At the simplest level, food equals survival, but it's also so much more: it's the comfort of home and childhood memories, and the way we celebrate the passing of seasons or mark key life events.
However, if you've been diagnosed with type 2 diabetes you can never look at food in exactly the same way again. A slice of apple pie is no longer just about sugary goodness and your memories of Grandma Bea. You'll need to mentally break it down into its calories, carbohydrates and potential impact on your blood sugar.
For many people with diabetes, this is one of the most difficult hurdles.
Tough to make changes
"We no longer just eat to get physically nourished, most of us also eat to fill some other need. We eat because we are bored, stressed, or lonely. We, as a society, haven't done a good job at finding non-food ways to cope," says Linda Sartor, a diabetes nutrition specialist at the Penn Rodebaugh Diabetes Center at the Hospital of the University of Pennsylvania in Philadelphia. "To make healthier choices, we need to practice new habits. That takes repetition and ongoing support, so we don't fall back in to our old habits."
Overall, it can be tough to change daily habits, particularly if you feel fine. And because complications might not show up for 10 years or more, you might be tempted to make no changes at all.
"I worked to make small healthy changes every day. Over the years that has added up to big improvements in my health."—Donna Kay, Type 2 Diabetes Patient
A 2007 University of Chicago study of 701 patients with diabetes found that many would trade years of their lives if they didn't have to bother with the details of managing the disease. Ten to 18 percent of patients said they would be willing to give up 8 of 10 years of healthy life to avoid the dietary restrictions, exercise and medication.
However, you should start making small changes as soon as you can. High blood sugar silently damages the body, even if you don't feel it.
"High blood sugar is equivalent to any poison," says Gerald Bernstein, MD, director of the Gerald J. Friedman Diabetes Institute at the Beth Israel Medical Center in New York. "So, if we were talking about mercury or lead or arsenic everybody would be quite upset. But when it comes to talking about an elevated blood sugar, most people don't respond."
Slow and steady wins the race
Changing the way you think about and consume food may not happen overnight. But making changes can help you avoid damage to your eyes, kidneys, nerves and heart.
"I didn't change everything at once," says Donna Kay, 40, of Prairie Village, Kan., who was diagnosed with diabetes five years ago. "I worked to make small healthy changes every day, and over the years that has added up to big improvements in my health."
Kay says that sticking to her eating plan can be a challenge and occasionally she slips up, but "I quickly forgive myself, analyze what went wrong and make immediate plans for improvement."
"My biggest challenge to overcome was (and sometimes still is) portion control," she says. "There is a difference between a spoonful and a shovelful of food, and over time I have learned to be satisfied with smaller portions of food."