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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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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.

Ps! Join me live next time, Thursday’s at 6pm CET on my Facebook or Instagram for another episode of Type 1 Thursday!

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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.

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Why No Protein Shakes?

Why no protein shakes? 🤔

Type 1 Thursday is here with another question from the audience:

“Hello, I notice that you don’t drink any protein drinks or shakes? Do you think they are unhealthy?”

Hanane

As a short answer, no, I don’t think they’re unhealthy. But I do think there needs to be a need for them, as protein needs are individual. Check out the whole explanation here!

Type 1 Thursday – Hanna Boëthius

I want to hear from you, do you drink protein shakes? Or do you get your protein from other sources? Let me know in the comments! 🙌

Transcription

If you prefer to read my views on whether protein shakes are good or not, you can find a written version here:

I am so excited, because there is another question from the audience today that I will be answering. If you have any questions that you think that I should be answering on these live chats (that we have every Thursday 6pm on Instagram, and Facebook), please do let me know in a comment somewhere on the interwebs and I’ll be happy to answer them.

To today’s question, it reads like this: “Hello. I noticed that you don’t drink any protein drinks or shakes is that because you think that they are unhealthy?”

Protein is a very individual

Protein threshold is very individual, especially on low carb, but also generally. Maybe on low carb you give a little bit more of a damn about the protein amount, especially if you have read #*#. Richard Bernstein’s book and checked out his Diabetes University. Protein needs are very individual and it can range from anything, for very sedentary people something like 0.8 grams of protein/kilogram body weight, which doesn’t mean 0.8 grams of meat but 0.8 grams of protein, to something more normal, if you are a little bit more active, maybe something like 1.2 grams per kilogram, or maybe 1.3, 1.5. But it can also go as high as something like 2.4 grams per kilogram, up to five grams per kilogram, if you are a super active athlete.

If your main fuel is protein and amino acids, then it is very individual how much you should be eating. This is why I personally don’t need to drink any protein shakes. I am not a very active athlete, well, I try to keep active but not that active. I’m also not a growing child. So I don’t need as much, and I can cover my protein needs with real food. You have to determine for yourself how much protein you need in your individual case.

Protein in Meat

All meat generally contains about 20 grams of protein per 100 grams of meat. Not all meat is protein, and not all protein is meat. Only one-fifth of the meat is actual protein and amino acids. If I eat 400 grams of meat a day, which is possible, not in one sitting, but if I have two sittings, lunch and dinner, which is normal for me. I don’t really have breakfast so I don’t have to pay attention there. If I have two sittings, and I have 200 grams of meat or protein filled food per sitting, that gives me 80 grams of protein for a day. And that would mean that that is 1.3 grams per kilo of body weight that I have (now you can count how much I actually weigh) Personally, I just prefer to get my protein from real foods because I can. And because I don’t have that extra need for protein shakes that you may have, as I said, if you’re a growing child or a very active athlete.

Need for protein shakes?

The short answer to your question is; I don’t think that protein shakes or drinks are unhealthy, per se. I just think that there needs to be a need for it. And in my case, I don’t have that need. Perhaps, in your case, because you are asking, there is a need for it and then you have to determine if that’s true or not for you.

If you do need a protein drink or a shake, I would recommend something that is clean without any sugars and any added stuff. Flavours is one thing, but you can also flavour it with other things like natural cacao powder or something. You don’t have to buy the ready mixed flavoured stuff, but something that is clean without sweeteners and without dextrose, please, because that will mess with your blood sugar, all the ways till Sunday. If I had the need for protein shakes, I would go for something like an egg white protein or a whey protein.

So, in conclusion, no, protein shakes and drinks are not inherently unhealthy. But there needs to be a use for them and a need for them. Thank you so much for your question!

I would love to hear from you – what are your experiences with protein and with protein shakes? Do you drink them? Or do you get the protein that you need from real food? Let me know in a comment below, and I’ll be happy to chat with you there.

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Low Blood Sugar and Weight Loss?

How does Low Blood Sugar Affect Weight Loss? 🤔Does it have to? What factors do you have to look out for?

Type 1 Thursday is here!

Do you have experiences with how blood sugars impact weight loss? Share them in a comment!

Type 1 Thursday with Hanna Boëthius

Thank you so much for watching. Please let me know if you have any questions!

Transcription

If you prefer to read my thoughts on this, here’s a text version on low blood sugar and weight loss:

Blood Sugar and Weight Loss?

This week I’m excited about the new audience question! (If you have any questions that you want to hear my answer to, then please let me know!)

This week’s question comes from Joe, and Joe writes, “how do low blood sugars affect weight loss?” Thank you for the question!

Are you insulin dependent?

A lot of it depends on if you are taking external insulin or not. Because weight loss happens when a) the blood sugar is stable and b) there’s no excess insulin in the body. There are different theories of weight loss, two main ones as I see it, which I’ve talked about before here on Type 1 Thursday. One is the good old calories in vs calories out which we know is maybe not as applicable as they thought that it was. The other one is that it is actually hormone regulated, mainly with insulin as it is the master hormone in the body. If you don’t have excess insulin, and your blood sugar’s are stable, weight loss will occur.

In diabulimia, which is a very, very serious condition to have, which is when you take no insulin to lose weight. But that is not the point of this. This is about healthy, happy weight loss, if that is necessary. This is not an eating disorder thing that I’m talking about. Just to clarify that, and I find that very important because it is a terrible, terrible condition to live with. So, none of that, just healthy healing, healthy weight loss if necessary.

What is a low blood sugar due to?

A low blood sugar is because you took too much insulin for that particular circumstance. For that particular food, for that particular mood, for that particular weather, whatever it is that is influencing your blood sugar, you took too much insulin for that. That’s why you ended up with a low blood sugar, because nothing else lowers blood sugar like insulin does, and nothing else can lower blood sugar lower than it should be in a normal human being than insulin. So, if you are treating diabetes with insulin, does that mean lows are equal to excess insulin? Which then means that it will be a slower weight loss?

Well, actually, not necessarily. It depends on how stable your blood sugars are. If they are jumping like a roller coaster, so that it’s super high and then goes super low (which means that you then have to treat it and then go super high and super low. Again.) That’s a completely different thing than if your blood sugar is really stable. And then sometimes it trends downwards and dips minimally and you can correct it very easily. I’s a completely different thing than if you are all over the place in terms of blood sugar, and are struggling with it. Balanced blood sugar is the key, not a jumpy blood sugar. That’s what we should aim for. And that usually also aids weight goals.

Low Blood Sugar anyway?

You know, we all end up there no matter how good (or whatever) we are as people with diabetes, no matter how well we take care of ourselves, circumstances do change in the body. And lows do happen. They happen to me, they happen to everyone I know who are normally quite well controlled.

The key here is how do you treat it? Do you choose to eat the whole kitchen? So you grab anything from grapes, to peanut butter, to that sugary candy you have in the back somewhere, to snacks, to yoghurt, to honey, to you know the whole nine yards which will end up on this rollercoaster blood sugar ride, which is quite detrimental for your health. And it feels, first and foremost, really, really frickin terrible. So try to avoid it for that reason alone! Or, number two, do you treat low blood sugars targeted with an exact measurement of glucose? Because that doesn’t create the rollercoaster rides. It creates an even curve, even if you do dip a little bit you take a gram, or two grams or three or four, depending on how much you need (and that you need to do a trial and error with). You just come up a little bit again, and then you’re fine. Again, you don’t get those big swings. So that is really important how you treat the low when it does happen.

Correcting a low is of course, necessary, it can and definitely does save your life. So don’t skip it, even if it would potentially kick you out of ketosis, if that is your goal. I’m not saying that ketosis and keto and low carb is everyone’s goal, but if that is what you’re worried about in this question that treating a hypo will kick you out of ketosis or something, don’t be! You really need to save your own life in that case. It doesn’t matter if you get kicked out of ketosis or not. If you are fat-fueled in that way, or you can burn both fat and sugar, you will get back into ketosis very fast afterwards, so don’t worry about it. It really is key that you do take care of this.

The short version of my answer to your question, Joe, is that low blood sugars do not have to affect weight loss at all. It depends on how you treat the low and depends on how stable you are blood glucose is normally and that you don’t have excess insulin in your body.

Hope that helps!

If you have any questions, do let me know. And also do let me know your experiences of blood sugar and weight loss? Have you managed to lose weight, or maybe you don’t manage to lose weight although your blood sugar’s as good as perfect? Let me know in a comment, and I’ll be happy to chat with you there.

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Type 1 Thursday – Bolus Gone Wrong?

Type 1 Thursday is BACK – and it’s all about the bolus!

Today, I’ll be answering a question from the audience about mealtime bolus gone wrong… How do you handle first high blood sugars, then low? Or high and steady after meals? Or low 3-4 hours after a meal? So confusing!

Do you have any experiences with mealtime bolus? How did you solve it? Let me know in the comments!

Type 1 Thursday with Hanna Boëthius

Also, do you have any questions for me to answer? I’d love to answer your question in a future Type 1 Thursday.

The bolus infographic from Diaverge.com that I mention in the video is this one:

Transcription

If you prefer a written version of the video above, here you go:

Type 1 Thursday – Bolus Gone Wrong?

I have a really interesting question today actually, because this is something that I’ve struggled with myself quite a lot. I got a question from the audience this time to answer.

“So, how do I time insulin for different meals? I’m struggling despite eating low carb, and I still spike sometimes dosing at the start of the meal and then go low one hour after. And if I dose at the end of the meal, I go high and then low three hours later? This is so confusing!”

Rachel

I do agree with Rachel, it is very, very confusing. It is difficult to figure this out. But I do have some rules of thumb that may help Rachel (may actually be a good reminder for myself, too) and maybe it will help one or two of you guys as well.

Dosing vs Timing?

As I see it, this can be both a dosing issue, but it can also be a timing issue.

This really comes down to first of all, what kind of mealtime insulin are you using? Are you using regular insulin as many people do on low carb? Are using some of the faster ones like Humalog or Novolog or Novorapid? Or are using the even faster ones like Alfrezza or Fiasp? It’s very difficult, as these insulins have different working time until they actually hit your system. Until you figure that out, it can be clue number one!

Clue number two is that it definitely can be a timing issue, but also a dosing issue. So let me go through this very, very carefully, point by point so that we don’t lose any details because that could be devastating!
– if you first spike blood sugar after your meal, and then you go low, that means that you took too much insulin. It was also too late, hence the spike first and then the drop. So, play around with that, maybe you need to dose a little bit less, or maybe you need to do the same dose but earlier.? So that can be one of the clues if that is your problem, which it was in the question.
– if you go low within the first hour, the amount of insulin you took was just too early because it hit your system before the food hit the system. So be careful and dose a little bit later.
– if your blood sugar goes high and remains high after food, your bolus or the amount of insulin that you took was just simply too small. You need more bolus for that particular food or that particular situation or that particular anything-that-you-know influences blood sugar (which we all know is about a gazillion things).
– Number four, which was also part of Rachel’s question, you go low two to three hours after food, that means that the bolus was too late. And definitely too much because your blood sugar dropped afterwards.

Those are the four different scenarios that I can figure out that may help. I shared this in a wonderful infographic from the beautiful ladies at diverge.com recently on my Facebook page, and it’s also above here in this post.

If you’re not recognising the patterns that you’re that you have. If you notice, for example, when you have certain foods, does the one or the other happen? If you have different timings of insulin, of course, this or the other happen? Or perhaps something completely new? Or, for example, if it’s the time of day – some people are more insulin resistant in the mornings than they are in the afternoons! So it can also be a timing issue, not just because of the insulin and when you took insulin and how much, but it can also be, depending on how or what time of day it is, because it just doesn’t always add up. It’s not always the same for people and especially not Type 1’s that are handling a lot of things at once.

I’m very, very happy to hear your experiences with mealtime bolus? Do you have any problems? How did you solve them? Have you maybe not solved them yet? Let me know in a comment below and I’ll be so happy to chat with you there.

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Type 1 Thursday – Mindset & Diabetes Management?

How important is mindset in diabetes management? What difference can it make? 🤔

It took me so long before I realized just how big of a deal mindset work is when it comes to diabetes management. How do you react when you see an undesirable number on the display? What are you thinking when you’re faced with a meal you know you won’t feel good eating? And what can you do to help your diabetes management be a success in the long run?

It’s time for Type 1 Thursday!

And – if you want the whole presentation on this topic from me, why don’t you join me at The Low Carb Universe in Mallorca, 12-17 November 2019? Check it out!

And 2 – I do a live every week on Facebook and Instagram to discuss a topic about Type 1 Diabetes that maybe you haven’t discussed with your doctor or healthcare crew. Join me at 6pm CET on Thursday’s!

Have you noticed a shift in your mindset? Or do you need one? Talk to me! 😊

Text Version

If you prefer to read rather than watch a video about mindset, here is a text version of the points I made above:

Mindset

How can mindset can help your diabetes management? How he can help it and what difference can it make, or how can it hinder you?

As I define it, these are my own figures, not at all scientific! This is my experience and from the people that I’ve talked to about this, but I see that having success maintaining a healthy lifestyle, 30% is food and medicine, I see another 30% in other lifestyle factors, movement, hydration, sleep. To actually make your health care successful, I do see that there is a 40% need for mindset, as well. Don’t discount the mindset part because it is very important! And maybe even more important than you know! How exciting is that?

There is a fear of geting caught in a trap of constant perfection. No type 1 diabetic is always perfect. No health cares are ever completely perfect. We all make mistakes. And that’s okay. And that’s a huge part to realise when it comes to mindset! You have to be kind to yourself – that is just the starting point. And do remember that all feelings that you have, whether it’s about diabetes or something else you’re trying to get a better grip of, all feelings are completely and entirely OK! It’s okay to feel them. It’s okay to have them. They are all OK.

“Fixed” vs “Growth”

There is this theory of that we flip flop between what is called a fixed mindset and a growth mindset. (I have a full length presentation on this, join me in Mallorca to find out more!) What I’ve seen from my research, we basically flip flop between these two mindsets depending on the situation, depending on what we’re faced with, actually depending on a lot of factors. As a sort of rule of thumb, a fixed mindset is that you avoid challenges, and that you give up very easily. Making effort is actually a bad thing for you, in the specific situation. You’re “just not talented”. A “why me” mentality usually goes into the fixed one. Running away from critique is also common. Other peoples success is threatening, too. I’m sure we can all recognise some parts of this in ourselves in what we were doing and how we’re reacting to things!

On the other side of the fixed mindset is the growth mindset. A growth mindset is where you seek challenges, you keep trying, even though you maybe fail sometimes and you see making an effort as the key to actually making something a success. You ask yourself, “what can I learn from this situation” rather than, you know, “why me” and “I’m not talented”. Your motto is basically “I can do it”, and other people’s success is inspiring to you.

These are the two mindsets that we flip flop between, depending on how we how we react to things. Also, I think that we are many who can recognise ourselves in the growth mindset. So it’s not all bad! We’re not only, you know, “everything is shit” and “why me” and “I don’t want challenges”. I think we all have parts of both! I find it very interesting when we start paying attention to this. And I’m sure this is something that you can do, for example, in your diabetes management. How do you react to, for example, that blood sugar reading? Is it “why me” or is it “okay, what can I learn from this?”, for example.

Mindset is not…

Mindset is not a magic bullet of motivation. It is definitely not a shortcut to success, if anyone got that, and mindset is nothing that we’re born with, it’s something that we learn. Mindset is not the same as positive thinking, either. It’s also not fixed in these two categories I talked about above. You’re never stuck in one, as I said, we flip flop between both of them.

Diet Mentality

Added to this, more specifically to food, is actually the diet mentality, or diet mindset. I wanted to highlight it, because I think it’s so terrible for lots of people with diabetes, and for anyone really who tries to look out for their health.

A diet mentality is where you see food as the enemy and you’re focusing on your bad habits – that you would have bad habits to break somehow. You’re looking for temporary fixes. And you’re focusing on what you don’t like about yourself, how silly is that? That’s not the way forward, the way forward is to focus on things that you do like about yourself and increase those and then the other ones will follow. Diet mindset is where you’re really focused on the scale. I don’t feel like that is a good measurement of anything really, the scale. I threw out my own scale very many years ago, and I only weigh myself at the doctor’s office, because they require it. Otherwise, I don’t really care what it says. It’s some sort of arbitrary number on a piece of electronic machinery (or even if it isn’t electronic) – it doesn’t really matter that much. Try to step away from the scale! Also in a diet mentality, you think that you have a finish line, that you will have arrived at some point, whatever that means. And I’m only highlighting this because I think it can offset the rest of your mindset work, which can be quite crucial in type one or diabetes management in as a whole.

Setbacks?

How do you view setbacks? Are setbacks something informative to you? Do you draw information out of it? Basically, going back to the growth mindset of “what can I learn”? Or are setbacks a label on you as a person? It’s also silly, but we all get to that point at some points of our lives, and that’s fine. It’s not a bad thing. It’s just something to be aware of!

Success = Mindset + Learning

Success whether within health, whether it’s in sports, whether it’s in life in general, it is mindset, plus learning and the willingness to learn new things. No one can do everything from the beginning. So we do need to learn, in addition to our hopefully, majorly growth mindset work.

How do you change your mindset? This can be a tricky one, but a few short tips is to start small. If you know the analogy of chopping up the elephant into small bite sized pieces, basically eating the frog first? That’s how you get forward so you look at the whole picture first and try to accomplish all of it at once. You have to start with the very smallest goal that you can imagine. Also, you have to think forwards. “How will I feel in a week of doing this?” (or in a day, and a month, in a year, in 10 years?) How will it feel making this change for me? Provided that it is for you, but I would hope so because otherwise it’s not going to be motivating for very long. You have to find what motivates you? No one else can tell you what motivates you, you have to find that within yourself. And that’s a very big part of mindset work!

And also, don’t make excuses. It’s all about prioritising. You can say that, “oh, I don’t have time to check my blood sugar”, but today, especially with CGM’s and these very fast blood sugar meters, it’s really quick. It’s just that you don’t want to do it. It’s that simple. So please don’t make excuses for yourself.

And now I would actually love to hear from you, have you noticed a change in a change in your mindset? Or perhaps you need a change of mindset? Talk to me in the comments below and I’d be happy to chat with you more there.

Diabetes Expert?!

“WHO THE FUCK ARE YOU TO CALL YOURSELF A DIABETES EXPERT?!”

I could sense the frustration behind his words, the anger in his question. (IG DMs are almost always a joy. 🙃)

“Oh, honey”, I thought, “it’s not the first (and presumably not the last) time someone gets triggered by my username & brand.”🤷🏻‍♀️

The thing is, I’m not THE expert on diabetes, by any means! 🛑 I am, however, the expert on MY diabetes, just like you are the expert on your diabetes (or at least should aim to be). 🌟 Figuring out the individual aspects of diabetes management is what makes you better at it, get more knowledge, know where to find resources for issues you can’t solve yourself – an expert! And it also makes you more able to help others figure out theirs. 💪🏼

I’m not a medical professional and I’ve never claimed to be one. What I am is a Type 1 Diabetic, who’s had 34 years of experience with this, and have made every mistake, every pitfall, every terrible decision a diabetic can make. I’m also a nutrition coach, specializing in T1D and lifestyle. 💉

What I’ve also done is to drag myself up after each and every single one of those downfalls. That’s the thing, right? Fall down 100 times, but what really matters is that you get up 101 times. 🔝

So, who the fuck am I to call myself a diabetes expert? I’ve figured out a formula of lifestyle measures that you can us to help your diabetes management. Things that your healthcare team haven’t even thought of yet, but can have an incredible impact! Because diabetes management is SO much more than just “eat whatever you want and cover it with insulin – oh, and do some exercise”. And I have tons of resources to turn to when I find something I don’t know.📚

All I want to do is to inspire you to take your health into your own hands, because I know you can. You can become the expert on your diabetes and your health, because it’s important, if not life dependent in some cases. If I could do it, so can you. 🙌🏼😃✨

Ps. This post was originally posted on my Instagram page, @hannadiaebtesexpert. Follow me there for more updates!

Also, you can read my thoughts of when I started using the word Expert in my branding here!

Barndiabetesfonden

The Swedish Child Diabetes Foundation, Barndiabetesfonden, celebrates its 30th anniversary! 💙

There is still so much work to be done when it comes to #T1D, from awareness and advocacy to realizing the importance of individuality in management. And, most important of all – finding a cure.🌟

#BlåKnuten , the Blue knot, is a symbol for this awareness. 900 people, just in Sweden 🇸🇪, are diagnosed yearly with Type 1. And a cure is yet, sadly, very far off from becoming reality.

We need more research. We need a cure. Until then, we’re not waiting. 💪🏼💙🎀 ✨

Ps. Post originally posted on my Instagram account, @hannadiabetesexpert. Follow me there!

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Type 1 Thursday – Nutritional Supplements

Are nutritional supplements needed for people with diabetes? And, which ones could potentially help?

Some say they can help diabetes management, others say supplements are the hugest waste of time and money. So what should you believe?

Here’s my take on nutritional supplements, and which ones may make sense for you to explore.

Type 1 Thursday – Nutritional Supplements – Hanna Boëthius

What supplements do you take, if any? Why?

Transcription

If you’d prefer to read this information, please find a written version below:

The topic for today is supplements and nutritional supplements. Are they are needed for people with diabetes? Do they actually help at all? Is there a point of taking them? Or why should you take them at all? It’s quite a weird topic here because this one I can actually somehow give a little bit of advice on in comparison to last week’s episode where I couldn’t really say anything.

What are nutritional supplements? They can be anything from enzymes, for digestive issues, to amino acids that you may need for something specific that is not working properly in your body, vitamins, minerals. herbs, if you find that they help for something. It doesn’t have to be diabetes that you’re taking supplements for, it can also be something else. And why would you take them as a Type 1 or Type 2, as a diabetic? Well, some have been proven to increase your insulin sensitivity, for example, which we can all appreciate very much. It can also lower inflammation, some of them that have been studied on that in that department. That can also be good. because fluctuating blood sugars do cause a lot of damage, not only complications of diabetes. If you think of inflammation as rust in a chain, they can basically make your body feel like a rusty chain. And who wants that? Nutritional supplements are there to add the nutrition that you may be normally wouldn’t get or not enough.

I, myself, do take supplements. I have optimised my supplement game quite a few years ago when I really studied this and really got into what is good for people wanting a potentially healthier blood sugar management, improving your insulin sensitivity. I found that if I take the supplements in “batches”, so I buy a package of them and I eat them until they’re finish, then I have a break, then I eat them again, I noticed the most actually benefit for myself. That’s only myself and cannot be said for any other person.

What do I consider the most important supplements for blood sugar management, at least in my own case? I’ll also mention a few more that I’m currently not taking myself.

Chromium Supplement

Number one of what I take myself is chromium. It helps the body to use glucose in a more efficient way. And it has also been shown to increase insulin sensitivity in that way. Chromium is one of these classic ones that I think when I was growing up, it was said to “help people with cravings”. My guess is that just means that it gets the nutrition in the form of glucose actually to be used better by the body- That’s why it would curb cravings, because cravings are sometimes (not all the time but sometimes) a lack of nutrition that is masking behind that.

Magnesium Supplement

Number two is another mineral that is magnesium. I swear by magnesium, I love it! I sleep better, for example. It helps the body relax, it builds up bones, it helps build and relax your muscles, and it also helps your insulin sensitivity to increase. That’s why I really, really like it. If you want a band aid of nutritional supplements, I would say magnesium is a big one of them, because it helps in so many ways! It can really be beneficial for a lot of things. Doesn’t have to be, but it is in many cases.

Vitamin D3 Supplement

Especially this time of year when is grey and crappy outside, vitamin D3 comes to the rescue. The “sun hormone” is what they call it in some publications. When the skin is hit by sunlight, cholesterol helps to build vitamin D3 to help the body with actually almost anything. That’s why they lean towards calling it a hormone, because of all the benefits it has. Vitamin D3 is unbeatable and if you have too low vitamin D, it can cause problems. Low vitamin D3 is linked to auto- immunity, that has been shown in a couple of studies. That’s my main reason why I take it, but also because I noticed it on my energy levels when my vitamin D3 is not in range. I really have to look out.

Zinc Supplement

Zinc is very helpful for the immune system, which you know, if the immune system works properly, maybe I don’t have to be sick that much? That’s also what vitamin D3 does, it can also help your immune system to function properly. I take supplements that help my immune system along so that I don’t have to be sick. Being sick complicates diabetes management a lot, whether you have good control normally or not – it doesn’t really matter. Zinc does a whole lot of other things, as well, for example, it activates the insulin signalling pathways in the body so that the body can realise that there is insulin, and in that way may increases your insulin sensitivity. It can also help in the processing of insulin and very many other things when it comes to insulin in a normal, healthy body, but also for us diabetics.

Omega 3 Supplement

Omega 3 fatty acids is another supplement I take. I don’t generally eat that much fish when I am in Switzerland because I’m not close to an ocean. I’m in the middle of Europe, put a pin in the middle Europe, and you get somewhere in Switzerland. I just don’t feel that fish is that fresh that often and that’s why I normally don’t eat that much fish when I’m here. When I’m by the ocean, say on a Mediterranean island, for example, I do eat a lot more fish. There it is actually freshly caught the morning, and for me, that feels a lot better. That’s why i supplement with omega 3 fatty acids when I don’t eat that much fish. Omega 3 can act as an anti-inflammatory in the body. It has not been proven to help diabetes management, per se, but if you get the inflammation reduced, it definitely can help your blood sugar management. What it has been shown to do, though, is to lower triglycerides and raises your so called “good cholesterol”, the HDL, so it does do good things in the body.

CBD Oil Supplement

CBD oil calms you down, it is anti-stressing, anti-anxiety, and leads to better sleep. Sleep is a crucial part in diabetes management! If you don’t sleep well, you won’t have good numbers. Magnesium can also do that, of ocurse. But sometimes you need a booster in this sleep department.

Those are the ones that I take; chromium, magnesium, vitamin D3, zinc, omega 3, basically every day and CBD on and off when I have to. What else could be good for people diabetes?

Berberine Supplement

I don’t like comparing a supplement to medicine, because they can’t be the same. But berberine can have a similar effect on blood sugars, as for example Metformin. It basically can make you more insulin sensitive.

Alph-Lipoic Acid Supplement

Alpha-lipoic Acid is an antioxidant, and it can increase insulin sensitivity, as well. It had also it has also been shown to help a couple of complications of diabetes, like for example, neuropathy or macular degeneration.

Probiotic Supplement

Also, you may find it a good idea to take care of those fancy little gut bacteria with some good quality probiotics, because we all know about the brain-gut axis and we know that we feel better when our gut flora is intact. Your gut flora can also be harmed by blood sugar’s fluctuating a little here and there.

Thyroid Supplements?

Also, thyroid specific things, because another thing that people with autoimmune issues get… are more autoimmune problems! If you do have problems with your thyroid being a bit lazy, maybe a Selenium supplement could help? Or iodine? Do read up on that so that you know what you’re doing!

As always, do check with a healthcare professional or your doctor before you start anything new, and adding anything to your diabetes management.

So what supplements do you take? Do you feel they’re helping? And do you understand why you’re taking them? Let me know and let’s chat more in the comments below.