Works Cited

Brewer, Sarah, Alan L. Rubin, and Alison G. Acerra. Diabetes Cookbook For Dummies. United Kingdom: John Wiley & Sons Ltd, 2007. Print.

Cheyette, Chris, Yello Balolia, and Chris Cheyette. Carbs & Cals: A Visual Guide to Carbohydrate Counting & Calorie Counting for People with Diabetes. United Kingdom: Chello Publishing, 2010. Print.

Dominick, Andie. Needles. United Kingdom: Virago Press Ltd, 1998. Print.

Nash, Jen. Diabetes and Wellbeing: Managing the Psychological and Emotional Challenges of Diabetes Types 1 and 2 . 2nd ed. USA: John Wiley & Sons, 2013. Print.

Oliver, Jamie. Jamie’s 30-Minute Meals. London: Michael Joseph an imprint of Penguin Books, 2010. Print.

Spelnda. ‘Sugar Free Blueberry Muffins Recipe’. Diabetic Gourmet Magazine. N.p., 2014. Web. 24 Mar. 2015. <http://diabeticgourmet.com/recipes/html/998.shtml>.

Tempest, Tessa Vane . ‘Sugarless Chocolate Cake’. Unknown Newspaper: Imperial War Museum Archive 1942. Print. 11 Mar. 2015

An Ending & A Begining: a Little Conclusion

When I first started this food blog, I wanted to answer three questions:

• Can recipes from famous cookbooks be effectively followed and adjusted to meet a Type One’s dietary needs?
• Are recipes from diabetic cookbooks good, bad or just plain ugly?
• How is Type One Diabetes represented in literature?

To the first question, Jamie Oliver's Jamie's 30 Minute Meals(2010) provided me with the answer of a resounding yes! I didn't even need to alter the recipe to meet my needs. While I'm aware this will not be the case with every cookbook or recipe, it shows it just takes a bit of persistence and patience to find what you're looking for.  

To the second question, my exploration of  Diabetes Cookbook for Dummies(2007), Diabetes Recipes(2012) and Diabetic Gourmet Magazine demonstrated that recipes for Type 1 Diabetics can be good, bad and ugly all in one go. But overall, they serve a purpose. I'd love the convenience of grabbing a Blueberry Muffin from a coffee shop, but going to the effort of learning to make my own is better than running high-blood sugars. I have a relentlessly sweet tooth and cooking this recipe has shown me that I can still enjoy sweet-tasting food without endangering my health.

To the third question, my analysis of Andie Dominick's Needles(1998) turned out to be more emotional than I anticipated. Dominick portrays Type 1 Diabetes in a remarkably frank way in Needles. She refuses to blame or make excuses for poor control, but depicts the daily battle of Type 1 Diabetes in an honest and controlled way. As a Type 1 Diabetic and someone who is also interested in memoir writing, I was impressed with Dominick's Needles and hope that one day I can put my story across in such a restrained way.

In this blog I also touched on carbohydrate counting, the relationship between depression and Type 1 Diabetes, 1940's attitudes to reducing sugar content, and gave an introduction to the disease. While not every post has been 100% food related, every post has pertained to a disease which is 100% related to food. Though this is the end of this project, it has sparked the beginnings of a new relationship with food. This blog has resulted in me discovering delicious recipes that will improve my health and taste delicious. To conclude, I hope you have enjoyed reading this blog nearly as much as I have writing it!

Sugar-Free Blueberry Muffins: A Recipe From Diabetic Gourmet Magazine

In my first post I asked: Are recipes from diabetic cookbooks good, bad or just plain ugly? For this recipe I wanted to cook a diabetes friendly dessert so I investigated the diabetic cookbooks I owned. Out of Diabetes Cookbook for Dummies(2007) and Diabetes Recipes(2012) I couldn't find anything that I wanted to cook (perhaps suggesting the answer is 'bad or just plain ugly'). So I cast my net wider and searched the internet. One of my favourite snacks pre-diabetes was a Blueberry Muffin, so that's what I decided to look for. Post-diabetes I have learned that Blueberries are considered a 'diabetic superfood' as they have been proven to increase insulin sensitivity and aid the management of blood sugar.

The recipe I used to make the muffins pictured above was from Diabetic Gourmet Magazine at this web address. The website does not give an author for the recipe, but gives Splenda as the source. 

The language in this recipe doesn't have the conversational tone that we saw in Oliver's and I found the instructions harder to follow. The last time I baked anything I required adult supervision, so I felt out of my depth starting this.

The Good: 

• They tasted amazing.
• >10g of sugar.
• Nutritional information provided so no need to carb count. 
• Recipe devised with diabetes in mind.
• Once I understood what I was doing this was really fun to complete. 

The Bad: 

• I thought my arms were going to drop off 'creaming the fat' 
• I had to ask someone to explain the recipe/ what I needed to do before I could start doing it. 
• The temptation to eat them all in one go is overwhelming. 

The Ugly:

• My kitchen after cooking these muffins. 

My overall thoughts are that diabetic recipes are far more good, than bad or ugly. I would give this recipe an 8/10. The muffins turned out great in the end and it was amazing to enjoy an old treat guilt free. Non-betics watching what they eat should consider giving Diabetic recipes a go, as a diabetic diet is fairly similar to the healthy diet nutritionists recommend everyone abide by. Will definitely be making this again in the future! 

Sea Bass & Crispy Panchetta: A Recipe From Jamie's 30 Minute Meals

In my first post of this blog, I asked: Can recipes from famous cookbooks be effectively followed and adjusted to meet a Type 1’s dietary needs? 

To answer this question I used Jamie's 30 Minute Meals(2010), by non other than Jamie Oliver. Jamie's aim in this book is to boost efficiency in the kitchen and encourage people to cook healthy meals quickly. I'll admit, my 30 minute meal took me 41 minutes and 59 seconds, but I am a notoriously slow cook! I wanted to cook a fish dish as omega-3 helps to prevent heart disease, a common complication of Type 1 Diabetes. So I had a go at his "Sea Bass & Crispy Pancetta [with a] Sweet Potato Mash"(180) 

This recipe was easy to follow and a lot of fun to make. The language used in the method was clear and precise. The best thing about it is I din't have to edit the main meal to fit my dietary needs (just omit the ice cream and lemon ginger drink). Fish is great for my heart; sweet potato is a fantastic choice as it is a low GI carbohydrate (meaning the glucose breaks down slowly); and green veg like asparagus and broccoli contain no carbs.

Jamie's recipe takes you step by step through the cooking process, saving time and improving your cooking technique. I found the tip "SEA BASS Check the fish - once the skin is golden and crispy, turn the heat down to low - but have the confidence to let the skin become good and crispy before reducing the heat"(182) especially useful. Turning the heat down too soon out of fear of overcooking the fish is something I had always done before reading this,

This meal released plenty of happy hormones, and after eating this meal my blood sugars were in range 2 hours after eating. I'd give this dish a 9/10 and will be cooking it again. Thanks Jamie! 

A Bitter-Sweet War: "Sugarless" Recipes from WW2

In the United Kingdom on the 8th January 1940, four months after the outbreak of the Second World War, rationing was introduced. The first foods to be rationed were: bacon, butter and sugar.  The typical sugar ration for one adult per week was 225g.

Last week I visited the Imperial War Museum in London, and had the opportunity to look through their archive material relating to food during the first and second world wars. The first thing that grabbed my attention (being pancreatically challenged as I am) were all the "sugarless" recipes. Great, I thought, I'd love to bake a 1940's cake that won't send me into DKA. To demonstrate why my excitement short-lived, here is one of the recipes I found from a newspaper clipping (Unknown Newspaper, 1942):

Another of [Tessa Vane Tempest's popular dishes] is a delicious sugarless chocolate cake:
3oz each margarine, good quality chocolate powder, S.R. flour, 3 desert-spoonfuls  of golden syrup, 3 desert-spoonfuls of hot water, 2 eggs (1 will do), 1 teaspoonful of cocoa powder -
Cream fat, chocolate powder, and golden syrup. Beat well or 5 minutes, adding hot water after 2 minutes. Add egg and a little flour. Beat well, add cocoa and rest of flour. Put in two small well greased sandwich tins, bake 20 mins. (Gas 5, 375 degF)
For the chocolate filling:
2oz margarine, 2 desert-spoonfuls syrup. 1 desert-spoonful cocoa powder, 2oz chocolate powder-
Beat, add a little hot water if too stiff. Sandwich cake with filling, use this also to rough with wet knife.

To me this recipe is far from sugarless. Useful if you're trying to negotiate the sugar ration, not so useful if you don't have a functioning pancreas.

As you can see, our understanding of the word "sugarless" has evolved since the 1940's. This recipe has given me a new-found appreciation for the time I live in, and the challenges that Type 1 Diabetics would have faced during this time.

Highs & Lows: a Laugh a Day Keeps the Doctor Away.

Mentioning 'highs and lows' with reference to Type 1 Diabetes, it would be natural to think the discussion was about blood-glucose. However, the psychological highs and lows involved is an issue which I believe unjustly receives scant attention. In Diabetes and Wellbeing: Managing the Psychological and Emotional Challenges of Diabetes Types 1 And 2(2nd Edition)(2013) Jen Nasher states that "The link between diabetes and depression was recognised as far back as the seventeenth century when English physician, Thomas Willis observed in 1674 that diabetes often manifested in patients who had experienced significant sadness, life stress, or a long period of anguish."(49) It's not just the cause and effect relationship between emotional well-being and the development of diabetes that fascinates me, but the way in which diabetes and depression can fuel each other. Nasher comments on this, saying that "Diabetes is a chronic illness that involves a high degree of self-care tasks and is a demanding condition to manage. Diabetes and depression often interact with each other, exacerbating the downward spiral of mood."(56) It can be a vicious cycle. You feel depressed and feel less desire to look after yourself. Your blood sugar rises as a result, leaving you feeling chronically fatigued and irritable. Low mood perpetuates and you feel even less desire to take care of yourself.

Last week I appeared on Channel 5's GPs Behind Closed Doors, a fly on the wall documentary showing consultations between patients and their GP's at my local Putney Mead Medical Practice. In the episode you see me and my GP Dr A Helm discussing my referral for psychotherapy, and the impact of my diagnosis of Type 1 Diabetes on my mental health.

Dr Helm hits the nail on the head when she says "Illness is not your fault" and I honestly feel blessed to have such an amazing GP. A large blame culture exists in the treatment of Type 1 Diabetes, often most acutely felt by the patient themselves (we're all our own harshest critic at the end of the day). Even if a patient isn't suffering from depression, they could be experiencing what I mentioned in the clip: 'diabetic burnout'. Nashler comments on this saying "individuals may be struggling with diabetes-specific distress, coined diabetes 'burnout'(Polonsky, 1999). Diabetes burnout occurs when a person feels 'overwhelmed by diabetes and the frustration of diabetes self-care'"(56). If you're a type 1 reading this and identify with any of what I've described, it's really important to recognise that none of this is your fault and that it's OK to ask for help.  

An ability to laugh at the macabre is one of the most essential life skills a Type 1 Diabetic can develop. In Diabetes Cookbook for Dummies(2007). Dr Sarah Brewsher et al  states that "If you have diabetes or any other chronic disease for that matter, keeping a sense of humour makes the inconveniences and associated complications much easier to bear... Rather than an apple, 'a laugh a day keeps the doctor away'"(23). While I'm not convinced that joke a day is going to prevent me from needing to see my GP regularly, I am sure that a positive mental attitude can be an invaluable ally in the fight against Type 1 Diabetes. 

Short Sharp Scratch: An Analysis of Andie Dominick's 'Needles'

Andie Dominick's Needles was first published in 1998 and is an emotive, profound and brutally honest portrayal of a young life irrevocably altered by Type 1 Diabetes. Dominick describes life before Type 1 Diabetes and her fascination with her Diabetic sister's syringes: "I know about needles. My sister leaves them everywhere. I fill her syringes with water, transforming them into mini-water guns."(3). Andie soon learns that Type 1 Diabetes isn't all fun and games, when she develops the disease at nine in 1980. Dominick describes her sister comforting her: "She tells me I'm going to have a happy life. Even if the needles belong to me."(15).

I remember the first time I was told I was going to have to give myself multiple injections a day in order to manage my condition. My initial reaction was, 'OH, HELL NO!'

Over a year and a half on, and an estimated 2,400 short sharp scratches later, I can safely say that I'm now accustomed to the needles belonging to me, too.

Dominick's Needles is the first piece of literature I came across pertaining to Type 1 Diabetes and my expectation was to find comfort through shared experience. Whilst I did find this, I also found an unexpected brutal honesty on behalf of the author regarding the delayed consequences of poor blood sugar control, and tragic effect of drug use. Dominick's portrayal of her sister's death and her own complications at the hands of the disease made for uncomfortable reading at times, as I reflected upon my own (admittedly poor at times) blood sugar control. 

Dominick describes finding her sister's body in the home they share: "My sister is on the bed. Her eyes are open and her face is bloated. She looks plastic and inhuman."(111) Dominick's depiction of her sister's death is the part of the memoir that moved me (admittedly to tears) the most. This emotional response was entirely to do with fears of my own mortality. Dominick declares that "The cause of death had been ruled an accident. Coronary disease, a heart attack, the result of diabetes and cocaine abuse."(132) Dominick's discussion of her sister's self-destructive behaviour is markedly frank:  

She wasn't the stereotypical addict. She was just Denise. She got up for work every day and relaxed with novels at night. I told myself she had her life under control. Now I know she was self-destructive. She had a subconscious desire to take her own life before diabetes did. Smoking and drinking in excess throughout her twenties and rarely visiting the doctor, she frequently ran out of insulin and needles and never tested her blood sugars... She always thought the disease would kill her eventually. She grew up knowing what would take her life. Denise laughed and said she wished she would live long enough to die from lung cancer. She didn't.(126-127) 

Dominick's refusal to chastise or condone her sister's behaviour is what I find most remarkable about this section of her memoir. Denise's 'subconscious desire to take her own life before the diabetes did' is something I can entirely relate to. In darker moments I'll admit to wishing the disease would just hurry up and kill me, rather than the thought of another 40 years or so of waking up every day to face another relentless battle with my uncooperative blood sugar. 'Smoking and drinking in excess throughout her twenties' made for even more uncomfortable reading. As a smoker who has tried to quit on multiple occasions and a university student with a healthy social life and an unhealthy desire for a good time, Andie's discussion of her sisters actions in her youth sounded all too familiar. Temperance Vs hedonism is a philosophical debate which has always interested me, but in light of Type 1 Diabetes it is one that has taken on a much higher significance in the last two years.

The second aspect of the memoir which truly struck a chord with me, is Dominick's portrayal of her fading sight. Dominick declares "My right eye fills with bloody gel and black lines. I blink and rub my eye, but the vision won't clear. Time stops. My heart races and the muscles in my neck tense up."(144) Going blind is the biggest fear I have related to my condition. As an English Literature student who wishes to pursue an academic career, the thought of never being able to read a book utterly terrifies me. Dominick reflects "I know a little bit about diabetic retinopathy, and I know seeing blood is a symptom... Diabetes is the leading cause of adult blindness. My sister always said she'd kill herself if she went blind. She didn't want to live if she couldn't experience the world through her eyes."(147) Again, I found myself relating to Denise's assessment of the situation. Dominick talks about her feelings of isolation, saying: "I can describe the condition, but I can never explain how I feel about it. I'm alone in this. No one can understand how fearful I am of going blind, how secluded I am in my thoughts about my future."(189) The words 'I'm alone in this' jumped from the page for me, and echoed entirely my own feelings about Type 1 Diabetes. 

Again we come back to the desire to relate to others and to feel that others relate to us: the desire to feel that we are not alone. Type 1 Diabetes can be an isolating experience, because you, and you alone are responsible for the management of daily blood sugars. However; literature such as Dominick's Needles; blogs such as this; and engagement with the Diabetic community on-line through social media can hopefully help Type 1 Diabetics feel less isolated. And resultantly, a little more human.