Diabetic Diner

Pilita

2008-11-24T15:21:00.000-08:00

For a delicious ethnic dining experience, I recommend Pilita in San Carlos. The food at Pilita is Turkish, and the staff will be happy to tell you about the various dishes on the menu. My regular order is the chicken kabob. It comes with rice and a good size portion of vegetables. The chicken must be marinated in yogurt or something that makes it incredibly moist. I do not adjust my dose for this, however, so it must not be too much of whatever is on there. I also typically order the Greek salad, which is huge, probably enough for two except that I am a big salad eater. For those vegetarians out there, Pilita also has excellent vegetarian dish choices (including the Turkish risotto, made from bulgur, which is more slowly digested than regular rice and has a good nutty flavor). Finally, what would a review from the Diabetic Diner be without a mention of the delicious basket of bread that lands on your table within minutes of your sitting down at Pilita. It is soft, warm, and very tasty. But also very white, so I have to bolus pretty darn quickly! One slice of that bread typically requires a 2.0-2.5 unit bolus for me.

Soizic

2007-12-29T10:13:00.000-08:00

The diabetic diner recommends the Soizic Bistro in downtown Oakland. For an appetizer, I had a delicious eel (unagi) salad. It had a sushi-like sauce on top, which I am sure must have had some sugar and starch, but I did not dose for it, not wanting to risk overdoing it. Sauces at a restaurant are a challenge, as any insulin dosers out there know. For the main course, I had halibut, prepared fairly simply in a wine and butter sauce. It also probably had some flour or bread coating, but again I chose not to dose for it. The server we had was very helpful in bringing my order without the side carrots, and with more green beans and less potatoes.

I also had some dessert, a flourless chocolate torte. My method of dosing for that type of dessert has had mixed results. Some chocolate truffles I have had are about 10g per piece. So I take my fork and divide up the cake into truffle-size pieces and multiply the number of resulting pieces by 10g to get the carb count. Like I said, mixed results. Flourless cakes seem to work well for this approach, regular cakes less so. The other issue is over what time period to dose. For the flourless cakes, I tend to do OK with a bolus. For cakes with rich frosting (you know, the really decadent ones), I sometimes need a dual wave bolus with most of the dose being delivered in the square part of the wave over several (many!) hours.

On the subject of insulin doses for unknown carb counts, I am curious as to your approach. What I tend to do is avoid foods for which a big part of the portion may be carbs but I can't estimate the carb count. An example is a sandwich with thick bread - it could be anywhere from 20g-50g per slice. There is a good chance I will not get it right, and end up low or high. On the other hand, if the item in question is a small part of the meal, like a little sauce, then I tend to ignore it in my carb counting. I may run a little high, but if I were to try to estimate it and overshoot, then I would end up low. So I take the high on the occasion that it does have measurable carbs. Your ideas?

Another sandwich bread

2007-09-15T11:36:00.000-07:00

One of the things that the Diabetic Diner enjoys most is the opportunity to have a sandwich -- with two pieces of bread. Many breads have 20 or more grams of carbs per slice. Our old favorite, the Oroweat Carb Counting bread, had much less than that, but it seems to have been discontinued. Well, I recently tried a new Alvarado Street product called Essential Flax Seed Bread. It has 15g of carbs for two slices. While Alvarado Street's other products have not wowed me, this one comes close. Try it out!

Pumping

2007-03-31T09:23:00.000-07:00

It has been a while since I have posted. That is because I have been in the world of learning how to use my new Minimed insulin pump, trying out several different infusion sets, and still working hard to manage my blood glucose control.

I may be the only person to have their A1C go up after starting on the pump. I attribute this to things that happened mostly before I started pumping, including:
(1) ramped up my carb intake a bit to try to gain some weight (to create more sites for my new infusion sets, presumably!),
(2) had a few glitches with my Lantus doses
(3) had a cold during which time my blood glucose was not so well-controlled

Things seem to be settling down now, however. I have found that the 6mm quick-sert and the 13mm silhouette work better for me than does the 9mm quick-sert infusion set. It seemed as if I was not getting any insulin using the latter, and pulling it out revealed an L-shaped (i.e. very bent!) cannula.

The flexibility of the pump, has allowed me to experiment with more types of bread, however. This has helped me to deal with what appears to be, for real this time, the discontinuance of Oroweat's carb-counting bread. But the diabetic diner will tell you more about this in an upcoming post!

First month on Novolog

2006-12-30T09:26:00.000-08:00

Well, my first month on Novolog has been interesting. I am using the Flexpen, which is very convenient. Counting carbs has become much more important now (not that it wasn't before). At first, I had a few times where I used not enough insulin, and my numbers went up a lot, and other times where I used too much, to find that my blood sugar was at 53 an hour after eating. Eating at home with known, more predictable meals works fairly well now. In restaurants, I am challenged to nail down the carb count, especially when the food includes some fun ethnic sauce. The other phenomenon I have noticed is that the timing of the Novolog is not always perfect. Sometimes my blood sugar rises 2-3 hours after eating, just when I think the post-prandial peak has passed. Part of that could be related to my Lantus dose. In other words, the bolus dose "covered " me for a few hours, and then as it wore off, the insufficiency of my basal coverage re-emerged. Still determining if that's the case. The diabetic diner is open to suggestions from any of you out there, on any of this.... Until then, I am preparing to post another fun restaurant review!

The honeymoon is over

2006-12-01T14:24:00.000-08:00

Yes, it's true. The Diabetic Diner's honeymoon is over. I am now taking Novolog before each meal. My numbers were getting higher over the last month despite a pretty restricted diet (10g carbs at breakfast, 20g at lunch, and 20-30g at dinner). The Prandin (4mg per meal) probably wasn't doing much anymore. This was a matter of time as a Type 1. My diet has become slightly more relaxed now and my numbers are much better after each meal. So far, I am using the Novolog Flexpen and finding it fairly simple.

Reviewed restaurants on a map

2006-11-11T13:16:00.000-08:00

For your convenience (and my fun in creating it), I have placed the restaurants reviewed on a Google Map. Just click the link below to see the map. You will not be directed away from this page.

Diabetes logbook

2006-10-23T15:20:00.000-07:00

I am kind of a techie geek in my free time, and have been thinking about developing a diabetes logbook that I can use online. I am interested to know what tools, if any, you use to track your blood glucose, meals, and so on, and what exactly you track.

In the meantime, I have developed early drafts of two different versions. If there's enough interest, I can develop something that others can use as well (for free, of course). Take a look at them here (a new window will open in each case).
Update: I took these offline on Dec 1 and am working on some revisions

Note: I have just added a poll regarding Lantus usage.
Go ahead and take it!

The Last Supper Club

2006-10-23T14:21:00.000-07:00

The Last Supper Club is a comfortable restaurant in San Francisco with excellent, tasty food. I had the Pork Tenderloin al Sale with Balsamic Braised Onions, Green Beans and drizzled with Saba Siciliano. Note that saba is made from grapes, so be somewhat careful with your blood sugar on this one. The pork itself was tender and full of flavor. The braised onions were delicious and were probably my favorite thing on the plate. And good for diabetics was the generous portion of green beans. I find sometimes vegetable portions are very small at restaurants and I am forced to order an extra side serving of them to get a balanced meal.

To start, my wife and I shared the large size of Organic Mixed Greens with Cherry Tomatoes, Chickpeas, Pecorino and Basil Balsamic Vinaigrette. Again, excellent flavor. In case you are wondering, my wife had the fusilli with eggplant and smoked mozzarella, not very diabetic-friendly but delicious. Bread is brought to the table with a nice dipping sauce.

The atmosphere is cozy and somewhat loud. The people around us all seemed to be enjoying what looked like delicious food. In fact, there is quite a bit of discussion across the tables as to what everyone is ordering. The staff is also very friendly and helpful. The substitutions and requests that we made were granted without any trouble. While the menu choice is fairly small, several of the dishes could be made into better candidates for the diabetic diner with a few substitutions. Enjoy!

Lantus timing

2006-10-21T08:37:00.000-07:00

I recently changed the timing of my daily Lantus injection, with some results that surprised me. Up until a few weeks ago, I took the Lantus right before bed. I would generally wake up in the morning with a blood sugar between 80 and 110, very good. But more and more, I was waking up in the middle of the night with lows. So I decided to switch to the morning, to see if that might help avoid the overnight hypos.

Lantus is supposed to be peakless and last around 24 hours (though it can vary by person). I found with the new timing that I was waking up in the morning with blood sugar between 90 and 130. That leaves me very little room to have breakfast and keep my post-prandial readings within my goal of below 140. But here's the surprising part, perhaps. Not only did I struggle with breakfast, lunch also was an issue. It was almost as if I never recovered from starting out too high in the morning. Typically I would be 80-100 before lunch, but under this new timing, I was 100-120. Again, starting out too high.

The one good thing was that dinner became easier, especially if we ate late that evening. In the old days, the Lantus was running out right about the time my dinner was peaking; now, I had the full dose on board for well after dinner-time. My guess is that Lantus does not last 24 hours for me, and somehow going "naked" in the diabetic-difficult morning hours presented a problem that my body needed half a day to overcome.

I am now considering going with a twice-daily regimen. One concern about this is whether I will then have two Lantus "gaps" at the end of each 24 hour overlapping period rather than just one. Anyway, for those of you on Lantus, I'd be curious to hear your experience. When do you dose? Any twice-daily people out there? What issues does your regimen present? What advantages do you find?

Take our Lantus poll

Conference report

2006-10-10T15:05:00.000-07:00

I am just back from the Taking Care of Your Diabetes conference. As usual, it was interesting to walk around the exhibit floor and meet representatives from product and service organizations. The biggest news of the day, from a practical standpoint, was that I learned BD is exiting the meter business. The BD meter, while probably not among the market share leaders, has become my favorite meter. I find it less pesky than some other meters, and the lancet is the least painful due to a spring-like mechanism. I picked up an Accu-Check Aviva to try as a potential replacement, as their lancet looks gentler than the one that comes with the FreeStyle Flash.

But enough about meters. You are here to read about food. I am happy to report that the well-liked but recently-discontinued Oroweat low carb bread still seems to be on some supermarket shelves. That leads me to a question for all of you - what are some of the foods you have discovered, either in restaurants, or at your local supermarket, or via mail order, that you rely on in your diabetic diet? And while you're at it, let me know your glucose meter likes and dislikes!

At the conference, I also had the pleasure of meeting a fellow blogger, the author of diabetesmine.com. She's writes about useful things for all of us, so go check it out.

Thea - delicious food!

2006-09-17T09:12:00.000-07:00

Santana Row in San Jose offers many dining choices. One of my favorites has become Thea Mediterranean. With all of the dietary restrictions that diabetics have, finding food that tastes great can be somewhat challenging at times. With this restaurant, the food has so many delicious, unique flavors that a good meal is easy to come by.

On my way to the restroom before dinner, I spied someone sitting at the bar eating a great-looking Greek salad. So I ordered that, along with the fish special, which was a Pacific sea bass coated with an olive tapenade, and served with roasted tomatoes, fennel, and a disappointingly-low number of green beans. The salad was great. It had a delicious oregano and oil dressing, with fresh tomatoes, cucumber, and feta cheese. The fish was prepared perfectly. I also managed to down a couple pieces of the delicious (trying not to overuse that word here!) warm bread and olive oil, and a glass of wine. Finally, as if that wasn't enough, I convinced my wife to let me taste the roasted pork that she ordered. Fabulous.

With some ethnic restaurants, dining out as a diabetic can be challenging due to a variety of ingredients included in sauces. I didn't know what was in each sauce at Thea, but my blood sugar did fine there, despite having two pieces of bread, which is more than my usual quota for a meal. All of that makes Thea a place that the Diabetic Diner highly recommends!

Discontinued Oroweat bread

2006-09-07T21:46:00.000-07:00

What am I to do? I have just learned that a staple of many of the diabetic diner's meals at home is being discontinued. That is the Oroweat Carb Counting bread. I confirmed it with a call to the company yesterday, and quickly made a run to a local Safeway to pick up a few loaves for our freezer. This bread is one that I can reliably have two slices of as part of a meal and not get high blood glucose. It has 9g of carbohydrates per slice, and 3g of that is fiber. It's also (to me, anyway), the best-tasting of any of the low carb breads out there. You can read a review of several brands of low carb bread here.

Post a comment below if you use any other breads that you would recommend. The diabetic diner needs to find an alternative, and fast!

Max's - watch the bread!

2006-09-03T09:02:00.000-07:00

One of our favorite spots for a casual dinner in the Bay Area is Max's. For this diabetic, that restaurant presents two challenges. First and foremost is the delicious warm bread placed at your table right after you are seated. I have yet to eat more than half of only one of those rolls and have my blood sugar go to anything less than 140. And that's just the plain sourdough rolls. The ones with the raisins, according to my testing, are completely off limits. Too bad, because they sure are delicious! Which brings us to the second challenge with Max's, and that is the portion size. Huge. For someone trying to count carbs and lose some weight, plan on taking a part of your dinner home. That is, unless it's a splurge night, which we all have to have occasionally.

Finally, one last note. They have a low carb menu at Max's. Several times, I have ordered a sandwich off of that menu with some steamed vegetables. Of course, you never have to worry about being too low on carbs at Max's - there are always the warm rolls! Anyway, the sandwiches (which, again, are huge) qualify as low carb due to the low carb bread on which they are served. Usually this bread has worked fine for me. But one time, it tasted a little different, a little too good, in fact. We asked the bakery counter on the way out, and were told they had actually run out of the low carb bread. Chances are I got two large slices of regular bread. Of course, my blood sugar skyrocketed. So now when I order a low carb sandwich at Max's, I confirm whether the low carb bread is truly in stock. That's what the diabetic diner recommends doing!

Sirayvah Organic Thai Cuisine - amazing staff and food!

2006-06-20T20:51:00.000-07:00

My wife and I went to Sirayvah Organic Thai Cuisine in San Carlos and had a great meal. One of the hardest things with most delicious ethnic food is that it is often cooked in sauces with many tasty ingredients that are a minefield for diabetics. This can include starch, sugar, fruit juice, soy sauce with added sugar, molasses, coconut milk, and so on. To ascertain with any certainty what is in the meal, let alone try to guess quantities and therefore count carbs (a pipe dream at times) is very difficult. What makes this restaurant great among many things is the helpfulness of the staff. We ordered our entire meal with no added sugar and they happily complied. It turns out that much authentic Thai food contains a lot of added sugar. The chef and owner came out afterwards and told us he often gets this request to not add any sugar and that it sometimes causes some sacrifice in flavor. No worry here, the food was delicious. Some of the dishes also come with rice powder but we did not ask for a change on that, hoping it wouldn't be too prevalent to cause a spike in blood sugar.

We ordered eggplant and a chicken dish, both of which were excellent. These come with rice, and we ordered one with vegetables instead in order to ensure the meal was balanced with more veggies than starch. To start, I had a very simple but tasty shrimp soup and my wife had a delicious salad (turned out to be a large portion of salad). We also each had a glass or organic cabernet (wine with dinner is a whole separate blog topic to be addressed some time).

Overall, the willingness of the staff to substitute veggies for rice, leave diabetic-unfriendly ingredients out, and be friendly about it, plus the great food, makes this a place we will continue to go to.

Dining in at 1AM

2006-06-16T01:47:00.000-07:00

Welcome to the Diabetic Diner blog! It's just past 1AM and my blood sugar is 73 after having been 113 at 10:30PM just a few hours ago. This sometimes happens to me when I exercise in the evening, as I did last night. To treat this near-hypoglycemia (before it becomes that), I just downed half of a Trader Joe's blueberry muffin (11g carbs per muffin) and half a cup of unsweetened chocolate soymilk (6g carbs per cup). Yum. I've been waiting for just the right moment to crack open that chocolate milk. Sometimes it's moments like this that are all it means to be a diabetic diner. 1AM with a handful of small snacks.

This blog will be about times like this, and, hopefully more often, times where my wife and I get to enjoy a nice dinner out and I get to share with you how the meal was from a diabetic's perspective. And I might even just pretend I am a regular old restaurant reviewer ("food critic") and talk about the service and the ambiance. Happy dining.