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All about my latest HbA1c…
“Your A1c is 4.8%”, she said with disbelief in her voice.
“No way”, I replied, laughing, “it must be an error!”
“It’s time for your yearly blood work anyway, let’s throw in an HbA1c, too. The labs margin of error is a lot less”, she mentioned.
Excellent suggestion!
Well, the lab results came back at 4.7% (29 mmol/mol)! My lowest ever reading, by far. And that without significant lows – Dexcom shows 6% lows for the past 90 days (a few of them are pressure lows too.)
I remember just a few years ago when I could easily have added a 1 in front of that result and it would’ve been my reality. I remember the pain, frustration and hopelessness I felt. I am reminded of my war wounds from having battled T1D for 34 years.
And I finally feel a sense of freedom. Freedom of having found things that work for me and my diabetes management. Freedom in the feeling that normal, healthy and healing blood sugars ARE possible, even after living this long with this disease.
This by no means means that I never have problems. That I never have days when it’s all shit. Or never have moments I want to give up. But there are less of them now.
If I can do it, so can you! 🙌🏼 Share your achievements with gratitude – they are worth it to be acknowledged!
Thank you for your support and for following me on my diabetes journey. 🙏🏼 You are the best.
Ps, do you want to know my HbA1c lowering formula? Watch my Type 1 Thursday episode about it here!
Type 1 Thursday – Hydration, why so important?
How important is hydration for diabetes? What can it cause if you’re not hydrated?
I’ve noticed it myself. Sometimes, if I have a particularly stubborn high (or event borderline high) blood sugar that won’t come down with my usual line of care, it may very well be that I’m a bit dehydrated.
But is that the whole story? In this weeks episode of Type 1 Thursday, I go over the main factors why hydration is important, what signs of dehydration is, the causes, and how all this can impact your blood sugar management.
Do you consider hydration an important part of your diabetes management? Why, or why not? Let me know in the comments!
Transcription
If you prefer to read about hydration instead of watching the video, here is a transcribed text version for you:
We all do it every day, hopefully. And we may not be paying enough attention to it though, which is why I wanted to make a point of it today: hydration, and how important hydration is to a diabetic or person with diabetes, depending on which you prefer.
What causes dehydration, and what can it cause if you’re dehydrated? Dehydration is a higher risk for people with diabetes, because of high blood blood sugars being dehydrating for the body. Even if you don’t have super high blood sugars, or maybe you are someone who is up in the 70 to 90% it time in range of blood sugar. But even then we do have those few circumstances when the blood sugar does go up so that we have to pay attention to our hydration.
High blood sugars don’t just cause dehydration, dehydration can also cause high blood sugars. I know this for myself, for example, if I have a more stubborn, higher blood sugar than I would like insulin is not really taking as it should, movement doesn’t help, insulin neither, all my normal strategies of trying to get my blood sugar down. Sometimes, it can actually be that you are a bit dehydrated! In that case, that’s why your blood sugar has gone up as well, because the body doesn’t have enough liquid to actually keep that blood sugar moving in the body. One doesn’t necessarily cause the other, they can both cause each other. It can be a vicious loop, unless you pay attention to it.
What are the symptoms of being dehydrated? The obvious thing is thirst. If you’re thirsty, you’re probably quite dehydrated and you should fuel up with some water. You can have a headache, often a creeping on headache can also be a sign of dehydration. Dry eyes and dry mouth, I know for myself when I have a higher than normal blood sugar, I can definitely feel my eyes being like a little bit sandy, and my mouth feels like it’s been swiped with about 15 cotton balls! You can become dizzy, especially in hot weather, for example if you’re dehydrated. You can become tired and sluggish. And, if you when you go to the bathroom and your urine is dark, that can also be a sign of dehydration.
What causes dehydration? One I already mentioned was high blood sugars. But as you remember, high blood sugars can cause dehydration, but the dehydration can also cause high blood sugars. Yhe jury’s still out on which one is which! Other things are you simply drink too little water, that is very likely one of the causes. Hot weather or strenuous exercise, so if you’re sweating more than normal, can be a contributing factor. It can be alcohol, for example, that dehydrates your body. Diarrhoea or that you’ve been vomiting can also dehydrate your body.
Why does dehydration happen? And why in relation to high blood sugars? When our blood sugars are high, the kidneys try to filter as well as much of it out as possible. This means that you actually filter a little bit more of blood through your kidneys at that point, which also brings with it water. In a simplified explanation, that’s why we get dehydrated and can feel dehydrated when our blood sugars are higher. Actually, the main point in diabetic ketoacidosis is not necessarily the ketones, for example. Ketones are not bad in limited amounts. It’s also not necessarily the high blood sugar, but it is the dehydration. The really dangerous part of a DKA, and especially if it has come to vomiting and other symptoms of DKA can bring with it, it is the dehydration that makes it dangerous. Please watch out so that you don’t become too dehydrated, as it can also be a contributing factor to the diabetic ketoacidosis. And, I can’t forget, every time I talk about DKA, I cannot miss the fact that it can only be caused by a lack of insulin in the body! This can be a relative lack of insulin in the body, when the body is simply not getting the insulin that it needs and requires to work properly. That is why DKAs happen – it’s not necessarily just because of the high blood sugar – the root cause is always too little insulin. Diabetic ketosis is not the same as ketosis, they are two completely different things. You can see and read my further thoughts on DKA av ketosis here!
Anyway, back to the topic! Dehydration can also cause a lack of electrolytes. If you’re severely dehydrated, you should and may have to go to the hospital to get IV fluids with electrolytes.
How much to drink is another question I often get and that is a little bit of a tricky one, because it is very individual. It entirely depends on how active you are, on what you do and depends on what shape your body’s in. It depends on so many factors! As a rule of thumb, I personally try to drink about two litres of water a day. This also helps me flush out any things that aren’t supposed to be there and also help to stabilise my blood sugar.
Thank you so much for watching. I can’t wait to chat with you more in the comments! If you have any questions, comments or experiences that you want to share with me, please leave them in a comment below, and I’ll happily chat further on over there.
Just remember kids and sweet friends, drink your water and keep hydrated!
Type 1 Thursday – Why Real Food?
Real food is actual food, food that comes from nature and is not refined, made in a factory or tampered with by humans. And no matter of what way you choose to eat, be it keto, paleo, vegan or otherwise, we can all agree that real food is what is the best for our bodies, health and blood sugars.
But why is eating real food so important? And especially so if you live with diabetes? In this week’s episode, I outline a few quick points. Watch the video, or read the transcription below, and let me know your thoughts!
Ps. If you do like the concept of eating real foods, why don’t you join me and an amazing group of people at The Low Carb Universe 2019 in Mallorca, Spain in November? Incredible international health experts, amazing views, movement, joy AND 100% real food! You can book your ticket here!
Do you eat mostly real foods?
Transcription
If you prefer to read to learn, below is a text version of the video about real food above. You can also read why low carb is a great option for Type 1 Diabetics here!
Why Real Food?
Today I have quite an exciting topic, if you ask me, because my background is within nutrition. My topic for you today is the importance of eating real food.
I am so happy to hear your comments and ideas and thoughts about this topic or any other topic, actually, I’m easy that way! Jot them down in a comment below and I will be happy to chat with you there anyway, about real food.
If you ask me, that is the only topic where we can actually agree on, no matter what kind of diet we choose to follow or eat. I don’t really like the word diet, but I choose to use it anyway, as it’s normally the one used. The thing is, whether you are keto, paleo or vegan, or, well, maybe not the Standard Western Diet, actually, because the importance of real food may not be so, so big there. In any other diet that you may or may not be following, I think real food is the one thing that we can agree upon, that it is very good for us.
What I define as real foods is foods that don’t have a label. Real foods actually comes from nature, which is quite rare, if you think about the standard Western diet. It is foods like meat, poultry, eggs, fish, seafood, vegetables, and all these things that actually come from nature and from the earth and not through a factory, or from a factory or has been tampered with too much with by human beings. They’re just as clean and natural and real as possible. That’s my definition of real food, so that we’re all on the same page throughout this discussion.
The main point of this is that real food has no additives. What additives often do, is that they mess with your blood sugar. For example, maltitol is a classic example of this! It is a sugar substitute that still affects your blood sugar. Don’t be fooled and eat that, although it’s supposed to be great and “diabetic friendly”, can be labelled whatever you want to be labelled with whatever health claim. They still include things that are really not good for your blood sugar and really not good for your health. In effect, you’re not doing yourself any favours by buying these “health foods”. No additives, so that they can’t mess with your blood sugar, in this case, if you are diabetic, or live with a blood sugar problem.
If you are going to venture into that kind of a sphere with pre-made foods, I have as a rule of thumb for you. The food item can include five ingredients, and those five ingredients all have to be recognisable to me, I need to know what they are, without googling, because that’s cheating. Then, if I approve all of those ingredients, then yes, absolutely, I will buy it and consume it and enjoy it. But if that is not the case, it will most likely go back on the shelf! “I see it, I love it, I want it, I checked the carb count, put it back”, is pretty much like going to the grocery store with me. My poor husband, I mean, seriously… Anyway, 5 ingredients that are recognisable otherwise, to me, it is not worth the gamble of a possible really high blood sugar or a possible low blood sugar, because I’ve overdosed insulin. It’s just not worth the hassle for me.
What are the top my top three “watch out” ingredients for additives in food?
If you do live in the States, or a similar kind of an environment, high fructose corn syrup. Just stay away, that can really mess up so many metabolic markers within you, so much of your metabolic health can be ruined, because of the consumption of high fructose corn syrup. It’s just so highly refined and so highly tampered with that it’s not really worth it to consume in my opinion. It’s no longer food, it is just factory made.
Number two, trans fats, man made oils, trans fats, are really not good for you. They add a lot of unnecessary strain on your body and your metabolism (that you can just actually fix with eating real food). Adding real fat such as butter, avocado, olive oil, things that are actually not man made, but is made by nature, is a lot better for you than highly refined and processed fats.
Number three, and this can be a tricky one, I do admit it. So bear with me before you slam down the lid of your laptop or turn off your phone, but it’s artificial sweeteners. And with that I really mean the artificial sweeteners, the ones that have been made in a factory. Maybe stevia is fine for you, if you enjoy the the flavour of it. And monkfruit can also be fine. Erythritol to a certain extent, absolutely. But things like aspartame and things that we don’t really know what it’s doing with our bodies yet. It’s definitely not natural in any way or form, and that I would be careful with. I remember growing up, this was a huge thing, as long as there were artificial sweeteners, then, hey, this product is a go! I was raised in the 80s and 90s, when it was still a little bit more controlled what people with diabetes should be eating. I had to eat a lot of terribly sweetened things. It’s been shown in studies since that for example, fructose, which we thought back then was the holy grail for diabetics, can actually clog up your liver, so that it can’t do its job properly. Then your whole metabolism might be damaged.
There’s a lot to be said about this stuff, of course! These three things impact your gut health, they can have an impact on anxiety levels, they can, as I said, clog up your liver, so that can do its job properly. And other things like your skin and other things that are really important for us to work properly. These additives can make an impact on our health, and that’s not very good, is it?
I do want to sort of give a special warning, I did touch upon it a little bit at the beginning of this. For example, “keto foods” some of them or “vegan food” or whatever it’s labelled, heart healthy, don’t even touch this stuff is not healthy for you at all. Don’t trust the labelling on the box! Look at the ingredients, does it have five ingredients? Do you recognise them? Buy it, if you think you’re going to enjoy it, if it doesn’t, maybe you should rather leave it alone? “Foods”, such as salad sauces, sauces, spice mixes, soups, ready made things that you don’t think will have an impact can actually contain a bucket load of sugar and will impact your blood sugar. Stay with the real food is my opinion! It’s better for us, it’s healthier for us, and we’re going to feel a lot better.
If you’re just starting out from, for example, a standard Western diet, to going to more into the real food way of eating, then I really suggest you adopt the 80/20 rule, so that 80% of the time, on work days, you eat real food, and on the weekends, you can still have a bit of what you still think is fun.
I would love to hear from you. Do you eat mostly real foods? Let’s talk in the comments below and I can’t wait to see you next time.
Type 1 Thursday – Period & Blood Sugar?
Type 1 Thursday is back!
This one is for the ladies – managing blood sugar before and during your period, HOW?! 🥵
I was asked on Instagram about how I handle my blood sugar during my cycle, and I wanted to share my four best tips on what to do. It can certainly be tricky and requires extensive trial and error in order to find what works for you, but it’s definitely worth it.
Watch the recording of my Facebook live session here:
How do you manage? Share in a comment!
Transcription
If you prefer to read about period and blood sugars, here’s a transcribed version of the video above.
Welcome to the return of Type 1 Thursday! Type 1 Thursday has been enjoying a beautiful summer break. But we are now back and more than happy to share thoughts, concerns and everything else regarding Type 1 Diabetes, and blood sugar management, food, nutrition, all of these things that really bother us in our everyday life.
I am Hanna Boëthius, the founder of Hanna Diabetes Expert. I am also a Type 1 diabetic since 34 years, I was diagnosed in 1985. And I have a fantastic topic for you today! This one is for the ladies, so if any guys are watching, please, you’re welcome to stay. But it’s going to get a lot with female hormones and so on. If you’re interested, please tag along. If not, I completely understand if you choose to maybe not stay around for it this particular episode.
Today we are talking about how to control blood sugar, before your period during your period, as that can be really difficult especially when you do live with Type 1 Diabetes. It’s not just one hormone that is fluctuating at same time, and remember that you don’t even produce one of the key hormones. That’s why maybe don’t have as easy of a time as other ladies have.
Fluctuating hormones ahead of your period will, in most cases give you a very bumpy ride when it comes to your blood sugar. Our blood sugar is impacted by everything, not just insulin, movement and nutrition, those things that are commonly known as influencers of blood sugar. Beautiful hormones such as estrogen and progesterone definitely have a big impact on what happens to your blood sugar’s during, or ahead of that time of the month.
Estrogen and progesterone are the two biggest female hormones and are made in the ovaries, which is a really important thing for our bodies to do. It’s a natural thing that should be there and we shouldn’t suppress them, like some may suggest. They essentially prepare the uterus for the upcoming pregnancy, and if it doesn’t happen, that’s when you have your period. That is the whole point of those two hormones. So PMS or PMD, or whatever you want to call it, is all about the changes in hormone levels. That’s why you sometimes feel cranky, sometimes you want to cry about it, sometimes you are really hungry, and sometimes you crave weird foods that you didn’t have any clue that you were even eating anymore.
A lot of things can happen when your hormones are at play. This is also what causes the erratic blood sugars ahead of your period. Female hormones can also call cause insulin resistance, which is why we get fluctuating blood sugars. The body doesn’t react to the insulin like it should, because it’s impacted by the other hormones.
What can you do to make this better, to improve this for yourself? And what are the tips and tricks that maybe you can can do to to help your time of month get a little bit easier?
(I’m of course super happy to hear your experiences. Please share those with me in a comment somewhere on the internet, and I will continue the discussion with you there.)
Before I start the what’s and the how’s, remember that very often, in very many cases, insulin sensitivity returns on day one, or two of your period. Be careful and do not push too hard on the insulin dosing.
Number one of what you can do is to track. Track your cycle, when you have what symptoms and also track your blood sugar. There are beautiful apps for this! If you know of an app that combines period tracking or cycle tracking with your blood sugar, please let me know because I’m looking for one of those myself. What you do is to look at the trends from both of these trackings, and compare them and see where and when when you can expect to see the pattern of insulin resistance increasing. Then you know exactly on which day, at which point of time in your cycle, you have to start reacting. This can be done by on paper, as well. But I like to keep as much as I can digitalized, I would prefer to have an app to track both of these at the same time.
In terms of tracking, this is where a CGM really, really does pay off. You can see exactly when the blood sugar went up, and not have to wait for the finger prick to show you. CGM is the movie of your blood sugar, and the finger pricks are the photographs you take every once in a while. You simply get a more complete overall picture. I recommend every single Type 1 diabetic, who has the possibility, to get a CGM of some kind, so that you have a better overview of what’s going on in your body. We’re all individuals and all react differently.
Number 2, this goes hand in hand with the tracking – find out how insulin resistant you become so that you can change your insulin dosages in time. Or even before even the blood sugar starts going up. You can change your basal dose if that’s what’s needs tweaking and tracking during that time, or bolus, or maybe both need to be increased a little bit in the week or days before your period? Some women also experience a few days of insulin resistance when they ovulate in the middle of their cycle, but not everyone. And so that’s also a good reason for tracking, so that you can find out how much more insulin you need.
Number 3 is be ahead of the curve. Make sure that you do find the patterns through your tracking, so that you know what is happening when, to empower you to act before anything really happens at all. You have to go through how much you should increase your doses when you become insulin resistance ahead of your period with your healthcare professionals. Or if you feel comfortable doing it alone, then you know what, that’s fine. I suggest that you talk to health care professional, like your doctor, your CDE or nurse, who can help you figure this out and how to play with the dosages if you’re not comfortable doing it yourself.
Number 4, I know it’s difficult in many cases, but keep to your healthy lifestyle. Try to keep to your nutritious and nutrient dense foods that you’re eating, make sure that you move your body (that also helps the cramping), make sure that you de-stress because this is an additional stress on the body (which could also cause insulin resistance and your blood sugar’s to be wonky).Make sure that you have the supplements that you need, for example Magnesium can be really good for relieving cramps and also for de-stressing. Hydrate properly.
The reason why I chose this topic today is because I was asked on Instagram how I handle it in my own case. I have to say that I used to have huge problems with insulin resistance ahead of my cycle a couple years ago. My blood sugars would be up in the 200’s mg/dl, or 10-11 mmol/l, without me doing anything differently. I tried to handle it with these tips and tricks that I’ve just given you, I tried to work with insulin dosages, tried to work with all these tools that I have in my toolkit. Frankly, it was a hit and miss. I didn’t really know if I was going to be successful, if I increased the dose too early so that I would go low, for example. It was really difficult. But actually, and I know this sounds stupid, but the longer that I have stayed low carb and keto and not have eaten that much sugar, the more my hormones have, all together, regulated so that I don’t really have a problem today at all. Maybe it could be an age thing, as well. I’m older now, and I have a different body than I did a couple years ago. I really believe strongly that eating healthy, nutritious food can really help regulate your hormones, even the female hormones. Today I maybe notice a day ahead of my cycle that “oh something is off, I’m a little bit insulin resistant today”, followed by “oh yeah, of course”.
What are your experiences wit hormonal fluctuations and blood sugar? Leave a comment below and I’ll be happy to chat with you there.
Type 1 Thursday – Weight Loss & Type 1 Diabetes
Today’s topic is T1D & weight loss, a hot topic!
I asked on Instagram what topics you wanted me to cover on Type 1 Thursday, and a good amount of people said WEIGHT LOSS!
So I took the opportunity to gather my thoughts on weight loss and Type 1 Diabetes in a short video for you! If you prefer to read about weight loss and T1D, I’ve transcribed it for you below.
What are your experiences with Type 1 Diabetes and weight loss? What worked for you, or what didn’t work for you? Let me know in a comment!
Transcription
If you prefer to read this, please go ahead:
Weight Loss & Type 1 Diabetes
This is the moving party of a Type 1 Thursday! I have been doing Type 1 Thursday for 17 episodes over on The Low Carb Universe (my other project). I’m very, very happy to welcome Type 1 Thursday back to where it belongs – on the diabetes page (that would make more sense, right?!)
I am a Type 1 Diabetic since 34 years, and I am very, very happy that you are here with me, because today’s topic is super interesting. And it turned out to be a really hot topic! When I asked on Instagram a couple of days ago what I should talk about, a good few people said this topic. I am very happy that I have the chance to cover that for you today. And the topic is, not maybe completely unexpectedly, Type 1 Diabetes and weight loss and how that works together.
It can be really tricky when you are taking a lot of the fat storing hormone, insulin. The more insulin you take, the more weight you gain. It’s not always easy to lose weight with T1D. I wanted to try to describe a little bit what is going on in your body and how it could work for you as well. (And please, please, please do share your experiences with T1D and weight loss, or weight loss at all in the comments! I am very, very happy to talk to you more there!)
Weight loss has many reasons, there can be a gazillion reasons as to why you want to lose weight. There are two main ones, with the first one being you want to improve your health. And that can be of course a reason to lose weight, which is good, that’s great. Secondly, it can also be vanity. So I think, first of all, anyone who wants to lose weight needs to be honest with themselves as to why they want to lose the weight. Is it because of health reasons? Or is it simply because it would feel great to have those last 5 kg/10 pounds, or whatever else off the body and feel accomplished? It’s definitely an important thing to consider.
There are also two main weight loss theories. The first one is the hormone theory, which is that weight gain and weight loss is all about the hormones. It’s all about insulin, and it’s all about how insulin is the master hormone, and how that then impacts the other hormones. The other theory is the the old one, to eat less and move more, the kcal theory, which I feel like we’ve disproven this one? In my humble opinion, I feel that it is actually a combination of the two. Yes, your hormones have to do with weight loss, absolutely. But so do calories, I don’t believe that you can eat 15,000 calories in a day and still be losing weight. Unless that helps to regulate your hormones in some way. Your hormones need to be balanced for you to lose weight. And that actually requires a certain amount of calories, and a certain amount of the right macronutrients. Enough amino acids, enough fatty acids, because those are both essential for the body, there’s no essential sugar for the body. There is essential protein, and there is essential fat so that the hormones can become regulated. Those two for me (not saying anyone else!) but for me really go hand in hand. So it does require both of them to work to get there!
The old saying “abs are made in the kitchen” is true! I’ve heard several numbers on this, but there is an 80/20 thing going on, that 80% is the food and 20% is the exercise. So there you have this again: both go together for weight loss. And if you’re really overweight, if you just start eating the right things, you perhaps don’t even have to exercise in the beginning. That’s great, right? Generally, if abs are made in the kitchen, movement does also play a part in regulating your hormones.
What do I eat if abs are made in the kitchen? Well, there are, like I said, essential protein to the body, amino acids are essential. Focus on that. That is also what, for example, Dr. Bernstein talks about in his “Diabetes Solution” – to focus on the protein. And if you see someone really ripped, there’s a good chance that they are eating a good amount of protein. That’s also because protein is thermogenic. It actually it burns calories when the protein is processed in the body, shortly explained. Also have some fat for good measure, and to regulate your hormones. It may be difficult to get up to an OK calorie count in terms of protein only. So do have some fat. But when you get to stable hormones, and become a fat burner, you will use the fat that you already have on your body, which is actually a very simple way of weight loss, right? Then, of course, carbs; keep them to a minimum, mainly leafy greens. This also really helps your blood sugar, which does help in weight loss, as well. It’s incredible how much goes hand in hand in this!
What does this kind of eating, focused on protein, some fat, a little bit of carbs, what effects does this have? Well, it’s clearly that if you lower the amount of carbs, you lower the amount of insulin that you’re taking. And because insulin is the fat storing hormone, and the master hormone, if you use less of it, there’s a good chance that you will store less fat, as well. And, like this, you won’t really add too many calories on to your diet, which is also goes back to one of the two theories that the calorie, “eat less and move more”, (the 80s called and they wanted their nutrition advice, or weight loss advice back!). I do think it does play a role, I just don’t think that is the only thing that plays a role. Protein does repair your body and it helps to build muscle, which really does help you in losing weight, as well.
In order to lose weight, you also have to be motivated, and you have to find your WHY? Why do you want to lose weight? This is where my background as a coach comes in quite handy! Ask yourself why in three levels; why do you want to lose weight? And the answer to that ask why again? And then the answer to that as why again, so that you really know what is behind your choice of losing weight.
But could it be something else? Why did you gain the weight in the first place? And did you gain it overnight? Or did it take a while to accumulate? Because there is no overnight solution to losing weight. It is hard work! And it is a lot of trial and error, just as getting a grip of diabetes is, so is the weight loss process. Could it be something else than just “random” weight gain? Could it maybe be your thyroid? That also has a lot to do with hormones! Could it be stress, which is the hormones cortisol, adrenaline, and can really drive weight gain. Can be fluid retention? Are you retaining fluid for some reason? Maybe not enough salt? And could you be pregnant? Could it be some sort of medication that you’re on? For example, antidepressants are usually causing weight gain, so it’s corticosteroids. Antipsychotic medications and birth control pills can really, really make you gain weight because that also goes back to the hormone theory.
Please do share your weight loss success or questions in the comments, and I’ll be happy to chat with you there.