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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!

Type 1 Thursday with Hanna Boëthius – Why Real Food?

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.

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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:

Type 1 Thursday with Hanna Boëthius – Period & Blood Sugar?

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.

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Type 1 Thursday – Jet Lag and Blood Sugar Impact?

How does jet lag affect blood sugar? And how can you ease the burden? 

Last week, I attended the most incredible of events, KetoCon 2019, in Austin, TX (awesome city, btw! If you haven’t been yet, you gotta go!). With closer to 3 000 people attending the event, it was amazing to talk to people, connect, share stories and experiences, meet new friends, listen to mind blowing talks with tons of new knowledge. I also had the incredible honor of being a speaker at #ketocon2019, which was an unforgettable experience! (Universe, please send me more speaking gigs! Kthx!) It really is an amazing community, and I’m so proud and honored to be a part of it.

With traveling that far, however, comes a certain amount of jet lag. 7 time zones back and forth within a week is a little…. intense. So I wanted to tell you about how jet lag impacts blood sugar, and share some of my tips on how to make the jet lag easier on you.

What are your best jet lag tips? Let me know in a comment!

Transcription

If you prefer to read, here is the typed up version of the video above:

Today’s topic has been a part of my life for the past week or so. So I thought if it affects me, then it may affect someone else out there.

I recently attended KetoCon 2019, in Austin, Texas, where I was also fortunate enough to be a speaker. I was very, very touched and humbled by that. I had a fantastic time! The amount of people that I met, the awesome storys that I heard, connections, some of the samples I tried… Everything was amazing! So many people were there, it was a huge event this year, closer to 3000 people. I was very, very fortunate to be there! I really hope that I get to go back to KetoCon next year, and I hope that you will join me there as well.

I love travelling! Sometimes with the travel comes changing time zones, perhaps not all the time. But when it does, meaning that your body might be stuck in one time zone, where as you have moved on to the next. That discrepancy between what your body feels like and what it actually what time it actually is, where you are is called a jet lag. This time, we did a very short trip to the States, it was only a week back and forth. It was a little bit intense. Usually, there is a way or direction that it’s easier for us. For me, it’s going to the east, which is apparently uncommon, I have a lot easier to come home from the States to Europe, then going to the States. This will be taken into account for future trips, believe me…

Jet lag can also affect your blood sugar because your body feels like it is in a different time zone than you are and your insulin pump settings are not in tune with your body’s needs. This is despite that you have changed your insulin pump settings by the time you touch down on the new ground. Your body might need a different amount of insulin than what you are giving in at that point in time. This also happens with basal insulin, or long acting insulin, it’s not novelty for insulin pumps.

It is also a huge stress for the body to change time zones. It gets all confused about times and when to sleep and when to stay awake and when you’re hungry and when you need to drink. And when you have insulin, for example. We also know that stress is a blood sugar killer. Because this is such a stress for the body, this can really cause havoc on your blood sugars. (It wasn’t too bad for me personally, this time. I suffered more from a terrible pump site, than the jet lag itself.) And it didn’t help that I was travelling very quickly back and forth, across 7 timezones within a week.

I was going to share a couple of my best jet lag tips. Although they’re not 100%, clearly, but they may alleviate a little bit so that you don’t have to have such a bad time as you may think it might. So first of all, I wanted to clarify that actually a lot of jet lag is a mindset. If you decide that it’s going to be a terrible time being jet lagged. Guess what? It’s going to be a terrible time to be jet lagged for you! That’s not really any magic. If you decide that hey, yes, okay, admit to yourself, yes, it’s not going to be great. But at the same time, it’s going to be worth it for what I’m doing. You’re already halfway there. If you then also add to it that I’m really excited to go and I can’t wait to see what awaits me where I’m going.

Change the timezone already before you leave. That way you are a little bit more acclimatised to the new time zone even before you leave home. That can involve blocking sunlight, when it’s supposed to be night in the new time zone, or it can be being in front of really bright lights when it’s going to be sunshine and it wasn’t at home. Or it can be regulating caffeine intake, all kinds of things. And there’s a lot you can do yourself. But of course, there’s also apps and I just did a quick search on App Store, and there are so many jetlag apps that you can use. Go explore and find what works for you.

Also, hydration is super, super important for trying to prevent as much as possible of jet lag. First and foremost, this is very important while you’re up in the air, because being that high up anyways dehydrates your body. Don’t make it worse for yourself, as dehydration can cause even more problems. A little bit of electrolytes might not be the worst thing to keep your body fully hydrated, healthy and happy throughout your journey.

Make sure that you expose yourself to sunlight when you’re supposed to. When you have arrived go outside, hopefully it is during daylight time, so that you and your brain and your eyes and all this stuff that works together gets used to when it’s supposed to be dark, when it’s supposed to be light. Sunlight is healing, as we all know, lots of vitamin D, that’s great. Also the fresh air helps to maybe keep you awake rather than stuffy indoor air, when you’re not supposed to sleep.

Stay awake until at least 10pm local time, or whatever your bedtime is, so that you are least a little bit more on to the new time zone. There’s also of course includes no napping, do try to stay awake as much as you can until as late as you can or until your bedtime, whatever hits first. And then hope for a really, really good night’s sleep. If you can’t sleep through the night, which may have been my problem going to the US, definitely do a lot of meditation, a lot of snoozing until you feel ready to fall asleep again. You can also add supplements, such as melatonin and that can really help at least to go to sleep. It’s still debated on whether it helps you to stay asleep but it may help to go to sleep. You can also try things like over the counter histamine drops. Check with your doctor first. CBD oil can also help you sleep when you’re supposed to sleep, as does double magnesium.

Being in nature in the time zone that you’re not used to yet and enjoy the walk. That also keeps you from sleeping when you shouldn’t sleep. Do some yoga doors perhaps, there’s also a lot of jet lag yoga on YouTube, for example, that was very helpful for me, as well. But forest bathing definitely does help.

Keep busy. When I got home yesterday morning, I made sure to unpack my whole bag, put on the washing, so that I had something to do the whole time so that I wouldn’t fall asleep. Today, I feel a lot better, probably also thanks to my hydration plan and my forest bathing and meditation and all these things that I do implement for in order to help my jet lag along a little bit quicker and not just suffer from it.

What are your best jetlag tips I can’t wait to talk with you more in the comments below.

And wherever you are exploring next, enjoy and hope the jet lag is not too bad.

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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.

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 – Blood Sugar Ranges

Welcome to this week’s Type 1 Thursday with me! I’m doing this series ahead of the world’s first event solely focusing on diabetes from a low carb perspective, diabetes. by The Low Carb Universe!

We’re talking blood sugar ranges today, what is normal, what can be expected on low carb and how to get there. 

Did you learn something new in this episode? Let me know in a comment below!

Diabetes Lies

How do you feel when you find out that someone has been lying to you?

You feel cheated, stupid and end up having trust issues.

It doesn’t even have to be full-on lying, it can also be a few mis-truths, or not telling you the whole story so that you can’t put things into context.

For 26 years I believed a lot of things about diabetes that I now know are untrue. For 26 out of 30 years I believed that I knew less than my doctors, that I couldn’t trust my instincts and that I was just doing it all wrong.

And all along my mother has said that “you’re always your own best doctor”. Boy, oh boy is she right! But when you’re told, repeatedly by people who “know better” that this isn’t the case and that you should really be doing it their way, which is usually straight out of a medical textbook, you start losing faith in your own thinking, reasoning and ways. What about what works for YOU as an individual? We both know that diabetes is a very individual disease and there are as many options to manage it well as there are people who have it.

It wasn’t until I was finally brave enough to look my own health in the eye and decide to take it into my own hands that I noticed that I truly had the power to change my own health destiny. This was an incredibly difficult step to take, not to mention scary.

I had been told for far too long, and far too many times, that what I was about to do I would probably die from. Straight away. This was clearly a blatant lie, I’m still here and I’m doing better health-wise than ever.

But what I’m really here to do now is to stop the lies. Stop the untruths that are clearly ruining more people’s lives than they have to. They’ve had their time on stage, it’s time for the truth.

Do you ever feel like there has to be more to it than just “eat like everyone else and take more insulin”?

Have you lost a little hope to ever get diabetes more controlled?

Diabetes can often put you in a life or death situation. Sometimes more often than you’re willing to give it credit for. This is why it’s so important to stop being lied to, to trust your gut feeling and to realize that more insulin isn’t automatically the only answer there is for you to control diabetes better.

I know what it’s like to being close to giving up completely, just do what the doctors tell you (because-they-know-best) and deep down wonder “why me?”. To play a game of Russian roulette with your life at stake – every day. It sucks. It feels so hopeless and there’s no end in sight. At the same time, you don’t have the energy to do anything about it, either. Mainly due to your fluctuating blood sugars, where curves closely resemble something like a roller coaster. You’re stuck in a well, looking for the rope you need to get out.

In order for you to actually get out, and here comes the major suckage, you have to take responsibility for your situation AND your own health. You need to look your own health in the eye and show it who is boss. Plainly put, it’s about going from not giving a shit to giving tons of shits.

But you can only get there if and when you know the true facts. The real things that will help you feel better, be healthier, happier and more blood sugar stable. The information that takes you off the roller coaster and puts you in the spinning tea cups, if you will.

Diabetes will never be completely at bay, especially not if you have Type 1. But with a few changes of food, simple tricks and lifehacks it can get so much better.

You just have to realize how to make the shift of going from doing-it-by-the-book-but-it-doesn’t-work to ah-this-is-awesome. With this shift, you choose to be healthy and happy.

A great first step could be to join the webinar I’m hosting on Monday, 13th July 2015, where I’ll be talking about 5 major lies your doctor tells you about diabetes. This is your chance to learn how to help yourself to a better life with diabetes. It’s not hopeless, if I can do it, so can you.

Sign up for the webinar here.

The Low Blood Sugar Make up

Diabetes gets in the way of life sometimes.

And the other way around, too. But that’s the topic of another story.

Being such a big part of our lives, it would be weird if it didn’t mix in and mash up your plans sometimes.

Sometimes we’re talking about interrupted sleep, another time it’s an unplanned meal on the menu. And sometimes it’s about being so tired, simple chores can be compared to climbing Mount Everest. At least. Not to mention the guesstimation game we play with the pancreas on our hip, in a pen or syringe. Up? Down? A little up and then down? The other way around? Or even *gasp* stable and level? (Watching your blood sugar do a salsa dance on a cgm is sometimes entertaining, as long as you don’t put too much personal attachment to the numbers)

You can almost never tell with 100% accuracy where your blood sugar will end up after a meal, some insulin or just by plain old living.

And sometimes you can’t let the stubbornness of diabetes get in the way, either.

Like the other morning, when I had to get to an appointment I had.

I woke up at 4.4 mmol/l (79 mg/dl), which I was happy about. My cgm curve looked smooth from the night and I was even more happy about that.

I jumped in the shower, washed my hair, moisturized and brushed my teeth. I was feeling a little sleep-groggy, but nothing else.

I went to put on my clothes, got dressed and noticed an odd, fuzzy thought popping up in my head that usually stems from the low-blood-sugar-drawer in my brain.

Nevermind that right now, I had other things to do, like taking my morning medicine (thankfully not insulin) and supplements.

When I got back downstairs from the kitchen, my next task was to do my make up. But I decided to check my cgm first, which showed 4.1 mmol/l (73 mg/dl).

Ok, I thought, that’s not bad, although I’m dropping. More of the odd, fuzzy thoughts popped up, and I decided to check my blood sugar on my blood sugar meter, if only to ensure myself that I wasn’t low.

3.4 mmol/l (60 mg/dl) “treat your low BG!”, my d-companion Doris (OmniPod) was telling me.

“Ahh, eff-word”, I said out loud. “I don’t have time for this!”

I usually don’t treat lows until below 3.5 mmol/l, as I find they usually recover fine from there with just the help of lowering the basal on my pump. But as I was leaving, and it was 0.1 mmol/l lower than my usual threshold, I decided to pop a glucose tablet and shut of the basal on my pump for 30 mins.

Knowing I’d be completely OK within 15 minutes, but had to leave the house in 20, I had little choice but to continue with my morning routine and my make up, which is a fairly effortless task.

If you’ve never experienced a low blood sugar before, let me tell you that it can be quite “interesting”. It feels a bit like being tipsy, without having had anything fun to drink. Or like being in a very fast, accelerating car while standing on the ground. It can be dizzy, vertigo, confused and temporary vision problems all in a big merry go round that doesn’t want to stop right now. (It can also feel a gazillion times worse than that, but thankfully that wasn’t the case this time.)

Having to think twice if you’re *actually* using foundation and not the bright pink blusher heavily all over your face is a challenge I’m usually blessed from. I usually know where things go in terms of make up…

Or double-checking that the eyebrow pencil is still brown and you didn’t accidentally reach for the turquoise eyeliner to fill in your eyebrows instead. Or concentrating so hard on getting mascara ON my eyelashes and not only underneath my eye. Not to mention actually getting that blusher semi-equally distributed. Or checking that the foundation isn’t blotchy anywhere.

This can, but probably shouldn’t, be compared to doing your makeup after a good after work drinking session with your colleagues. In short, no bueno.

Throughout this particular mornings routine work, I kept thinking if I actually managed that well with everything, or if, once I was back on track again, would find myself looking like some Cubist rendition of myself. Or like a clown. Or like Gene Simmons from Kiss.

All I could imagine seeing once the low blood sugar fog had lifted was some weird version of myself, as it would have been painted by Pablo Picasso himself. Or something equally scary.

This time I was lucky, though.

When my blood sugar was back in normal range again, I saw that I looked more or less like myself, if only ever so slightly more tired.

What do you do when your blood sugar drops low, do you keep going or stop and wait? What does your decision depend on?

HbA1c, just a number?

Do you ever find yourself paying a little too much attention to a specific number?

Your weight? Your distance covered? Milestones reached? Friends on Facebook?

Or, perhaps, your HbA1c, the “lighthouse” of how you’re doing as a diabetic?

It’s easy to put a lot of weight on a number (pun intended!), because it’s something measurable, something you can follow and have a direct understanding of whether it improves or gets worse.

What’s difficult to understand is that these numbers, none of the ones I mentioned above, matter much.

Your weight technically doesn’t matter much, as long as you feel fit and healthy with it. Neither does the amount of kilometers you ran last week, unless you were in a race… Counting milestones only creates an inner stress and pressure to reach your goals faster, harder, more productively. And, friends on Facebook – are they r e a l l y friends…?

I know. This is crazy cakes.

We’ve been told, time and time again, to set measurable goals, and it’s really hard to find ways to measure improvement without those numbers.

So also when it comes to diabetes care and the HbA1c value.

I’ve been conditioned for 30 years to regard my HbA1c as the shining light of how well I’m doing, so the habit isn’t easy to break. Even when I know I’ve done pretty darn well lately.

I had my a-few-times-a-year appointment with my endocrinologist earlier this week.

Driving there (only takes about 7 minutes, but still), I was super-nervous and kept sending little wishes out for a lower-than-last-time HbA1c reading (which was 6,4%).

I got there, peed in a cup, had some blood taken, weighed in and measured my blood pressure. For someone who has a severe case of “White Coat Syndrome”, which is when you get nervous just seeing, being near or even thinking of a doctors office, the last part always seems a little stupid. And it was this time too, because it was through the roof.

I got into my endo’s office and we chatted a bit about life in general, before we got into the whole diabetes thing.

Once again, I was complimented by her on how well I’m doing. This is still a weird feeling to me, after having basically been a disappointment and being scolded for the other 28 years I’ve met with endocrinologists.

She told me that there probably isn’t much more I can optimize about my care without having a lot more hypos. “Watch me” I thought to myself, as I still think I can, and I will keep trying to optimize and improve until the day I die.

Anyway, to the value that every diabetic has been conditioned to regard as a sign of life or death: my HbA1c was 6,2% this time, or 44 mmol/mol.

This is the lowest I can ever remember having during my 30-year career in and with diabetes. I asked my parents, too, and they can’t remember anything lower either.

The fact that I’ve put so much emphasis on it and then receiving exactly the result I was hoping for made me ecstatic. Happy, euphoric and close to tears of pride. In my opinion, with all right. (And I have yet to celebrate this properly!)

After we had discussed some other topics, and I had received all the supplies I needed from their office (making it feel like Christmas every time I go there!), I got into my car and drove off, full of joy!

I got home, told my husband about the result, he gave ma a huge congratulatory hug, and I was so darn pleased with myself. I posted a rarely-seen-selfie  and got on with my day.

Later in the evening it hit me though. I was sad. Despite my excellent HbA1c result. Despite the praise and the congratulations. I felt saddened.

It took me a good few minutes to figure it out, a little EFT tapping and some meditation came in very handy at that point.

I was sad, because that result didn’t mean anything, really.

Fine, it means that I’m reasonably well controlled in my diabetes. It means that I’ve come a long way from where I started a few years ago after a long diabetes burn out, giving me double figure HbA1c’s. And it gives me a little hope for the future.

But it also means that I’m not really awarded in anyway for it (unless I buy myself something pretty, or have a glass of champagne to celebrate). It doesn’t give me a break from diabetes, not even for a minute. It doesn’t stop the poking, prodding and always having to be on alert. It doesn’t mean I can live carefree and forget about everything.

It just means that I’m alright and that my doctor is proud of me. And that I’m technically “pre-diabetic” according to my HbA1c. 

Don’t get me wrong.

I love the fact hat I’ve found my own way and am finally in the position where I feel like I have even the faintest of clues about this whole diabetes thing.

I love the feeling of not being scolded by my dream health care team. And I love that I can say that I’ve reached a new record in my life.

But I don’t think it’s the best idea to put as much of a value as I do on this one value. Especially as there are so many other factors that determine how well I’m doing and/or how healthy I am.

 

What about you – do you also put too much emphasis on one single number? Perhaps it’s your weight? How far you’ve run this week? Or maybe you’re like me and put (too) much focus on your HbA1c?