by Aileen McGraw
For fifteen years, what I put in my body has been all-important. Hyperawareness of my intake and output continues as a daily priority. My choice to go vegan occurred just over two years ago in April of 2010, but my diagnosis with type 1 diabetes mellitus, commonly known as juvenile diabetes, happened in August of 1997.
While I used to administer upwards of five shots of insulin via syringe each day, in 2007 I transitioned to the insulin pump. Instead of time-dependent injections, I now deliver rapid-acting insulin continuously through a catheter to manage my blood glucose level. Need to clear up the medical jargon? Find explanations and definitions of diabetic terminology on the American Diabetes Association or Medline Plus websites.
So – what is diabetes?
Diabetes is a disorder of metabolism— the way the body uses digested food for growth and energy. Most of the food people eat is broken down into glucose…the main source of fuel for the body.
After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach. (National Institute of Diabetes and Digestive and Kidney Diseases).
When I eat, unlike non-diabetics, my pancreas cannot give proper insulin doses. Glucose does not move to cells from my blood as my pancreas sends out too little insulin. The result? I need to self-administer different amounts of insulin depending on my personal food intake, activity level and current blood glucose level.
Considering that people with diabetes have trouble using food for growth and energy, the omnivore-vegan transition might initially intimidate. Personally, the journey towards veganism brought both challenge and triumph. My childhood consisted of avid milk drinking. A cup of cow’s milk equates roughly to one slice of bread or one small fruit in carbohydrate content. I turned to milk whenever I needed a quick, easy snack that supplied carbohydrate and also included calcium and protein. When my go-to blood sugar stabilizer, cow’s milk, fell out of the picture, I found that along with plant-based milks like soy milk, many fast-acting carbohydrates like apple juice, bread, crackers and glucose tablets still fit the vegan tab. When I became vegan, I noticed that my blood sugars were lower on average, and reduced my basal rate (the continuous drip of insulin) to compensate. Lower blood sugars presented several potentially serious risks, but with proper management, I kept my levels largely within my personal target range. My A1C (an indicator of how well my blood sugar was controlled within the past couple months) dropped more than half a point, a sign of effective control.
Energy plays a central role in both diabetic and vegan lifestyles. Challenge came in managing carbohydrate intake while choosing foods for their protein content. Meeting with a registered dietitian revealed the importance of adequate protein to maintain strength as well as hair and nail health. With a relatively active lifestyle (I was a competitive cheerleader in high school and I dance at college), my dietitian and I decided to select for protein to help me gain muscle mass. Meals like pancakes and cottage cheese, while high in both carbohydrates and protein, contain dairy and eggs. Protein-rich vegan combinations like tofu, broccoli and almonds provide lower carb content. My personal remedy? Include carb sources like oatmeal, brown rice and bagels with other typically protein-rich/low-carb foods. That’s not to say pancakes disappear in a vegan meal plan. I love using bananas or flax seed and water as egg replacers in pancake mixes. Come breakfast time, water and nut or plant-based milks ensure that my pancakes retain their fluffy texture.
Being a vegan diabetic, I know that I need to eat more before physical activity. This past winter, I skied for the first time. While I was far from Olympic caliber, learning technique took a lot out of me. As my friends refueled with dairy products and meat-based protein, I made sure to pack along my favorite soy protein powder (Whole Foods Soy Protein Powder in Natural Vanilla flavor) and consume my fair share of peanut butter and lentil soup. However, even with meal planning, I experienced late-night blood sugar drop, or post exercise hypoglycemia. My body responded to changing stress levels and stores of glycogen with a drop in blood glucose level. Everyone’s reaction to exercise varies, which is why I check my blood glucose level before, during and after physical activity and pack snacks in case of low blood sugar. I found instant oatmeal and apples to be quick and easy fast-acting foods. My best advice, simple and overused: prepare and plan ahead.
If the vegan shift brought tremendous change, then the college-vegan-diabetic transition created a trifecta of new and unexpected (yet manageable!) challenges. At Northwestern University, I balance picking up my own prescriptions with buying additional groceries and navigating the dining hall options. Lucky for me, Northwestern won Most Vegan-Friendly College from PETA2 for the second year in a row. Oven roasted herb potatoes and hummus flatbread plates? As both a vegan and a diabetic, I can’t complain! For me, NU’s on-line weekly menus provide invaluable planning information. I access menus at my favorite dining halls, being sure to fill any nutritional holes with a quick run to Walgreens, Whole Foods or my dorm room.
As freshman year wraps up and I enter my 16th year with diabetes and embark on vegan year three, I can say sincerely that I enjoy myself in health and life at large. Bottom line: use experience to your advantage and have fun! As a diabetic, I’m used to knowing my body. This made the switch easier; I adhered to the already familiar routine of monitoring how what I eat makes me feel. My advice? Dive in full force. Know your body; explore the make up of your food. Be innovative with low blood sugar snacks (might I suggest “vegan cookie dough?” Instant oatmeal, peanut/nut/sunflower seed butter, bananas, and – if you’re up for it – raisins). All changes present risk, but for me, keeping confidence up and reflecting over my convictions allow me to lead a “vegabetic” lifestyle with ferocity.
Questions about monitoring carb intake, planning meals, finding recipes or “free foods” (those low enough in calories and carbs that they are considered “free”)? Many solutions and resources can be found in VRG’s Vegan Menu for People with Diabetes (containing a carb exchange/equivalency table and daily menu pattern, also available in Spanish) and the Physician’s Committee for Responsible Medicine guide to going vegan with diabetes. You can also find general information about nutrition for people with diabetes on the American Diabetes Association “Food & Fitness” page.
As stated in Vegetarian Journal 2003 Issue 2 in “Vegan Menu for People with Diabetes:” “Every person who has diabetes has his or her own individual energy and nutrient needs, so please consult your health care professional to make sure our suggestions will work for you.”
This is not personal medical advice. This article stems from personal experience and things that I individually find helpful. Consult your healthcare professional for personal suggestions and/or medical advice.
Written by Aileen McGraw during her internship with The Vegetarian Resource Group