This week Nicole Johnson marks an important anniversary: She is beginning her 20th year of living successfully with Type 1 diabetes. • Since being diagnosed, she has won a Miss America title, earned three college degrees and is pursuing a doctorate in public health, has launched a small business, written several books, given birth to a daughter who is now 6 years old, helped raise millions of dollars for diabetes research and serves as executive director of a new diabetes research and education program she helped create at the University of South Florida. • Not bad for the woman who was told at age 19 that she would never be a mother and should avoid stress.
"Back then we were told to eat chicken and broccoli and pretty much avoid everything else," said Johnson, looking like a beauty queen as she shaped ground turkey into patties in her bright South Tampa kitchen.
"I said to myself, there's got to be more."
Johnson quickly learned there was plenty she could do, but that the essential ingredient was maintaining a well-balanced diet and lifestyle.
She also learned that balance didn't have to mean drudgery — information that she knew wasn't reaching many Type 1 and Type 2 diabetics struggling to balance carbs, fats, protein and calories.
Johnson teamed up with a popular cook she met at a diabetes conference — a guy known in the 1990s for his syndicated television cooking segments called Mr. Food.
Art Ginsburg had been diagnosed with diabetes and Johnson suggested they work together on a cookbook for diabetics. The pair produced three books for the American Diabetes Association. Then, in 2010 Johnson came out with a book of her own, Nicole Johnson's Diabetes Recipe Makeovers (Publications International Ltd., 2010), that transforms more than 100 family favorites into healthy dishes that diabetics can enjoy.
The book addresses something Johnson says is missing in similar cookbooks.
"It teaches people about negotiation and shifts the conversation away from focusing on limitations to one that focuses on options," said Johnson. "I show you how to negotiate your way through a meal so your carb bank isn't full when you get to foods you love."
She notes that the holiday season, with its parade of food, is particularly challenging for diabetics and can be even more daunting if you are a guest and can't control what is served at a meal or party. Instead of thinking of all the things you can't eat, Johnson suggests scanning the entire menu and deciding which high-carbohydrate item you want the most and skipping or having just a bite of the others.
For instance, if dessert is your goal, skip the mixed cocktails, potatoes and bread.
"I find out what is being served and make food decisions before walking in the door," said Johnson.
As you might expect, Johnson has her diabetes under good control. But it takes hard work every day, particularly when you have Type 1, the most serious form of the disease in which the pancreas fails to produce insulin. Even with vigilance, there's no guarantee she won't have a scare with low blood sugar.
In fact, she now is training her 6-month-old Labradoodle puppy, Lucy, to alert her when her blood sugar levels are dipping.
How can a dog do that? By learning to detect a scent on the human breath that develops when blood sugar levels drop rapidly. When the dog notices this, she nudges or licks her mistress, gets help from somebody else in the house — and can even fetch food or liquid.
Lucy, who wears a vest identifying her as an assist dog in training, is an apt, well-behaved pupil. As Johnson was cooking, and delicious aromas filled the air, Lucy stayed close by, but never angled for a handout.
The same, however, couldn't be said for Johnson's human guests.
Irene Maher can be reached at firstname.lastname@example.org.