Guilt and Misunderstanding in the Juice Aisle (Diabetes Awareness Month, 2015)

When Aaron was diagnosed with diabetes over two years ago, I knew we'd have some new and unusual and scary issues to navigate.  But believe me, I never guessed how much drama there'd be over JUICE!!

We're not a juice family.  It's a health thing and it's a preference thing.  Juice is not the "health food" they market it as, and I just don't care for it that much (except for the occasional fresh squeezed orange juice that pancake houses serve in a shot glass for $4.99.  It's criminal... but oh, so delicious!) so I don't really serve it to my family.  

I think I can count on one hand the times our kids drink juice each year - they get orange juice at Easter brunch (cause the adults gets mimosas *glug, glug*!), apple cider at the Fall Soup Party and Thanksgiving, and maybe a sip or two on those Saturday mornings when my husband has one of his biannual I-must-have-juice-now!! episodes and runs out for a frozen orange juice concentrate leaving all the kids sitting at the breakfast table waiting like baby birds for him to come home with the delectable nectar.  

So, we don't really drink juice.   But we have a pantry stocked with juice.  And we never leave the house without juice.  And I have a bottle of juice in the glove compartment of both cars.  And the kids... all these kids I have... are frequently pestering me about can they drink the juice juice juice juice juice!?!

Aaron drinks juice.

And it is a constant source of conflict for me.

Because everyone knows that juice rots your teeth, and has little nutritional value compared to an actual piece of fruit, and juice spikes your blood sugar in a major way. 

Bingo.  Aaron drinks juice to spike his blood sugar in a major way.  

Since a diabetic's body does not naturally regulate blood sugar, if his glucose levels are  very low (hypoglycemia) they must be brought up immediately and artificially, to avoid severe complications such as comma, brain damage, and even death.  

Scary.  And that's why, despite all my instincts not to, I buy juice. 

For most diabetics the preferred methods of raising blood sugar quickly (because it must be done quickly) are juice, frosting, candy such as Skittles or Smarties, or glucose tablets.  It must be something with lots of sugar, little fat, and low to no nutritional value, because fat and nutritional goodness slow down the effectiveness of the sugar.  If a diabetic's blood sugar drops low enough that he is uncooperative, is too confused or incapacitated  to chew or swallow, or is unconscious, he will need an immediate emergency and life-saving injection of glucagon (a hormone that's kind of like the opposite of insulin.)  And believe me, ain't nobody want the glucagon...............

I mean, you might as well cue the Psycho music... right??  

So juice it is.  

And even though I know that juice is part of my son's life-saving first aid kit, I still feel guilty buying it.  

I hear little whispers  from the nutrition angel on my shoulder as I head for the juice aisle at the grocery store, "Juice is evil!!!  Don't purchase the evil!"  I hear the JAWS theme music play as I scan the shelves and reach for a six pack of apple juice.  I feel the piercing and disapproving stares of health-conscious shoppers as I put the juice in my cart and lower my eyes so that our gazes don't meet.  I act distracted and all "how'd that get there???" when I put the juice up on the checkout counter.

Ok, I know.  It's all in my head.  I mean, they don't really play the JAWS theme at the place where I shop.    

And I know I'm just imagining the piercing stares.  Seriously, no one else in the store cares what's in my cart.  No one is really judging me for buying juice.  

Except for the day that they did.

I was in the juice aisle, chatting to myself but making it appear less awkward by directing my mumbles in the general direction of the baby sitting in the shopping cart.  I crossed juice off my list and reached for a six pack.  

"Oh wait!  That's the low sugar kind," I said out loud to myself as I withdrew my hand, realizing my mistake.  

A nearby, well-meaning shopper overheard my private conversation with myself and said, "Oh sweetie, it tastes just as good as the other stuff and it's so much better for your kids." 

In retrospect, I should have been an on-the-spot type 1 diabetes educator, politely said, "Not for my child, it isn't," and given her my speech about the dangers of hypoglycemia and the life-saving properties of juice, frosting, and Skittles.  But I had that baby in the cart and four other kids in the grocery store kids play room, so I just laughed off her misunderstanding of the situation, found the juice I wanted (the kind with the extra double shot of sugary goodness), and bustled out of there. 

Cause the truth is, I sort of get it.  It goes against every fiber of my being to have juice in the cart, in the fridge, in the pantry, in the car, and in my purse.  But it's a diabetic's necessary accessory and in an emergency situation, that sugary, tooth-rotting, non-nutritive, sugar-spiking juice, could spike the sugar of the exact person that needs it to save his life.  

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Know the signs of hypoglycemia:

shakiness
sweating, chills, clamminess
irritability, impatience
rapid heartbeat
lightheadedness, diziness
hunger, nausea
sleepiness
blurred vision
weakness, fatigue
lack of coordination
confusion
seizures
unconsciousness


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I encourage you to read some of the other things I've written about 

diabetes and our family life.  And as always, please feel free to 

ask questions here!

Looking Back on Aaron's Diagnosis

What is Type 1 Diabetes? and Other Things You Can Learn From 

Highly Scientific Internet Memes

Insulin is Not the Enemy

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You may also like...

5 Extras I Recommend for Your Child with Diabetes

Children with Type 1 Diabetes and Heroic Courage

by Amanda Perales

It's the Club Pack Life for Me (Adventures in Grocery Shopping)

So You've Invited a Type 1 Diabetic to a Birthday Party... What Now?? (Diabetes Awareness Month)

November is National Diabetes Awareness Month.  

Each week I'll be featuring a diabetes-related post. 

Anything specific you'd like to read about?  Let me know!

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A blogger friend, Ann-Marie, asked a great question regarding hosting a party or event that a child with type 1 diabetes would be attending.   Thanks, Ann-Marie!  It was so thoughtful of you to ask for suggestions on how to help a family with this specific need!  

cupcake image from publicdomainpictures.net

I have to be honest, if I was to give you a list of the things that are trickiest to navigate with a type 1 diabetic child, parties would be very close to the top.  Perhaps other t1d moms would answer differently, but for me, buffets and tables filled with snacks for the taking are kind of a nightmare.  Snacking and drinking go hand in hand with mixing and mingling, but the carbohydrates consumed while "grazing" as it were, are very tricky to keep track of, especially when a child is running around and enjoying all that a party has to offer!  

But I have children, and I know what it's  like to host and attend large-scale parties with lots of kiddos, so I know that buffets will never go away!  Busy hostesses know that snacks and buffets are the way to serve a crowd without going crazy, right?  On top of all that, children (and adults) with diabetes have to learn to live and be healthy in the real world (which includes parties and buffets!) so in my mind, there's really less that a hostess has to worry about and more that we have to do to educate and train our child.  Instead of expecting a party to be catered to our diabetic's needs or turning down invitations to parties that don't have a pre-planned menu for a sit-down meal, Russ and I have to work at guiding Aaron through how to attend a party that has a snack table and how to have fun and enjoy himself while also taking into account his health and well-being.

With all that being said, a thoughtful hostess can still help a diabetic (and his parents!) by taking a few things into account.  

* Let the parents know that they are welcome to attend the party and stay for the duration.  At this point in our diabetes journey, I cannot imagine dropping Aaron off at a party alone.  He is not fully capable of doing his own carb counting/insulin dosing/correcting for physical activity, etc... and I would never place those responsibilities on the hosts of a party.  I can't speak for everyone, but I think that for most families, if the parents aren't welcome at the party, the diabetic child would not be able to attend.  

* If you know what you're going to serve, offer to send the menu to your guest ahead of time.  This is probably the best case scenario.  A diligent parent will have an idea of what her child will most likely eat off of that menu and can begin to prepare even before the party starts.  They might alter what a child eats for breakfast, for instance.  Or some parents, knowing that there will be a snack table with party-perfect carbohydrate delights (like chips, pretzels, and fruit), may prefer to give their child a partial bolus of insulin so that the child will have some "on board" as he makes his first trip to the buffet.  (A bolus dose of insulin is insulin given to specifically cover carbohydrates consumed as opposed to the daily injections which provide a baseline.)  

* If you serve something from a package or make something from a box mix, save the packaging or the nutrition label, so that the carbohydrate info is available to the parents.  I have gotten pretty good a guessing on basic party foods like pizza, cake, and ice cream, but if you make something out of the ordinary or you set out a bowl of Chex Mix, it would be a really nice gesture to have the serving size, carb info, and measuring cup on hand.  

* Have diet drinks available.  Even though diet drinks are one of those things that make health-conscious people cringe, they can set a parent's mind a little more at ease at a party.  At a party, people tend to grab drinks and enjoy them over the length of the gathering.  Having diet pop or diet lemonade lets a diabetic hydrate with something a little more "fun" and "party-like" than water, but not have to consume it all at once and take insulin injections for each glassful.   If you're uncomfortable serving diet drinks, the next best thing you could do is suggest that the guest bring his or her own.  It really makes that big of a difference!

* Ask your guest to bring a treat to share at the party.  Many parents may offer anyway, but even if they don't offer outright I think most would be happy to bring a treat to share that would be appropriate for their diabetic child.  Giving them the OK to bring something low carb or carb free might make the party more "do-able."  Treats like no sugar added popsicles or sugar free jello can easily be enjoyed by all the kids in attendance.  

* After you've made some, all, or even none of the suggested accommodations for your diabetic guest, you're done.  The child is not your responsibility.  His parents should (and will!) monitor him and care for him.  You don't have to drastically change your party, but the parents and the diabetic child do have to be attentive and diligent.  Attending events with food and managing blood sugars while there is all part of learning to cope with the lifelong illness.

* Finally - and I'm pretty sure this goes without saying - please don't make a fuss over the child with diabetes.  Unless a child is visibly unwell, there is no need to comment on his condition, and especially not about what he's eaten or what's on his plate.   He may want a private place to check his blood and receive insulin so as not to draw attention to himself, but in my experience, those things become second nature so quickly that a child and his parents won't think anything of just doing it to the side and having it done with before anyone else notices.  There really is no need to draw attention to anything diabetes related, and if a concern or question does come up speak to the parents in private.  Kids even with this chronic disease are still kids, and it's healthier for them emotionally and psychologically to be "just another kid" at the party.   The parents will thank you for treating him as such and will be so grateful that you invited him in the first place!  Thanks for not holding back the invitation because of his condition!!

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Ann-Marie, I hope that helps.  I truly appreciate the question and I'm touched by your thoughtfulness and desire to support parents and kids with this particular situation!  Bless you!

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Other posts in this series:

Insulin is Not the Enemy

Children With Type 1 Diabetes and Heroic Courage