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What Happened At Lunch. (Alternate title: Sorry, Mom.)

There are only Yodels in here.  Way back when I was a young kid with type 1 diabetes, my school lunches were ruled by the American Diabetes Association exchange program.  (That link takes you to their current iteration of the program.)  The version I used looked like a meal card plan without any wiggle room, listing the food requirements for each meal.  Lunch, for example, included two starches, one protein, one vegetable, one fruit, one milk, and one fat exchange. 

Looking at this list now, I see things like carb counts and insulin-to-carbohydrate ratios, making meals seem like options and not force-feeding to chase the spike of NPH insulin.  But back then, meals were carefully structured to meet the peaks of my insulin, and my mother took great care in planning my lunches so that I wouldn't tank during the school day.

I'd leave the house each morning with a brown paper bag that contained some combination of my exchange combinations, like a turkey and cheese sandwich (two starches, the milk, and meat, with the lunch meat weighed on the food scale at home) with some mayonnaise spread on the bread (the fat), a bag of carrot sticks (vegetable), and a pear (the fruit).  And my mom was probably feeling pretty secure about the whole thing, knowing that she dosed me with my morning insulin shot (a mix of Regular and NPH) that would work to cover my breakfast and then the lunch. What happened at lunch, theoretically, is that I'd eat what she packed and birds would sing and squirrels would jig in jubilant step with one another and my blood sugar would be 104 mg/dL when I came home in the afternoon. 

What really happened at lunch was that, like any other kid at school lunch, it wasn't about eating your lunch.  It was about trading. 

Which meant that my mom's carefully packed lunch, in line with my insulin dose and my food exchange to best take a bite out of type 1 diabetes, sometimes ended up being traded for Ring Dings and a piece of pizza.  I felt bad about it, at the time (and still now), but I distinctly remember trading a plastic sandwich bag containing white rice cakes smeared with peanut butter for someone's Yodel (oh, Yodels).  It was a normal lunchtime trade for the other kids, but for me, it was like the black market for snacks, gaining me access to the forbidden fruits (and Yodels) my parents avoided having in our home.  In retrospect, I was following "the exchange system" too literally.

Most days, I ate what my mother packed for me, but on those days when I caved to the middle school bartering system, I went right off the rails.  And then I'd marvel, alongside my mother, at the high blood sugar I'd be hosting when I came home from school.  "I have no idea why I'm so high."

As a kid growing up with type 1 diabetes, I had the chance to make more than my fair share of less-than-optimal management decisions.  But, like the time with the cupcake, it's the guilt that made its way into my adulthood than the impact of those off-days.

I'm thankful that the insulin options, both in actual insulins and delivery, have progressed to make meals times less stressful.  At least then I would have had the wherewithal to bolus for that Yodel.


A lovely little essay on the importance of kids being kids and diabetes management advancing to allow that to happen as much as possible. Real progress is best measured in the hard realities of middle school.

Mom wasn't the only one you hoodwinked, how did you convince a kid to give up a Yodel for rice cakes!?! Kids do dumb stuff; we just hope they come out unscathed. When my daughter was 19 she told me that when she was 12 a friend taught her how to traverse our town through the sewer system. Still makes me weak in the knees to think of that.

I'm sure my dd does the same and doesn't account for the carb differences when entering them in her pump. Or just takes a stab at them, sigh. However I too am wondering who the heck trades their Yodel for rice cakes w/pb? You definitely got the better deal there. Well except for the high later....

When Lauren was first dx, that was the case too. So, she was featured on a TV health segment. They stopped in at lunch and had her show her lunch and explain it. (I need to get it off video and on DVD so I can share some day). It made sense to the exchange world, but the rest of the world must have been like WHAAAT?
she holds it all up in her 6 yr old voice and explains it:
slices of cucumber. a mayonaise sandwich, a low fat mlik, a spoonful of peanut butter and a peach

is "bolus for that Yodel" a country and western song?

Makes you wonder how we made it this far, eh? Thanks for sharing this.

"Psssttt... You got my Flaky Puff?"
"Yep. You'll do my math problems?"
"Only if the Flaky Puff is strawberry."
The exchange happens under the lunch table.
(I didn't switch my lunch out. Heck, no. I augmented the *3500* calorie diet they started me on after my diagnosis and didn't change soon enough.) Thanks for letting me know I wasn't the only one who was "dealing".

I hear you loud and clear. I hated that prescribed diet of my daily lunch. Sometimes I would hide the carrot sticks or whatever vegetables in the bottom of my bag and throw them out. At home I loved vegetables, but at school I craved processed foods. Most of the time I was scared to eat things like that, but on occasion I loved a good old Rice Crispy Treat.

Also, I remember the guilt of tossing food because Mrs. Mac the lunchroom monitor would check our bags before we threw them away after eating and before going to recess. My lunch was big and I couldn't eat it fast enough to get time outside to play, in turn I tossed the vegetables. More than once I got sent back and was forced to eat celery sticks, broccoli, carrots, etc.

The guilt still looms in my mind on occasion.

This is my life, except I am on the other end. I am not sure about your mother, but M doesn't fool me with her wide-eyed innocence! Fortunately,she is at last starting to make those food connections, and she is managing them better, even if she isn't eating better.

who traded the yodel for the rice cake, and what is that person doing now?

I agree. I want to know who traded with you. I don't ever remember trading, but I do remember the day my lunchbox was stolen and the WHOLE SCHOOL had to have an assembly because of it.

What kind of person gives up a Yodel for rice-cakes and peanut butter? Must be a good friend of yours! I remember those rice-cake meals all too well. Six of 'em for breakfast. Can you imagine!?

Then, one day. rice cakes suddenly jumped from 5 carbs (3=one starch exchange) to 7 or 8 (2=one starch exchange). Awfulness in smaller doses, but increased hunger. It was a mixed blessing indeed.

It never occurred to me to try trading my lunch like everyone else. I did however sneak forbidden cereals at friends' houses. I can still remember shoveling in frosted flakes by the handful.

I presume you have Twix bars in America? Yeah...they encapsulated a lot of my childhood with diabetes...

Lunch at school is an amazing time. Try this. My son misplaced his retainer at lunch. So, my son and I took the time to go thru the waste from lunch at school for that day. Oh wow. Fully packed lunches and some were unopened, various combinations of cut fruit and veggies and other various combinations. Having lunch after some three hours of sitting and not sharing with friends can lead to interesting choices. Some locations have begund to change lunch. Move the time for running and sharing first and followed with the eating of your meal with your friends. Doing trades are just part of lunch. The real question is an equal carb trade. Have a great day and something interesting to eat for lunch. As always have a great day.

I'm always amazed and impressed when you write about what your mother did for you when you were a child! I have three boys now, and I think if just one got diabetes, I'd collapse on overload. But then, moms do what they have to.

Diagnosed at fourteen, I was pretty much left to my own devices. Maybe my own mom was on overload? I guess it's a miracle I survived, blood-sugar-wise…!

As I no doubt had a hand in this as well, I should probably also apologize to your mom...

While I don't think I traded the rice cakes and peanut butter for a Yodel, it could very well have been me - sometimes you just get sick of the same ol' chocolate snack cake

Excellent post! I was diagnosed in high school, and was too much a newbie to have thought of trading lunches. In fact, the dietician had trained me, rather than my Mom, so I made my own lunches! Anyway, I was in the hospital last year, and received a breakfast that had been ordered for me by a nurse. (Diabetic special!) I called to inquire how many grams of carbs were in the Cream of Rice, and the answer came back "two!" (Obviously, that hospital's dietician is still using food exchanges rather than carb counts. In this day and age?!!!

I still remember how my mom (wearing a nightgown and robe, of course, for maximum mortification factor) pulled over the school bus when I was 9 so that I could drink my milk that I had left on the table after breakfast. At the time, I couldn't believe she had done that, but now I really appreciate it.

And I too was a trader. I would trade anything for Doritos!

When did you 'fess up?

I didn't trade, but I did have contraband candy on occasion at friends' houses or forbidden pizza. I recall it wasn't even in the ADA exchange book and the Endo told my mom what he guessed the fat-meat-starch numbers were. Along with, "You shouldn't really be eating that" and a stern glance...

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