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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.
A Cure?
“A CURE IS JUST 5-10 YEARS AWAY”
If I (& my parents) had a penny for every time we’ve heard that “promise” during the past 34 years, we’d be laughing all the way to the bank.
Let’s talk about the prospect of curing T1D. Do you think we’re getting close to one? 🤔
After a weekend of particularly shitty blood sugars, this is more relevant than usual. A weekend where I had to, yet again, come to terms with my own mortality. And insulin acting like saline.
With diabetes awareness month coming up in November, there is somehow a communal hope brewing. A hope of more awareness, because awareness should lead research teams everywhere to be motivated to finally find a cure. Right?! Don’t get me wrong, awareness is GREAT! It’s necessary, it’s inspiring and needed in the world. All T1Ds should speak up, and not only during the month of November. But – diabetes awareness alone won’t cure us.
And frankly, not to be too pessimistic, but rather I choose to see it as a realistic mindset, I’m not sure there will be a cure in my lifetime. 🤷🏻♀️ Have we gotten any closer on this in the past 34 years since my diagnosis? Since the diagnosis of those who have lived with this a lot longer than I have? I don’t know.
Just because ones diabetes is (mostly) “well controlled” doesn’t mean the fears aren’t there. The fears about the future. What the future may, or may not, bring. Will diabetes cause any limitations to my life? And it certainly doesn’t mean I wouldn’t be first in line when they start curing it. Even though diabetes tools and tech has evolved at an astonishing speed in recent years – we still need a cure. Even if it is very possible to have happy, healthy blood sugars with T1D – we need a cure. And we would have needed that cure yesterday.
Until then, we’re not waiting. Do whatever it takes for you to be healthier, to live your best life and thrive with T1D. ✨
Ps. This post was originally posted on my Instagram account, @hannadiabetesexpert. Follow me there for more on the go updates!
Type 1 Thursday – Self love & Diabetes?
Diabetes & self love – why is it necessary? 🤔And why is it so crucial to find your way of showing yourself self love?
We’re going deeper than the ordinary advice when it comes to diabetes (“Medication, food & movement” 🙄) , this is more about the mental aspects of living with a chronic illness, such as diabetes. The mental aspect that no health care professional has ever talked to me about in my 34 year long experience with Type 1 Diabetes. But that is oh-so important and can make a world of difference to your management!
It’s time for Type 1 Thursday!
How do you show yourself some extra love when it’s needed? Let me know!
Transcription
Prefer to read this information about self love and diabetes? No problem, I’ve got a text version for you right here:
I cannot wait to discuss today’s topic, which is maybe a bit more on the “fluffy” side, rather than, you know, what health care tells you, which is, “medication and nutrition and movement – that’s all that matters in diabetes care”.
No, no, it’s not. As we’ve seen, during the past few couple weeks, I have gone through quite a lot of interesting topics (if I can say so myself!) with you guys, and this is yet another one! This is about diabetes and self love. Why is self love is so important when it comes to diabetes? I will first go through what self love is, because the idea of it is kind of fluffy on its own, I will go through how to show yourself a little bit more self love. It’s maybe not as difficult, or as easy, as you think it may be. And then I will also go through why it’s especially important in diabetes, to take good care of yourself in the form of self love.
What is self love?
So let’s get right to it, and start with what self love actually is? Self love is, to me, the same as self respect, self improvement, self compassion, that you feel compassionate towards yourself. It’s self acceptance, and remember acceptance – it will come up a couple of times in this piece, so bear that in mind. Self love is integral to your well being, because it just makes sense to make yourself feel better than you would feel otherwise. But it’s not just about feeling good, it’s also about making the right decisions for you as an individual, whether you are diabetic, whether you are not diabetic, whether you are struggling with a health issue, whether you are not, it doesn’t matter. It’s about making the right choices for you. And these can, of course, differ as I so often say in my videos, be very individual. So don’t just take model from someone else who’s doing something, and calling it self love. You have to figure out what works the best for you. And this also comes down to that you have clear values for you, and that you accept your weaknesses, as well as your strength (there was that word again!)
How can you show yourself self love?
So how can you show yourself a little bit more self love? Well, let’s get all cosy up in here, on this episode of Type 1 Thursday! For example, you can find your happy place. Where do you feel good, what is a good place for you to be in, whether mentally or physically, whether actually spatially. What would be a good place for you to be at? For me, it somehow often involves a beach and some sunshine… Make sure that you know what places work the best for you.
In order to raise yourself love game a little bit, do something you’re good at! It’s not even that out of this world, just do something you are good at, whether that’s knitting or writing a story or and maybe that’s growing a plant – it could be anything that you’re good at. (Maybe you should choose something that has more immediate results, maybe leave the plant thing for another time?) Do something that you’re good at, because that really raises your self love feelings.
Practice mindfulness. Whether that is in the form of a meditation practice or some other form, it really helps to put things into perspective, and makes you see the positive things a little bit more, well, positively.
Decide whether you’re going to act on what you need, or what you want. What you need is often more permanent, and what you want in that instant, can actually just be very, very temporary. Make sure that you always go and make choices for what you need, rather than for what you want in that moment, because that can lead you astray.
Make sure that your self care game is levelled up! That means eating the right nutrition for you, for example, it means moving your body, it means sleeping properly, making sure they have the right sleep hygiene, as they say so nicely, and make sure that you have social connections. Make sure that you are working with people that you enjoy being around, and that you have people around you that you can turn to. This is the whole point of the series that I’ve been making recently and Type 1 Thursda, it’s been a lot about self care and how to improve it.
When it comes to people, do set boundaries! Set boundaries for things and people. For example, if you notice that you’re not feeling uplifted after talking to person, or being with the person, or even thinking about a person, then maybe they are an energy thief and maybe they need to get out of your life for a while? It’s the same with things like workplaces, offices, make sure that you set boundaries. And even on social media, do set boundaries, about when you answer messages, so that you make sure that you are appreciating yourself and respecting yourself.
A real biggie is forgiving yourself. You know what? You’re not perfect, but you know what? It’s completely OK not to be perfect! No one is perfect. No one’s ever going to be perfect. No one’s gonna be that one perfect person. So let it go. And make sure that you understand that it is completely fine. Forgive yourself for not being perfect, because you never will be. Okay?
Live by design. This means your design, not my design, not that person’s or another one’s. Make sure that you know what you want from your life! This goes back to boundaries, it goes back to self respect, it goes back to self improvement, compassion, acceptance… What are the things that you want to achieve in your life? It’s not going to be the same as for me, and that’s fantastic! Go for it, as long as it is by your design.
When you start something like this, it can be really good to check in at in the beginning. Where are you now? Mentally, physically? Where are you in terms of self love? That’s how you know what you’ve got to be working with!
Self love & Diabetes?
Why is this particularly important for diabetes and living with diabetes? Well, we know we all know that we are more than people with diabetes. And and we also know that it’s a mentally frickin’ difficult illness to live with. It’s incredibly difficult to live with it, especially if you have no idea what your blood sugar is going to do next, for example. That’s really where the self love, self compassion and self acceptance comes in! The whole thing is that you have to take excellent care of you, because no one else will. You see your doctor seven minutes a couple of times a year? What are they going to do? Nothing. Who’s going to take care of you between those doctor’s visits? Yeah, that’s you. Don’t look to other people to take care of you, because you’re the only one who can actually do that.
When it comes to diabetes, no matter what the number, whether that is cholesterol, blood pressure, blood glucose levels or HbA1c – it doesn’t matter. You are enough! I have problems realising this myself sometimes, but you really are enough and you don’t have to do anything more than you’re already doing. You work your best and I know you’re working really hard, so please just show yourself one love and make sure that you know that you are enough!
You can also turn it around and look at the positive sides of diabetes. I know some of you out there right now, thinking “there’s nothing good with diabetes and it’s all shit”. It’s actually not! NEWSFLASH – it’s not all shit living with diabetes! it’s actually quite cool, because you get stronger than most other people, you have more courage, you are more resilient, you are more independent. You have all this amazing knowledge about health that not very many other people have, how cool is that? It’s actually a kind of a blessing in disguise to live with diabetes, if you think about it. It’s not just all negative and all shit, I promise, it’s it’s actually it has a lot of positive points as well.
The main point when it comes to self love and diabetes is acceptance. accepting yourself, accepting diabetes as a part of you, that is a huge topic in self love for diabetes. And it really just means that if you fight against the diabetes, you, first of all, know that it’s going to come back and bite you somewhere it hurts quite quickly. Secondly, you’re not going to get anywhere by fighting it! Your ultimate goal, my ultimate goal, everyone who lives with diabetes’ ultimate goal is to befriend diabetes. I know some of you are shaking your heads and probably closing your phones and laptops right now, but it is to befriend diabetes and work with it and not against it.
So now I want to hear from you, how do you show yourself some extra love when it’s needed? Let me know in a comment, and I’ll be so happy to talk with you there.
Ps. Want to learn more about this? Join me in Mallorca in November 2019 for The Low Carb Universe! I’ll be speaking on mindset and diabetes!
Diabetes Expert?!
“WHO THE FUCK ARE YOU TO CALL YOURSELF A DIABETES EXPERT?!”
I could sense the frustration behind his words, the anger in his question. (IG DMs are almost always a joy. 🙃)
“Oh, honey”, I thought, “it’s not the first (and presumably not the last) time someone gets triggered by my username & brand.”🤷🏻♀️
The thing is, I’m not THE expert on diabetes, by any means! 🛑 I am, however, the expert on MY diabetes, just like you are the expert on your diabetes (or at least should aim to be). 🌟 Figuring out the individual aspects of diabetes management is what makes you better at it, get more knowledge, know where to find resources for issues you can’t solve yourself – an expert! And it also makes you more able to help others figure out theirs. 💪🏼
I’m not a medical professional and I’ve never claimed to be one. What I am is a Type 1 Diabetic, who’s had 34 years of experience with this, and have made every mistake, every pitfall, every terrible decision a diabetic can make. I’m also a nutrition coach, specializing in T1D and lifestyle. 💉
What I’ve also done is to drag myself up after each and every single one of those downfalls. That’s the thing, right? Fall down 100 times, but what really matters is that you get up 101 times. 🔝
So, who the fuck am I to call myself a diabetes expert? I’ve figured out a formula of lifestyle measures that you can us to help your diabetes management. Things that your healthcare team haven’t even thought of yet, but can have an incredible impact! Because diabetes management is SO much more than just “eat whatever you want and cover it with insulin – oh, and do some exercise”. And I have tons of resources to turn to when I find something I don’t know.📚
All I want to do is to inspire you to take your health into your own hands, because I know you can. You can become the expert on your diabetes and your health, because it’s important, if not life dependent in some cases. If I could do it, so can you. 🙌🏼😃✨
Ps. This post was originally posted on my Instagram page, @hannadiaebtesexpert. Follow me there for more updates!
Also, you can read my thoughts of when I started using the word Expert in my branding here!