Eating Out at a Restaurant When You Have Diabetes
Pregnancy Tracker: 23 weeks, 2 days
Size of the Baby: The size of four cubes of butter!
Biggest Obstacle: Adjusting to my changing body
Restaurant eating can be dangerous for diabetics: hidden ingredients, unknown carbohydrate contents, and large portion sizes combine to create a matrix of issues for someone trying to control their blood sugar.
Recently, a New York judge ruled against a city health regulation that would have required restaurants to list calorie contents on their menus. Lobbyists for the restaurant association argued that nutritional information was posted elsewhere voluntarily. My question is: if the information is readily available anyway, why not put it directly on the menu?
Of course, we know the reason. Most people won't take the time to hunt down nutritional information, which is typically located on difficult-to-access signage, or on pamphlets that you'd have to request from an employee. Having the calorie, fat and carbohydrate content printed directly on the menu might cause some patrons to second guess their meal choice.
Since becoming pregnant, I have taken more care to find out the exact carb content of my meals. This has proven difficult when eating out. For starters, there was last weekend's fiasco at the microbrewery. Also, a couple weeks ago I asked for the carbohydrate count for a corn dog, excuse me, "hot dog on a stick," from the restaurant by the same name. Yes, I was actually corrected when I called it a corn dog! (If you're wondering, it's 23 grams.)
Then, just today, I went out with a group to celebrate two coworker's birthdays. We went to a local chain restaurant that serves a delicious Thai Chicken Salad. Since I've been experiencing some insulin resistance lately, I was sure to check the web site for nutritional info before we left. Unfortunately, the only menu items that display calorie, fat, and carb information were the eight items on their "Healthy Eating Menu."
I debated having one of the salads from that menu, which had 47 grams of carbohydrate. But, darn it, I wanted my favorite salad! In the end, I had the Thai Chicken Salad, delivered a combo bolus, and tested my blood sugar frequently over the next few hours. The results were good: I peaked at 155 mg/dl 90 minutes after lunch, and was down to 93 mg/dl by 3 p.m.
That's basically the approach diabetics have to take when eating restaurant meals. In the case of this particular salad, I suspected that the dressing had some sugar in it, but I had no idea how much. I chose to bolus for more carbohydrates than I'd typically estimate in a plate of assorted vegetables, chicken and peanuts.
Another tactic for eating out is to choose the same menu item each time you visit a particular restaurant. I don't eat out all that often, so when we do typically I choose a restaurant based on my favorite dish. Through trial and error, I have devised insulin bolusing plans for my favorite meals, such as the soy curry "chicken" with vegetables from our local vegan restaurant, a half order of pasta primavera from the Italian place, and the tempura shrimp roll with brown rice when we eat Japanese. Once I've learned how my body will respond to these meals, I can deliver an adequate dose of insulin without knowing exactly how many carbohydrates are present.
Over-bolusing, monitoring then correcting, and trial-and-error are survival tactics diabetics employ when they venture into the jungle of restaurant eating. Wouldn't it be wonderful if we had some tools to help us navigate?
A little bit of extra print on the menu could arm us with the information we need to administer our insulin confidently, so that we could relax and enjoy our dining experience. Perhaps the industry will catch on and choose to provide nutritional information for the large number of restaurant patrons who need those numbers for their health and peace of mind.