I wish I could boast that my blood glucose levels during my four week holiday were amazing, but that would be lying! Even at home, they are never 100% in range, so expecting this to happen while on holiday would be like wishing for the moon! Almost a year ago, I went on a DAFNE course (Dose Adjustment For Normal Eating) and it helped build my confidence with adjusting insulin to what I was eating rather than the opposite way around. I wish I could even say that I followed all the DAFNE principles while away, but trying to spot blood glucose patterns outside of a regular rhythm while eating exotic foods with dubious carb guestimates is a little difficult! I did still try to carb count, and correct high BGs, but the outcomes were a bit of a mixed bag (an understatement if any!)!
One of my highlights of the trip was the food though! I love Asian cuisine in general, and Vietnam and Cambodia definitely offer some amazing treats compared to other countries in the region! From the amazing noodles, and spring rolls to the wonderful French-colonial influenced cakes and pastries, and not to forget the freshest fruit and juices imaginable! Although I wasn’t very familiar with the local dishes before our trip, I have a few noted down to make at home (probably for a nostalgic evening scrolling through photographs!).
Of course, food also became a challenge: I discovered quite early on that similar to Chinese food (a.k.a. Arch-Nemesis Number 1!), Vietnamese and Cambodians also sweeten a lot of their dishes with “hidden” sugars, although luckily it seems not as much as their northern neighbours! I decided to allow some upward rounding of insulin doses to try take into account these hidden carbs. It was a bit of a gamble, but with conservative estimates, it was one which mainly paid off well.
At home, I also tend to avoid fruit juices and often only eat fruit with a meal (it just simplifies insulin injections a lot), but temptation of some of my favourite fruits at their freshest was just too great: Pomelo, Mango, Pineapple, Coconut and Banana! How wonderful (and sometimes even better with alcohol… Mango Daiquiri… Yum!)! It meant I often faced the conundrum of putting in an extra bolus for those drinks or snacks, or taking them into account at the next meal. Particularly for a small piece of fruit close to a main meal, the latter became my preferred strategy.
Throughout the trip, I tried not to let diabetes influence my culinary experience! I still enjoyed many of the traditional dishes despite being at a complete loss for their carb value! One of my favourite dishes of the holiday was Pho Bo, a beef and rice noodle soup which unfortunately doesn’t feature in Carbs and Cals! This dish was a particular challenge as the rice noodles are completely immersed by the broth, making it tricky to estimate how many noodles there are. The portions were often also quite large, making it extra hard needing to decide how many noodles you’ll actually eat!
My “enjoy all aspects of the local cuisine” mentality (OK, maybe also my lack of discipline), did mean I spent some less enjoyable moments in the upper half of the teens and had to chase those few highs with insulin. While a little unpleasant, it luckily never stopped me from enjoying the food or the holiday. It will probably nudge my HbA1C up a little though, but I keep reminding myself that these four weeks are not an eternity, that my control will improve when I’m back to foods I’m used to eating (or which feature in Carbs and Cals!), and when I feel more comfortable being at the lower end of my targets rather than including a safety factor for the stresses of walking around tourist sites in insane heat.
I have a few more stories from the trip to share, so see you soon!
The … Diabetic