What on Earth Can I Eat? - The Book

Life is full of unexpected surprises. There is no way in the world I could have envisaged ten years ago that one day I would publish a book. Even less credible was the possibility that it would be a book to help people with type 2 diabetes find a way of eating to assist in individually managing their condition.

But that is exactly what I have done today. If you look at the side-bar, there it is. I can hardly believe it myself. How on earth did that happen?

A little over eight years ago I was just like many of the people who are reading this right now. I had just left the doctor's surgery with a handful of diet brochures, a new blood glucose test meter and a new diagnosis of type 2 diabetes to add to my various afflictions. But, unlike many newly diagnosed people, I was determined to conquer this one. I hit the ground running. I started seeking information and I haven't stopped since.

In the eight years since then I have learned from every source I could, commencing with my doctors, dieticians and educators but not limited to those and continuing with usenet and the web. I turned my affliction into my hobby. I learned to use the various medical search engines on the web and subscribed to email alerts from sites such as the New England Journal of Medicine, the American Diabetes Association, Journal of the American Medical Association, Heart, Endocrine Today, Diabetes in Control and many others. I read everything I could find. I learned to understand “Medi-speak” and how to pick a valid research paper from a poor one; and believe me, there are far too many poor ones.

I started on usenet's misc.health.diabetes, back when it was very active (usenet is fading these days), and later added more diabetes groups and web forums. I learned a lot from many good people who helped me. Over time I started trying to help others as they arrived, shocked and scared, on those forums. If their situation sounded like mine and I felt I could suggest a way to help, I did. And slowly, over time, I found that many people started to experiment for themselves using my suggestions and they worked for them too. Often we both learned from the mutual feedback of advice and experiment.

Over time I found that I am a good coach. Like many coaches, I found that some of those I helped achieved better results than the coach. I respect them but I do not envy them, because we each have to choose the right balance for ourselves. I could work harder and achieve tighter goals, but I balance that with my enjoyment of life. My signature on the web is “Everything in Moderation – Except Laughter”. I keep that in mind when making lifestyle decisions. But I never forget that the laughter may become a bit strained if the terrible diabetes complications start to appear in my life. So I try to make sure I work just hard enough to ensure they do not. That can never be guaranteed but after more than eight years they have not arrived yet.

After a while I added other forums and groups to my morning and the number of new arrivals I responded to started to grow, especially on the American Diabetes Association Forum. I found that I was repeating myself daily. So I looked for a way to store the “standard” suggestions and discovered blogging. This blog started in 2006 as a type of archive; a way to give a new person a link to more information without typing it several times daily. Then it started to grow, as I answered more questions and posted some of those answers to the blog.

The book I have published today grew out of that experience, partly to help those who are more comfortable with a book than a computer screen. I finally made the decision to write the book when many of those who had followed my suggestions over the years urged me to write it for their relatives and friends.

That is the story behind the book. I'm a good coach, but not much of a salesman because I tend to be too honest and "tell it like it is".

I do not promise a cure. I don't have a magic bullet. I don't sell herbal mixtures, special potions or promise reversal of your diabetes in 30 days. After buying the book you don't get follow-up mail to buy anything or join a program or start a business. All you get is a book that is easy to read, easy to understand and offers clear and simple ideas to help you take control of your diabetes.

What I can promise is that following the suggestions in my book will help you understand much more clearly the relationship between the foods you eat and the consequences for your long term health. I can teach you a way to find an enjoyable way of eating that suits you. My hope is that this information may help you take control of your own diabetes management, just like many others who have reported back to me, and may help you delay the progression of your diabetes towards those terrible complications.

If you're really quick - you might even get delivery before Christmas :)

Seasons greetings to all. I just received my Christmas present; I hope you receive what you wish for.

Cheers, Alan, Australia

Low Carb Crustless Quiche

I experimented for a while with various quiche recipes, but almost all included either flour or milk leading to carbohydrate content higher than my goal .

Eventually I made this simple version myself tonight from basic ingredients. It was intended to be the next in a series of new experiments. I was quite surprised to find that it set well and tasted delicious. Even better, my spouse, who will not eat eggs in any other form, loved it.

Ingredients.

4 whole eggs, free range if possible
200ml reduced cream
¼ tsp baking powder
2 rashers bacon, chopped (one rasher is 3 or 4 American strips)
1 medium onion, sliced
1 cup sliced swiss chard or spinach (1/4 cup if frozen)
30gm (1oz) of grated or sliced cheddar cheese
¼ tsp cayenne pepper
A grating of black pepper
Salt to taste – remember that the bacon will add salt too.

Method.

Four eggs and 200ml cream was the right quantity for my quiche dish, but if you have a larger dish add an extra egg and cream in proportion. Beat the eggs with a whisk until smooth. Add the cream, cayenne and baking powder and beat again until smooth. Set aside.

If you do not have reduced cream use your local equivalent. The cream I used is 35% milk fat, which is a little less than UK double cream or US heavy cream. I will try it with fresh cream next, which is a little lower in fat but I see no reason why that should not work OK. The fat content will be slightly lower and the carb content slightly higher.

Turn the oven on to let it heat up to 170C (340F) . In a suitable pan or skillet cook the bacon and onion until the onion is starting to caramelise. Add the chard or spinach, remove from the heat and set aside for a moment for the chard to wilt while you prepare the dish.

Use olive oil or butter to grease a suitable quiche baking dish well. Place it in a larger baking tray and add enough water to that tray to surround the quiche dish without causing it to float. Drain any excess liquid from the vegetable mix then spread the vegetables over the base of the quiche dish. Pour the egg and cream mix over the vegetables and spread the cheese over the top. I pressed the cheese down, but if you prefer a crusty top leave it on the surface.

Bake for about 30 minutes, but test with a skewer in the centre at 25 minutes in case your oven cooks more quickly than mine. When it is almost, but not quite, set in the centre it is time to remove it from the oven; it will finish cooking from residual heat.

Let it sit for a few minutes after you remove it from the oven. Don’t be disappointed if it goes flat – that is normal, it is a quiche, not a souffle.

We cut it into four serves, but double that would still be a very low carb meal. This is not a low fat meal. We had a simple lettuce, cherry tomato and onion salad with it. Delicious.

Nutrition Table
for one serve:

Energy 340 kcal
Protein 11 gm
Carbs 5.5 gm
Fat 31 gm

Bon Appetit

Up-date added 14th January 2011. I now use 5 eggs and cook it a little longer, about 40 minutes. It provides four substantial main meal serves.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter

To Medicate - Or Not?

Quite often type 2 diabetics appear on forums that I read announcing that their goal is to become medication-free or to avoid needing insulin.

Although that sounds like a good goal, and for some individuals it may be, I think they may be confused about the true goal. To me the true goal is to delay or defer the terrible complications of diabetes for as long as possible; preferably to a date about ten years after I die in my sleep as a very old man.

I do not fear medications. If medications are needed to achieve my true goal I will take them. I added metformin a few years back for that reason. However, and it is a very important however, I will use them if, and only if, reasonable application of diet and exercise cannot achieve the desired result. There is an enormous difference between fearing medications and having a healthy and informed respect for the full implications of adding drugs to our bodies.

In my opinion medications should be used to complement a healthy lifestyle, not to attempt to compensate for an unhealthy lifestyle. If the diabetic's circumstances are such that further changes in lifestyle are unreasonable, impossible or not capable of producing the same benefits as medication, then medications are appropriate and valuable. But, if that is not the case, medications may be adding to their problems instead of solving them. Nor am I in favour of prophylactic medication, prescribed because some study somewhere showed a statistical benefit for some people. I'm interested in the effects on me as an individual, not a percentage of a study group who may or may not represent me.

There are no side-effects-free medications. As with all things in life a risks-benefit analysis is needed when considering adding medications or insulin.

I am unapologetically selfish about testing of new drugs. When new medications appear, often with lots of fanfare and research papers supported by the manufacturer of the new wonder drug, I have decided to wait for a decade or two of human experience before I will add that to my regimen. I will let others be the human guinea pigs over that period unless there is an urgent need that no other course of action can meet. Selfish? True. But sensible.

The history of many drugs makes salutary reading. First the euphoria, then the glowing reports, then the doubts, then the reaction. Some recent relevant cases for the drugs commonly prescribed for type 2s include the statins, Byetta, Avandia, Actos and even insulin. All may be beneficial to a large number but have significant risks for minority. The difficulty is knowing whether you are in the majority or the minority in advance. Nothing is risk-free.

Medications should not be feared. They are a valuable tool for us - but they should be respected and used only when needed.

Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter