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Type 1 Thursday – Unexpected high blood sugars? 🤔

…it could be THIS!

When you’ve done everything you normally do to keep your blood sugar healthy and stable, and your blood sugars all of a sudden rise to the point that you have to drastically increase your basal dose or rate.

You’ve eaten low carb, taken insulin & other meds you may be prescribed, hydrated, moved, supplemented, not stressed too much, changed insulin vials, stuck to your routine – all to no avail. Your blood sugar is stubbornly and unexpectedly high anyway!

In thisType 1 Thursday, I will discuss a possible reason why, based on my own very recent experience.

Watch the video or read the transcription below:

Type 1 Thursday – Hanna Boëthius

Have you experienced something like this? Leave a comment and tell us more!

Transcription

If you prefer reading the information, here it is:

Today’s topic is actually a bit of a personal note, because this is something that I’ve recently experienced. If I’ve experienced it, there may be others out there who experienced the same and may need help with similar situations or at least help figuring out what it can be.

If you live with Type 1 Diabetes, you know that some days are just weird, blood sugar-wise. It doesn’t matter what you do, your blood sugar’s either high or it’s low, or it’s whatever where it shouldn’t be. Usually it is a little bit on the higher side, and if you have frequent lows, you just think that you’re cured for a split second!

When you have those stubborn high blood sugars, to the point where you do a basal test to find out how much basal you should be taking. And that actually shows that you’re taking too little basal all of a sudden! It’s not due to hormones, if you’re growing or a woman or anything hormone related. It is not due to the seasons, because whether can involve insulin resistance, too. It’s not because you’ve changed your diet, you’re eating the same thing. Basically, you keep everything the same. Just all of a sudden, your blood sugar’s up, and you need more insulin overall.

“Oh, okay. Have I not exercised enough? Yes, I’ve done that.” Check off the list. “Am I coming down with something? Am I getting a cold or a fever? Is there something like that going on? Nope.” You feel fine as a little baby bird, just maybe apart from the high blood sugar situation? Hmm, what else? “Am I injured somewhere? No, not that I know. And have I been drinking enough water and I’ve been taking my supplements? Have I been eating low carb enough?” It can also of course, be stress, it could have been stress in my case, definitely. And it could have been a bad insulin vial. But as this kept going throughout insulin vials and stressful periods and stuff, I figured out it wasn’t that. All these things that will checklist of lifestyle factors that do influence blood sugar. Everything is in check. What the *bleep* is going on?

Well, this, as I mentioned, did happen to me quite recently. In the past few months, all of a sudden, my basal requirements increased with, I kid you not, 30%! This is, of course, it’s just a number and you have to use the insulin that your body needs. But to me, it felt very weird. Wait, what could this possibly be that is going on? I didn’t think more about it. My blood sugar was then back to their stable, wonderful self, with the 30% extra basal insulin requirement.

But then I started getting a tooth ache. We were traveling at the time, and I was like, “Oh, no, I have to like find a dentist!” I’m not too fond of dentist, as it is. I contemplated finding an emergency dentist where I wasn’t notat home, and didn’t really speak the language. And I don’t know what I’m doing. I don’t know where I am and all the stuff. I’m like, oh, what am I gonna do?

But I made it. I could soothe the symptoms until I got back to my normal dental hygienist, who happily took an X ray of my lower jaw on the left side and noticed, “oh, you have an abscess underneath that tooth that was hurting.” I’m like, “oh, okay, so it was an inflammation. I just couldn’t feel it at the time!” I had walked around with an inflammation, which is known to cause high blood sugars and insulin resistance (or both, which is probably the case here). I was very jolted when she said that it has to be surgically removed.

Now, I’ve had a fair amount of dental work done. Especially when I was still in my high sugar eating days, my teeth started crumbling a little bit. I didn’t know why, because I was eating the way I was supposed to. Since going low carb, I haven’t had any problems at all. So for a long time, I haven’t had to go to the dentist, I’ve only gone to the dental hygienist to get my teeth cleaned and and she checks my teeth. If everything is good, I don’t have to go to dentist. Yay. Happy me. But this time, she’s like, “well, you know, you can’t really remove this on your own, it won’t go away. So we have to actually surgically open up your gums on the lower left side.” This sounded lovely. (If you’re sensitive, please just fast forward!)

“We have to open up your gums on the lower left jaw and we have to dig out the inflammation by hand because it won’t go away.” And I’m like, “No, this is terrible!”, feeling my stress regarding dentists as it is, my blood sugar immediately went up a little bit. I wasn’t very happy about that (but that wasn’t the point of the story.) The point of the story is, that when I finally managed to get the courage to make that appointment, and the dentist was allowed to cut up my gums (and ended up doing a lot of other work that I just don’t even want to remember, because it was terrible.) Then, when the inflammation was out, and I had started healing, look at that, hey, presto – there went my 30% basal rate that I had added on top! My basal rate went back to normal. It was that inflammation.

The moral of my terrible experience and story is that if you do have unexpected highs and your basal rate does go up, it doesn’t have to be anything that you’ve done or that you’re doing wrong, or that you’re not being “compliant”. That’s a terrible word! It can also be something that is going on in your body that you don’t even know about, as in my case, it was a dental inflammation, a dental abscess.

I don’t recommend it to anyone. But if it does happen to you, make sure that you get it taken care of, and go check it out. And this is why it’s actually quite good as a diabetic to get your teeth cleaned quite regularly so that someone can see the differences going on.

Have you ever experienced anything similar to this? Anything that all of a sudden raise your blood glucose values or all of a sudden raise your basal rates?

Let me know and let me know how you sold that in the comments and we’ll be happy. I’ll be happy to do chat with you there.

I hope this story hasn’t put you off! It did me for a good while, but I’m happy that it’s now over and I can look forward again.

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Type 1 Thursday – Injections vs Insulin Pump?

Today’s topic is MDI (multiple daily injections) vs insulin pump – which is better?

This comes after a question I got on an Instagram post, where I was asked if it’s necessary to use a pump as a Type 1 Diabetic?

My short answer is DEFINITELY NO! If you achieve great results and reach your goals, it doesn’t matter what kind of insulin delivery system you use. The main point is that you have normal, healthy, happy blood sugars.

Watch the video (or read the transcription below, if that’s more your thing) to find out my pros and cons of MDI and insulin pumps.

I want this to be a conversation starter, so why don’t you let me know YOUR pros and cons in a comment below? And, what do you use to deliver insulin? Let me know!

Transcription

The age old question for most people living with insulin dependent diabetes, is the question I recently got on my Instagram post.

The question was about whether it is necessary to use an insulin pump, or if multiple daily injections, either though a pen or syringe is better for diabetic?

This is very difficult to answer straight off the bat, because this is a highly individual topic. In my opinion, the short answer is that it doesn’t really matter what you use to deliver the insulin, that you do need as a Type 1 Diabetic, as long as you do. If your diabetes is well managed with maybe a completely crazy version of either MDI or insulin pump or whatever, then hey, that’s fantastic. You found what works for you, and that is great.

Today, I wanted to have a conversation starter with you, which we can happily continue in the comments below. I wanted to outline my pros and cons for both MDI, which is multiple daily injections, you deliver your insulin by injecting yourself every so often with both basal and bolus insolence. And also pros and cons for the insulin pump that I’ve noticed for the past couple of years. Maybe this can help you make up your mind, maybe there you find out something that you want to try, and if you do, please let me know in a comment.

My own story in regards to my insulin delivery method has been a little bit jumpy. Well, I was actually flat out refusing to have an insulin pump for so many years. I had had diabetes for 27 years before I finally agreed with my diabetes nurse that now I was ready to try. And this despite health care professionals suggesting an insulin pump to me, for the majority of my upbringing, (well, maybe not in the 80s. They weren’t super common back then.) since they have become more common, they have been suggest to me every once in a while, and I’ve always refused. Because, and this was the biggest con for me the insulin pump back then, was that there’s something always attached to me. I was afraid that I would feel sicker than I have to be. And I was afraid that I’d be constantly reminded of that I am maybe not as chronically healthy as I would like myself to be or as other people may be. (I am, however, chronically awesome!)

So I was very, very hesitant and very afraid of getting myself my first insulin pump. I opted for a tubeless patch pump, which then changed into a tubed pump, about one and a half years ago, I took the step towards a tubed pump for a variety of reasons, which we can happily discuss, and maybe a little bit later. I’ve done multiple daily injections for a lot longer than I have lived with an insulin pump constantly attached to my body.

I wanted to outline few pros and cons of them each.

So let’s start with MDI, as that’s where I actually have most of my personal experience. I want to start with the pros. This is a biggie for me, and for very many other people who live with diabetes, the freedom factor you have with multiple daily injections. You don’t have anything attached to your body, unless you’re wearing a CGM, but they are a lot smaller and maybe you don’t want two things connected to your body at all times.

Hand with this goes also that it makes the illness more invisible. Because you don’t have a pager looking thing stuck to your hip or your clothes somewhere. It becomes a very much more visible illness to live with, with an insulin pump.

If you do multiple daily injections, you can also take a lot more different types of insulin, because different insulins act in differently during different times. For example, as Dr. Bernstein always recommends, is that you take regular insulin, or R insulin, to cover protein, and the protein spike that comes a few hours after you eat a lot of protein. This is easier to do if you are on MDI then having to remember to also have another shot when you’re on an insulin pump. You can also then take fast acting insulin, to which you have to correct high blood sugar or for covering for carbs. Finally, you can choose which long acting insulin that you combine this with in a way more flexible way. When it comes to types of insulin that you take, you can find a routine and a regime that works for you. And for your diabetes, to manage it properly.

MDI can also be seen as being a bit simpler, you take an injection and you’re done. Instead of having to care about every time you remove a piece of clothing or something that the tubing gets stuck or you snag the the infusion set… If you get the benefits and reach your goals with MDI, then why not stay with that?

I think it can also be argued that MDI is cheaper than being on the pump. With the pump comes very many things that you have to pay for, such as rent of the pump, for example. I have to pay rent every month for having my pump. All the supplies for it also cost a lot. It’s not just the insulin that costs! With MDI, either you use syringes that are reasonably cheap, or you have insulin pens that most people with diabetes actually get for free.

Also, from a very, from very superficial point of view, because sometimes you need to be that, too. On MDI, you can wear anything, and you won’t see any devices poking or sticking out, or being in the way, or there’s a seam or there’s something that is just obstructing either the pump or the tubing. With MDI, you are freer in that way too.

I would conclude that with the main point of the pros of MDI is freedom.

The cons of MDI! I find it in hindsight, it is quite inconvenient to be on MDI for myself. I can only speak for myself here! But every time I had to correct, every time it’s time for the the basal shot, I had to pull up my shirt, or pull down my pants… For me, it became quite inconvenient, because I had to inject myself about 10 times a day, before I swapped to the pump. That was a big sales argument for me, to be honest, not having to pierce myself with a needle 10 times a day, only do it once every three days, that sounded like heaven! That’s why I went for it, actually. You also have to remember to take your basal insulin at the right time. It became a huge effort for me to try to remember when and how and how much, which dose at this time of day…

What else I see as a con for MDI, in my opinion, is that you have a lot more to carry along with you when you leave the house. An insulin pump is always on you. So that’s it for the insulin thing. Then you need a blood sugar meter, maybe some glucose tabs and that’s fine. That’s a lot easier to carry then two types of pens and the pen needles and blah, blah, blah, for me it becomes a lot more carrying along. That being said, for most people is not a problem.

Another, slightly inconvenient part of MDI, is that you have to expose body parts. Usually this is not a problem at all, whether you’re female, male, whatever. But – imagine what is it really, really cold, and you have to like take up your shirt, and you feel that icy wind against your skin. Then you also have to inject yourself. I don’t miss that at all. I really do enjoy the fact that for example, if I am out and about around town or something, I can just take up my insulin pump, I can look like I’m texting (or whatever ignorant people choose to believe). That’s how easily I’ve saved my life with more insulin if that’s what I need, or turned down the basal if that’s what I need. But it becomes a little bit inconvenient for me to expose body parts here and there, especially when I’m out and about.

The importance of rotating sites becomes very, very big on MDI, because we all have those favorite spots that we like to inject ourselves in. And that’s fine. But you do have to rotate your sites! I noticed for myself, that it is a lot easier for me to rotate pump sites than it was to rotate injection sites. It even got so bad that no one could touch my upper thighs for a while because I had just injected so much long acting insulin into them.

For the MDI cons, in conclusion, inconvenient to me.

Let’s move over to the pros of the insulin pump. So the absolute highlight for being on an insulin pump for me is that it is very, very flexible. I can be very flexible with my basal rate, for example. If I notice that I’m trending upwards, I can change it, I can add on a bit of temporary basal to see if that’s the problem. And also with the bolus, you have the different bolus profiles. Instead of, as I was talking about in MDI, you can use different insulins for this, you use the same insulin the whole time, just in different profiles, so to speak. For me, it’s a lot easier to just remember that I have one tool to work with and I can do different things with this same one thing.

My second favorite pump benefit, it is micro-bolusing. I can take bolus’ in the size of 0.1 unit, for example. If I really want to, I can do a 0.05 bolus on some pumps, making it much more precise. This is not possible on MDI, because there you have the minimum is half a unit. So it depends a little bit on how tight you want to steer your diabetes ship. I really like the fact that I can really micro manage my blood sugars, to a certain extent, not overly so of course, because that becomes ridiculous on all other levels. But it is very nice that I can do a micro bolus every now and then. When I see the CGM trending up, I’m like, oh, let’s try with 0.X units and see if it comes a little bit down. If not, then I have to redo and recalculate. But it is a good check for me to see what’s wrong.

As I mentioned before, it is very easy to handle when you are on the go. You can even take care of your health and blood sugar during a business meeting (I have done that many times before), and when you’re out with friends, if you are in a busy street. Or imagine, for example, it’s rush hour at the farmers market and you feel or you get a notification for your CGM that your blood sugar is a little bit high, you would like to correct but you can’t really find a quiet corner. With an insulin pump, it’s a lot easier because you just click a few buttons and you’re done. You’ve taken care of the situation and you can move on with your day.

To a certain extent, I also find that it’s more efficient for me to treat and manage my diabetes with an insulin pump. I don’t use nearly half of the insulin as I do before. I also don’t spend as much time managing my diabetes as I did with MDI. Also, of course, if you are a data nerd, you have a lot of data to take care of and see and have insights and analyze and see trends. And the ever so important tech integration, more and more pumps now do integrate with a CGM, so that you can get both things at in the same device. And also, the looping possibilities that are coming up now that are very, very exciting to everyone who lives with diabetes.

The cons of insulin pumps (yes, yes, they are. There are cons with these ones too, it’s not all just roses and happy flower dances.)

I already mentioned one of them, which is that this is something that you always have attached to your body. And that can be very draining, both emotionally and physically and mentally, for some. It’s not always easy to always be connected in that way.

The tubing does, if you have a tubed pump, get caught on stuff like door handles, and other things, clothing, everything. It’s not really the most maybe smooth thing in the world to live with, you do have to watch out and make sure that your tubing is inside of your clothing, preferably, so that you don’t snag it somewhere.

I find that using an insulin pump produces a lot more trash than MDI. I’m not really happy about that, but as it is a lot easier for me to manage my diabetes with the help of an insulin pump, I keep with it, and I hope that the insulin pump provider companies will at some point really reconsider their recycling policies, so that you can maybe even send that stuff back so that they can take care of it. And not to mention Dexcom, please get your act together! But that’s another video. 😉

One problem with insulin pumps is that if it for some reason, malfunctions, and that can be the site malfunctions, the battery runs out, or the insulin goes bad or the machine get some sort of hiccup. If it somehow malfunctions, you don’t get any insulin at all and that can become dangerous quite quickly. That is one of the bigger cons for an insulin pump.

For me, airport security, or generally when you travel, insulin pumps can sometimes get a little bit interesting. They will want to swipe them for explosives. For certain airports, I do have to take more time into consideration when I travel through there because they just don’t know really what it is yet. It is unfortunately becoming more and more common, meaning it is less of a problem. But sometimes I could happily maybe be on MDI for a trip!

What do you have to add in terms of pros and cons for MDI and pros and cons for insulin pump? What do you use it to deliver insulin?

Please let me know in a comment below. I will be happy to chat with you there.

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!

My HbA1c Formula

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)? 

Type 1 Thursday with Hanna Boëthius – Why the Dietary Wars?

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?

Type 1 Thursday – Type 1 vs Type 2 Diabetes

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:

I share my best tips for dining out with Type 1 Diabetes, while maintaining normal blood sugars.

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!

Type 1 Thursday – How to treat hypos

Let’s talk about treating hypos/low blood sugars in today’s Type 1 Thursday!

How do you treat your lows? What do you use?

Comments and questions are, as always, welcome!

Transcription

If you prefer to read:

Hello and welcome to Type 1 Thursday with me Hanna Boëthius, one of the cofounders of The Low Carb Universe. And of course, also a type one since 34 years this year. Yay. Let’s celebrate. That’s a question actually for an other T1T about dia-versaries. Do you celebrate your dia-versary? Or do you not? I tend to not really because I don’t really see the point. But let’s keep that for another live.

Today, we are talking about hypoglycemia. And that is, for those who maybe aren’t as in with the diabetes lingo, low blood sugars, so when your blood sugar level drops too low, and you maybe won’t be able to carry on as usual.

Yes, this will also happen, of course, when you are low carb, this is no guard against lows and hypos, but I will tell you this, it will happen less, because of the of course now legendary law of small numbers. Because you’re not adding tons of insulin and tons of sugar, you don’t have the that huge error margin. So you’re playing with small amounts of sugar and small amounts of insulin, so that you don’t ever really dip that low. Anyway, so hypos do happen and they still happen on and off for me.

What has changed for me, of course, from when I was high carb to eating low carb, and therefore took a load of insulin is that the amount of carbs needed to treat a hypoglycemic episode is, of course, a lot less. And I will go through this in a little bit to show you the comparison.

Hypoglycemia has different symptoms, you can be shaky, you can have a bit of brain fog, you can’t really think clearly your vision can go blurry. And you can, there’s so many different things that for example, at times, I’ve had that my nose get goes tingling, or my lip. But now I rarely experience these episodes. And when I do they’re not as low like my blood sugar level is not as low as it maybe it has gone before.

What happens when you have a hypoglycemic episode is that you’ve taken too much insulin, there’s nothing in the world that can cause you to hypo and but actually taking too much insulin for the required thing that you took more insulin than you needed in that in that specific example.

So for example, maybe you took a little too much for the meal that you just had, or maybe because of exercise, you got extra insulin sensitive, there’s so many variables that can make you sort of overdose on insulin, but you know, apart from just shooting up too much. So yes, there are many, many reasons for why but there’s only one sort of correlation as to why you get a hypoglycaemic episode, and that is taking too much insulin for in comparison to your needs. And that’s it.

What I think is very, very interesting, when you do go low carb and high have lower blood sugars than desired is actually that ketones, and this has been proven in some fancy study or another, actually seem to have a cognitive protection for your brain. So even if your your blood sugar is low, and you don’t have enough, well enough, let’s call that sugar in your system, your brain will still function, because it is also fueled by ketones, so it always has fuel rather than relying on only sugar, which is of course, a little bit, well, maybe not ideal. It’s always nice to have double, and fuel sources for your pretty little brain to keep busy with.

What is the definition of a hypoglycemia?

This is something that we can debate forever, because it is very, very individual. So for me, for example, I think the official one is under 3.9 mmol/l, which is about 60 mg/dl, is the lower limit. Anything under that should be treated as a low blood sugar.

According to the conventional method, one should treat hypoglycemia with eating 15 grams of carbs, wait 15 minutes, measure again, and repeat if necessary. That is what it’s taught to all of us diabetics out there. I have figured out that I maybe need something a little bit different than that specific method. But then again, I don’t do things by the book anyway, do I so no surprises there.

Because my carb sensitivity has gone up so much. I’m so sensitive to carbs now because I don’t need them too often. So that’s something I’m happy about. Because in return, my insulin sensitivity has gone up like crazy.

What I usually do is I if I measure a low or if my CGM tells me that I have a low, I will take, listen to this, two grams of glucose. And maybe four grams, if it’s really, really low, and then I will be fine within about half an hour. And because I can keep cognitive for longer, how do I say this without getting into trouble, at relatively low measurements, I can still stay cognitive. And I don’t mind waiting instead of shoving everything in my face, like have done many, many times. When I was high carb, I sometimes needed 25 to 50 carbs to treat a low because I simply had that much insulin swerving around in my system and it being too much for me, of course. So that’s why I needed so many carbs to treat back then. And now I need to for maybe if it’s a really bad one, I will need six grams of glucose.

What is low for me? I don’t generally treat until sort of around the 3.0 mmol/l, about 60 mg/dl. And that also depends on if I’m at home or if I’m out and about. If I’m at home, I can take my time treating it, I don’t have to hurry up and get into a safe zone. But that’s different if I’m out and about, and then I take two grams of glucose, I will minimize the basal on my pump, so that it is at 10 or 20%. So that doesn’t keep giving me insulin during my low as well. That’s usually is enough to get me up to a safe sort of 4.0 mmol/l, so 80 mg/dl to 5.0 mmol/l. And this is where I feel the best as well.

I don’t want to overcorrect it either, because this is not comfortable. This is where the most damage happens to your to your system, with either continuously high blood sugars or jumping blood sugars. I try to avoid that those two things as much as possible, which is why I don’t, or I try not to, over treat my hypos when they do happen, which is not very often anymore. I do not read my kitchen over there to find whatever I want to eat, because this is the opportunity to just eat all these things that I normally can’t, because then I would be over treating it. Anyone who has had a hypoglycemic episode or a low blood sugar knows that it’s a terrible feeling. It’s an absolutely terrible feeling. And your natural instinctive is to just stuff your face with as much food as possible, to be safe, and to be to get your blood sugar into a safe range.

I have relearned this. I actually had a period of my time of my life where I was really really afraid of hypos. So I knowingly kept my blood sugar at a higher rate, which I don’t recommend either, because that didn’t work out, as everything else that I tried back then. What I do now is I keep my calm because I know I have this alternative fuel source that will keep fuelling my brain, which are of course ketones. But if it does happen, and this is not a sponsored post, I pay with my own little cents and dollars for these, I take one or two of these, which I can find in any pharmacy. One of these is 2.2 grams of pure glucose. I take one of these, and then I put my pump on a minimum basal rate. And then I retreat after 25 to 30 minutes, if the level hasn’t changed. I want to show you my favorite flavor as well, which is blueberry yogurt. If you’ve had to use them, you know that the taste of glucose tabs isn’t fantastic, ever. They do taste like chalk. They don’t have very imaginative flavors, but this one is actually the best one out there.

Glucose tablets are just another medicine that I need to actually save my own life at times. So I don’t see it as an opportunity to stuff my face or or treat myself to anything. It’s just another part of medicine that I need to in order to be well. That is how I treat my normal hypos.

I have to touch wood here, I haven’t had hypoglycemia where I need help from other people. in very many years, since I actually started low carbing, those have completely disappeared. Before, it used to be a lot more, as I was playing with a lot of active insulin in my system. And that is sometimes a recipe for disaster. I also have, as I spoke about in the previous episodes, a glucagon kit in the kitchen so that it’s easily easily reachable for my husband, for example, and who is mostly the one who’s here with me, or for myself, if I would really need it. And this could be a case of life and death. This is where the glucagon does so, it activates the liver to push out its extra sugars, and glycogen storage. And that’s how the blood sugar raises itself. Well, not by itself, but how it’s prompted to raise with a glucagon kit. And those are always good to have around, because you never know how you’re going to react to something. In case something isn’t going to plan, then it’s good to have one of those. And you can actually, which is in emergency cases, you can also micro dose these. So for example, if you have a stomach bug or something and can keep anything down, not even liquids, although going to a hospital is a very good idea if you can’t keep down liquids. GLucagon could be a treatment option then, as well. I also read that they’re working on a nasal glucagon, like a nasal spray to activate the glycogen storage in that way, which I think would be fantastic. Because that mechanism of filling a glucagon kit can be quite intimidating. Luckily, I have drilled this into my husband’s brain, so he would be able to do it in the case of an emergency. But normally, I can do with one or two or maybe three glucotabs if it’s really bad, and I am happy.

As I said, this is not a fun topic because hypoglycemia are very, very, very uncomfortable. And even more so when you are maybe with people who don’t quite understand what is going on. But as long as you know that you can treat your own hypos, then you are pretty much all right to go and enjoy everything.

Anyway, I love that you were here with me today that you’re watching that you are sharing successes, writing all of these things. Thank you so much for the hearts and the likes and loves.

I’ll be back next week with another episode of type one Thursday. I’ll see you then. Bye!

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Type 1 Thursday – Traveling with Diabetes

Today we’re talking about traveling with diabetes on Type 1 Thursday!

What are some tips and tricks you should bear in mind when traveling? And what shouldn’t you do?

You can find my travel check list for diabetes here!

What are your best tips for traveling with diabetes? Let me know in a comment!

Type 1 Thursday – Total vs Net Carbs?

Today, I’m talking about total carbs vs net carbs – which one should you count?

Carb counts are sometimes difficult to bolus the right amount for, so also on low carb/keto. Especially since food manufacturers love to state “net carbs” instead of total carbs on their products…

Find out more about what I think of this, and, more importantly, what you should do, here:

If you want to learn more, why don’t you join us at diabetes. in Sweden in June? bit.ly/dia2019

How do you bolus on low carb, for total or net carbs? Let me know in a comment below!