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Type 1 Thursday – My HbA1c Formula
Lowering your HbA1c as a Type 1 Diabetic is HARD!
How did I turn my double digit HbA1c nightmare into a healthy 5.0% habit? Find out all about my 12 step formula in this week’s Type 1 Thursday!
What is your goal A1c? Or healthy goal in general? Let me know in a comment below!
Transcription
If you prefer to read about my HbA1c Formula, here you go:
Getting your HbA1c down as a Type 1 Diabetic is hard! It’s really, really hard and requires a lot of work and effort. So how did I turn my HbA1c from a double digit nightmare to a 5.0% healthy habit?
In this week’s Type 1 Thursday, with me Hanna Boëthius, one of the cofounders of The Low Carb Universe, as well as a Type 1 Diabetic since 34 years. I don’t know if you know, but I reached something magnificent. I have had a long, long standing dream of reaching a HbA1c of 5.0% (31 mmol/mol) in the “other scale”. This week, I finally got confirmed that this was the case and I couldn’t be happier! But what you may not know about me, yet, at least is that not that many years ago, I was a total diabetic mess. I failed to take care of myself. I had terrible blood sugars and very little knowledge of how to actually manage diabetes. So my A1c not too long ago was in the double digits, which is not good for anyone who knows anything about blood sugar. At the same time, I was so hopeless because I was clearly not given a the proper tools of taking care of my diabetes.
I actually shared my full story a couple of weeks ago, but so that no one else has to go through all the trials and tribulations that I did, I have formulated my getting a better HbA1c formula!
It’s what I have done to bring my HbA1c from double digits to a healthy, happy 5.0 habit. I’ve actually been under 5.5% for more than three years now, something I’m very happy about! That means that it’s stable, that means that I have found out a few things that work for me. That doesn’t necessarily means that they work for every single Type 1 out there, but they work for me. And maybe just maybe you or someone you know will be able to draw a little bit of inspiration from what I’ve done, so that you can get healthier and to your health or A1c goal as well.
This is a 12 point plan, so buckle up and get ready, we have a lot to go through!
Number one is definitely eat low carb. I know, it’s a very heated topic in all of this. But if you have problems with blood sugar, there is really nothing else that will work as well as to lower your intake of dietary carbohydrates. This also means my favorite topic in the world, which is the law of small numbers. Instead of with a lot of carbs, you add a lot of sugar, and then you have to chase it with a lot of insulin and then the margin of error is just equally as big. Instead, you can eat a little sugar, you add a little insulin and the margin of error is smaller. This is the number one reason why low carb for diabetics is such a great idea, because it leaves out so much of the guessing work. I also incorporated intermittent fasting into my routine a good couple of years ago. This means that I skip breakfast every day, just because I’m just not hungry, and I don’t see the point of stressing my body with trying to, to digest more. Intermittent fasting that has helped me a lot, and maybe it’ll help someone out there too.
You have to find out if you are intolerant towards any sort of foods. A very common intolerance is dairy, for example, which is a big thing within low carb. If you have any issues or allergies, then maybe it’s not going to help you reach those blood sugar goals that you are so dearly after. Make sure that you find out other things, for example eggs, night shades… People have intolerances towards many foods, but you might not find out.
What is your personal carb threshold? I know this is also very widely discussed within the diabetic community. I personally eat maybe 20 grams of carbs a day, most days not even. For example, the great Dr. Richard Bernstein says that you should eat 30 grams a day with six grams of carbs for breakfast, 12 for lunch, and 12 for dinner. It’s all up to you finding out what kind of level that you should be at for the best results. This is definitely not carbs from cookies, and pasta, rice, potatoes, all this stuff. This is green leafy vegetables, vegetables that have grown above ground, as these vegetables don’t impact your blood sugar as much.
Treating the few hypoglycemia as that you still will experience, but not as many, with precision so that you don’t go up and down and down and up and up and down as we were used to on the high carb lifestyle that I was on before, but treat lows with precision. Use the exact number of grams of glucose that you need to get into back into a healthy, safe level of blood sugars. If you overshoot too often, then your average blood glucose is going to go up. If you want to bring your A1c down, then make sure that you stay in range as much as possible.
Second point is medication, whatever kind of medication you’re on. Yes, insulin, but I don’t want to discount any other sort of medications you may be on, they may have an impact on your blood sugar, please check this with your doctor. When it comes to insulin, there are two really important things that you have to do: number one, basal rate or your basal dose of insulin, the long acting insulin that should keep you stable throughout the day and night. Please test that this is correctly dosed. If it’s not, then it’s going to cause you to either slowly but surely go up in blood sugar or go down and blood sugar if you’re take too much basal. You can test this by fasting and checking your blood sugar every hour of that fasting window, you can either divide it up or do 24 hours in one go. The second part is of course, bolus insulin, the mealtime insulin. Make sure you know your ratios, and that they are properly calculated, or found out through trial and error, as they are in my case. The common ratio calculations that exists with high carb eating, don’t quite apply to all diabetics eating low carbs. So for very many of us it has to become a trial and error. With a law of small numbers, the error margin is not that big. So you’re not going to be in for a wild ride. It takes some time to figure it out.
Also pre bolus for your meals, even if they don’t contain that many carbs, just so that the insulin has a bit of time to start working before the food comes and does the same. What really helps when you’re trying to find out your medication and ratios and pre bolusing for meals, and everything else, is of course to have a continuous glucose monitor. This is either Dexcom, for example, or Freestyle Libre, or any of the other ones that are out there, whatever one fits you the best. I know they’re very expensive, and they’re very hotly debated as well. But they are a huge, huge help when it comes to really lowering your A1c, because when you see a trend you can start acting before the catastrophe is a fact, hyper or hypo.
The next point, is blood sugar levels. As a perfect diabetic, or whatever that means, you should try to aim for an average of 4.6 mmol/l or 83 mg/dl. This is what people who are healthy and have a functioning pancreas’ are on average. If you are at a much higher average right now, don’t try to get down to 4.6 or 83 in one go, do it step by step. All of the modern blood sugar meters have an average measurement of blood sugar. Depending on how often you prick your finger, it might may be representative of what it actually looks like. As soon as you see where that average is, just try to aim for values slightly below that. You will slowly but surely take it down to normal healthy levels and therefore achieve a normal healthy A1c. You HbA1c, in short, it’s the average blood sugar for the past sort of six to eight to 12 weeks.
How you correct blood sugar also matters! Don’t be aggressive about it, whether you have to correct a hypo or a hyper. That causes the large margin of error. Be careful about it, and have a little bit of patience. I’m the worst person to talk about this, as I have zero patience! Be sure that you have a little bit of patience when you do treat, as things can turn quite suddenly. Find out if you are affected by the dawn phenomenon, for example, which is when the liver kicks in and starts shooting out sugar so that you wake up in the morning. Or if you have something that is called boots on the ground syndrome, which is when you are have woken up and you put your feet on the ground and the stress of your day gets your liver going and your blood sugar consequently goes up. Those can also be fine tuned with basal insulin, which needs to be handled by a doctor.
Then number next is stress. Stress is a really a blood sugar killer! It really aggravates your whole system, and it causes your blood sugars to go up. Make sure that you can prevent and avoid as much stress as you can in your every day life. How can you reduce it? Well, you have to find what works for you. Could it be yoga? Could it be meditation? Could it be a long walk in the nature? Could it be a hobby, could it be having a pet? Stress is really something that we have to work all of us, but especially people with glucose problems need to work hard at trying to eliminate it.
Next point, movement. I don’t like the word exercise, so I’m going to use movement. Our bodies are made to be moving and our bodies feel good if they get to move often and in different ways. Find out what makes you happy. What is fun for you, what way of moving is so fantastic that you just forget about time? It could be dancing, it could be the ones that I mentioned before, yoga, walking. It could be weight training, it could be dancing on the beach (which we do happen to do in Mallorca! If for nothing else, join us to find out how much fun that is in November.)
Movement has a very individual reaction on blood sugar. In the long run it definitely smooths things out. But when you’re doing exercise, or you’re moving vigorously, chances are that your blood sugar is going to go up. You need to find out what strategy works best for you. There is a rule of thumb – strength training makes your blood sugar up and cardio makes your blood sugar go down. But that’s not true for everyone, that’s just a rule of thumb! You have to find out what works for you and what happens to your body in different movement situations.
Next point is planning. Make sure that you are prepared for basically anything when it comes to diabetes. If you’re traveling, carry a glucagon kit, always have glucose tabs with you, no matter where you go. And even if you’re only doing a quick run, make sure that you are prepared for anything that can happen.
No matter how great of control you have of diabetes, things still do happen. Please be prepared for all eventualities at all times. For example, also bring enough test strips for your blood sugar meter, make sure that your insulin pump or your vials have enough insulin in them for the day or the time you’re going to be away. It is all about planning. It really is about treating and treating blood sugar – if you fail to plan, you really plan to fail. Don’t get caught in that trap. That can save you a lot of “interesting” moments with diabetes.
Next point is mindset. What is your goal? Set a clear, actionable, timely goal. Also make a plan of how you’re going to get there. Without motivation and a proper mindset, you aren’t going to reach your goals.
Next one, acceptance. Accept that diabetes is what it is, life still happens with it. And you can only do the best you can, and you can only do the best that works for you. You can’t do much more than that. And please don’t hate diabetes! The more you make it your enemy, the more it’s going to lash right back at you and you’re not going to be able to work with it, which is what you have to do. You have to be kind to yourself, you have to show yourself some love, even when things go wrong. That way you’re going to get to a better relationship with your diabetes, which is also a huge point.
Find your support network, whether that is that our coaches, CDE’s and nurses, doctors, spouses, personal trainers, and other happy people around you, like your friends, family, pets – all of these people that that create the network around you. Make sure they are supportive. This is who you turn to when you have a bad day, or when you want to celebrate a fantastic achievement. You don’t have to sit there by yourself, you can turn to other people and let them help you both in good times and in bad. When it comes to the medical side of your support network, please make sure that you have a Medical Dream Team. This is a key to getting the care that you know that you need, and to try to find out what works best for you. This is where you can really get support for your lifestyle choices, and also help you with your diabetes management.
Hydration, you have to hydrate! Make sure that you hydrate properly, because this helps the body to keep all that, perhaps, unnecessary sugar at bay. The body really does well when it is well hydrated. I personally try to aim for about two liters of clean water a day. It doesn’t have to be that for you.
Finding a routine that works for you . A daily routine, as in you get up sort of the same time in the morning, you go to bed sort of the same time at night, and everything in between. Of course you should be spontaneous and have fun, too! But the main parts that could have a little bit of a structure will help you manage your blood sugars better. Perhaps this could include when you take your basal injection, if you’re on pens or syringes, or when you change your pump site. Also work into your routine when you take your supplements, when and how much you hydrate, when you eat, what you eat, when you move… Building it into a routine is great, because blood sugars, as far as I’m concerned, aren’t too happy about uneven routines, they tend to do better when there is a routine, so that you know what you’re doing.
My final point are supplements. Some potentially blood sugar lowering supplements may be of use. The ones that I take, for example, are omega 3, vitamin D (helps autoimmunity) magnesium (high blood sugars do require a lot of magnesium), also zinc for the immune system. Chromium also can help keeping your blood sugar levels a little bit more stable, as it helps with insulin sensitivity way down in the cells. Also, I’ve heard a lot of good things, but I haven’t tried it myself yet, about alpha linoic acid, ALA.
These are my 12 steps of what I did, and my HbA1c formula to lower mine from a double digit nightmare to a healthy and happy 5.0% (which actually in fact, if I get to brag for a second, is better than even some healthy people have!). I’m very very proud of myself, especially after 34 years of living with this disease and it not having been very easy at for very long periods of time.
What is your A1c goal (or if you are not focusing on A1c – what is your health goal)?
Let me know in a comment and I’ll be happy to chat with you there.
Type 1 Thursday – Why the Dietary Wars?
In today’s Type 1 Thursday, it’s time for a more personal comment…
Why do people disagree so strongly about what people with diabetes should eat, when we all should have a common goal (notmal, healthy blood sugars)?
What’s your opinion about this? What tools and tricks have you tried to try to manage your diabetes and what worked for you? I would love to hear in a comment somewhere and I will be happy to chat with you there. Comments and questions are welcome!
Transcription
If you prefer to read, here’s the transcription of the episode above:
Hello, and welcome to another episode of Type 1 Thursday with me Hanna, one of the cofounders of The Low Carb Universe. Also, as I’m sure you’ve heard me say many, many times now, I’ve had Type 1 Diabetes since I was two years old. So for 34 years, I’ve been juggling this wonderful roller coaster that is Type 1 diabetes. And I am happy to share some of my knowledge with you that I figured out and some of the aces up my sleeve that I have gathered in these 34 years! I wasn’t always in control, as I am today. I was very uneven moment, even majority of my diabetes career…
But today, I want to talk about a topic on more of a personal comment. And this is actually something that I’ve gotten comments about before and also during this series, namely the nutrition debate for people with diabetes.
Why is it so inflamed regarding what you should eat as a person with diabetes? How can there be such divided opinions? Everyone who has an opinion seems to be going head to head with each other about this?
I’m actually sad about this, because we all should have that one common goal, which is that all people with diabetes are worthy of normal, healthy, happy healing blood sugars. How the person in question, who is living with diabetes, gets there should be less of a question – as long as they do. If someone comes to me and says, “Hey Hanna, I went vegan and since then my blood sugars are really great!” I’m like, “amazing, great! I’m so happy you found what works for you!” Or if someone says, “you know what, I’m following the Western diet to a tee, and I have amazing blood sugar’s” My response? “Great, fantastic!!
No one could be happier for you than I am in that moment, when you tell me that you have fantastic blood sugars regardless of how or what you’re eating, I, and I know very many people with me, who do advocate for a lower carb, real food, sugar free way of eating don’t want to be militant about it. It’s not that I want to convert every single person with diabetes, that’s not my point. It will never be my point.
But the point is to educate, to inform, and to make people with diabetes aware that they do have a choice.
There is a choice when you’ve tried everything else. When you’ve tried every single diet, every single insulin, every single supplement, way of eating, timing of insulin, there are still options. There’s always, always, always something that you can do in order to improve your health.
It’s not about being militant, it’s not about standing my ground and holding it tight. No,. My goal is for every person with diabetes, to know that there are different ways of managing blood sugar and diabetes, and it but it doesn’t have to be according to the standard Western diet, it doesn’t have to be a vegan approach. It doesn’t have to be low carb, it can be something completely different, as long as it works for YOU. The main point to find what works for you, you can’t look at anyone else. You can draw inspiration from other people who are doing something that is working for them, and then take the good parts. And leave what doesn’t work for you, it’s all about information.
I have had a struggling past with diabetes, it’s been very, very difficult for me to control my diabetes with the standard Western diet that I was told to eat for 26 years. Which, requires, well, recommends, 35 to 60 grams of carbs per meal, five times a day. For me that became unreasonable. It didn’t work. I couldn’t maintain good, healthy, normal blood sugars, without mountain tops and valley bottoms, in terms of blood sugars, which of course doesn’t make you feel great at all. It makes you feel terrible.
My whole point about advocating for low carb for diabetes, and I know very many with me, it is that as long as you get stable, healthy, happy blood sugars, we are all game for it. It wasn’t until I actually did start cutting down my carbs, coincidentally, perhaps, that I started to get better control of my diabetes. So I went from a double digit HbA1c, to a level of 5.1% last time. This is well within the healthy range!
I swear that I could not have done that without the help of dietary change, a change in my lifestyle, and a change in the way that I was eating. For me, I know that it’s not sustainable to do that on a standard Western diet with up to 240 grams of carbohydrate a day, I can’t chase that with insulin. We come back to the law, small numbers, this works a lot better for many, many diabetics.
I really wish I would have had the choice myself earlier to know about that there is a low carb way of eating so that I could have made the decision and try it out earlier, seeing the benefits. I would have saved myself a lot of pain, a lot of suffering a lot of worry, a lot of anxiety because that always comes hand in hand with wobbly blood sugars
This is this is why it’s become such a passion for me, and for the rest of us talking about low carb for diabetes, that every single person with diabetes knows that there is that option to try out as well. When every other option has been explored and transpired, that’s run out of time. It is so important to me that you know that there is another option. And that there are very many options beyond this, too. The main point is that this isn’t disregarded as an option.
So it’s so sad to me that the nutrition debate, especially within diabetes, but also generally, for the general population, has become so inflamed. And I really wish that we could see that we all have a common goal, all of us trying to educate people with diabetes, whether it is with different ways of eating, with exercise, with all of these lifestyle measures… I just would be so happy if we could just realize that we have a common goal, and that is that people with diabetes have normal, healthy, happy blood sugars.
If you have any questions or comments, or what’s your opinion about this? What tools and tricks have you tried to try to manage your diabetes and what worked for you? I would love to hear in a comment somewhere and I will be happy to chat with you there.
Type 1 Thursday – Type 1 vs Type 2 Diabetes
It’s Thursday – time for another Type 1 Thursday!
Today’s topic is Type 1 vs Type 2 Diabetes. What are the differences? What are the similarities (if any)? And what about management and treatment, what are differences and similarities there?
What are your take aways from this video? Share in a comment!
Transcription
If you prefer to read, here it is:
For today’s topic, I wanted to explain and go through the differences between the two main types of diabetes. So that is, Type 1 Diabetes, as I have, and also Type 2 Diabetes that is the more common version. There are also many other versions of diabetes together with it.
I wanted to draw the outline of the sort of differences between these two, and perhaps if there are any similarities. And what about management? How does that work between the two different types?
So basically, Type 1 Diabetes, as you may or may not know, is an autoimmune disease. That means that my beautiful immune system decided that those insulin producing cells looked a little bit dodgy when I was two years old, and kick them out of commission, which is not great because that means that I am all other type 1’s will have to inject insulin for the rest of our lives no matter what we do, no matter whether we go low carb and no matter if we go carnivore – we will always have to inject some insulin. Perhaps not as much as when on the standard American or Western diet, but still a bit so that we keep our engines running, as insulin is the master hormone. And it’s very much needed. So if you don’t produce any, you have to add some.
It is, as I already said, it’s the pancreas that get or a part of the pancreas that gets kicked out. That means that I produce no insulin, but other Type 1’s may produce some, but it is nearly not enough insulin. This can be hereditary, but Type 1 doesn’t have to be hereditary. I, myself, am an example of that. I have no history of Type 1 Diabetes in my family, I am the lucky chosen one. How great is that?
Type 1’s are about 5% only of all diabetes cases. Considering there are over 420 million diabetics in the world, that means that we are very small minority. And I’m not sad about this, because I don’t wish this on anyone. It does explain that we have to do a little bit more advocacy for our type of diabetes because we are not represented as much as Type 2’s.
The onset of Type 1 Diabetes can be very sudden, and it’s usually discovered within weeks. If it’s if it’s not LADA or other side types of Type 1, you will be very, very sick very suddenly. Symptoms include frequent urination and thirst, incredible unquenchable thirst, falling asleep everywhere, because your blood sugar is skyrocketed high. There are few warnings to look out for, that can also be mistaken for the common flu. Don’t wait in case you have this suspicion, go and check it out, if it happens to a family member, for example.
There’s no cure for Type 1 Diabetes. We do have better management possibilities than we’ve had in the past 34 years that I’ve been living with the condition, but there is to date, no cure, and I’m not positive about one happening anytime soon. I secretly, or not so secret, I do wish for it every single day of my life, even if it is easier to manage with lifestyle choices, it’s not as easy as maybe it would have been without having to act as your own pancreas.
Type 2 Diabetes, what is that? That is basically a severe insulin resistance. So your body is still producing insulin. In fact, it’s actually producing tons and tons and oodles and oodles of insulin. But the problem is that your cells don’t recognize the insulin that you’re producing, making you insulin resistant, making you not be able to take up the sugar from the blood stream, making it hang around in the blood stream. That is why you have higher blood sugar in Type 2 as well. Basically, the body does not recognize its own insulin. And this can be very tricky, but there are a lot of things that you can do to improve insulin resistance even as a Type 1, but definitely as a Type 2.
Type 2 can be lifestyle related, or it can also be hereditary. But the lifestyle part is a majority of the cases.
Diabetes cases that are Type 2 in comparison to Type 1 are basically the remaining 95% (and 5% are Type 1.) This can take years to develop, although the symptoms are just the same as in Type 1, just maybe not as severe from the beginning. You might notice a need for more water over a while or you might notice that you’re more tired than usual. But that can also be attributed to stress and all these kind of things that are lifestyle related, as well. The lucky thing with Type 2 is that many cases actually can be reversed with the help of lifestyle measures, like changing your diet, movement, taking supplements, all these things that you can do with your lifestyle is to alleviate and also perhaps reverse Type 2. Even if your Type 2 has so called been turned into Type 1, which it can’t, Type 2 can only become insulin dependent, but it can never be Type 1, because it’s not an autoimmune attack on your insulin producing cells.
What are the commonalities of these two types of diabetes?
Both of them lead to the same complications. These includes retinopathy, potentially blindness, that leads to nerve damage, potentially neuropathy, and/or amputations. And it also can lead to kidney problems and nephropathy. It can lead to cardiovascular disease, it can lead to stroke… All of these things that aren’t so nice with diabetes can actually be attributed to the high blood sugars or the constant constant fluctuations in blood sugar and not the diabetes itself. If you manage to keep your diabetes at bay and keep your blood sugars at a normal, healthy level, then the risk of complications, DKA and all these things, it’s very much smaller than if you don’t and you go between minimum and maximum at all times.
A second similarity is that you have the same goals of achieving normal, healthy, stable blood sugars. Make those continuous blood glucose monitor things look like lines, not roller coasters, but lines. That goes for any diabetic, independent of type.
Thirdly, the want to reduce insulin. Before before people get angry with me here, let me explain why.
In Type 1, if you keep adding lots and lots of insulin the whole time, the risk is that you’re going to be a double diabetic. That means that you, in addition to your Type 1 Diabetes, develop severe insulin resistance so that you have both types of diabetes. For me personally, and I know very many with me, this is something that we definitely want to avoid. You can’t think of insulin as a free for all thing that can make you eat anything that you want. For those of you who works for, great! For those of us who maybe it doesn’t work for, and we need more insulin than necessary, it’s not maybe the best idea. The risk is there, and I was there myself a couple years ago, I am very sure that I had double diabetes, because I was on so much more insulin than I am on now. But it wasn’t confirmed. So I can’t say with security.
Why you want to reduce insulin as a Type 2? If there isn’t that much insulin to not react to for the cells, then maybe they start listening a little bit. It’s like a small toddler, when you scream at them, and try to reinforce your power and try to make them understand… Do they ever listen? No. If you, on the other hand, just keep calm and really give it instructions with a point and and with direction, there is at least a chance that they might listen. It’s similar with Type 2 and insulin, in my opinion.
How can you reduce the amount of insulin needed or used? How can you get stable normal blood sugars? And how can you, as a Type 1 diabetic, not get double diabetes? Lifestyle measurements. As a Type 1, as I said, you will always have to take some insulin, but it will it can be reduced. The power of nutrition in diabetes is just so immense. You can eat a sugar free, low carb, real food kind of diet (and I hate the word diet but there’s no other way of explaining it). If you eat real food, if you if you eat sugar free and if you low carb, chances are that you will be able to improve your health a lot.
This doesn’t just go for people with diabetes – this goes for everyone. Whether you have diabetes or not, if you’re healthy, if you have no health issues at all, you are always going to be better of health wise, if you eat a sugar free, low carb, nutrient dense, real food diet. That’s just it. That and of course, movement, exercise, make sure that you feel joy in your life, make sure that you take supplements if you need them. Make sure to hydrate, make sure that you have a routine that works for you. Make sure that you alleviate your stress. All of these lifestyle measurements are good for both diabetics and non diabetics.
If you have any takeaways or any ideas or any comments, let me know below and I will be happy to chat with you there.
Type 1 Thursday – How to eat at restaurants
Is eating at restaurants difficult while trying to maintain normal blood sugars?
Not necessarily!
This is my little guide of how to eat at restaurants while maintaining the normal blood sugars all Type 1 Diabetics deserve and should strive for!
I share my top six tips for successfully dining out, what to focus on and how to build a meal. Check it out here:
What are your best tips for dining out with Type 1 Diabetes (or if you’re mindful of your sugar consumption over all)? Let me know in a comment!
Transcription
If you prefer to read, here’s an unedited version:
Hello, hello, hello and welcome to another episode of type one Thursday with me Hanna which is one of the founders of The Low Carb Universe. We organize Europe’s truly healthy hundred percent real food events. But that’s not what we’re here to talk to you about today.
Today is, of course, another episode of Type 1 Thursday, where we discuss all things, type one diabetes, and low carb and healthy food and healthy eating and all of that stuff that may not be talked about as much in other places. So I thought, hey, why not? Let’s do it.
I am a type one diabetic since 34 years this year, which is yay, you know, alive and stuff. Today, I will be sharing with you you how to navigate restaurants, and eating outside of your home with type 1 diabetes, and how to maintain normal glycaemic blood sugar levels throughout this. And do stay tuned, because I will be revealing my top six tips on how to actually make this happen properly, after a bit of an introduction and stuff like that.
Why are normal blood sugars so important?
This is I don’t know, like the 13th video I think I’m making in this series. So if you watched any of my previous stuff, I think you know why normal blood sugars are so important. And so also, of course, whether you are either treating yourself or don’t have another option, but to eat at a restaurant, where it is more difficult to figure out what they have added to your meal, which you may not have added at home. Yes, healthy normal blood sugars. All diabetics are deserve them. All diabetics should strive for them. And we should not be content and happy with anything else but normal levels.
That’s my opinion. And I’m sticking to my guns. And that’s why I’m making all of these videos. And of course, why it is so important is of course that you have to, well, I assume if you’re anything like me, you want to live a long, happy, healthy life with diabetes, despite diabetes, thriving in your life. And then normal blood sugars will keep you there for longer. Let’s just keep that as at as a baseline.
I am very, very happy now because this wasn’t the case before. But healthier options at restaurants are becoming more available more readily available. Just things like for example, a big normally very pasta focused chain has recently brought out noodles as an option. And that is great, of course for us who are trying to mind our glucose and trying to mind the sugar intake in our foods. For example, there’s a lot more vegetables on the menus, there’s a lot more that you can get sauces on the side and no one looks at you weirdly, you can substitute a lot of the the sides with vegetables, and no one looks at you weirdly, and side salad is a huge thing, which you can also of course, when you are fueled by other things but sugar in your body, then you can have that too without a problem and not feel deprived or anything.
So there are three things: first of all, when you see go to a restaurant, that is important that is of course, as always, no matter where if you’re all at a restaurant, but focus on the protein and vegetables, which can be solved, they can be changed. All the pasta, rice, potatoes, fries, all of these things that you know, don’t leave you feeling your absolute best when you eat a restaurant, substitute them for different types of vegetables. Here is a great tip actually, that I found out a couple years ago is that when you look at a restaurant menu, and you see, let’s take an example, a sirloin with mashed potatoes. “okay, well, the mashed potatoes aren’t great for me, but I see here with the with the seven on this menu, you serve asparagus, do you think I could swap the mashed potatoes for these asparagus?”, for example. Check what they have on the menu in other dishes, and what type of vegetables they have there. And maybe you can find your favorite there or something that is at least better for you than mashed potatoes that are currently being offered. And of course, then number three is keep all or most sauces on the side. Make sure that you get the source in a little couple of sites so that you can first of all taste how much sugar there’s in there. Even if someone tells you that they’re Oh no, it’s completely sugar free, there’s no sugar, you can taste it very quickly. And you can make your choices after that.
Easy restaurants to go to when you are minding your sugar intake and you do not have the metabolic capability of breaking these things down as effectively as maybe other people do.
This includes but is not limited to, for example, steak houses, burger places. Seriously burgers without buns with all the good cheese and bacon and maybe an egg on top and a side salad, you’re going to be full four hours. When your friends who ate a normal burger menu starts going on about “I could go for like a coffee and cake”, you know, just fueling up again, you’ll still be full, “I am winning at this game”.
Also, Italian places are fantastic for low carb you wouldn’t think it but and very very little of the Italian cuisine is actually pasta, pizza, all these heavy things. It’s more like fresh meats, fish, seafood, and a lot of vegetables. Italians eat a lot of vegetables, and the yummy yummy olive oil, of course. And that is a great tip for if you are out and about and see an Italian restaurant, if it is authentic enough, and hasn’t zoomed in on the pizza thing, because then you can just scrape off the toppings, but it’s not a great experience for anyone. So let’s not go there!
You can also go to salad bars, that’s a given. Or deli places, maybe somewhere that makes sandwiches and you can ask to have the sandwich feelings on a salad or on a plate instead.
Brazilian steakhouses are fantastic. You won’t be lacking protein after going to a Brazilian steakhouse, I can assure you that. French places are great, not as much bread as you would think. And also Greek places are fantastic, all the Mediterranean really Greek, Italian, Spanish, of course with all the tapas, and it’s fantastic. And then of course Italian as I mentioned before.
Mexican is also surprisingly good, because there you can have things like fajitas without the bread and the beans and all this stuff and the rice. You can have all of these things that are really, really yummy that people don’t quite realize are yummy, because they cover it up with all these carby things so that they don’t actually get the flavor of the real thing, which is the protein of course.
Even sushi places actually are quite great for low carb because, and bear with me, you can have a few edamames and you can have a whole plate of sashimi, which is of course the sushi without the rice, so if you’re minding your sugar intake, don’t despair if you only have sushi place at hand. There’s always always things that you can do. And I’ve seen now actually sushi places who make rice out of cauliflower rice, there is one place for example in Stockholm. I think it’s spreading, too, and this trend of maybe not wanting sugary rice is becoming bigger.
Alright, I promised you my six top tips on how to manage restaurant but the restaurant visit with type 1 and wanting to keep your blood sugar’s at a normal level, because this is what we’re striving for.
As I said before, number one, if you can do research the menu online so that you want you know what you’re handling, you can already make a couple of choices, you can have an overview of what the actually have, you can check the starters, the mains, the deserts, but seriously don’t have too much hope for the desert, because you probably won’t find much apart from maybe a cheese platter, which also is a fantastic dessert. This also helps you if you are a bit conscious about your spending.
Number two, of course, stay away from the starches. If you get offered a bread basket and you know you can’t resist it, ask them to take it away. Make sure that your dish does not contain rice, pasta, potatoes, fries, or mashes if you know you can’t navigate around them. And I’m not saying that you always have to be 100% – you do what works for you. And if tasting a bit of these things works for you, then good, keep doing that. But if you know that you can’t keep away from them, make sure you stop them from the beginning.
Number three, which I already mentioned in the beginning, but it’s very, very important: focus on the protein and the vegetables. That is the easiest thing that you can do. Even at a restaurant or at home or anywhere you are. If you’ve been invited to a dinner somewhere at a friend’s place, that is sometimes a little bit tricky. But always focus on the protein and the vegetables, and then don’t pay so much attention to the things that you can’t have. Of course, this is as much a mind game for you as anyone else. Instead, pay attention to things that you can have. Take it as a positive thing that you are doing something good for you, your body and your health. Because you want to stay healthy for as long as you of course, possibly can.
Number four, which is something I struggled with a lot. In the beginning, when I first went low carb, I’m often said, “oh, it’s okay. Don’t worry. Just bring this and this and whatever else. Like, take everything out of it. It’s fine!” No, no, no, actually, the proper way of doing it is Dare. To. Ask., make sure that you do find the option that works the best for you. Because no one else is going to be looking out for you. Dare to ask “what do you put in that sauce?” “Oh, is this gluten free?” (If gluten is a problem for you.) “Oh, is this sugar free?” Waitstaff should know this. If they don’t, they are very welcome to run back to the kitchen and check with their colleagues. It’s really important for you to know what the food that you eat actually contains. “Oh, is this thing breaded?” “Do you have bread crumbs in your Parmesan Melanzane?” There are so many ways of cooking food that should be “free food”. Not everyone does it the same way. Dare to ask. As I mentioned before, if you see a vegetable in some other dish, maybe you know they’re willing to swap that for the thing that you don’t want in the dish that you want, or with the protein that you have chosen. Dare to ask what’s in your food. How can you swap it? What can you do to make this work for you? At the end of the day at a restaurant, you are a paying customer and they generally would very much want happy, healthy customers that keep talking about their wonderful establishment and the fantastic service that they got. They will very rarely rarely be snarky about your dietary restrictions, because they want repeat customers too.
Alright, number five, you know what, if it doesn’t go perfectly fine, if something goes wrong, like you have a glass of wine too many than you expected, or if you’re eating a bit more of the starch than you expected – just don’t panic. It’s alright. You’re not going to die from screwing it up once, but it is a learning curve. So don’t panic, make sure that you remember it so that you know next time what not to do and what didn’t work for you. Work with the things that do work for you, and what you leaves you feeling the healthiest, best version of yourself.
And then number six, which is actually something that I did for myself, in the beginning. Now it’s just second nature, but in the beginning, I made every restaurant menu a game for myself. Everywhere I went, whether it was Chinese, (that is a tricky one, though, because they mix everything in sauces), or a pizza place, or Italian or burgers or whatever. Wherever I saw a menu, I made it into a game for myself to make a nourishing, sustainable dish for myself from any menu. That is my tip number six, make it a game. Oh, what can I eat at this restaurant? Uh huh. Okay, but if I swap that, with that, and then, instead of that I have that, and then I get a meal that works for me and leaves me healthy, happy and feeling fantastic. Even after my restaurant visit.
Those were my quick tips for you. Actually, let’s call it the little guide of eating at restaurants with Type 1 Diabetes. I hope you have enjoyed this video!
I want to know from you what your best restaurant tips are with type 1, or even without. If you’re just minding your sugar intake, what are the best tips that you have figured out they’ve seen someone else do that you’ve heard someone else do?
Share them with me in a comment and I’ll be happy to chat with you. Until next time!
Type 1 Thursday – 5 Lies Your Doctor Tells You About Diabetes
Today, we’re talking about 5 lies your doctor has told you about Diabetes.
It’s not your fault that you’ve been told these lies. Or that you believed them, either! Do these sound familiar to you? Do you need carbs? “Eat and cover for it with insulin”? DKA? Complications? A cure for Type 1 Diabetes?
Check out this episode of Type 1 Thursday and see what is really going on with these lame excuses!
Which ones have you believed? Are there any you still believe? Or have you been told other ones? Share in the comments and let’s talk about it!
Transcription
If you prefer to read, here’s the whole (pretty much unedited) text:
Hello, and welcome to this week’s episode of Type 1 Thursday with me Hanna Boëthius, one of the founders of The Low Carb Universe, as well as a type one diabetic for the past at least 34 years. I have a few years of experience with this chronic disease, and I am now happy to share some of my knowledge with you all in this series that we call Type 1 Thursday. I have a whole thing planned for you guys, and it’s a presentation that I have done in the past but I thought it’s very important information and so that you should know it as well.
This is the five lies that your doctor has told you about diabetes. And I cannot wait to get started. Because these are quite fundamental things that a lot of medical professionals or even doctors have troubles realizing and that I’m quite sure that you have been told as well. So let me know in the comments which lies you believed or which ones you’ve been told, so that we can get those straight and maybe not believe them anymore.
My number one lie that your doctor has told you about diabetes is you have to have carbs. This sounds very, very silly to me now, after eight years of low carbing my way through life, as a healthier, happier, better human being. So that sounds really weird to me now, but it didn’t sound weird to me then, which is when I believe this and I was told it that, yes, your body needs carbs.
This is partially true, your body does need some carbs and some sugar. But your body’s also clever enough so that it can sort that mess out on its own and you don’t actually have to add any, if very, very few carbs from the outside to maintain that equilibrium of carbs versus rest of stuff in the body.
The carbs and insulin are not a match made in heaven. injected insulin is first of all, not by any means as precise as endogenous insulin so if a human being produces insulin on his or her own, that is a lot more effective than the injected insulin that you as a type 1 diabetic will have to inject. And, of course, the disparity between these, you can never chase a lot of carbs with a lot of insulin because the equation very rarely will match. This goes back to apparently my favorite topic in this, which is the law of small numbers. So if you work with small numbers, small levels of sugar, and work with small levels of insulin, they are easier to make happen and make that into an equation that actually adds up.
Also, of course, this makes me wonder why the official recommendations are still 45 to 60 grams of carbs per meal for diabetics? I think that is ludicrous, I don’t understand why because clearly, clearly, clearly, you can survive on almost none carbs because your body is so beautifully clever in that way, so you don’t need carbs is the conclusion for line number one. And there are alternative fuel sources for your body to function.
Lie number two, hey, just eat what you want and come in for it with insulin, that will work. Right?
Well, it does work for some, it just doesn’t work for myself, and many, many, many other type 1 diabetics out there. It is, as I already mentioned, too difficult to match a lot of sugar with a lot of insulin. So it isn’t the ideal treatment. I mean, it is the best treatment we have out there but it’s not the ideal treatment because it doesn’t work with injected insulin and with carbs. So don’t be fooled that you can just eat anything and just cover for it with insulin because in very many cases it doesn’t even work.
Hyperinsulinemia has been shown also to cause an array of crazy things in the body. It has been linked to certain cancers, to coronary heart disease, to Alzheimer’s, it’s been linked to a lot of things. So if you can help it, maybe it’s not the best idea to put a lot of insulin into your system if you don’t have to, what is the point of that. Also, insulin toxicity is of course, another thing to mention here. That is something that we need to of course, have a lot more research on but for now, I don’t want to jinx anything and I don’t want to be playing with uncertainties, when I have another way of doing it.
It also of course, when you eat whatever you want and cover for it with insulin, it does make the margin of error way to big for comfort, and that is one of my main points of eating low carb as a type 1 diabetic, it is the margin of error or just too large to handle for me. This sends your blood sugar on a roller coaster rocket ride, it goes up and it goes down and you have to treat with insulin, you have to treat with sugar you have to treat treat, treat. You still have to have a normal life. But all you’re going to do if you are on that roller coaster is to manage diabetes, and that is not what I want for you. That’s not what I want for myself. That’s not what I want for any type 1 diabetic. This is why I call it a lie because it’s not sustainable for very, very many of us. For those who it is sustainable for, yay, good for you! Awesome that you found what works for you. But for us that it doesn’t work for I want you guys to know that there is another way of managing diabetes. So conclusion for number two; too much insulin isn’t good, either.
All right, and then I have a sneaky lie, number two and a half. Without masses of insulin in your body, you’re gonna go into diabetic ketoacidosis (DKA). I did a whole video about this a couple of weeks ago, and I think I, well, at least I aimed at trying to explain to you that this was not the case. This has nothing to do with how much insulin you have in your body, it has to do with that you have enough insulin in your body, but it doesn’t mean that you need masses of it.
There are many, many factors that that are needed for a diabetic ketoacidosis to happen. High blood sugars, dehydration, there are large ketones and not like the large ketones that they mentioned in these nutritional ketosis graphs. No, no, like really high ketones like 10 mmol/l and upwards for it to be a DKA.
A DKA requires, what did we learn a couple weeks ago, we learned that it requires a lack of insulin in the body and nothing else. Nothing else can actually push you into DKA apart from the lack of insulin or being dehydrated.
There are very many ways that you can avoid a decay even if you’re a type 1 on a ketogenic diet. Normal glycemia (normal blood sguars) has been shown to actually have less occurrence of DKA. If your blood sugars are normal, stable, healthy blood sugars that all diabetics deserve and should aim for, the risk of going into a DKA is pretty small.
This is leads me shamelessly onto my third lie, which is all ketones are bad. Even trace ketones are bad for every single diabetic.
It feels like I also did the video a couple weeks ago on this topic, because this is of course, when diabetic ketoacidosis isn’t at all the same as nutritional ketosis. They’re two completely different things. And what’s needed in between is of course, the lack of insulin we come back to this again. So, trace ketones may be a danger if you are a sugar burning diabetic, who is not receiving in either way, the insulin that the body is needing or that you actually just don’t have control of your diabetes that then trace ketones can be bad. Yes, absolutely. But if you are a controlled fat burning machine of a diabetic, there won’t be a DKA. As long as you keep taking the insulin the body’s needing, you keep hydrated and you keep an eagle eye on your blood sugars, it’s not harder than that. So keep at it.
Ketones are a great fuel, if you know how to use them. So the conclusion for line number two and a half and three is DKA is easy to avoid even as a type one on a ketogenic diet.
Lie number four, complications are a natural progression of diabetes. This one actually really annoys me because not only is this said widely and freely and by everyone who is educating diabetics around the world, but it also comes with the terrible advice of eating 45 to 60 grams of carbs per meal, how is that possible? Those two things are absolutely are correlated, because high HbA1c, above the normal, healthy level and ranges, has been shown to cause more diabetic complications.
I know I don’t have to, but I’m going to anyway, diabetic complications are things like retinopathy, potentially blindness, amputations, nerve damage, renal failure, heart problems, high blood pressure, all of these things that can be correlated with high blood sugars, and of course, you get high blood sugar if you keep eating all that sugar!
Furthermore, a healthy A1c is nax 5.5%, which I think is very interesting because for a diabetic is anything between 6.5 to 8% of HbA1c. Why is that? Why do they think that diabetics are going to be healthier at a higher level than normally healthy people? That is an equation that I can’t make work in my mind. So that is why I also call this a lie because, of course, when the goal is set so high for diabetics, they are more prone to complications. Then it becomes a natural progression.
Stable, normal, happy, healthy blood sugars are the leading cause of absolutely nothing. Then you can live a healthy happy life with both type 1 and type 2 diabetes, and all the other types as well. But that does have the prerequisite that you do get the chance to get the information that this is a possibility, which of course a lot of people don’t today. That makes me sad.
Conclusion from lie number quatro is stable, low blood sugars will keep you safer from complications, then the high blood sugars that are set as the goal for us today.
Lie number five is a cure is just around the corner. And I bet if you do live with Type 1 Diabetes, you have heard this at least a gazillion times. Every time I went to my endocrinologist as a child, every time, and I can’t even imagine how many times my parents have heard this too.
Back in the day, and it’s always in five to ten years. Yeah, listen up people. It’s been 34 years, and I’m still waiting for this cure to happen. So, I’m sorry, but I’ve lost a bit of faith in this statement, which is what is causing me to also call it a lie.
There have been fantastically promising advancements made in terms of managing diabetes. We have, we have insulin pumps, we have continuous blood glucose monitors, we have got blood glucose monitors that need a lot less blood, they’re a lot less invasive. We have so many treatment options now and especially super exciting with the closed and open loops that are coming out on the market. And that is going to be fantastic. But I have to be a little bit pessimistic when it comes to cure because I don’t think that that is actually even on the horizon, although there are a lot of attempts going on. But there’s not that much progress being made. So the conclusion from why number five is, there’s going to be a lot more done for diabetes management, but maybe not as much as we hope for a cure in the foreseeable future. At least, I hope someone proves me wrong. I really, really do hope someone proves me wrong, but from what I can see right now, this is not the case.
Which one’s of these lies have you believed? Have you been told maybe or have you been told any other lies that I didn’t have time to bring up in today’s live session? Let me know in a comment, and I will be happy to discuss it. There. have fantastic rest of the day. And I will see you next week with a new episode of Type 1 Thursday. Bye!