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Influenza & Type 1 Diabetes?
The influenza & eating very low carb, what happens to blood sugar and ketones? 🤔
That blood sugars can increase when you’re sick is pretty much common knowledge. But by how much, and especially when you normally eat very low carb? What about ketones? Is there a correlation?
All this, and much more, in this week’s episode of Type 1 Thursday!
How do your blood sugars react when you get sick? Let me know!
Transcription
If you prefer a written version of this information, please keep reading:
Influenza & Type 1 Diabetes
Last week, I was very much under the weather, and I did not manage to do anything. Last week, I spent the whole week in bed, because I got a nasty case of the influenza. This never happens to me *touch wood*, I never get sick like that. So it was a first in a good while. I also got a question about this, which is today’s topic on Type 1 Thursday:
As a Type 1 diabetic, eating very low carb, what happens to blood sugars and ketones when I got that sick?
Gina
No. It didn’t go perfectly, let’s just be honest about that. I definitely did not have any smooth CGM lines during last week when I was really, really ill. And it’s not an easy feat to try to get, especially as a Type 1 diabetic, but definitely also as a healthy, “normal” person, whatever you want to call it. What did I do, how did I handle it, and what happened to me? Maybe it can help you, if the influenza gets you, too!
I heard today that just in Switzerland, we have about three virus strains going around right now. That’s a lot! I think I just had one of the influenza strains. Last Tuesday, I was so ill that I thought I had pneumonia. I was 99% sure that I had pneumonia. I went to the doctors to get an X ray, especially to check that it wasn’t pneumonia. Well, it wasn’t. But I really felt that badly. I really am not one of these people who just runs to the doctor for whatever, there has to be a legitimate cause for me to even visit a doctor’s office. That’s how bad I was last week. And I’m amazed at my body for turning something that I thought was pneumonia just a week in a bit ago to standing here. You know, I was fine already last weekend, again, and that is astonishing to me that my body managed to get turned around That will and I would like to thank my wonderful gut bacteria. And I would like to think that I did a few things right, which I will get into a little bit later in this life.
Influenza & Blood Sugar?
But first of all, I wanted to go through what happens to your blood sugar when you get ill, because it will go up. Evidently, your blood sugar will go up, especially if you’re a Type 1 diabetic, because you are, of course a little bit more (I don’t like to say it, but), a little bit more sensitive towards infections that way. Blood sugar goes up, for sure. And what can you do against that? Well, you can actually just manage as well as you can. Increase your basal as much as you dare to until you see an effect. With that in mind, I was on + 200% basal on my insulin pump, and it barely budged from 10-11 mmol/l, around the 200’s mg/dl. That was of course scary for me, as I normally have quite good blood sugars. It was good to to know that it was the infection causing it and nothing that I ate, because I also fasted due to that I had such a sore throat and I was coughing so much that I couldn’t eat anything for four days. I only had broth, tea, soups and water for four days. And I think that also helped to turn the influenza around a little bit quicker.
In addition to this, your bolus is not going to be the same as when you’re not sick. Your corrections and mealtime insulin is not going to be as effective, that ratio will also go up, get worse, and you will need more insulin. I used almost 50 units of insulin in one of the days that when I was the sickest, and that I haven’t done since eating high carb, so it was quite bad.
Remember to hydrate because both having influenza and having that high blood sugars will dehydrate your body. So think about hydrating a lot the whole time, sip small sips even if you have the worst throat ache in the world (like I did!) Also consider adding electrolytes, because that can be something that could help you.
Influenza & Ketones?
What happened to my ketones? Normally my ketones are under 2.5 mmol/l on a very low carb way of eating. And this seems to be a normal thing for me. As soon as they go over I get a little nervous. As ketones are never really a goal for me, I don’t really measure them too often, but when I do, they seem to be staying under the 2.5 mark. Because I was fasting, liquid fasting, and because I was sick, my body needed more energy, and because my blood sugar was maybe a little bit high, and my ketones went up to 4.3 mmol/l.
This was actually nothing that worried me at this point, though, because I didn’t feel worse (I already felt like absolute shit…) But the ketones didn’t actually worry me any extra, because I knew I was doing everything that I could for them to do their job. I just chose to monitor them and as long as they didn’t go higher, didn’t have a panic attack about it, and I didn’t worry about it. My theory is that both blood sugar and ketones go higher, because your body needs more energy to get well again, the immune system needs more energy to kick the nasty bugs that you are fighting. I don’t know, maybe the this is not even true, but if you do know why blood sugar goes up when you are ill, and also ketones, please let me know in a comment! I’d be really interested to know from someone who really knows their stuff.
Influenza Treatment?
How do you treat a really bad influenza, especially as Type 1 diabetic (but also as a normal person)? I would say hydration is definitely the number 1 thing! Your body can survive without food and might actually get healthier quicker without food. But hydration – we need to hydrate a lot. So make sure you flush out those nasty bugs and the high blood sugar. Make sure you hydrate when you get sick!
Also painkillers, I cannot tell you… I don’t normally take painkillers at all. But last week, they were a Godsend. And I had water soluble ones so I didn’t have to swallow any tablets. Absolutely amazing, saved my life.
Throat lozenges with that numbing effect also really helped me to get through the influenza. Along with echinaea, I have a specific one in a alcohol solution that really helps your immune system to get into a higher gear. To sip, I had my beautiful, beloved “throat coat” tea, which I love when I am sick, because it really feels like your throat gets a coat! Also CBD oil, because it is anti inflammatory, and can help with all the mucous-y stuff going on in your face.
So that’s what happened to me last week, I got sick, blood sugar up, ketones up, but I was not worried because I knew my body was just doing its job in trying to make me healthier.
How do you react with your blood sugars when you get sick? And please let me know in a comment somewhere on the inter-webs and I’ll be happy to chat with you there.
Why No Protein Shakes?
Why no protein shakes? 🤔
Type 1 Thursday is here with another question from the audience:
“Hello, I notice that you don’t drink any protein drinks or shakes? Do you think they are unhealthy?”
Hanane
As a short answer, no, I don’t think they’re unhealthy. But I do think there needs to be a need for them, as protein needs are individual. Check out the whole explanation here!
I want to hear from you, do you drink protein shakes? Or do you get your protein from other sources? Let me know in the comments! 🙌
Transcription
If you prefer to read my views on whether protein shakes are good or not, you can find a written version here:
I am so excited, because there is another question from the audience today that I will be answering. If you have any questions that you think that I should be answering on these live chats (that we have every Thursday 6pm on Instagram, and Facebook), please do let me know in a comment somewhere on the interwebs and I’ll be happy to answer them.
To today’s question, it reads like this: “Hello. I noticed that you don’t drink any protein drinks or shakes is that because you think that they are unhealthy?”
Protein is a very individual
Protein threshold is very individual, especially on low carb, but also generally. Maybe on low carb you give a little bit more of a damn about the protein amount, especially if you have read #*#. Richard Bernstein’s book and checked out his Diabetes University. Protein needs are very individual and it can range from anything, for very sedentary people something like 0.8 grams of protein/kilogram body weight, which doesn’t mean 0.8 grams of meat but 0.8 grams of protein, to something more normal, if you are a little bit more active, maybe something like 1.2 grams per kilogram, or maybe 1.3, 1.5. But it can also go as high as something like 2.4 grams per kilogram, up to five grams per kilogram, if you are a super active athlete.
If your main fuel is protein and amino acids, then it is very individual how much you should be eating. This is why I personally don’t need to drink any protein shakes. I am not a very active athlete, well, I try to keep active but not that active. I’m also not a growing child. So I don’t need as much, and I can cover my protein needs with real food. You have to determine for yourself how much protein you need in your individual case.
Protein in Meat
All meat generally contains about 20 grams of protein per 100 grams of meat. Not all meat is protein, and not all protein is meat. Only one-fifth of the meat is actual protein and amino acids. If I eat 400 grams of meat a day, which is possible, not in one sitting, but if I have two sittings, lunch and dinner, which is normal for me. I don’t really have breakfast so I don’t have to pay attention there. If I have two sittings, and I have 200 grams of meat or protein filled food per sitting, that gives me 80 grams of protein for a day. And that would mean that that is 1.3 grams per kilo of body weight that I have (now you can count how much I actually weigh) Personally, I just prefer to get my protein from real foods because I can. And because I don’t have that extra need for protein shakes that you may have, as I said, if you’re a growing child or a very active athlete.
Need for protein shakes?
The short answer to your question is; I don’t think that protein shakes or drinks are unhealthy, per se. I just think that there needs to be a need for it. And in my case, I don’t have that need. Perhaps, in your case, because you are asking, there is a need for it and then you have to determine if that’s true or not for you.
If you do need a protein drink or a shake, I would recommend something that is clean without any sugars and any added stuff. Flavours is one thing, but you can also flavour it with other things like natural cacao powder or something. You don’t have to buy the ready mixed flavoured stuff, but something that is clean without sweeteners and without dextrose, please, because that will mess with your blood sugar, all the ways till Sunday. If I had the need for protein shakes, I would go for something like an egg white protein or a whey protein.
So, in conclusion, no, protein shakes and drinks are not inherently unhealthy. But there needs to be a use for them and a need for them. Thank you so much for your question!
I would love to hear from you – what are your experiences with protein and with protein shakes? Do you drink them? Or do you get the protein that you need from real food? Let me know in a comment below, and I’ll be happy to chat with you there.
Low Blood Sugar and Weight Loss?
How does Low Blood Sugar Affect Weight Loss? 🤔Does it have to? What factors do you have to look out for?
Type 1 Thursday is here!
Do you have experiences with how blood sugars impact weight loss? Share them in a comment!
Thank you so much for watching. Please let me know if you have any questions!
Transcription
If you prefer to read my thoughts on this, here’s a text version on low blood sugar and weight loss:
Blood Sugar and Weight Loss?
This week I’m excited about the new audience question! (If you have any questions that you want to hear my answer to, then please let me know!)
This week’s question comes from Joe, and Joe writes, “how do low blood sugars affect weight loss?” Thank you for the question!
Are you insulin dependent?
A lot of it depends on if you are taking external insulin or not. Because weight loss happens when a) the blood sugar is stable and b) there’s no excess insulin in the body. There are different theories of weight loss, two main ones as I see it, which I’ve talked about before here on Type 1 Thursday. One is the good old calories in vs calories out which we know is maybe not as applicable as they thought that it was. The other one is that it is actually hormone regulated, mainly with insulin as it is the master hormone in the body. If you don’t have excess insulin, and your blood sugar’s are stable, weight loss will occur.
In diabulimia, which is a very, very serious condition to have, which is when you take no insulin to lose weight. But that is not the point of this. This is about healthy, happy weight loss, if that is necessary. This is not an eating disorder thing that I’m talking about. Just to clarify that, and I find that very important because it is a terrible, terrible condition to live with. So, none of that, just healthy healing, healthy weight loss if necessary.
What is a low blood sugar due to?
A low blood sugar is because you took too much insulin for that particular circumstance. For that particular food, for that particular mood, for that particular weather, whatever it is that is influencing your blood sugar, you took too much insulin for that. That’s why you ended up with a low blood sugar, because nothing else lowers blood sugar like insulin does, and nothing else can lower blood sugar lower than it should be in a normal human being than insulin. So, if you are treating diabetes with insulin, does that mean lows are equal to excess insulin? Which then means that it will be a slower weight loss?
Well, actually, not necessarily. It depends on how stable your blood sugars are. If they are jumping like a roller coaster, so that it’s super high and then goes super low (which means that you then have to treat it and then go super high and super low. Again.) That’s a completely different thing than if your blood sugar is really stable. And then sometimes it trends downwards and dips minimally and you can correct it very easily. I’s a completely different thing than if you are all over the place in terms of blood sugar, and are struggling with it. Balanced blood sugar is the key, not a jumpy blood sugar. That’s what we should aim for. And that usually also aids weight goals.
Low Blood Sugar anyway?
You know, we all end up there no matter how good (or whatever) we are as people with diabetes, no matter how well we take care of ourselves, circumstances do change in the body. And lows do happen. They happen to me, they happen to everyone I know who are normally quite well controlled.
The key here is how do you treat it? Do you choose to eat the whole kitchen? So you grab anything from grapes, to peanut butter, to that sugary candy you have in the back somewhere, to snacks, to yoghurt, to honey, to you know the whole nine yards which will end up on this rollercoaster blood sugar ride, which is quite detrimental for your health. And it feels, first and foremost, really, really frickin terrible. So try to avoid it for that reason alone! Or, number two, do you treat low blood sugars targeted with an exact measurement of glucose? Because that doesn’t create the rollercoaster rides. It creates an even curve, even if you do dip a little bit you take a gram, or two grams or three or four, depending on how much you need (and that you need to do a trial and error with). You just come up a little bit again, and then you’re fine. Again, you don’t get those big swings. So that is really important how you treat the low when it does happen.
Correcting a low is of course, necessary, it can and definitely does save your life. So don’t skip it, even if it would potentially kick you out of ketosis, if that is your goal. I’m not saying that ketosis and keto and low carb is everyone’s goal, but if that is what you’re worried about in this question that treating a hypo will kick you out of ketosis or something, don’t be! You really need to save your own life in that case. It doesn’t matter if you get kicked out of ketosis or not. If you are fat-fueled in that way, or you can burn both fat and sugar, you will get back into ketosis very fast afterwards, so don’t worry about it. It really is key that you do take care of this.
The short version of my answer to your question, Joe, is that low blood sugars do not have to affect weight loss at all. It depends on how you treat the low and depends on how stable you are blood glucose is normally and that you don’t have excess insulin in your body.
Hope that helps!
If you have any questions, do let me know. And also do let me know your experiences of blood sugar and weight loss? Have you managed to lose weight, or maybe you don’t manage to lose weight although your blood sugar’s as good as perfect? Let me know in a comment, and I’ll be happy to chat with you there.
Type 1 Thursday – Bolus Gone Wrong?
Type 1 Thursday is BACK – and it’s all about the bolus!
Today, I’ll be answering a question from the audience about mealtime bolus gone wrong… How do you handle first high blood sugars, then low? Or high and steady after meals? Or low 3-4 hours after a meal? So confusing!
Do you have any experiences with mealtime bolus? How did you solve it? Let me know in the comments!
Also, do you have any questions for me to answer? I’d love to answer your question in a future Type 1 Thursday.
The bolus infographic from Diaverge.com that I mention in the video is this one:
Transcription
If you prefer a written version of the video above, here you go:
Type 1 Thursday – Bolus Gone Wrong?
I have a really interesting question today actually, because this is something that I’ve struggled with myself quite a lot. I got a question from the audience this time to answer.
“So, how do I time insulin for different meals? I’m struggling despite eating low carb, and I still spike sometimes dosing at the start of the meal and then go low one hour after. And if I dose at the end of the meal, I go high and then low three hours later? This is so confusing!”
Rachel
I do agree with Rachel, it is very, very confusing. It is difficult to figure this out. But I do have some rules of thumb that may help Rachel (may actually be a good reminder for myself, too) and maybe it will help one or two of you guys as well.
Dosing vs Timing?
As I see it, this can be both a dosing issue, but it can also be a timing issue.
This really comes down to first of all, what kind of mealtime insulin are you using? Are you using regular insulin as many people do on low carb? Are using some of the faster ones like Humalog or Novolog or Novorapid? Or are using the even faster ones like Alfrezza or Fiasp? It’s very difficult, as these insulins have different working time until they actually hit your system. Until you figure that out, it can be clue number one!
Clue number two is that it definitely can be a timing issue, but also a dosing issue. So let me go through this very, very carefully, point by point so that we don’t lose any details because that could be devastating!
– if you first spike blood sugar after your meal, and then you go low, that means that you took too much insulin. It was also too late, hence the spike first and then the drop. So, play around with that, maybe you need to dose a little bit less, or maybe you need to do the same dose but earlier.? So that can be one of the clues if that is your problem, which it was in the question.
– if you go low within the first hour, the amount of insulin you took was just too early because it hit your system before the food hit the system. So be careful and dose a little bit later.
– if your blood sugar goes high and remains high after food, your bolus or the amount of insulin that you took was just simply too small. You need more bolus for that particular food or that particular situation or that particular anything-that-you-know influences blood sugar (which we all know is about a gazillion things).
– Number four, which was also part of Rachel’s question, you go low two to three hours after food, that means that the bolus was too late. And definitely too much because your blood sugar dropped afterwards.
Those are the four different scenarios that I can figure out that may help. I shared this in a wonderful infographic from the beautiful ladies at diverge.com recently on my Facebook page, and it’s also above here in this post.
If you’re not recognising the patterns that you’re that you have. If you notice, for example, when you have certain foods, does the one or the other happen? If you have different timings of insulin, of course, this or the other happen? Or perhaps something completely new? Or, for example, if it’s the time of day – some people are more insulin resistant in the mornings than they are in the afternoons! So it can also be a timing issue, not just because of the insulin and when you took insulin and how much, but it can also be, depending on how or what time of day it is, because it just doesn’t always add up. It’s not always the same for people and especially not Type 1’s that are handling a lot of things at once.
I’m very, very happy to hear your experiences with mealtime bolus? Do you have any problems? How did you solve them? Have you maybe not solved them yet? Let me know in a comment below and I’ll be so happy to chat with you there.
Type 1 Thursday – Mindset & Diabetes Management?
How important is mindset in diabetes management? What difference can it make? 🤔
It took me so long before I realized just how big of a deal mindset work is when it comes to diabetes management. How do you react when you see an undesirable number on the display? What are you thinking when you’re faced with a meal you know you won’t feel good eating? And what can you do to help your diabetes management be a success in the long run?
It’s time for Type 1 Thursday!
And – if you want the whole presentation on this topic from me, why don’t you join me at The Low Carb Universe in Mallorca, 12-17 November 2019? Check it out!
And 2 – I do a live every week on Facebook and Instagram to discuss a topic about Type 1 Diabetes that maybe you haven’t discussed with your doctor or healthcare crew. Join me at 6pm CET on Thursday’s!
Have you noticed a shift in your mindset? Or do you need one? Talk to me! 😊
Text Version
If you prefer to read rather than watch a video about mindset, here is a text version of the points I made above:
Mindset
How can mindset can help your diabetes management? How he can help it and what difference can it make, or how can it hinder you?
As I define it, these are my own figures, not at all scientific! This is my experience and from the people that I’ve talked to about this, but I see that having success maintaining a healthy lifestyle, 30% is food and medicine, I see another 30% in other lifestyle factors, movement, hydration, sleep. To actually make your health care successful, I do see that there is a 40% need for mindset, as well. Don’t discount the mindset part because it is very important! And maybe even more important than you know! How exciting is that?
There is a fear of geting caught in a trap of constant perfection. No type 1 diabetic is always perfect. No health cares are ever completely perfect. We all make mistakes. And that’s okay. And that’s a huge part to realise when it comes to mindset! You have to be kind to yourself – that is just the starting point. And do remember that all feelings that you have, whether it’s about diabetes or something else you’re trying to get a better grip of, all feelings are completely and entirely OK! It’s okay to feel them. It’s okay to have them. They are all OK.
“Fixed” vs “Growth”
There is this theory of that we flip flop between what is called a fixed mindset and a growth mindset. (I have a full length presentation on this, join me in Mallorca to find out more!) What I’ve seen from my research, we basically flip flop between these two mindsets depending on the situation, depending on what we’re faced with, actually depending on a lot of factors. As a sort of rule of thumb, a fixed mindset is that you avoid challenges, and that you give up very easily. Making effort is actually a bad thing for you, in the specific situation. You’re “just not talented”. A “why me” mentality usually goes into the fixed one. Running away from critique is also common. Other peoples success is threatening, too. I’m sure we can all recognise some parts of this in ourselves in what we were doing and how we’re reacting to things!
On the other side of the fixed mindset is the growth mindset. A growth mindset is where you seek challenges, you keep trying, even though you maybe fail sometimes and you see making an effort as the key to actually making something a success. You ask yourself, “what can I learn from this situation” rather than, you know, “why me” and “I’m not talented”. Your motto is basically “I can do it”, and other people’s success is inspiring to you.
These are the two mindsets that we flip flop between, depending on how we how we react to things. Also, I think that we are many who can recognise ourselves in the growth mindset. So it’s not all bad! We’re not only, you know, “everything is shit” and “why me” and “I don’t want challenges”. I think we all have parts of both! I find it very interesting when we start paying attention to this. And I’m sure this is something that you can do, for example, in your diabetes management. How do you react to, for example, that blood sugar reading? Is it “why me” or is it “okay, what can I learn from this?”, for example.
Mindset is not…
Mindset is not a magic bullet of motivation. It is definitely not a shortcut to success, if anyone got that, and mindset is nothing that we’re born with, it’s something that we learn. Mindset is not the same as positive thinking, either. It’s also not fixed in these two categories I talked about above. You’re never stuck in one, as I said, we flip flop between both of them.
Diet Mentality
Added to this, more specifically to food, is actually the diet mentality, or diet mindset. I wanted to highlight it, because I think it’s so terrible for lots of people with diabetes, and for anyone really who tries to look out for their health.
A diet mentality is where you see food as the enemy and you’re focusing on your bad habits – that you would have bad habits to break somehow. You’re looking for temporary fixes. And you’re focusing on what you don’t like about yourself, how silly is that? That’s not the way forward, the way forward is to focus on things that you do like about yourself and increase those and then the other ones will follow. Diet mindset is where you’re really focused on the scale. I don’t feel like that is a good measurement of anything really, the scale. I threw out my own scale very many years ago, and I only weigh myself at the doctor’s office, because they require it. Otherwise, I don’t really care what it says. It’s some sort of arbitrary number on a piece of electronic machinery (or even if it isn’t electronic) – it doesn’t really matter that much. Try to step away from the scale! Also in a diet mentality, you think that you have a finish line, that you will have arrived at some point, whatever that means. And I’m only highlighting this because I think it can offset the rest of your mindset work, which can be quite crucial in type one or diabetes management in as a whole.
Setbacks?
How do you view setbacks? Are setbacks something informative to you? Do you draw information out of it? Basically, going back to the growth mindset of “what can I learn”? Or are setbacks a label on you as a person? It’s also silly, but we all get to that point at some points of our lives, and that’s fine. It’s not a bad thing. It’s just something to be aware of!
Success = Mindset + Learning
Success whether within health, whether it’s in sports, whether it’s in life in general, it is mindset, plus learning and the willingness to learn new things. No one can do everything from the beginning. So we do need to learn, in addition to our hopefully, majorly growth mindset work.
How do you change your mindset? This can be a tricky one, but a few short tips is to start small. If you know the analogy of chopping up the elephant into small bite sized pieces, basically eating the frog first? That’s how you get forward so you look at the whole picture first and try to accomplish all of it at once. You have to start with the very smallest goal that you can imagine. Also, you have to think forwards. “How will I feel in a week of doing this?” (or in a day, and a month, in a year, in 10 years?) How will it feel making this change for me? Provided that it is for you, but I would hope so because otherwise it’s not going to be motivating for very long. You have to find what motivates you? No one else can tell you what motivates you, you have to find that within yourself. And that’s a very big part of mindset work!
And also, don’t make excuses. It’s all about prioritising. You can say that, “oh, I don’t have time to check my blood sugar”, but today, especially with CGM’s and these very fast blood sugar meters, it’s really quick. It’s just that you don’t want to do it. It’s that simple. So please don’t make excuses for yourself.
And now I would actually love to hear from you, have you noticed a change in a change in your mindset? Or perhaps you need a change of mindset? Talk to me in the comments below and I’d be happy to chat with you more there.