Diner: Hey, Look at Me

Is it possible to be both diabetic and a restaurant critic?

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Woodrow J. Hinton



As a food reviewer, my work depends on being aware of what I should eat — giving readers the vicarious joy of the desserts, heavy sauces and filet mignons I consume. When diagnosed as an insulin-dependent diabetic, my life required me to be aware of what I shouldn't eat — too much sugar, fat and protein.

So how on earth can someone whose culinary life centers on the word "can't" enjoy and report on the world of the gourmand?

If you have Type 1 diabetes (like I and about 1 million other Americans), your body's immune system begins to cannibalize its pancreatic beta cells — the cells that make insulin — and you have to take daily injections to live. Basically, insulin "unlocks" cells, allowing glucose to enter and be used as fuel. When glucose can't get in, it remains in the blood stream, clogging the arteries and generally wreaking havoc.

Diabetes is a progressive disease. Over time, high blood sugar levels can lead to complications such as heart disease, stroke, kidney disease, amputations and blindness.

With diabetes, many people think the insulin shot is all there is to the disease, like a pill that "cures" you. But the needle is just the beginning.

Insulin, food and exercise are the Holy Trinity for diabetics. Just like onions, celery and green peppers in a Creole recipe, these three factors are the basis for life.

To counter the effects of all that swirling blood sugar, my daily tasks include multiple injections, regular exercise and carefully monitoring what I eat. I have to count carbohydrate exchanges, measure my rice and weigh my low-fat cheese. The party line is "follow your meal plan," a cute little number you and a nutritionist work up in a room full of plastic food and posters of naked chicken breasts. Top players in these plans include skim milk, broiled fish, plain rice and steamed vegetables.

There's definitely good reason for all this advice. High blood sugar leads to the complications bogeyman. If you go the other direction and take too much insulin, the effects are more immediate, making for a dramatic evening out. Too much insulin causes hypoglycemia, which, if untreated, leads to passing out, so your dining partner will be calling 9-1-1 and pulling your head out of your soup.

Unlike most people scribbling about cuisine in restaurants, the timing of my meal is as important as its components. Not only do you need to balance the amount of insulin you inject with the amount of food you eat, you also have to make sure both hit your blood stream at the same time. Insulin works on the carbohydrates your body breaks down to glucose, so each meal has to include a certain amount of carbs, determined by how much insulin you shoot.

Trying to keep both feet firmly planted in consciousness, I immediately request bread when seated in a restaurant. If disaster strikes and the kitchen gets slammed or a server quits in the middle of a shift, I am armed with my soft, grainy security blanket tucked into napkins with pats of butter.

When I started eating out as a food critic, I felt my job was to eat what normal people would, and my spartan new dining habits seemed unworkable. So I did what any self-respecting foodie would do: I threw caution to the wind. I swore to eat fried foods and scarf down three- and four-course meals. I would eat hunks of meat the size of my forearm rather than the size of my hand. Dare I say it? I would order dessert.

For my first review, I was ready. After three courses, I waded into the dessert menu, feeling the soothing tug of words like chocolate ganache and crème anglaise. I wanted to dive in with eyes closed and mouth open.

Plagued by the pull of my diabetic lizard brain, however, I placated a growing sense of guilt and chose the poached pear in wine sauce. It was fruit. It wasn't really dessert. My husband, acting as "my companion" that evening, ordered the chocolate banana bread, topped with caramelized bananas and served with homemade malt ice cream.

Looking at the moist, chocolate confection, I decided that I had to taste it if I was going to write about it. To truly write about the dessert and do it justice, I shouldn't just take someone else's word for it. Maybe he wouldn't taste the hint of cinnamon. (Oh, my god, this is good.) Or notice that the ganache has the perfect ratio of chocolate to cream.

Two or three bites in, and I was no longer diabetic, no longer talking to my husband, no longer in a public dining room. The tiny veins behind my retinas began to glaze with a thin coat of sugar, blocking out everything except that chocolate slice of heaven.

Conquering my first hurdle, I soon moved on to the next: fatty foods. My own meal plan allows me 25 grams of fat a day. To put this into perspective, according to the Web site www.calorie-count.com, Don Pablo's Chicken Fajita Enchiladas have 80.7 grams of fat, and a serving of Kung Pao Chicken at P.F. Chang's contains 50.

Once again, eyes shut and mouth open, I dove. I demanded fried calamari, gorged on five-cheese pizzas and inhaled the Green Derby's "Famous" Fried Halibut Sandwich. And while my foodie heart sang fat's praises, my diabetic heart was reaching for the nurse call button.

Even with all the timing gymnastics and the associated paraphernalia of needles, lancets and testing meters, like many diabetics I have learned to be a stealth diner. It's hard to say whether this is to keep others from feeling uncomfortable or to pretend that we're normal.

We surreptitiously pull out meters that get smaller and smaller and give results faster and faster. Putting them on our laps to test blood while continuing to discuss the merits of the Côte du Rhone just delivered to the table. We silently excuse ourselves to scurry away into bathrooms to take shots in dark stalls, squinting to read how much insulin is in the needle's cartridge.

In the company of each other, however, we are the norm. My mom is diabetic too, so when I take my parents out for reviews matching cases appear from our purses. Zip, zip. We open the bags that hold our meters and test strips. Pop, pop. Click, click. We open the test strip vial, prick our fingers with lancets and out come two perfect little droplets of blood that get soaked up by the test strip and determine our next moves.

In the middle of this process, a waiter usually arrives, looking worriedly at the freshly laundered white napkins and our bloodied, scarred fingertips. When our food is delivered, our vials of insulin and syringes come out in unison as we chat about how good the jambalaya looks and "oh, that is too much food — I'll never finish it." Up come the needles to eye level, then back down to land in the fleshy bits of our stomachs.

The server doesn't bat an eye. I can't tell if he has no idea what he is witnessing or if he's trying to decide if he should call the cops on the two junkies at Table 9 now or after he gets his tip.

As I pack up my gear and move on to the next culinary assignment, I realize it's funny how things turn out. After eight years of trying to skirt around the word "disability" like anchovies on pizza, I've finally come out of the bathroom stall to shout "Hey look at me — the diabetic food critic!" ©

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