long) lifetime of too many carbs and, possibly, too little exercise. No myth at all. It may be a myth for type 1′s but the overwhelming majority of PWD’s are type 2′s with a problematic lifestyle (plus problematic genes plus, I expect, some unidentified factors brought to us through the wonders of modern chemistry).
Whether you’re Type 1 or Type 2, if you don’t have the gene for it, you won’t get it. If people who overindulge in carbs develop diabetes from that alone (Type 2), we’d have 150 or 200 million diabetics in this country. Instead, we have about 30 million. I just don’t want my Type 2 brethren to feel this weight of guilt about the development of their disease. It doesn’t help you control your diabetes better, just like Type 1s who berate themselves for a day of poor control aren’t helping themselves.
How you developed diabetes doesn’t matter as much as how you deal with it now. (And I have a sneaking suspicion that heredity plays a much bigger role than we thought). Don’t carry any more extra guilt (or weight) than you need to.
It’s remarkable how the non-diabetic system can keep glucose levels in a tight range, and no matter how hard we try, we can’t do it quite so well. Your candy experiment is evidence of that, but then, we’ve all been doing this experiment everyday of our diabetic lives. Candy isn’t the problem… it’s the rapid deployment of glucose and slow deployment of insulin. This happens with pretty much every food we eat.
I don’t eat candy unless hypo, and I also avoid most other rapid acting starches. I find that when I taste sugar I crave more, so it’s best to keep it at arm’s length. My doctor thinks I might be a bit obsessive about my glucose control, but he also says I’m one of his healthiest patients. I guess there’s always a trade-off.
Do you freak out similarly over four grams of carbs of orange juice?
I’m with Mary Fairweather Dexter. This post made me roll my eyes. Did you employ *any* useful strategy to address the increase in BG?
You could have pre-bolused. You could have combined the candy with a low GI meal. You could have had a couple of olives or a bit of vinegar to delay the absorption of carbs. You could have noticed a downward trend, and used it to prevent a low. Had it before exercising.
But noOOOOOOooo. You’d rather put your little diva hat on, pout, and talk about how misunderstood you are. All while propagating the “PWDs can’t have sugar” myth and promoting an air of helplessness.
Geesh.
Hey @Anon (real brave name there), I purposely didn’t pre-bolus or use any of those glucose-lowering strategies because I just wanted to see what happened if I ate one candy WITHOUT doing all that.
I never said PWDs can’t have sugar or pouted or anything else so negative that you’re reading into this post.
It’s a shame my little experiment bothers you so much. You sound very angry.
It’s a matter of keeping the numbers in perspective: too few endos, too many diabetics with limited or no access to one. One who isn’t perfect is better than none. One who offers you a piece of hard candy isn’t as dangerous as the one who let his staff cancel my insulin prescription because my A1c was under 7 or who decided one vial should last 6 weeks. They learn from us; we learn from them.
I believe in and practice tight control. I also have to be confident I can weather the situations that aren’t completely under my control that raise my blood sugar.I can graciously accept a small candy, check my CGM and enjoy it then, knowing I don’t need to eat a bagful, or tuck it in my pocket for later or to give to my hubby.
For the last month I’ve been battling bubbles forming in my reservoir, blocking the top, and sending my bg above 300. And yes, Medtronic reps and my CDE have verified I am doing everything right so don’t ask. I can’t prevent them from forming. All I can do is fix the problem. So several times a day when my bg starts wandering up, I remove the reservoir, rewind, use the plunger to move them into the tubing, and flush them out. Going back to MDI would give me more problems. A 4g piece of candy is miniscule.
I liked your article. Your endo sounds just fine. Hard candies aren’t treats for me, but they’re useful, handy little gifts to keep in my bag for the next unexpected sprint to the subway. Sometimes you need a 20-point rise, right? No problem
Like they say ” you will never realy know until you walk a mile in another man’s shoes
Good experiment. (And *nice* starting numbers!) My endo would not offer me a candy unless I were low, I’m certain. He is very anti-sugar in most of its forms. I never bother eating hard candy when I’m not low – it’s a waste of my limited carb allowance to me. I rarely drink OJ when not low either, though it’s my new goto for borderline low morning numbers. And I rarely pop anything with 4 or more grams of carbs in my mouth without a BG check and bolus. It’s not obsessive; it’s doing the best we can – and it ain’t easy!
You Go Amy!! The other night my husband brought home a jar of wonderful nuts. some candy coated (beer nuts) others like the chocolate covered almonds sat on my counter for a few days. Last night my daughter opened the jar and yes, i grabbed a couple (3) of the almonds. I did not test before, I did not bolus for, and I did not test after. I just enjoyed. My BG probably went up, but shortly after eating them I ate dinner, so que sera sera. I have been type 1 for 38 years and i hope to live for another 38 at least. a couple wont kill me. i don’t eat candy on a regular basis and i work really hard to keep my levels in “normal” range. But as any diabetic knows, that “normal” is somedays harder to reach than others. Just go with the flow and enjoy your life. And Amy did say her “not even close to scientific” study was just that. To me, it’s like eating white rice and seeing how high my BG will go so I know for next time.