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“Why are you so harsh on yourself?” 😳

I got a DM on Instagram recently, where the (probably) well-meaning person asked something along the lines with “why are you so harsh on yourself when it comes to diabetes?” 😳

It was implied that I pay too much attention to things like blood sugars, nutrition and HbA1c, when “all you have to do is count carbs and cover for them with insulin.”

Well. I don’t agree. 🤷🏻‍♀️ To me, that is a way too simplistic way of looking at managing something as individual as diabetes can be. Check out the rest of my answer in this short clip:

https://youtu.be/vMiX2ykf170
Type 1 Thursday – Hanna Boëthius

👉🏼 What tools have you found that work the best for you in your diabetes management? 👈🏼

Disclaimer

The only purpose of this video and website is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This video and website is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.

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Double Diabetes, Double The Fun? 😳

What on Earth is Double Diabetes? How does it develop, and who is at risk to get it? Are there ANY solutions to it?

Learn this and so much more from this week’s episode of Type 1 Thursday:

https://youtu.be/HmgNFm34Q44
Double Diabetes – Type 1 Thursday with Hanna Boëthius

What is Double Diabetes?

Double Diabetes is when a person with Type 1 Diabetes develops severe insulin resistance. They may need to use medications that are traditionally used for Type 2 Diabetes, essentially having developed both types of diabetes – hence the term Double Diabetes.

The problem is that T2D can’t really be diagnosed in T1D, no glucose tolerance test or blood insulin measurements will be accurate. Instead, the clinical diagnosis goes a little something like this: do you need a lot of insulin? IS your BMI high (although BMI isn’t even a reliable measurement!), Waist to height ratio high? High blood pressure= Fatty liver? High HbA1c?. If you are T1D and do have these, you could be in the risk zone for Double Diabetes (and no, it isn’t double the fun!). Whether the insulin resistance comes from T1D, lifestyle factors or it’s genetic, the result is the same.

Are there any solutions to Double Diabetes?

We know from the T2D, some cases of it can be reversed with lifestyle changes. But T1D will always persevere. My top tip to cut down the insulin resistance would be to decrease the amount of carbs you eat. It works (and is an acknowledged treatment) for T2D, which is half of the issue!

I actually think I was a Double Diabetic before I changed my lifestyle in 2011. Since the term was coined in 1991, there hasn’t been much activity in this field until very recently, so I was never diagnosed. But I needed an almost obscene amount of insulin, along with the other symptoms mentioned above… 🤷🏻‍♀️

Have you heard of Double Diabetes before? Do you have any experience with it? Let me know in a comment!

Disclaimer

The only purpose of this website and video is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This website and video is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.

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The Ultimate Diabetes & Alcohol Toolkit

…or, “You can also have fun WITH alcohol!”

Yes, you can absolutely drink alcohol, even if you have diabetes. 🍷🥂 🍸

The main point to remember is – alcohol impacts the liver in doing its job of regulating blood sugar.

The main function of your liver is to store glycogen, which is the stored form of glucose, so that you will have a source of glucose when you haven’t eaten. The liver is also responsible for cleaning the body of toxins. Unfortunately, the liver cannot do both jobs at the same time. While it is detoxifying, it stops secreting glucose.

The Ultimate Diabetes & Alcohol Toolkit – Hanna Boëthius

Here are some helpful tools to add to your diabetes management toolkit, alcohol specific:

🌟 Keep an eagle eye on your blood sugar, before, during & after drinking.
🌟 Know what’s in your glass, alcohol % and carb count Stick to dry wines/bubbly, light beers, or liquor with club soda or diet drinks. It makes all of it easier!
🌟 Wear medical alert bracelet/jewelry, just in case.
🌟 E N J O Y your drink!
🌟 Keep hydrated
🌟 Enjoy some food or snacks with your drink
🌟 Bring glucose tabs with you .
🌟 Don’t drink alcohol if your blood sugar level is low
🌟 Don’t skip food 🌟 Don’t necessarily drink alone – alcohol is best enjoyed in company! (Also someone to check up on you.)
🌟 Avoid sweet drinks, craft beers, sweet wine… Concentrate on having FUN, not worry about how high your blood sugar will go.
🌟 Don’t drink and dance (without food)!
🌟 Don’t play around with meds.

I enjoy alcoholic beverages, and sticking to low sugar options (dry wine or mixed liquor) works the best for me. That way, I can concentrate on ONLY caring for the alcohol part, and not having to additionally care for the carb count/hyperglycemia. I usually drink with food, as part of a meal/aperitif.

What are your views on diabetes and alcohol? Do you enjoy alcoholic beverages, and do you have any tips to share? Or do you steer clear from it? 🤔 Let me know in the comments!

Transcription

If you prefer to read the information, here is a text version of the video above:

Coming soon!

Disclaimer

The only purpose of this video and website is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This video and website is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.

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My Food Log Experiment (Patterns revealed!)

Do you ever keep a food log? 🤔 As you may know, if you’ve seen it on my Instagram I’ve been doing an experiment on myself with exactly that this week.

Having had to do so many, many times since my T1D diagnosis 35 years ago (including during my nutrition training…), the result is that I absolutely can’t stand it. It’s fiddly, too many numbers and honestly, I don’t even care about them (anymore).

Despite this, I decided to check that I’m eating enough, if I eat consistently and how/if my blood sugar and insulin requirements would change with changes in kcal (etc) intake. Normally, I care as little about kcal as I do about ketones, i.e. not at all. Counting calories doesn’t work, food is nutrition, which is information that the body uses.

BUT – I do believe in eating when I’m hungry/my body needs fuel, which ends up being two meals a day for me. I also believe in eating real foods from nature and minimally processed. And I believe natural fat is good for us (yes, also saturated fat). Throughout this week, I found a few patterns:

🌟 I ate somewhere between 1100-2000 kcal/day. My basal metabolic rate is around 1300 kcal. I had a few comments that that would be too little as an intake, but if you see me I’m not exactly skin and bones. I’m also a big believer in nutrition density, and I think my kcal contain more nutrition.

🌟 I seem to intuitively vary the amount of kcal according to what my body needs and tells me. LISTEN 👏 TO 👏 YOUR 👏 BODY! It’s natural that the level of hunger varies, and as long as I’m happy, full, satisfied and well nourished, I trust my body to eat what I/she needs. For example, I seem to be eating slightly less on my more active days. And I’m ok with that.

🌟 I bolus for my meals (this I already knew, of course). As bolus strategies are very individual, I didn’t see the point in announcing doses. Throughout this experiment, I’ve used a total daily dose of 17-21 units/day, with a 85% basal, 15% bolus split, just like I usually do. My blood sugars have been fantastic, too!

How do you feel about logging food? A fun experiment or personal torture? 🤔 Discuss!

Food Log Experiment (Patterns Revealed!) – Hanna Boëthius

As a reminder, to yourself or someone you know needs to hear/see it, this is my main point:

Food Log – Hanna Diabetes Expert

Transcription

Would you prefer to read more about my food log experiment? Here’s a written version:

My Food Log Experiment

I have done something different this week. And I’m excited to tell you about it. I will tell you what I did, how I did it (well, that’s pretty straightforward)! But I will also reveal all the patterns that I found doing this little experiment.

As you may have seen, I have been logging my food, again for the umpteenth time in the history of my diabetes career, which has become quite long by this point, despite me only being 25 and I cannot see how that works?! 😉 But as you may have seen on Instagram, I have been logging my food again. I want to know from you, while I keep yapping on here, how about you tell me in a comment somewhere whether you are pro or contra logging food? I am very much against logging food – I really frickin loathe it, like I hate logging food. I hate it so much and this comes from my diagnosis having to do it well, I didn’t have to do it my but my parents had to do it for my diagnosis about 35 years ago this year. And also I’ve had to do it so many times since and especially when I’ve been struggling with diabetes, and it was really shit everywhere. And I yes, also of course, when I became a nutrition professional, I had to log a lot have food and I really, really don’t like it. So that’s, you know, my bias.

Despite this, I decided to do it now anyway, because I do think it’s good to sometimes check where I’m at in terms of how much I’m eating and all this stuff. I have to be honest and say that I really don’t care about calories, I really don’t care about macros, I really don’t care about the percentages here and energy percentages there. I don’t care about ketones at all, unless I’m sick, and ruling it out as a cause. I just focus on minimising the carbs because that’s what works for me. I know you’re a lot of people out there where this doesn’t work for or you don’t agree with it. But let’s just assume that we can be individual in our care and that different things fit different people. So yes, I really think it is a good idea sometimes to do check what it is that I’m eating. And you can do this with different providers such as My Fitness Pal or Cronometer.

Calories?

My basal metabolic rate, as in what my body burns, when I do nothing when I sit and breathe, basically, is about 1300 calories. You can find out this in many ways, you can use manual things, or you can use online calculators or I also have my wearables calculate for me as well, and they’re always around 1300 calories. So that’s, you know, what I’m working with here.

In this week’s experiment, it has revealed itself that I eat something between 1100 and 2000 calories a day. To be honest, I don’t even believe in calorie counting. So I don’t even know why I’m keeping track. But I thought it could be interesting. I don’t see that calorie counting works, and especially not the way it has been made to seem to work. I much more believe in that nutrition is information for the body that the body can use to function properly. And I also strongly believe that our bodies are wonderful machines who can regulate this! If you dare to listen to your body, and this is my main message today; if you dare to listen to your body, it will tell you if you need more calories, less calories, more energy and in which form less energy in which not form.

I did get a few comments, not just one, about why am I eating so little calories? Again, for me, this is not really a problem because I don’t really pay attention to it, I pay much more attention to whether I’m full, whether I’m happy, whether I’m satisfied, whether I’m in a good mood, all of these things. And of course, my yearly checkup, I check if I have any deficiencies, but so far, it hasn’t been that way. So why so low calories? I really believe that I do eat food with very dense nutrition. So there’s a lot of nutrition per calorie, per gram of carb, per gram of fat and protein. There’s a lot of nutrition in the calories and the macros that I do eat. That’s why, if I’m not hungrier than 1100 calories one day, I’m not going to force feed myself just to get up to an arbitrary number for me. I am well nourished, as you can see, I’m not just skin and bones. There’s ample things to take off from here, so I’m not malnourished either. I eat however much I want, I don’t have any limits for myself, I eat however much I want until I’m full, happy, satisfied. And I really believe in that.

Intuitive eating?

This experiment showed me that I intuitively vary calories according to my needs. It is something very natural for hunger to vary, and for calories to vary from day to day, depending on what you’ve done, how you feel, all of these things that have an impact. I came to the conclusion that I am quite good at intuitive eating actually, where I really listen to my body in terms of what it wants, in terms of how much it wants, in terms of what nutrition it needs on that day in that moment. Really, my philosophy is really as easy as, Eat when you’re hungry. Don’t eat when you’re not hungry. This leads me to mostly eat two meals a day, sometimes I have a snack between the meals, sometimes I don’t. It really depends on what my body is calling out for. An important point, because this is a completely different ballgame if this is your problem, but I eat without emotion. I think that food is joyous and it’s good and I enjoy food and it has to taste good. But I don’t eat because I’m sad. I don’t eat because I’m happy. I don’t eat because you know, there’s an underlying emotion. So if this is your ballgame, then there are tonnes of experts out there who can help you with this, but it’s a completely different thing to handle.

I also noticed that I tend to eat less when I have a more active day which sounds completely weird. Three days a week, I do bodyweight exercises for half an hour, I go out walking at least half an hour, and I do at least half an hour of yoga. So that’s 1,5 hours on those three days that I move my body. I do it because it feels good and not because I feel I have to do it. And again, I listen to my body, and it wants to move! On the other four days of the week, I do walking or yoga or both. It all depends on how I feel during the day. But yes, on the days I move more I eat slightly less calories, which was weird to me. But again, I don’t worry about it. I know my body can take care of itself. It’s fine.

Bolus for minimal carbs?

I also got a lot of questions if I bolus for the meals that I eat, considering there’s very little carbs in the food that I eat. Do I even bows for it? And yes, I do bolus for my food (which is what I said in my Instagram Stories very many times, “yes a bonus for this”). It is very important, of course, to keep blood sugar stable, healthy and at normal levels. This was a great success in the in that respect as well this week, my blood sugar’s have been great! I’m very grateful for that. I also corrected when I had to, and used insulin as normal.

Because bolus strategy for every person with diabetes is very, very individual, I didn’t see the point of actually disclosing any numbers or how many units I was taking or anything like that. It’s turns out to be a pretty arbitrary number, much like calories. How much bolus I take doesn’t really matter because it’s so individual. A lot of it comes down to what your routine is, what your eating habits are like, what do you usually eat? Do you eat a lot of carbs usually? Or do you eat less carbs? Usually, your bolus strategy will depend on these factors. It also depends on what kind of a role of your basal insulin, the underlying insulin, plays, along with so many other things, like what your fat and protein factors are and how much you need to bolus for protein, for example. There are rules of thumb, absolutely, for all of this, but for you as an individual, you will need to play a little trial and error to see what works for you in certain circumstances.

But as a little factoid, I used anything between 15 and 21 total units per day in my insulin pump. That means it’s both basal and bolus insulin. It works out to a ratio of 85% basal and 15% bolus. It doesn’t really tell you much, but it just shows that I do take insulin and I do take adequate amounts of insulin and I won’t go into DKA (as that is the danger of taking too little insulin, DKA is always due to at least the relative lack of insulin in your body).

Food Log Conclusion

So what is my conclusion of my (now) four day experiment, I cannot wait to finish it tomorrow. But my four day experiment so far is that I still loathe, I still hate logging food. It was a great reminder for me., It really takes away that joy for food, the joy of eating the sheer pleasure of eating and puts it too much into my head. There are too many thoughts, there’s too much planning. There’s too much of, “oh yeah, how many blah, blah blah was this and how many walnuts did I eat there?” and “how much cream was that?” It takes the complete joy out of it for me. And it also takes me out of trusting my body, listening to my body-feeling, that I find is so, so important, especially when it comes to eating. This was the quick-ish conclusion of my four day experiment of logging food!

Before I go, I wanted to ask you, what does food logging mean to you? Have you used one of these terrible chart-things that I used to get from my dietitian (when I still saw one)? Is it a fun experiment to check in on yourself every once in a while, or are you more Team Me and it’s a bit of a personal torture? Please let me know in a comment!

Disclaimer

The only purpose of this website is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This website is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.

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Great sleep, great health!

Today on Type 1 Thursday we’re talking about the importance of SLEEP!

How can sleep improve your health? And what on earth does it have to do with diabetes and blood sugar management? 🤔

Find out in the sleep video below, check out my graphic for my top sleep tips or read the information below.

Type 1 Thursday – Sleep – Hanna Boëthius

My questions for you: Do you get enough sleep? What are your best sleep tips? Share them with me in a comment!

The graphic I’m talking about in the video, is this one. It’s a quick reminder of the things we can do to prepare, invest and do for great sleep. Share it with someone you think would need it!

Sleep Tips – Hanna Diabetes Expert

Transcription

Do you prefer to read about just how important sleep is for your health and blood sugar management?

Great Sleep, Great Health!

This super exciting topic actually has a lot to do with blood sugar management and diabetes, although we might not think about it. I asked on my Instagram Stories if I should do a Type 1 Thursday on sleep and the importance of sleep and an overwhelming amount of people thought that was a great idea!

We have to really step away from this old notion of that “we can sleep when we’re dead” or “we can sleep later” or “we can catch up on sleep later”. No, we really cannot. Healthy, proper sleep is actually super important for us, for our health, and for our well being. So no more pushing it til later! You should invest in your sleep and you should definitely make it a priority, because it is “no backsies” as Sheldon Cooper in Big Bang Theory would say. You can’t take it back and you can’t make up for it later. So it’s very important that you handle that.

Sleep science is growing exponentially right now and it is showing that sleep is actually essential to your health and to your performance. Even though we might not feel like it, or think we can push through and all these stupid things that we tell ourselves. No, sleep is actually super important for our health and performance.

How much sleep?

So how much sleep do we need then? Actually, we need seven to nine hours a night, not a week, not anything else. We need it a night in order to function properly and to reap all the benefits that sleep does have because it is quite astonishing. This is when sleep becomes restorative, when it becomes rejuvenating. I’ll go through a couple of types of sleeps, or sleeping patterns a little bit later. But first of all, please don’t think that you can survive on less than six hours of sleep a night (unless you are one of these 5% of the population that have a genetic mutation, which makes them able to survive on less than six hours sleep). Otherwise, it will lead to a lot of problems, such as cognitive dysfunction, and your immune system won’t work fully. The brain is trained actually to disregard sleep deprivation so you might not even notice if you are sleep deprived or not, or have had too little sleep.

Benefits of great sleep?

So what does enough sleep do? What are the awesome features that come with enough sleep? Well, one of them is of course, which is super important right now, is immune function. Your immune system cannot function without proper sleep. So if nothing else, it is very important for you to get proper sleep right now so that your immune system is on 100% and on top. Your energy and strength, that goes without saying and of course also blood sugar control. Yes, it does help with your blood sugar management because lack of sleep is a huge stressor for the body. And as I say all the time, stress is the blood sugar killer number one. So try to eliminate as much stress for the body as possible.

Also, it can aid in weight loss because your hormones are regulated when you sleep properly. It also leads to better skin, for example. And of course, things like coordination and flexibility are increased when you do sleep enough. As I mentioned, hormone regulation but not just hormone regulation in terms of weight loss, but also in terms of stress management, in terms of emotional regulation, in terms of everything. So sleep really helps there as well.

And it also leads to better recovery because your hormones are regulated, You can drain yourself and then recover better if you sleep better. And enough sleep helps with focus and creativity and this leads to better performance as well which is quite an important thing.

As I already said, emotional regulation, we react in a different way when we have slept properly than when we haven’t, I’m sure you recognise this! And sleep helps with longevity as some studies actually show that when we sleep better, we live longer and healthier. So that’s a good thing to keep in mind. Also, our resilience grows a lot when we sleep properly. So it’s not a bad idea to actually prioritise your sleep.

Something that is very in the air right now is that proper sleep also helps your metabolic function and there is a lot to do with the immune system right now, but also metabolic function and metabolic syndrome. So maybe there is something to the fact that you are not sleeping properly if you are suffering from something like that? This can, in turn, if your metabolic function is not optimal, lead to insulin resistance, both Type 1 and Type 2. So if you haven’t slept properly as a Type 1, you can get insulin resistant, or if you don’t have Type 1, you can actually start developing functionally insulin resistance and Type 2 diabetes. By the lack of sleep, and of course, other co-founding factors, but it can be a contributor. Lack of sleep makes you produce a lot of cortisol. As long as cortisol is high, it cultivates a bad gut bacteria in your gut and that can also be a problem because that leads to poor health and that’s poor immune system and it all goes in a circle.

That’s why sleep is so important. All of this goes in a circle and they go hand in hand. Good sleep also helps you become more effective when you think, improves your reaction time. Whether it’s sports or in traffic or just generally in life, your reaction time gets better. Sleep helps your memory function better.

Types of Sleep

So what are the types of sleep? Well, there are three main ones and we fluctuate between them all night every night. And that is light sleep, there is REM sleep, which is 20 to 25% of your total sleep, deteriorates with age and this is where you dream. This is where your memory improves. This is where you become or have creative thoughts because some of our dreams I can tell you, if you’ve ever paid attention to them, they are quite creative, if not crazy, but yes, a bit creative.

And then the third one is deep sleep, which is 0 to 35% of our total sleep, and it’s very individual depending on what you’re used to, and that’s where it’s very restorative and rejuvenating. And that of course is also needed for your body to regenerate.

Tips for better Sleep

So what are some sleeping tips? These are some sleeping tips that I came across myself and from other people. For example, no screens at least one hour before bedtime. This can be very challenging because what does one do without a screen nowadays? Especially when we may be on a lockdown, and we need to somehow entertain ourselves until it’s proper bedtime? What does one do? Read a book, read a magazine and do something just creative outside of the screen world. Make sure that you have a bedtime routine also on weekends. (I mean seriously, most of these tips make you sound like a really boring old person but I gotta say they do have a point to it because most of them actually aren’t that bad – they actually work!)

Make sure that the temperature in your bedroom and what you’re wearing and in your bed linen, like the thickness of your duvet is suitable to how you sleep the best. If we are too warm, we don’t sleep well and if we’re too cold we don’t sleep well. So we have to be like Goldilocks “just right” in terms of temperature in order to sleep well.

Don‘t have any big meals or a really strenuous exercise right before bedtime because that gets your pulse going. That gets your digestive system going if it is food and that it won’t have time to come back down in time for your sleep. So don’t have anything heavy to eat right before bed. And this also, of course, more diabetes specifically, helps with your blood sugar control throughout the night if you don’t do anything crazy, right before bedtime, and you know what the outcome is. Also, unwind, but that’s easier said than done in some cases, and especially now, but do unwind and make time for unwinding in the evening so that you can fall asleep swiftly and carelessly and get rocked away by your sleep.

Limit alcohol right before bed, especially and this of course also has a huge blood sugar benefit. Limit caffeine after 2pm, seriously, I sound like an old lady but this old lady has a point. It is very beneficial to cut the caffeine after 2pm and this also has a blood sugar benefit, like a lot of these tips actually do.

Move your body regularly, not right before bedtime but during the day and in the days regularly. Find out what you think is fun to do, and how you want to move your body and make sure that you get a little exhausted at times because that does help with your sleeping patterns.

Make sure that your bed is for two things: for rest and for romance, nothing else. Do not watch TV in bed, do not technically play with your phone in bed. It’s just for rest and romance. And you will thank yourself and maybe even your partner’s gonna thank you for having that new rule in your life. 😉

Yes, napping is fantastic, but they have to be well timed. So ideally not before 3pm so that it doesn’t impact your night’s sleep, either from the beginning or towards the end of your day. But naps can really help as well.

Use wearables. If you can measure your sleep, it’s actually quite interesting. You can do this with tons of providers out there but there’s for example the Oura ring. You can use Fitbit, you can use the Apple Watch, all of these things that you can track your sleep with so that you see how much you sleep and on which level and how you can improve it.

Now I want to hear from you: do you have problems sleeping or is sleeping a breeze for you? And what are your best sleep tips? Do share them with us in a comment somewhere on the interwebs. I’ll be happy to chat with you there.

Disclaimer

The only purpose of this video is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This video is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.

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10 Diabetes Things To Do – Lockdown Edition

10 Diabetes things to do – #lockdown edition!

Type 1 Thursday is here, with a special edition of some diabetes things you can do if you find yourself a little restless at home these days.

Of course, if you are feeling too overwhelmed by everything right now, it’s not a requirement to accomplish anything at all during the lockdown. But, if you’re looking for some inspiration, maybe this could help?

Come along and share your diabetes thing to do, that you may not have the chance to do otherwise, during lockdown?

10 Diabetes Things During Lockdown – Type 1 Thursday – Hanna Boëthius

Do you want help with adding these to your life? Or discuss something completely different with me? Book a PowerHour with me and we’ll hash out all the diabetes issues we have time for: https://hannadiabetesexpert.youcanbook.me

I’ve created a graphic overview of the things I mention in this week’s Type 1 Thursday. Feel free to share it with someone who needs it (and make sure to tag me @hannadiabetesexpert so I can cheer on from afar!)

10 Diabetes Things To Do – Lockdown Edition

Transcription

Today we are talking about 10 diabetes things that you can and you might want to do during a lockdown, that you might not have the chance to do otherwise. This is basically because we are all spending more time at home right now so we have a little bit more of a chance to experiment and stuff, but I’ll get to that.

First of all, I did want to say that I know this is a very uncertain time. This is a very scary and messy time and you don’t need to accomplish anything at all  during this lockdown, during your time at home, you don’t have to as it’s not at all a must or a requirement. But for the ones that might want to start exploring a little bit more about what is possible, you can, for example, do one of these 10 things that I’m going to share with you today.

As I mentioned already, this is because we are spending more time at home and we have a little bit more time, space, maybe opportunities and chances to experiment a little bit, as we are in the safety of our own homes. We are not stuck in an office somewhere, we are not stuck in public transportation where something could go wrong blood sugar wise, or you don’t feel well doing this thing or whatever. And so that’s why I suggest this is a good time, even though as I said, you don’t have to.

Basal Test

The big one. The number one diabetes thing that you can do if you are stuck at home in a lockdown and that is, of course basal testing. I did a whole whole Type 1 Thursday episode on this. So I don’t feel it’s necessary to explain too much. You can just scroll back, go to my blog or my YouTube to find that episode to learn how you can basal test properly. Basal testing, something that usually requires quite a bit of effort and a bit of time and a bit of patience. So this might be a great thing to do now that you are at home a little bit more than otherwise. That means that you can still basal test and fast without having the extra stress of getting to the office. For example, you have time to correct either highs or lows if they happen, all of this in the comfort of your own home. How awesome is that? How often do we get to do that, and who wants to basal test during an actual holiday? That’s not the point, the point is to keep the rest of your life as semi normal as possible and just do the basal testing, to find out if this fits you at this point of your life and in your insulin management.

Organize Supplies

Another thing you can do is organise your supplies. I like when things are organised and I do enjoy organising things, even though it takes a lot of effort. But this is very good to do right now to throw away those half eaten glucotabs or low things that are somehow crumbled between your CGM sensors and your insulin pump cartridges… Just really clean everything out, make sure everything is nice and clean and take stock of what you actually have now so that there are no strange surprises of “oh crap I don’t have that or that” and you can order things in time. As we know, some companies (definitely not all of them) but I am sure some of them will experience a shortage at some point. So don’t be, you know, caught short. 

Clean Gear

Next tip is to clean your gear with an alcohol swab or one of those disinfectant things that you have before you have an injection or insert a new pump site, for example. Use one of those and clean your pump, your CGM, your CGM receiver, your pen, you know all that lint and dust and stuff that gets stuck in the little corners, nooks and crannies. Get all of that out. Clean your gear to make it all feel a lot fresher. It feels a lot nicer when everything is nice and clean. And you’re not going to do that when you sit at the office so do it now while you’re at home.

Lancet Swap

Number four is a little favourite, which I do every Monday. I have to say I’m a good diabetic that way! Change. Your. Lancet. Lancets get really disgusting really fast so make sure you do change it at least regularly and not just once a year. Try to have it on a day, but if you haven’t gotten there, at least do it now that you have the time to actually find the lancets in your newly cleaned out a desk or drawer of diabetes supplies. 

New Meal

How about trying a new dish, for example, so that you know already how your blood sugar reacts to it and how you can manage it insulin wise? I have some great recipe resources. Some of them are for example Ketogenic Girl, there’s Maria Emmerich fantastic recipes or dietdoctor.com. They all have gantastic real food recipes that you can’t really go wrong with. Most of them also have carb counts. So don’t be afraid to try them because it’s really nice to widen your repertoire when it comes to food a little bit. Otherwise things get so boring if you eat the same thing all the time. 

New Movement

How about trying a new form of movement or a new workout? I may or may not have just completed a 20 minutes of dance party in my living room to the best of the noughties R&B – it’s so much fun. It is something that makes you smile. It can be an online movement, apps that are widely available right now. There are so many yoga apps,  so many high intensity things if you want. How about trying Darryl Edwards primal play with his Animal Moves cards for example, they’re fantastic. There are so many resources that you don’t need to go to the gym for. If you are allowed to go out for a walk, I highly recommend doing that daily to get some fresh air and some sun on your nose, hopefully. Just try something new. And this is also the time that you can experience and experiment how your blood sugar reacts to that kind of movement so that you can incorporate it into your normal life whatever it is going to look like after the lockdown. 

De-Stress

De stress, my sweet friend, take a deep breath, unclench that jaw, roll your shoulders back. Lay your hands flat on your lap. Relax. Relaxing is so so important and especially right now when everything is so uncertain and there’s a lot of anxiety in the air and in the world. I did a whole anxiety video last week that you can also find either on my blog or on YouTube. There I shared some tips on how to handle that, but de-stress, whatever de-stressing means for you. If it is meditation practice, fantastic. If it is EFT tapping (Emotional Freedom Technique), awesome. If it is yoga, go for it. If it’s taking a long bath, yes, if it’s a good cry, do it! Anything that makes your stress levels go down makes you a happier, calmer and a nicer person really. Stressed people are never really nice, so be a nice person and de-stress for yourself and for the sake of your diabetes management. Because as we know, stress is really the blood sugar killer number one, as I say all the time. So find your way of de-stressing and enjoy it. It could also be something like a beauty day like face masks. hair masks, paint your nails if you want to do that,  these are just ideas, you have to find your way of doing it properly for you.

Hydrate

Have you tried to hydrate really properly? As in really drinking a lot and enough water and not just take a sip and then forget about the fancy water bottle that you purchased for yourself to have available at all times? Can you actually make that commitment for yourself to hydrate? Also, if you need them, add some electrolytes so that your body feels better and it works better and it’s happier. Do it because there’s a huge difference. I saw that Ketogenic Girl posted about hydration and a comparison picture of her face when she was dehydrated to hydrated and it was such a huge difference. So if nothing else, if making your body feel good is not a convincing argument for you, how about looking a little bit better, then maybe that’s an argument that will convince you. I don’t know. Let’s see.

Find a Routine For YOU

In preparation for whatever life looks like when we get out of this lockdown, how about finding a routine that works for YOU? Not for me, not for your neighbour, not for the person you live with, not for your mom, your sister or your pet, but for YOU. How do you feel the very best throughout your day? Is it starting your morning with meditation perhaps, or is it starting with a really energising chat with a friend? Or is it with a cup of coffee or is it to dance to your favourite song for a couple of minutes? Really find the routine for the whole day and in the way that it works best for you. What follows that first thing you do in the morning. What’s the next thing? Okay, and what’s the next thing? And when do you want to do X? When are you actually hungry? Rather than eating just according to conventional 12 o’clock as lunchtime, and you know, whatever 6,7,8, to 9pm, depending on where you live, it’s dinnertime and between there you know, blah, blah, blah, when are YOU hungry? When do you want food and what works for you so that you can apply this even when you go back to the office. When you reevaluate a little of your current routine and maybe swap some things out, that could work better for you. It doesn’t have to be harder than that. 

Foot Care

Another tip which I actually do enjoy when I have the time and energy is actually foot care. We all know that people with diabetes are prone to problems with their feet, maybe not everyone of course, but all feet love a little bit of extra TLC. So get a good foot bath and get a Pumice stone to take away the not so pretty areas and the hard skin, the dry skin, all that stuff and then moisturise and give yourself a really well deserved foot massage. You are going to thank yourself, your feet are going to thank you and yes, it will be time well spent. This is again the time that we normally don’t have available to us because we are stuck in offices or with other commitments and socially or whatever else. But now that we are at home more there is more time to get this done.

If you are interested in hearing more or learning more on how to incorporate this kind of stuff into your life from me, I have opened up a few coaching spots and you can book those via my Instagram profile right now and I’ll put the link here to my Facebook as well as YouTube. I have opened up a few spots so you can book your time with me and we will hash out all your diabetes problems that we have and time during our power hour together. And I would be so happy to help you: Just click here to book!

But first, I do want to hear from you: what are some of the diabetes things that you are looking to do or accomplish? Or maybe it’s none of it at all and you just think this video is complete bullshit, and that’s fine too.

Let me know and leave a comment below and I’ll be happy to chat with you there.

Disclaimer

The only purpose of this video is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This video is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.

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Anxiety?

Anxiety – how does it feel and what can you do? 🤔

On this week’s Type 1 Thursday, let’s discuss exactly this! If you don’t want to watch the video, you’ll find a transcription of this topic below, too.

Anxiety is currently a bit higher among most of us, due to what the world is facing and what we’re all communally going through. But don’t despair, there are tools and tricks you can use to alleviate the anxiety (at least momentarily)!

PS. If you want more help with your diabetes lifestyle, I’ve just opened up a few spots for 1:1 coaching with me! Book your power hour, where we blast through all your troubles, right here!

Anxiety – Type 1 Thursday – Hanna Boëthius

**What are your best tips to relieve anxiety? Share in a comment!**

Please share this with someone you know needs this!

Transcription

Anxiety?

Considering the state of the world today, anxiety isn’t an unimaginable response. I don’t really want to say too much about the virus situation, but what I can do and what I’m happy to do, and what I’m more than joyful of doing is to talk about anxiety, how it feels and what you can do to maybe alleviate your anxiety a little bit.

I would love to have a conversation with you. So if you want to share your tips on how to alleviate anxiety a little bit, please leave a comment and I will be so happy to chat with you there!

What is Anxiety?

What is anxiety actually, because we hear it everywhere? I don’t know if everyone is on the same page on what it is, but it’s “just” your body’s natural reaction to stress. That’s when you feel anxiety. And that’s when all those terrible feelings start coming. It is essentially a fear of the future or because you don’t know what’s going to happen in the future and the uncertainty/fear of the future. So that is what happens when you are anxious in your body. And if this goes on for a longer time, you can of course have anxiety disorder, which will need medical help and maybe some of these tips that I will share will help, but I think you also would prefer to find medical attention on that one.

Signs of Anxiety

Signs of anxiety can range from anything such as feeling judged by others or by yourself. And it can be that you’re fidgety, you can’t find the peace, and you’re very restless. It can be perfectionism. Probably not the case right now, but yes, perfectionism can be a sign of anxiety, and you feel a bit afraid, you feel  stressed, you feel worried, you feel negativity. These are all things that make up anxiety and anxious feelings. They’re not very comfortable to live with. So that’s why I’m going to share my best tips with you in a little bit.

What you can do about Anxiety

But first, I wanted to share a quote that I read from my friend and fantastic person Shawn Mynar, and if you don’t know who she is, check her out as she’s fantastic. She shared a fantastic quote the other day, that I wanted to share that with you because it’s very relevant: “worrying is like praying for something you don’t want to happen”. How true is that? If we keep on like mulling over the whole time, the things that we don’t want to happen and the things we’re worried about, or the things we’re anxious about how are we ever going to get to right where we actually want to be? I found that quote amazing. Now, to the point of what can we do about it? 

Yes. A lot of people are anxious right now whether you live with diabetes or not, and yes, diabetes can add an extra layer of anxiety. Of course it doesn’t have to, but a lot of people are anxious right now because of the situation in the world. Some tips that I’m about to share with you might actually help you as well, to feel a little bit lighter in life; a little bit easier and a little bit, maybe not so strung up and stressed. 

Focus on the Good

So my first sort of anxiety “blaster” (can we call them that) is “focus on the good”. So this can be anything from like noticing the smallest thing as the:

  • Sun is shining today
  • That’s a beautiful flower
  • Do you hear the birds chirping?
  • Look at nature, how beautiful it is
  • How beautiful is that tree that is just about to bloom (if you’re in the Northern Hemisphere and spring is on its way)

You know small things like that, focusing on the good things and not on these huge things that could and may and should go wrong according to your brain right now, but focus really on the good. In that way you actually get a more positive outlook and that can really help you.  This goes hand in hand of course with the old and very used term of “gratitude”. 

Have a Gratitude List

Do make a list, why not have a list of things that you’re grateful for and write it down every day? It can be on your phone, it can be on a piece of paper, it can be in a journal, it can be anywhere you want, but why not make a gratitude list?

That can also help.

And when these anxious feelings come, why not try at least to turn it around: “hey, what if this works out”? What if this becomes the best thing that has ever happened to me? Try to think of it and turn it around to a little bit more positive. I know when you sit there and you’re super anxious, it’s not easy, but at least it can be worth a try.

Cultivate Good Sleep Routine

Make sure that your sleep routine is really good. Be constant with the timings of when you go to bed, when you get up and make sure that you sleep well. I’ll go through some supplements in a minute that can help with anxiety and of course help with sleeping too so they go a little bit hand in hand as well. 

Check your Self-Talk

How is your self talk? Check in on your self talk, do you notice that you could be a little bit kinder to yourself? Could you maybe tell yourself that you love yourself and that you are beautiful to your mirror image? Could you at least try even if it feels silly because it is important to really check in on how you’re talking to yourself.

Reduce Social Media 

Is it maybe time for a social media cleanup? Look at the pages you follow, groups that you’re in, negative people, negative followers, if you have those, negative friends… Could you just try to take at least a break from them, if not unfollowing completely? Clearing up what has become more of our mental space, which is social media unfortunately, can really help get you out of that anxious loop.

Good Nutrition

Nutrition of course has a lot to do with it easing anxiety. I cannot have a Type 1 Thursday unless I mention nutrition! And make sure that you try to primarily, at least, stick to real foods rather than, you know, processed factory made, yucky food. Make sure that you eat real food. If your body doesn’t have the nutrients that it needs, it’s easier to become anxious because you don’t get the nutrients to your brain. You don’t get the new nutrients to your neurotransmitters and stuff like that. So make sure you eat real food and none of the fake stuff. 

Anxiety Supplements?

When we talk about food, we have to talk about supplements, of course, and there are some supplements that may work for anxiety (or against anxiety?). If you’re unsure you should before trying to seek a medical opinion on these.

It could be that GABA helps you,  it’s a neurotransmitter in the brain and taking an extra dose sometimes helps to calm the whole nervous system down.

Valerian Root – this helps me for example, when I have trouble sleeping, I have tea with Valerian Root in it and oh my god, I sleep like a baby. So that could be worth trying. 

How about Ashwagandha, it’s a root from India, as the name indicates, and that can also help with anxiety and restlessness. 

Make sure that your anxiety doesn’t stem from inflammation, so maybe a little extra boost of Omega 3 wouldn’t hurt right now. Magnesium also helps for sleeping and relaxing.  

CBD oil – I am a big fan and it has saved my life on many occasions in this past year. So I can really recommend that if you want to calm your nervous system down.

Anxiety can also stem from a bad gut bacteria so maybe look into if you need some probiotics, for example, to recultivate your gut with happy little bacterias and not sad ones. Anyway, that’s it for the supplements!

Human Connection

How about when you feel really anxious, call someone. Call your mom, your friend, your sister, your husband, your wife, you know anyone who will listen and that you feel comfortable with.

Call them, have a Skype coffee or as I like to do it with some of my friends, have a Skype after work session where you get to choose whatever beverage you are drinking. That can also be fun.

Reevaluate your why in life? What are you doing? What are you trying to achieve? What do you want to achieve? And why is what you’re doing giving you anxiety and not taking you closer to that.

Doing something purely for fun. Have a dance party! Darryl Edwards just put up his fantastic dance party to 90s tunes… Love it. And I can say that this may or may not be happening in my living room at certain intervals of the day/week/month. But yes, have a dance party, for example, or anything that you think is just pure fun, just to enjoy yourself a little bit. 

Just Breathe

Maybe the most important one, which I should have mentioned first, is breathing. If you breathe up here, in your chest, and can’t seem to catch your breath. It’s probably a little bit of anxiety and stress in there. If you on the other hand breathe from like down here, your belly button area. Imagine how much more oxygen you get in and imagine how much more calmness you can breathe in and breathe out the stress. It is a wonderful, powerful tool and I suggest you use it wisely. 

Meditation, Yoga and EFT

Do you have a meditation practice? It has been shown to reduce anxiety and stress in everyday life. If you haven’t  tried it or you’ve had a longer break or something, I suggest you get back on it because it’s really helpful. With that also comes yoga, of course, a huge personal favourite of mine to relieve anxiety. And if my anxiety is really pressing, then I do like to keep a little EFT practice, a little tapping. I’m sure there are tons of videos online where you can tap along to to relieve your anxiety. There are tons of resources online that you can find about Emotional Freedom Technique. That’s basically acupressure/acupuncture thing that lets your nervous system know that everything is okay. We’ll be fine. We can get through this, too. This too shall pass, you know. It really calms you down. And that’s the whole point of getting out of an anxious moment in your life. 

Journaling

I’m not a huge fan myself, but I know what helps a lot of people is journaling which can also help anxiety and well, if it works for some people, I’m sure it could work for you as well.

Just jot down your thoughts, your anxiety, put it in a beautiful notebook that you keep handy or on your phone or there is a fantastic app called Cocoon Weaver, that you can speak into and it will transcribe your thoughts. So make sure you get those thoughts on paper!

Living with diabetes?

If you are a diabetic and have to manage your blood sugars, how about making sure that you are okay with managing your blood sugars as well as you can at this point of time when anxiety strikes. Anxiety as I said in the beginning is a form of stress, it is caused by stress and stress as we know is blood sugar killer Numero Uno. It will and can cause havoc on your blood sugars. It is not easy to try to control your blood sugar when you are stressed, and definitely not when you’re also anxious.

Just do the best you can and please forgive yourself for it and be okay with that being your goal for that point of time. Also, while there’s so many ideas and tools to relieve anxiety, make sure that you do feel your feelings, sit with them, perhaps in a meditation, perhaps breathing them through because bottling them up won’t help either and it won’t get better, they’ll just burst out in some other way in another in another time in another place where you’re really not prepared. 

So maybe now that we are all staying at home, I hope we have time to actually feel our feelings and really process them properly so that we don’t get caught up later. 

Please, I want to hear from you: what is your best tip for relieving anxiety? Or did you find the tips I shared with you in this video useful? share which one you like the most down below in a comment.

Disclaimer: The only purpose of this video is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This video is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.

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Basal Insulin Testing – Why, How & When?

Do you have frequent low blood sugars? Or high? And they all seem to come out of nowhere?

It could be something wrong with your basal insulin, dose or timing! Learn all about basal insulin testing in today’s Type 1 Thursday!

When was the last time you checked you basal insulin settings?

Type 1 Thursday – Basal Insulin Testing – Hanna Boëthius

Transcription

If you prefer to read all about basal insulin testing, you can do so below. Enjoy!

Basal Insulin Testing

‘I want to ask you this first, do you perhaps experience frequent hypos or frequent highs that seem to come out of nowhere? They are not really connected to when you’re eating and your bolus insulin, and it’s not really connected to anything else either. So maybe it is something else, could it be? (As we all know, with diabetes, chances are it could be…)

Butt first, hypos, or low blood sugars, never, ever happen because you’re not eating enough food! Hypos always, always, always happen because you’re taking too much insulin for that particular circumstance. That actually leads us back to today’s topic, basal insulin settings and how to check that your basal insulin settings, like your long acting insulin, or basal settings on your pump, are correct for you. Not for anyone else, never ever compare insulin dosages with anyone else. It is what it is for you and if it is correct.

Basal insulin is really key, either is dose or the timing. If you are on MDI, timing of the basal insulin could be a problem. So let’s figure out what it is, how we do it and all this stuff when it comes to basal insulin testing. It’s not necessarily fun, but hey, you know, it needs to be done if you want as good of a control as you can have on your Type 1 Diabetes. Having your basal set properly also helps you bolus correctly for your food or it makes it a lot easier to calculate.

What is a basal insulin test?

The point of basal insulin is to keep your blood sugar stable when you’re not eating, when you’re exercising when you’re not doing anything. It works the same in healthy people, the ones that don’t need to add insulin from the outside. Basal insulin is there to keep your blood sugar very stable during the whole day when you’re not eating, not exercising, not doing anything of the few things that actually help lowering your blood sugar, or any of the 42 or 45, or whatever things that can increase your blood sugar.

What is a basal test? Well, it’s basically to determine what your proper basal setting is, whether you are on a pump or taking long acting insulin. Without the influence of food and without bolus insulin, without exercise.

How to basal insulin test?

How do you do it? Well, trick number 1 is to start at a normal blood sugar level. Don’t start if you’re too high, don’t start if you’re too low, start at a normal that is the baseline of basal insulin testing.

You can either do it in two ways. Either you fast the full 24 hours and get it all out of your system and you have done in one go or you divide it up on 4 days and divide the 24 hours into 6 hour increments, where you fast for 6 hours and then check your blood sugar’s hourly to see what happens to them.

This is also where a CGM is very helpful, although I would not trust it to be exact for all of that, I would also prick my finger a couple of times in those 6 hours or those 24 hours, just so you can actually see what is doing what. If you choose to do it in four days, then you do overnight in one go and then you do a morning session, followed by a day session and then an evening session, so that you get those 24 hours all checked.A suggestion is that you basal insulin test one week and then the next week you do the same, to just double check and fine tune and really tweak your basal insulin (because this is really key for good blood sugar management)

Do & Don’t when Basal Insulin Testing

Don’t eat or take insulin (bolus) 4 hours before you start the test.

You can have water and herbal tea during your fasting hours, anything that’s not caffeinated and nothing that will do a number on your blood sugar. Anything that is neutral is fine.

Don’t eat unless you go too low, if you’re having a hypo. Also, don’t correct unless you go too high. (If you go too low during your your basal insulin testing, it means that you’re taking you’re taking too much basal insulin, whether it isn’t a pump or injections. If you go too high, your basal insulin is sett too low.)

Make sure you’re not sick or on your period or have something going on that you know influences your blood sugars.

It is completely okay to break the test if you have to! If you have a hypo, you have to correct it. It’s fine to break the basal insulin test, you just do it another day instead. And the same if you go too high, it’s fine to break the test, you have a bolus and get on with your day. The main point is that you take care of yourself! The basal insulin test can be done another day instead.

Also, one, one very important tip, is to write down the results, so you have them on paper. It makes it a lot more easy to overview instead of having it in some app and you have go back and forth between resources. Good old pen and paper works the best in this case, I would say.

What are the results of basal insulin testing?

If your blood sugar drops too much, you’re taking too much insulin. You’re taking too much basal for your needs. If your blood sugar goes up too high during the basal insulin test, you’re taking too little basal insulin, and you need to increase it.

If you are an MDI and notice something could be better during these 24 hours, perhaps you need to split to your dose? This is something you can discuss with your doctor. And if you’re on a pump, remember that it’s usually the basal setting that is about an hour to 2 hours before that impacts your blood sugar’s right now, so you have to be a little bit flexible in adjusting this, if you need to.

That was my very short run through on how to basal test your insulin properly.

I want to know from you, when was the last time you basal tested your settings or your dose or timing for that matter?

Let me know in a comment below. I’ll be so happy to chat with you there.

Ps. Want to learn more about basal insulin testing? Check out Dr. Richard Bernstein’s video here!

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High or low blood sugars?

How often do I have high/low blood sugars that need treatment? 🤔 A question from the audience!

Learn how I attempt to avoid the high and low blood glucose readings (that are, more or less, a part of life as a Type 1 Diabetic).

Type 1 Thursday with Hanna Boëthius

What about you? How often do you have highs or lows that require treatment? Let me know in a comment!

Transcription

If you prefer to read the information in the video above, please find a written version right here:

High or Low Blood Sugars?

This week, I have another question from the audience. And it’s a personal one-ish. Well, I don’t want to get your hopes up, it’s not that bad. Actually a normal question, but it is more personal natured one. So I’m looking forward to answering it. Because this person writes:

How often do you have a real low or high blood sugar that you need to correct? Is it rare, or is it part of everyday life?

I thought this question was very, very interesting. And I guess I’m not that open, perhaps, with my blood sugar levels online, because I frankly don’t think it’s very interesting to share them. If you want me to, I could share more of my day to day values. (If you do, please leave me a comment so that I know because I cannot read your thoughts out there! 😃)

High and low blood sugars are of course part of living with Type 1 Diabetes and no one can deny that. The frequency of them, however, can greatly and amazingly be influenced by different lifestyle factors, for example. For me, for example, a low carb lifestyle has really helped to eliminate most highs and lows. I no longer get those extreme highs followed by extreme lows, because I simply follow the law of small numbers so I don’t have that much insulin in my body. And also not that much insulin required, that I get those quick drops. Furthermore, I don’t eat that much sugar and carbs so that I get the high highs. You can do a lot with lifestyle factors!

It’s also a question of definition. For me is low is below 3.2-3.5 mmol/l, which is about 65 mg/dl, and my highs are already around 6.5 mmol/l or 117 mg/dl. It’s really a question of definition. Do you mean those super-highs of 400 mg/dl and then down to 20 (22 mmol/l to 1.3)? Or, do you mean this sort of gradual, just on the verge kind of sugar surfing highs and lows? It differs from person to person.

Basal Testing

The number 1 thing that I would advise people in this situation is to check your basal settings. Whether you have your long acting insulin or an insulin pump with a basal setting, make sure that those dosages are correct. That can save you a lot of trouble! This is something that I do on myself, as well, I make sure that my basal settings are correct (or as correct as they can be because life happens and things go up the wall sometimes) If you want me to do a video about how to basal test properly, then also let me know in a comment!

If your basal dose is correctly set, you also need less corrections to get the results you need. If you’re too low or borderline too low, for example, and your basal isn’t too high so your blood sugar won’t keep going down much further. With the right settings for you, you only need very little carbs to get you back up into a healthy safe range. Same with highs, if you are borderline high, you don’t need that much insulin to get yourself into a nice, safe healthy range again, because your basal insulin is correctly set.

My Trick

I correct before there is a high or a low. Of course when I can, things like sleep, illness, travel, stress and things like this too much work (guilty as charged!) can of course make this a little bit trickier and hinder me from keeping that level of control. But whenever I can, I do react before it the low blood sugar or the high one is a fact.

Managing this before they’re a fact, I cannot say enough that a CGM, a continuous glucose monitoring system, really is worth its weight (well, really is worth its value) in gold, because they’re quite expensive. They’re small, but expensive things. Anyway, they are worth absolute gold so that you can react before there’s a high or there’s a low blood sugar.

CGM’s are of course not exact. I don’t know of any CGM system that is absolutely exact. Especially when my goal range is so small, it is very, very annoying that it is more most often 1-3 mmol/l (18-60 mg/dl) off. It’s not really exact, but it is invaluable to see the trends! Where is your blood sugar trending? If your blood sugar is steady and starts to trend downwards, then you can already treat so that you need a lot less and the the hypo doesn’t become a fact. Or, if you see that you’re trending upwards, you can play with either temporary basal if you are in a pump, or wait it out and see what happens ,or correct with insulin. For the trends, and the CGM is fantastic and I could not recommend any more!

Timing

Reacting in time actually also helps the Standard Deviation of your blood sugar, as well as your Time In Range, which is what reacting in time will help. This will also help your HbA1c. That little trifecta is a fantastic measurement of health for diabetes. And that also is helped by reacting in time so that you don’t go high and don’t go low, but you can react before it is a thing.

Doing it this way, reacting before a high becomes a high or low becomes a low, makes them very rare. It actually makes them more rare than then it would be, if I, for example, added a ton of sugar, or the recommended amount of carbs for example. This is true for me, and I’m not going to talk about anyone else. But for me if I added that, I would have many more highs and I would have many more lows, because I would have to fight the carbs as well as my body with the stress, work, illnesses, and all of the other 45 things that always influence our blood sugar.

This is my Dexcom G6 24 hour curve from 20th February, and I’ve marked where I used my method and reacted before a high was a high and a low was a low:

I want to hear from you:

Do you have highs and lows often and that you need to react to? Or are they rather rare for you? Let me know in a comment. I’d be happy to chat with you there.

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Influenza & Type 1 Diabetes?

The influenza & eating very low carb, what happens to blood sugar and ketones? 🤔

That blood sugars can increase when you’re sick is pretty much common knowledge. But by how much, and especially when you normally eat very low carb? What about ketones? Is there a correlation?

All this, and much more, in this week’s episode of Type 1 Thursday!

How do your blood sugars react when you get sick? Let me know!

Type 1 Thursday with Hanna Boëthius

Transcription

If you prefer a written version of this information, please keep reading:

Influenza & Type 1 Diabetes

Last week, I was very much under the weather, and I did not manage to do anything. Last week, I spent the whole week in bed, because I got a nasty case of the influenza. This never happens to me *touch wood*, I never get sick like that. So it was a first in a good while. I also got a question about this, which is today’s topic on Type 1 Thursday:

As a Type 1 diabetic, eating very low carb, what happens to blood sugars and ketones when I got that sick?

Gina

No. It didn’t go perfectly, let’s just be honest about that. I definitely did not have any smooth CGM lines during last week when I was really, really ill. And it’s not an easy feat to try to get, especially as a Type 1 diabetic, but definitely also as a healthy, “normal” person, whatever you want to call it. What did I do, how did I handle it, and what happened to me? Maybe it can help you, if the influenza gets you, too!

I heard today that just in Switzerland, we have about three virus strains going around right now. That’s a lot! I think I just had one of the influenza strains. Last Tuesday, I was so ill that I thought I had pneumonia. I was 99% sure that I had pneumonia. I went to the doctors to get an X ray, especially to check that it wasn’t pneumonia. Well, it wasn’t. But I really felt that badly. I really am not one of these people who just runs to the doctor for whatever, there has to be a legitimate cause for me to even visit a doctor’s office. That’s how bad I was last week. And I’m amazed at my body for turning something that I thought was pneumonia just a week in a bit ago to standing here. You know, I was fine already last weekend, again, and that is astonishing to me that my body managed to get turned around That will and I would like to thank my wonderful gut bacteria. And I would like to think that I did a few things right, which I will get into a little bit later in this life.

Influenza & Blood Sugar?

But first of all, I wanted to go through what happens to your blood sugar when you get ill, because it will go up. Evidently, your blood sugar will go up, especially if you’re a Type 1 diabetic, because you are, of course a little bit more (I don’t like to say it, but), a little bit more sensitive towards infections that way. Blood sugar goes up, for sure. And what can you do against that? Well, you can actually just manage as well as you can. Increase your basal as much as you dare to until you see an effect. With that in mind, I was on + 200% basal on my insulin pump, and it barely budged from 10-11 mmol/l, around the 200’s mg/dl. That was of course scary for me, as I normally have quite good blood sugars. It was good to to know that it was the infection causing it and nothing that I ate, because I also fasted due to that I had such a sore throat and I was coughing so much that I couldn’t eat anything for four days. I only had broth, tea, soups and water for four days. And I think that also helped to turn the influenza around a little bit quicker.

In addition to this, your bolus is not going to be the same as when you’re not sick. Your corrections and mealtime insulin is not going to be as effective, that ratio will also go up, get worse, and you will need more insulin. I used almost 50 units of insulin in one of the days that when I was the sickest, and that I haven’t done since eating high carb, so it was quite bad.

Remember to hydrate because both having influenza and having that high blood sugars will dehydrate your body. So think about hydrating a lot the whole time, sip small sips even if you have the worst throat ache in the world (like I did!) Also consider adding electrolytes, because that can be something that could help you.

Influenza & Ketones?

What happened to my ketones? Normally my ketones are under 2.5 mmol/l on a very low carb way of eating. And this seems to be a normal thing for me. As soon as they go over I get a little nervous. As ketones are never really a goal for me, I don’t really measure them too often, but when I do, they seem to be staying under the 2.5 mark. Because I was fasting, liquid fasting, and because I was sick, my body needed more energy, and because my blood sugar was maybe a little bit high, and my ketones went up to 4.3 mmol/l.

This was actually nothing that worried me at this point, though, because I didn’t feel worse (I already felt like absolute shit…) But the ketones didn’t actually worry me any extra, because I knew I was doing everything that I could for them to do their job. I just chose to monitor them and as long as they didn’t go higher, didn’t have a panic attack about it, and I didn’t worry about it. My theory is that both blood sugar and ketones go higher, because your body needs more energy to get well again, the immune system needs more energy to kick the nasty bugs that you are fighting. I don’t know, maybe the this is not even true, but if you do know why blood sugar goes up when you are ill, and also ketones, please let me know in a comment! I’d be really interested to know from someone who really knows their stuff.

Influenza Treatment?

How do you treat a really bad influenza, especially as Type 1 diabetic (but also as a normal person)? I would say hydration is definitely the number 1 thing! Your body can survive without food and might actually get healthier quicker without food. But hydration – we need to hydrate a lot. So make sure you flush out those nasty bugs and the high blood sugar. Make sure you hydrate when you get sick!

Also painkillers, I cannot tell you… I don’t normally take painkillers at all. But last week, they were a Godsend. And I had water soluble ones so I didn’t have to swallow any tablets. Absolutely amazing, saved my life.

Throat lozenges with that numbing effect also really helped me to get through the influenza. Along with echinaea, I have a specific one in a alcohol solution that really helps your immune system to get into a higher gear. To sip, I had my beautiful, beloved “throat coat” tea, which I love when I am sick, because it really feels like your throat gets a coat! Also CBD oil, because it is anti inflammatory, and can help with all the mucous-y stuff going on in your face.

So that’s what happened to me last week, I got sick, blood sugar up, ketones up, but I was not worried because I knew my body was just doing its job in trying to make me healthier.

How do you react with your blood sugars when you get sick? And please let me know in a comment somewhere on the inter-webs and I’ll be happy to chat with you there.