As a self professed foodie, it hasn't always been easy for type 1 diabetic Nathan Shackelford to manage his diabetes. Diagnosed at age 12, Nathan neglected his diabetes care throughout his adolescence, but now that he has a family of his own, he has made his health and wellness top priority. By making changes to his daily diet, while still finding small ways to indulge in the foods he loves, Nathan has found what works for him. He shared his personal story with us, as well as some tips on "living large" with diabetes.
Name: Nathan Shackelford
Can you tell us your diagnosis story?
I was diagnosed in 1985, so I’ve been living with diabetes for about 26 years. My dad is also a type 1 diabetic, so my parents were watching me and my six siblings closely to see if any of us showed symptoms of diabetes. As a precaution, we ate a pretty healthy diet and had very little refined sugar growing up. When I was twelve, I had a kicker of a virus during the summer that was bad enough to visit the doctor. Not too long afterwards, I began to show signs of excessive thirst and frequent visits to the bathroom. My parents already had the test strips and knew pretty quickly that I had diabetes. They tried to see if it could be treated with changes in diet and vitamin supplements, but it didn’t work. I started taking insulin fairly quickly. At that time, glucometers weren’t available to us, so we only tested when my blood sugar was bad enough to cause sugar to show in my urine. It was pretty easy to have poor glucose control back then.
Through high school and college, I was pretty nonchalant about my glucose levels. Truthfully, I felt pretty awful most of the time. I remember the periodic endo visits, being told that my A1C’s at 8-10 were not so great. When talking to my wife about my diabetes in my young adult years, I remember telling her that I could still live a pretty long life, until age 50 or so. She wasn’t impressed. Post-college I started to settle into a routine and think about living a longer life. My real efforts to gain good control were in 2003, when I decided that I needed to qualify for life-insurance for the benefit of my family. I got serious, began testing obsessively, eating better, and getting tuned in to the best ways to live as a diabetic.
Why did you start your blog?
I started my diabetes blog this year because I was finding myself wanting to blog about my diabetes on my personal, multi-purpose blog, but felt that the audience wasn’t really right. I was pretty sure it wouldn’t be interesting for many of my readers. I’ve learned a lot over the past eight years striving for good diabetic health. I want to share what I’ve learned with other diabetics that are also searching for answers to their struggle with diabetes. I think with access to crucial information, we can all live longer and healthier lives.
What are some of the biggest challenges you have faced living with diabetes?
I think food has been a big challenge for me. I love travel and food. I have spent much of my adult life pursuing an interest in cooking and flavors that are fascinating to me. As I have gotten more in tune with how my body works (or doesn’t work), I have discovered that I have to eliminate or limit certain things from my daily diet, even a few I love. For instance, I got pretty skilled with artisanal sourdough bread baking. As I have learned what affects my sugar levels the most, it’s become clear to me that my health is worth more than certain foods. It’s a little harsh but a great discipline that has helped me to achieve much better health.
Have you had any particularly scary moments experiencing a high or low?
I haven’t had many scary situations. When my control is poor I’m more likely to spend my time in the hyperglycemia realm. I can honestly say that hypos have been few and far between, even when young and eating high-carb. Once in high school, I was on vacation with a friend’s family and my insulin vial fell on the floor and broke. I was at a beach resort in the Philippines and far from a pharmacy. It was a little strange to realize how dependent I was on that little vial. Similarly, when something goes wrong with my insulin pump, it has a domino-effect on my health.
How does diabetes affect your daily life?
Diabetes affects my daily life in many ways. I am aware of it when I wake up the morning and when I go to bed at night. My meals are impacted, and sometimes my energy levels and moods are affected by it. All that said, I think most people are unaware of my diagnosis. With my diet choices, most people just seem to look at me like you would a vegetarian, someone who has chosen to eat a different way, no big deal.
Do any of your other family members also have diabetes?
My dad and one sister also have type 1 diabetes. We were all diagnosed in our adolescent years. The three of us exchange ideas about how to make things work better. I’m always surprised how nice it is to have a chance to talk with them about something that is such an important part of my daily existence. Unfortunately, we live far away from each other, but we try to share ideas anyway.
What are some essentials in your diabetes management and care?
I began using an insulin pump about 4 years ago. I have become pretty dependent on the level of control and freedom it allows me to have. Once you get it dialed in, it can really be the thing that gives you consistency.
I’m on year two with a CGMS and it has really helped me fine tune my treatment. I have balanced out the inconveniences with the actual benefit and I’m starting to love the data that it provides.
In my diet, I focus on eating “good” fats, protein, and green vegetables. The result is that I can control my glucose almost all day with just basal insulin because the food I eat affects my glucose very slowly. I love seeing a flat graph of BG on my CGMS readout.
What are your top three health and fitness tips for peopleliving with type 1 diabetes?
1) The rule of small numbers- Most of my focus for the past 10 years has been on diet. I have found that Dr. Bernsteins’s rule of small numbers plays out well in my body. If you eat small amounts of carbs and take small amounts of insulin, the chances of getting hypos or highs are cut down big-time. I learned that the hard way, but it really works for me. I’m able to keep my glucose pretty close to normal without hypos (like almost never), which is pretty elusive any other way.
2) Have indulgences- Figure out the things that you love that can be part of your healthy regimen without compromising your best results. I have found that the following foods make me feel like I am living large, but they have minimal effects on my diabetic goals: bacon, avocados, almonds, cream cheese, dark chocolate, beer, wine, tequila. All in moderation of course…
3) Get your curiosity going- The best way to understand something is to get curious and find out more about it. Knowledge is power. I have found answers to some of my most puzzling diabetes questions by reading bulletin boards and hearing about other diabetics’ experiences. Not every book is going to be helpful but the more you read, the broader the perspective you will have on what is going on with your body. Some people think denial and apathy are just fine when it comes to a disease they didn’t ask for but I think the more you know about it, the smarter you can function with it. I am learning new things everyday.
As a diabetes blogger and advocate, what is your message to other people out there living with diabetes?
I want everyone to know that people with diabetes can live healthier lives than a large portion of the apathetic general public if they make decisions to be smarter than the disease. We have opportunities to focus on our health, get blood work done, see our doctors. Make that work for you!
Nathan’s D-Blog: http://ediblesdiabetic.blogspot.com/
Nathan’s Personal Blog: http://nshack.tumblr.com/