LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Friday, September 21, 2007

The Taco Bell White-Knuckle Badge of Courage Award

Our good friends at Lilly Pharmaceutical have published a comprehensive Nutrition in the Fast Lane pamphlet. It gives you all the horrifying Super-size Me un-nutrition data from a long list of fast food joints. It’s an honest-to-God Webster’s carb-fest.

As Debbie has a Taco Bell craving, I now have the opportunity to put the data to the test. We are in Colorado City, about 20 minutes down the interstate from Pueblo, the likely location of a great many Taco Bells.

I don’t know quite what I’m going to order, but all the food at Taco Bell tastes the same to me. Doesn’t matter if you wrap it in a flour tortilla, stuff it into a corn-shell, fry it up, serve it rolled, flat, or in a bowl. The stuff all tastes the same to me.

Bottom line, it won’t really matter what I order. I decide on a Burrito Supreme and two crunchy tacos. 70 carbs. With this size of meal I decide that a 30 minute pre-bolus will be in order.

After a quick conference with Deb, we decide to go for it. I shoot up with seven units from my grey & white pen. Adding to the risk, I had, 15 minutes before, taken a couple of units to knock down the excursion from a bottle of Godiva we picked up at a Gas station in northern New Mexico.

As we zip up the interstate I have a down arrow on the Guardian.

Ut oh.

On the south side of town we find a Taco Bell. Rio wants to eat outside, but it is getting dark. There is a stiff wind and it looks like rain. He’s overruled. We go inside and order. Before I can fill my diet soda, gather up hot sauce packets and napkins, our order is ready.

None too soon. I’ve got two down arrows.

I scarf down a taco, then eat the burrito. After polishing off the second taco, Guardian has me at 140 and dropping like a stone. I do a fingerstick on an Abbott Precision X-tra meter. 75. Oh crap.

Drink some real soda, suggests Jezebel.

Now, I know that eventually the food will soak up the insulin. If I wait long enough, and if I don’t pass out, it’ll all work out just fine.

I cross the Rubicon. No fast acting carbs. I don’t want the excursion. I commit myself to wasting several more test strips. Guardian still has me dropping, but she’s still playing catch up to the fast moving hypo. That doesn’t necessarily mean that I’m still really still dropping. But in this case I am. Now I’m at 69. The family is still eating. I play with a straw to try to take my mind off the blood sugar. I tear the tip of the wrapper off and slide the paper down the straw about an inch. I quickly bring the straw to my mouth and with a quick puff send the paper missile flying at Rio. It strikes him square in the nose. “Hey!” shouts Rio. Bull’s eye! It’s one of our favorite games. His mother hates it, mainly ‘cause his aim is sometimes off and he’s shot untold numbers of waiters and guests at neighboring tables. Most people are pretty good sports about it.

My patience being worn down by fear, I check again. Now 72. Maybe a rise. Maybe the same, it’s well within the tolerable 20% error allowed for “accurate” test strips. But not dropping. Guardian is now at 80 and still showing a drop.

We make small talk, but I’m not really engaged. Finally, Guardian stops around 76 and begins to level out. Finger stick shows 79. Looks like I’m in the clear.

Scary stuff, but it worked out perfectly in the end. The meal peaked at 159 around two hours out, and settled down nicely. The combination of “nutrition” data (using the world lightly), a good carb-to-insulin ratio, and white knuckle courage, won the day.

I love eating out with hard carb data. It’s good to know what to bolus for. Makes eating out less work. And isn’t that what eating out is supposed to be about? You don’t need to cook, serve, or clean up. Eating out is much less work for “normal” folks. For us D-folk, it’s a hell of a lot more work.

I think there should be a Federal Law requiring all restaurants to publish calories, fat, carbs, and fiber on their menus.

Then eating out could be a treat for all.

3 Comments:

Blogger Kelsey said...

I'm so with you on this! I agree, the fun and relaxation of eating out is totally lost when you have to guess about the carb count.

I blogged about this the other day: http://www.healthcentral.com/diabetes/c/5868/13608/restaurant-eating/

Unfortunately it looks like restaurants have the right to make their nutritional info as difficult to find as possible!

4:48 PM  
Blogger Jenny said...

Before you get too excited, the other problem is that the PORTION SIZE they give you often isn't the portion size that they serve you.

I've verified this by looking up nutritional info on company web sites and then bringing home a portion and weighing it. Often what I buy is considerably heavier than the portion listed in the nutritional info.

Also, with Taco Bell, all that fat is going to slow down digestion. I'd test at 3 and 4 hours too because you might see a lot of the carbs hitting then.

7:04 AM  
Blogger Allison said...

Wow, sounds like a wild evening, leave it to diabetes to make meals interesting. When you are low, the last thing you want to worry about is if the number on your meter is accurate, or as you stated, within the 20% allowed error. I have been using the Wavesense KeyNote meter due to the high level of accuracy it provides. It is a great little meter that is very easy to use. If accuracy is a main concern, check it out at www.wavesense.info/data to see how it compares to a laboratory standard. I work for the company that makes the meter, so If you have any questions I can answer them directly.


Allison
Community Outreach
AgaMatrix, Inc.
www.wavesense.info

6:52 PM  

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