How to treat your favorite diabetic, on Valentine's Day and beyond

This is my second year of being a type 2 diabetic - my surgeries and other cancer treatments having somehow pushed me over the edge from the prediabetic range. Although diabetes is a very widespread disease (more than 100 million Americans are diagnosed with type 2 or pre-diabetes, a staggering number), many people have no idea what it's like to live with it, and how diabetics keep it under control. Yes, us diabetics do have to be careful about our sugar intake, or anything that makes our blood glucose levels spike. But for most of us, unless we are at a very serious stage of the illness, manage to live with it pretty well.

What gets to me more sometimes is the way people react when I tell them I have diabetes. Too many times I've had people look at me with eyes full of pity, saying things like "Oh, you can't have anything nice to eat anymore". And yeah, having this diet or another pushed at you constantly isn't so fun either. Holiday times are particularly hard for a diabetic, since everything and everyone wants to push sugary snacks at you, from 12 days of Christmas Cookies to chocolate Easter eggs and bunnies. But somehow Valentine's Day is especially difficult, since it's become closely associated with chocolate gifts and sweet things in general.

So, for those of you who have diabetics in your life, here is how I, as one of them, would like you to treat us, on Valentine's Day or the rest of the year. Take it with a grain of um, sugar.

Please don't pity us

Believe it or not, most of us don't feel as if our lives are over because we can't indulge in a big box of chocolates, or a plateful of cookies, or three slices of cake, or whatever our furtive sugar-loaded indulgence used to be. Most of us have adjusted to the need to watch our sugar intake and monitor our blood glucose levels, and we're pretty fine with it.

We don't really need the lectures and well-meaning advice

Most people who get diagnosed with diabetes and want to live a normal life take a lot of time gathering information about how to handle their condition. We are, in most cases, far more informed than you. We know about the importance of exercise and diet and all that. So, while you may mean well, we really don't want to hear your unsolicited advice, thanks. In particular, if we look overweight to you chances are we're working on that already and we don't need to hear how we should lose that weight. (And not all diabetics are overweight either.)

A small amount of sugar is not going to kill us instantly

Some people seem to have this idea that sugar is instant poison to a diabetic, and that if if a diabetic ingests sugar they'll keel over instantly while foaming at the mouth. Some of this may be blamed on the portrayals on TV and in movies of people going into diabetic shock or comas, but this only happens rarely, and mostly in cases where the person does now know they have diabetes or just hasn't been taking care of it. (My own father went into a diabetic coma several years ago, mainly because he wasn't taking his medications or watching his diet at all. He was fine for many years after that until his health deteriorated again, again due to not taking care of himself properly after his 2nd divorce.) If your favorite diabetic says they are going to have a couple of mouthfuls of cake, they are most likely going to be fine afterwards, as long as they don't make it a daily thing.

Don't assume that white sugar is the only culprit

Sugar is not the only thing that is bad for us. Any carbohydrate, especially the 'simple' or refined kind, can make our blood glucose levels rise rapidly and to dangerous levels. By refined carbs I mean things like white rice, potatoes, white flour products like bread, pasta, and so on. So, giving us cookies that are baked with a sugar substitute but use lots of white flour is well-meaning but not that helpful. (And we don't even know what the long-term health consequences are of ingesting large amounts of artificial sweeteners anyway.) In addition honey, corn syrup, maple syrup and agave nectar/syrup are all high in sugar, even if they aren't called 'sugar' and some people like to tell you that they are 'healthy'. (Agave syrup does have a lower glycemic index than regular sugar, but is still a sugar.) So are things like preserves and jams and many chutneys.

Dried fruit is high in sugar, and fresh fruit is iffy

Once I was reading one of the crowdsourced advice-giving sites about 'treats' to give to diabetics, and someone recommended dried fruit. Um, no. Dried fruit is a pretty concentrated source of sugar, and some commercial dried fruits have been sweetened with additional sugar. Even fresh fruits have to be taken in moderation by us, so a big fruit basket which has to be consumed within a short time is not such a good idea. (Fruit juice, even the "100% juice" kind, is basically water with sugar plus a few vitamins and none of the fiber of whole fruit, so it tends to make the blood glucose levels zip up as fast as drinking non-diet soda.)

Edible gifts for diabetics

So what edible gifts can you safely give to your favorite diabetic? In general, think quality, not quantity. Here are some things I wouldn't mind getting myself.

• Nuts are great - no sugar or starch, fill of fiber, plus they satisfy that urge to have something crunchy to snack on instead of potato chips and Doritos. Good nuts tend to be expensive to boot, so they are a welcome treat.
• There are now an increasing number of pretty tasty, low or no-sugar chocolates that are certified as safe for diabetics available. Some of these are pretty good. (Switzerland, where people consume tons of chocolate, has quite a few good diabetic-friendly chocolate bars. If you find yourself in Switzerland and you're diabetic, look for the ones marked "ohne Zucker/sans sucre".)
• Some no-sugar candies are quite good too. Do some research to see what's available.
• Sweet baked goods made specifically for diabetics can be ok, although some are pretty awful.
• Many people who have their blood sugar under control can indulge in the occasional sugary treat, in moderation. If your favorite diabetic is in this position (ask first), get them a small, exquisite quantity of the best you can afford, such as a tiny box of the best handmade chocolate truffles or pralines available in your town, or one perfect home baked cookie. In our town (admittedly it is in France, and yes the French are rather good with confectionery) we can get the most gorgeous chocolates made by a Meilleur Ouvrier de France chocolatier. They cost 2 to 4 euros (US $2.60 to $5.70 or so) per piece. We can get a big box of mass manufactured chocolates at the supermarket for around 8 euro, but for the decadent diabetic the top end expensive stuff will bring much more joy in each precious mouthful.
• While I nixed the idea of a big fruit basket, small quantities of really great fruit would be much appreciated, especially if it's something exotic and expensive.
• And there's nothing wrong with savory gifts either, even if they are not the expected thing. I remember those 'gift basket' catalogs places like Hickory Farms that used to arrive in the mail, usually around holiday time. Amongst the fruit and petit fours and cheese balls and such, they always had something called summer sausage. Growing up in Japan, England and around New York City, I've never had a summer sausage and have no idea what it tastes like, but it sure did sound delicious. Anyway, gifting a big sausage to your sweetie may send a provocative message, but if she or he likes it, why not? Other 'safe' savory foods include things like cheeses, hams (try not to get the ones with sugar glaze) and beef jerky (again, for for the ones without a lot of sweet marinade/sauce).

...and of course, we love non-edible gifts

Chocolates and sweets aren't the only Valentine's Day gifts. Flowers are nice of course, and so is jewelry. Or how about a beautiful book, a lovely scarf, or taking us away on a great vacation? In other words, there are plenty of ways to treat your honey without making them dangerously sweet.