Diabetes - Day 6

Today was a very different day for me, food-wise. I was at work and did not eat lunch until after 3pm, so I didn’t need my afternoon snack. We also decided to go out to dinner tonight, at a restaurant I’ve only eaten at a few times. Needless to say, this required some estimation once the food was in front of me. I ordered the cabbage rolls, which were stuffed with beef, rice, and herbs. Using the exchange system, I estimated the carbohydrate content the best I could. When I got home, I looked up the actual information and saw that I was quite close! The restaurant we ate at did not have nutrition information on their website, and they are not a large chain so probably aren’t required to have it available. I used the information for a similar recipe to decide whether my estimation was correct.
I also had two glasses of wine with dinner, which is really a good choice if you have diabetes. A 5 ounce glass of most types of wine (Pinot Noir was my choice) only has about 3 grams of carbohydrate, whereas a 12 ounce glass of beer has 10 grams. I won’t even get into how high some of those mixed drinks/fruity martinis could probably get.
The fact that I’m playing a person with type 1 diabetes, and the fact that I was drinking, made me think of an ex-boyfriend of mine (this was over 10 years ago) who was in that situation. I was only 19 at the time and didn’t really understand anything about his condition, except he was always saying that he had to eat (it was not optional) and of course, had to give himself shots of insulin. On his 21st birthday, he had a huge party at his house and was drinking hard liquor in excess. Early the next morning, I was sitting next to him and he starting having a seizure and passed out. It was terrifying! I screamed for his parents and we called 911. The paramedics arrived and gave him a shot (glucose?) and he woke up and was fine.
For a long time, I thought that this directly resulted from his drinking alcohol, but I now know it was a severe case of hypoglycemia. He hadn’t eaten, and was only drinking hard liquor, which contains no carbohydrate. Maybe if he would have thrown in a beer or two, or had something to eat at some point, the situation would not have escalated the way it did. All I know is that if I hadn’t been sitting right there, it’s possible that no one would have found him for hours since everyone else in the house was asleep. Even then, things were not going great between us and we broke up shortly thereafter, but I still believe that I was meant to be with him long enough to help in that situation.
Today I learned that the greatest challenge of carbohydrate counting/insulin dose adjustment would likely be going out to dinner at an unfamiliar restaurant. You would need excellent skills of estimation, or would need to know what you were going to order before arriving at the restaurant. These days, as many people have access to the internet via their cell phone (I am not one of those people), I could see this being less of a challenge because you could probably locate the needed information very quickly. Also, if the evening was going to involve alcohol, it would be important to be aware of the carbohydrate content (or lack thereof) of the drinks you would likely consume. This would be especially relevant for people with type 1 diabetes, as it is typically diagnosed during the teen years, prior to gaining any kind of experience with alcohol. As with my ex-boyfriend, unawareness of these facts, coupled with the effect that alcohol consumption has on reasoning, situations like this can turn dangerous very easily. I will definitely keep this in mind in the future if and when I work with teenage/young adult patients with type 1 diabetes.