For many of us, a delayed meal is just a minor inconvenience. At most it makes us irritable, but generally, like nature’s call, hunger can be kept at bay for an hour or two: we can starve through unending meetings without harm to ourselves, and can even extend joyful moments well past mealtime. But did you know that being able to dodge food—for just half an hour more without an ounce of anxiety—could be a real superpower?
Over 100 million Indians live with diabetes, and many use medication, including insulin shots. One common side-effect of diabetes treatment is that it can reduce your sugar more than you want. The solution is simple in theory: eat enough so that the insulin dose has enough carbs to keep working with. If you don’t eat on time, sugar levels can crash.
It isn’t as simple in practice. For anyone routinely stepping out of home, the day can throw unexpected twists. Traffic that Google Maps didn’t preempt, a flat tyre 20km from home, a wedding dinner delayed so the groom’s best friend could finish a hilarious speech: we cannot always foresee how the minutiae of the day will turn out.
The result is a little understood fact: A delayed meal is the worst nightmare for a diabetic and for their close network of caregivers. It comes with extreme anxiety and mortal risk. I happen to be one such caregiver. One fine evening in 2022, our doctor told us that my wife, then 31, had diabetes, and needed emergency insulin to bring sugar levels into the safe range. She remains on a daily insulin shot ever since. While her condition has been under control, the anxiety of low sugar (hypoglycemia in medical terms) follows us everywhere we go.
Food brings people together, but expecting it unceremoniously can also make you look rude and fussy. It’s not rude to create a scene during usual medical emergencies, but urgently asking for food to avoid an emergency—as if your life depends on it (because it does)—isn’t easy. Sometimes one may take the chance just to remain polite. Think of a gathering where the host nonchalantly serves dinner at 9pm, an hour later than promised, and we helplessly wait, trying not to make a fuss, relieved at every second that doesn’t become a crisis. Sometimes rudeness saves us: when we’re hosting and she’s hungry, she must start eating first—both impolite and awkward.
On a bad day on an outstation trip, when delays add up at each step—the flight, the taxi, the traffic, and even the hotel dinner—you just pick the lesser evil, and munch on harmful chocolates and settle for higher sugar than lower.
We don’t see the ability to delay meals as a superpower because the stakes aren’t usually high. Erratic schedules are too normalised, and we usually fit food around our lifestyle, work, social and travel rush, rather than the other way around. But with India’s fast-growing diabetes prevalence, education about hypoglycemia is essential if you want to be a caring and well-prepared host, an aware guest, or a useful first responder—or even when you head for an evening with an insulin-dependent friend, who may be waiting for you while you unhurriedly, guiltlessly, stay true to the notorious Indian Standard Time.
One’s fate with diabetes also depends on how medicine-friendly their profession is. Soon after my wife’s diagnosis, we had a long journey with a taxi driver in Tamil Nadu who had also recently seen the same fate. His, like many others, was a job that doesn’t go well with diabetes, even if he had all the money to afford the expensive insulin treatment: his day depends heavily on passengers’ whims and fancies. A stop for a photoshoot that goes on too long, a stop at a restaurant that ends too quickly, or no stop at all for hours because the passenger is in a hurry: all pose real danger.
Think of all professions where the day’s timetable is hostage to the punctuality, behaviour or magnanimity of others. Once my chat with a 55-year-old colleague went longer than planned. He suddenly started shaking and speaking incoherently; his continuous glucose monitor was flashing red. He rushed to get a packet of juice to regain his wits.
Here’s a risk that can be triggered by just the extra 10 minutes you keep someone in a conversation. Or just 10 minutes of a food delivery partner losing his way. Everything needs to be planned; yet days can go off script. I’m thinking of a 21-year-old diabetic journalist figuring out her beat, running from pillar to post for a story, with a bureaucrat keeping her waiting for an interview well past her mealtime. Or a mid-career field researcher or social worker out in a village for interviews, with the added headache of dehydration (which can lift sugar levels) and poor cold storage for insulin. Or a 47-year-old CXO, with all the world’s luxuries, delivering a keynote address at an event, having had no time to grab a bite after a delayed flight. As a journalist, I’ve withheld hunger way too often on busy days; on Budget days, food is usually the last thing on the mind: diabetes could, indeed, be a setback for colleagues who otherwise look healthy.
Of course, those at this risk like to be prepared—and they must. An apple, a toffee or a juice tetrapack are regulars in my wife’s carrybag. In life sometimes one gets complacent; remember, diabetes is a daily battle against your biochemicals. She didn’t carry a snack to an event held in Delhi by a world-famous charity known for top-tier work in healthcare (of all fields). The team had floated a form asking for attendees’ food needs, and she duly described hers, impressed by the thoughtful question. But the snack-time buffet had only cakes and cookies, and when she asked about the meal preferences she had filled in the form, she was told she was too demanding.
Don’t forget the horror of multiplexes, which neither let you take your food inside, nor sell anything even remotely healthy. Or mysterious flight journeys that are a matter of pure luck: even after asking for a diabetic meal, the tea may turn out to be premixed with sugar. It may even be sugar-free, but it’s a surprise. One airline once gave a diabetic food box with potatoes in it—so along with knowing that a diabetic must eat on time, we also must learn what they can and cannot eat. Young diabetics who need to survive many decades without complications cannot afford to go easy. The disease may not always have a cure but can definitely be managed well, and it takes a whole village to raise a diabetic into a person who will be healthy in old age.
Controlling diabetes well needs high-level scientific calibre to understand how the body reacts to different foods, medicines and stresses. To keep it simple, doctors may avoid giving full guidance—I’ve seen anecdotes where patients didn’t know the discomfort they were facing was due to low sugar, nor did their caregivers know they must check their sugar first.
So congratulations if you can hold your hunger for long; for you and me, starving may be a life skill. But for a fast-growing number of our compatriots, by virtue of poor genes, sorry lifestyles, demanding professions, or just bad luck, it’s a moment of crisis. And they need us to know.
The simple tip is to be more mindful whenever you are holding someone up while being in a position of power: like when you are hosting a wedding where lengthy, unpunctual rituals may delay food as if it’s not a priority, or if you have an appointment and the guest is waiting outside your cabin with hope and impending hunger. Here’s another tip. The choices you make assuming the presence of a diabetic around you (which is only growing in India) will also be the choices that will work well for everyone in general: everyone appreciates punctuality, and no one will mind a default platter mix that has less carb-heavy options along with, maybe, some indulgent choices to make up for it.