365 Days of Type Two: Adjusting to Mom Life as a Newly Diagnosed Diabetic
Which is the healthier snack choice: A fresh sliced organic apple, or a double cheeseburger from McDonald’s?
For most individuals, this question is a no-brainer. Apples are a nutrient-dense whole food, and fast food burgers are highly processed and loaded with saturated fat. This year for me, though, I learned that the answer to this deceptively simple question is actually a lot more complex.
Newly diagnosed with Type Two Diabetes (which I’ll be abbreviating to “T2D”), I have to factor in several variables when determining what a healthy snack looks like. While apples are nutritious and unprocessed, they contain a lot of fructose, or naturally occurring sugar that is present in fruit. While fructose doesn’t hit me as hard as, say, table sugar, an apple by itself can send my blood glucose level through the roof in a matter of minutes.
On the other hand, to people with normally functioning bodies, the double cheeseburger is really calorie-dense and fatty, and may not find itself on most “healthy” diets. Through the lens of diabetes, I recognize the burger for what it is to me: a macro-balanced meal, containing plenty of fat, protein, and carbohydrates, in amounts that work together to keep my blood sugar stable.
This is just one example of mental reframing that I’ve had to do over the course of the last year of my life, due to an unexpected health outcome that caught me in the middle of an already-stressful life transition.
During my pregnancy, I was diagnosed with Gestational Diabetes. GD functions really similarly to Type 2, with the exception of the fact that in roughly ninety-nine percent of cases, the diabetes goes away immediately after delivery of the placenta.
I was the perfect candidate to recover fully from Gestational Diabetes, reassured by medical professionals that I’d surely return to normalcy after having my son. I have distinct memories from my third trimester, frustrated at the constant monitoring and mental load of meticulously choosing “safe” foods that would not harm me or my unborn baby.
“I can’t wait to not be diabetic anymore,” I’d say, over and over, very literally counting down the days until I was full-term and ready to have my healthy body back.
All my life, I had a fast metabolism. I never struggled with being overweight, in fact my experience was quite the opposite: In my teenage years, I was picked on at school for looking “anorexic” despite my “eat-like-a-truck-driver” mentality. I had a positive relationship with food, intuitively eating when my body felt hungry.
I missed this mental peace during my pregnancy. For the first time in my life, I was counting calories, macros, and tracking carb intake all day every day. It was exhausting. For someone like myself, with OCD tendencies, this is a slippery slope that can quickly spiral into disordered eating.
My meticulous food-tracker, on which I kept recordings of my blood sugar numbers for every meal, every day, throughout my pregnancy.
In addition to the mental toll this took on me, I was also plagued with needles constantly, being subjected to blood draws and finger-prick glucose tests four times a day for the duration of my pregnancy.
Since childhood I’d sustained a serious phobia of needles, so a diabetes diagnosis was really jarring in that sense.
I looked forward to the day when I’d have my body back (and frankly, my sanity, too), but when I delivered my son, things didn’t quite return to normal as expected.
Like I stated before, I was reassured by every medical professional that things would be fine for me after giving birth. Let me put it into perspective: as soon as I had my baby, I sighed, “I’m parched.” When the nurse asked me what type of beverage I wanted, I told her I’d take anything sugar-free.
“Sugar free?” she laughed. “Girl, you’re not diabetic anymore! I’m bringing you an ice-cold Ginger Ale to celebrate.”
Through this interaction and many others, I was led to assume that the chances of me carrying my Gestational Diabetes outside of my pregnancy were so incredibly slim, if not impossible, given my low risk factors.
At six weeks postpartum, I was offered another Oral Glucose Tolerance Test (OGTT)-- the very same test where you drink the syrup and get your blood drawn after, which is done in pregnancy to detect GD-- just in case my insulin sensitivity had not returned to normal.
The day I received my test results, I thought my life was over.
OGTT in itself is considered enough for a diagnosis, and my results were well into the diabetic range. I had full-blown T2D.
This news was devastating to me, while my husband didn’t quite seem to understand how serious it was, and I felt like I was lacking in the emotional support department. Misunderstood and isolated from others my age, I had few (if any) people to turn to or to relate to.
I found solace in an online community of women with T2D, learning the ins and outs of the American Diabetes Association’s recommended diets and medications. Educating myself felt like a good first step, which I fell headfirst into, leading to compulsive Googling and obsessive research.
Much of my time was devoted to thinking about all the negative outcomes I’d be at risk for, like heart disease, kidney failure, dialysis, limb loss, constant insulin injections, and premature death. I knew that statistically, due to my diagnosis occurring so early in life, I’d have a higher chance of developing complications in the long term. Essentially, by being diagnosed in my early twenties, I’d be likely to live a good fifty to seventy years with diabetes, allowing the condition more time and opportunity to mess up my organ function.
Each blood sugar spike causes damage to blood vessels, nerves, and organs, most notably the kidneys. This is why it’s so common to see unmanaged diabetics on dialysis and with kidney failure after years of high glucose levels. It’s not a quality of life I want to live, and the thought that my life expectancy may very well be cut short is a terrifying thing.
While processing these fears, I sought comfort from others in my online community, but was instead met with disdain. Several vocal women in my group lashed out, informing me so matter-of-factly that I was not diabetic. I was young, slender, and well-controlled, which meant I did not belong in this community.
Friends, family, and even my primary care doctor assured me that it was probably nothing, and I was overthinking the test results. I demanded to see an Endocrinologist, which is a specialist that treats diabetes and other hormonal disorders. Hearing non-experts dismiss my concerns was tiring, and I needed answers.
It took nearly six months of waiting before I actually got to see a specialist. Six months of uncertainty, six months of being dismissed, and six months of denial. Sure enough, when I went to the Endocrinologist though, she confirmed my diagnosis right away.
She also put some of my fears to rest, telling me that so long as I keep my blood sugar levels close to “normal,” my kidneys would not fail, and my toes would not fall off. In this jarring and turbulent situation, I actually did have some control.
A Dexcom continuous glucose monitor reading of mine, indicating a blood sugar spike post-meal.
Finally after emerging from the denial stage, I was met with new challenges: guilt and shame. Uninformed friends and family members would make comments about how “This is why diet is so important,” and “Téa has always had a sweet tooth,” implying that it was my choices and my lifestyle that led me to an early diabetes diagnosis.
I want to bust this myth right here and now. T2D, while linked to obesity and poor diet in some cases, is actually far more likely to be caused by a combination of genetic factors and uncontrollable life events. Otherwise, every person with a poor diet would be diabetic at age twenty-five.
My enjoyment of a fast food-heavy diet in my first year of college did not cause my diabetes, and to imply that that was the case is an insult and a gross misunderstanding of the disorder in its entirety.
In my Endocrinologist’s expert opinion, I was destined to become diabetic at some point in my life. The genes were there. The genes have to be there.
In order for the genes to show themselves and actually make me diabetic, some certain life event would have to “wake them up.” This life event could be a poor diet, which tends to be gradual. It could also be pregnancy, especially one with Gestational Diabetes, or it could be something like COVID-19. I just happened to have the perfect mix of genetic factors and life events to make my inevitable diabetes diagnosis pop up in early adulthood, which is garbage luck, but it’s as simple as that.
This brings me to COVID. Research shows that new-onset diabetes is more likely to show up in people after a COVID diagnosis. My first bout of COVID happened in 2021, with subsequent infections after. This could have caused my cells to respond differently to insulin, leaving me with undetected diabetes until my pregnancy, during which testing and monitoring becomes extremely stringent.
While there is no decisive way to determine if my condition was caused (or exacerbated) by COVID, there is a chance that this could have been the very life event that caused my genes to wake up early.
Now, a year after my diagnosis, I try not to get hung up on the “how” or the “why.” It is so easy to dwell on sentiments that I don’t deserve this, or that this is unfair. Of course it is unfair. Diabetes is not fair to anyone that suffers from it, nor is any chronic illness. Who is subjected to it seems arbitrary in the scheme of life.
Instead, it is productive to focus on managing it in a sustainable way.
I’ve spent countless hours grieving the foods I believed I could never eat again, only to discover that through proper portioning and balancing with protein and fat, no food is off limits. By not cutting anything out entirely, I’ve been able to find a diet that doesn’t make me depressed and sad for the future.
For example, today for breakfast I had cream puffs. Now, I love cream puffs. I love dairy desserts, and whipped cream is especially light and fluffy and just slightly sweet in the right amount. These have got to be one of my absolute favorite foods, and for a long time I assumed they’d be off the menu post-diagnosis.
At the grocery store yesterday, mid-freezer aisle, I made the life-altering discovery that the mini frozen cream puffs only contain eighteen grams of carbs (including six grams of sugar) per six puffs.
To say I was over the moon would be an understatement.
Without a second thought I bought the box, thawed them out, and enjoyed with breakfast. Pairing them with two eggs and a piece of sausage would be the ideal way to balance my macronutrients. Through meeting with a dietician during my pregnancy, I learned the invaluable fact that protein, fat, and fiber slow down the absorption of sugar into the blood, meaning that I could eat more carbs without shooting my glucose levels up so drastically.
Finding lower-carb alternatives has also been a helpful tool to enjoy foods I’ve always loved, without damaging my body.
While my blood sugar numbers are not always perfect 24/7, I’ve learned not to strive for perfection, but to strive for “good enough.” I want to live a long life and not be uncomfortable as I reach old age, but just like my macros, I need to find a balance. It’s important to recognize that I also want to live a happy life, not bursting with anxiety and toxic perfectionism every time I want to enjoy a meal.
Even with this mindset, it’s not all rainbows and butterflies. I still deal with blood sugar spikes, intense episodes of hypoglycemia (dangerously low dips in blood sugar), midnight alerts from my glucose monitor waking me up to tell me my numbers are too low, chronic fatigue, and a lowered immune system. I’m still not the same as I was pre-diabetes— and never will be— but it is getting more manageable.
I want to go back to my initial question, of “What’s healthier, an apple or a fast food cheeseburger?” If you remember, I discussed that for me, a cheeseburger is actually more balanced and is less likely to cause a blood sugar spike on its own. In theory, this sounds great-- but what I’ve learned over these last 365 days is that there’s a lot more complexity to the situation.
Yes, the apple may cause me a glucose surge. But what if I pair it with some peanut butter, and a piece of cheese? These elements add crucial fat and protein to my plate, dulling the effects of consuming simple carbs. In this scenario, I reap the beneficial fiber and nutrients from the apple, I’ve mitigated (or at least subdued) the leap in blood sugar, and I live life knowing that apples are not evil, and that I can still enjoy them too.
My diagnosis alienated me from my peers, and led me down a path of denial, shame, and fear. As in many cases, time truly has been the best medicine, giving me opportunity to adjust and reach an era of acceptance.
While I continue to navigate a newfound distrust in my own body, I have learned to trust my brain even more. Knowledge, education, and community have proven to be valuable resources while calibrating after a chronic illness diagnosis.
As I’m beginning to settle and adjust, newfound challenges pop up. My plans to have another baby seem less and less likely, knowing the risks that come with pregnancy in T2D, for one.
I don’t believe the challenges will ever cease, at least not permanently. My hope is that again, with time as medicine, I will learn to meet those challenges with vigor and confidence. I suspect that although not every mom gets a serious diagnosis immediately postpartum, many of us can find common ground in that we all experience major changes to our bodies. Complicated pregnancies and deliveries can trigger newfound doubt in one’s own body. This feeling is familiar but not often talked about, which is a shame.
We sacrifice a great deal to bring our babies into the world, without much support or sympathy as it is so often written off as “part of being a woman.” Femininity comes with responsibility, and that responsibility altered my life and health forever. In other ways, it probably altered yours, too.
Me and my sweet boy, one month old.
Acceptance and recovery is hard, but I am committed to it so I can continue to live my life with balance, and I hope other moms can do the same. One year later, I will say that it can and does get easier with time, self-love, and acceptance. While I may have a new knack for reading food labels, keto recipes, and guessing carbohydrate content with ease, I can’t forget to live— and neither should you.
