Wow. Thanks jnette! :blushkiss
Something I try to get orders for on any restricted diet patient is a diet holiday order, frequency to be determined by the doc. It's my personal opinion that to expect anyone to adhere to restrictions for a lifetime is an impossible and unrealistic expectation. Meds can be adjusted easily to accommodate a weekly "diet holiday" but it is hard to adjust meds for unplanned, after-the-fact "noncompliance."
I came to this conclusion watching my own behavior objectively (if that is entirely possible). If I tried not to "cheat" on my diet, I'd do a really good job of it for awhile. Then, I'd go on a binge, even knowing what the consequences would be (hyper-glycemia with nausea, vomiting, headaches, etc.) Once on a binge, by the nature of diabetes, the body would think it was "starving" because it wasn't getting any nourishment, but high levels of blood glucose. When the body thinks it's starving, a diabetic starts to crave (in the worse possible way) carbohydrates. So, the problem would esculate until I was so out-of-control . . .
But, before long, I'd binge again, and back on the upward spiral I'd go.
To stop this pattern, I gave myself "permission" to have a sweet everyday, and adjusted my insulin a little to accommodate MY TREAT. Now, I happily have a couple of cookies after dinner, or a small bowl of ice cream, or a donut at work . . . not only is my BGs in much better control, but I'm happier. No binging for quite sometime now, and I don't feel deprived or resentful anymore.
It's easy as nurses and doctors to just look at the physical effects of diet and compliance "cheating." But, it is my belief that if the health care profession doesn't also look at the psychosocial effects of chronic illnesses, we set our patients up for failure and frustration, not to mention the frustration it causes to us when we see our patients doing things we know are destructive. Nothing is destruction, though, in controlled, moderate amounts.
Soapboxing again. Thank you all again, for allowing me to speak about a subject near and dear to my heart!