Diabetic Diets

Susan Sontag is the one who alerted us we should pay attention to the way people talk about illness and, by extension, their bodies. It’s no doubt to her I owe my mind’s wanderings after talking to two friends on medical diets who each delighted in telling me what they were allowed. When my mother was diagnosed with diabetes, our household lived in fear of what was forbidden.

In some ways, the different responses are similar to how people notice if a glass is half full or half empty. They indicate states of mind that outsiders roughly translate into optimism or pessimism, happiness or sadness, tranquility or depression. Beyond that, they indicate how people react to limitations and how those reactions affect their long term health.

The first woman has been overweight as long as I’ve known her and seeing specialists who tried to help her deal with a diabetic condition with diet. To no avail. She remained overweight but constantly talked about what she was told to do.

When I noticed it looked like she had lost weight, she said she had recently had her gallbladder and uterus removed. She was now fully diabetic, and again she told me about what she was allowed to eat. In addition to her three meals, she believed she could snack all day on nuts. It was in this context that she said she was allowed so many nuts a day and had them stashed in different places in her office. She sounded like a happy gerbil who didn’t pay attention to the warning that she could only eat so many calories a day, composed of foods from the list. She took the list to be a list of what was permissible within her traditional dietary patterns and was always confused that nothing ever changed.

The second woman has also been overweight as long as I’ve known her, and suffering from stress or emotion triggered symptoms like severe rashes. At one time she was told she was pre-diabetic, and I remember then she shopped the internet until she found some kind of bran muffin that tasted good and met her dietary restrictions. She allowed herself one in mid-morning.

Her conditions never really change. When I saw her this time, she mentioned all the medicines she was taking and noted she was back on Prozac. This time she has a gluten allergy which limits what she can eat, but it was when she was discussing her dietary list and mentioned what kind of chocolate she was allowed, that I asked was she still pre-diabetic. She looked at me as if she didn’t understand the question.

I was about five when my mother was diagnosed with diabetes. At the time, the early 1950's, diabetics were put on strict diets. She ate a poached egg and whole wheat toast every noon. Our dinners usually were some meat leached of all fat (and nutrients) and boiled, canned vegetables, usually peas, corn or string beans. When I later talked to other diabetics and learned even corn and peas were too starchy, I realize my mother’s condition was serious enough to warrant giving herself a daily shot of insulin, but not severe.

Like many diabetics, she was obsessed with the forbidden, and would indulge in fudge or other chocolate when she thought she could. She looked on the times my father was away on business as periods of freedom when we could go to the local drive in. Still, she had some kind of internal monitor because I only remember a few times when her biochemistry was off and she needed a quick dose of orange juice.

The difference between focusing on what’s permitted or what’s forbidden, however, may be more than a difference of individual psychology. Since I was a child, organizations representing diabetics and individuals like Mary Tyler Moore have been arguing that diabetes is a disease that can be treated, not some contagious or debilitating condition that requires special handling by society.

I was reminded of the reasons for such campaigns when I got my driver’s license renewed a few weeks ago. The form asked if I was a diabetic, alcoholic, drug user or had heart problems. No one is going to voluntarily admit to being a member of that quasi-illegal group. When I asked the clerk about the reason, he said diabetics might pass out. I didn’t say, so might I if I had a fever and was driving to the drug store to fill a prescription.

There is a profound difference between saying someone with a disease should be treated equally by the Department of Motor Vehicles, and saying they, in fact, are like others. The attempt to convince society to treat diabetics as normal has morphed into a belief by some diabetics that they are normal, and that their dietary lists are simply menu choices not clarions to change behavior.

My working friends will probably outlive my reclusive mother simply because they are more active, but I doubt they’ll live so many years with diabetes. The first women I mentioned is probably around 50, and I’ve heard her complaints about ill-health for about 10 years. The other women is a little older, and she’s been on a physical roller coaster the 15 years I’ve known her.

My mother, although a deeply unhappy woman who died just before she would have turned 60, managed to live 25 years with diabetes with no concerns about her weight and, until her heart attack in her mid-50's, no dramas of physical malaise.

Living with the forbidden may actually have been healthier than exploiting the permitted.