Can I Still Be Italian If I Don’t Eat Pasta?

Illustrated by Mallory Heyer.
“Cut out the booze and the coffee. And dial back your workouts.” That’s what the doctor told me a few months ago. My first reaction: no, no, and no. When a woman gets that kind of talk from a doctor, it’s probably because she’s pregnant. But not me — I had just been diagnosed with adult onset Type 1 diabetes (it’s commonly known as juvenile diabetes). I was floored — I exercised five times a week and steered clear of fast food and soda. Turns out, that didn’t really matter. “This is an autoimmune disease, it has nothing to do with your lifestyle,” my doctor said. To stay alive and manage my disease, I had to accept rules and restrictions on a part of my life that had very few. I now had to fundamentally change the way I ate and lived — forever. For an Italian woman who grew up on pasta, this was like creating a new identity. For me, cooking and eating meals were passionate and sometimes irrational affairs. My pursuit of good food could sometimes reach absurd extremes. I once walked into a "humane" butcher store and asked for veal knees so my Roman grandmother could make a traditional bone soup for Christmas. "Veal isn't humane," barked the bearded lumberjack-cum-butcher behind the counter, "and it's not sustainable." When my husband and I heeded warnings to evacuate our Lower Manhattan apartment a few years ago ahead of Hurricane Sandy, the first thing I grabbed was my large cast iron pot and a can of San Marzano tomatoes so I could make fresh Bolognese sauce that night. I was the exception to Maslow’s hierarchy of needs — for me, food came before safety. But that’s not how it works with diabetes. Your body is basically attacking the cells that make insulin, which your body needs to use sugar for energy. People with Type 1 diabetes have to walk a fine line their entire lives. If their blood sugar is consistently high, they risk nerve damage, including blindness, kidney failure and heart disease. If glucose levels get too low (because they’ve injected too much insulin), the brain shuts down and they can lose cognitive function, have a seizure, and even die. To avoid complications, diabetics have to run a gamut of checks and calculations before eating. Diabetics have to count every carb they eat. We literally measure our lives in teaspoons and grams, recording all of it. We prick our fingers before every meal to test our blood sugar level. That number, along with a tally of carbs, goes into a formula that determines the correct insulin dose. And almost anything — from the hours you sleep to the intensity of your workout — can change the outcome. So even if I get the math right, the dosing could still be wrong. A couple of times, I’ve taken too much insulin and almost passed out. Finding time to manage diabetes along with the rest of my life has been a big challenge. As a correspondent for CNN, my days sometimes start with a surprise wake-up call at 4 a.m. telling me to be camera-ready in two hours. Checking my sugar levels regularly while covering a breaking news story was already a big enough imposition — weighing how many blueberries to put into my yogurt while out in the field proved to be impossible. So I resorted to cutting most carbs out of my diet. Although eating became a lot less complicated, I still had to inject myself with insulin several times a day. But how much time could that take? When all this started, I figured about five minutes for each injection for a total of 20 minutes of lost time every day. What I hadn’t factored in, however, was the awkwardness of injecting anywhere else but at home. I had to explain to my sources and colleagues why I was suddenly demanding to speak to a chef about hidden carbs on the menu (I’m amazed at how much sugar restaurants add to food).
Illustrated by Mallory Heyer.
Even if I skipped the interrogation and ordered a piece of grilled meat, diabetes found ways to interrupt my meal. Like spending 15 minutes in the bathroom to prick myself a half dozen times because I couldn’t draw enough blood from my bruised fingers to make a test strip work. I hid the diagnosis from my family for a month. I knew it would crush my parents and grandparents (it did), but I also didn’t want my family to change their traditions for me. As a child, my grandmother and I would spend hours together rolling fresh gnocchi for Christmas dinner. Now these and other memories were corrupted. Eating had become an ugly, mechanical chore. Insulin injections were daily reminders that I was broken and couldn’t be fixed. Changing my diet, increasing my exercise, and reducing stress would never eliminate the need for insulin. I would have to carry equipment with me for the rest of my life (or even worse — on me, in the case of an insulin pump). In an episode of self-pity and rage, I ransacked my closet, looking for clutches that were too small to hold my meter, needles, and insulin pens. I threw them all away. Life slowly became hell. I became resentful of everyone who could eat what I couldn’t and who didn’t have to plan their day around meals. My husband, seeing the agony I was going through, started avoiding carbs too. You’d think that would’ve helped, but it didn’t. I hated the fact that my disease was now affecting his enjoyment of food. Diabetes was robbing me of my culture — and by default, my identity. Did having diabetes mean I had to stop being Italian? Would I still be able to achieve my career goals and aspirations? Would I ever feel “normal” again? These questions haunted my existence as the days blended into an endless parade of grilled chicken breasts with steamed spinach. Around this time, my mom invited us over for dinner one evening. When we sat down to eat, she put a familiar pasta bowl in front of me full of spaghetti. Its aroma held the cherished smells: oil, pan-seared garlic, and pancetta. I started to bawl. “I can’t eat this,” I sobbed. “Yes you can,” said my mom. “It’s zughetti — spiralized zucchini — not pasta.” I devoured the dish as tears streamed down my face. With that simple hack, my mother rekindled a fighting spirit she had instilled in me long ago. My diagnosis made her more upset and angry than anyone in my family, but her response was to reclaim a special part of my life that diabetes had stolen. By bending and molding traditional recipes, she single-handedly restored some of the joy I had written off (and taught me how to bake the best 10-carb cookies I’ve ever eaten). I still contend with the swings of diabetes — the shakes I get when my blood sugars are high and the sweats that come with bottoming out. But now I’m striving to define the disease rather than the other way around. Although I don’t derive the same kind of pleasure I used to from eating, I’m still passionate about it. The love of food can’t compare to the love of family — it’s not even close. Diabetes hasn’t robbed me of my identity. I am and always will be Italian — now just with a spiralized twist. Thanks, Mamma.

Cristina Alesci is a correspondent for CNN and CNNMoney. CNN just published her investigative series on food,
“Raw Ingredients: The unprocessed story of where your food comes from.”

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