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Type 1 Thursday – Hanna’s Story

Join me for this week’s Type 1 Thursday!

Today, we’re talking about diabetes stories, and I will of course also share my own, full of struggles, trials and tribulations and how I’ve finally realized what is best for my own diabetes management.

If you are interested in diabetes management and hearing the stories of it, do join me at diabetes. by The Low Carb Universe in Sweden in June!

What is your story with diabetes? Leave a comment!

Travel Checklist for Diabetes

Maybe you’re planning a trip soon and would love a travel checklist for diabetes?

(I made you a travel checklist for diabetes below, make sure to check it out!)

What is necessary to bring along on a long trip with diabetes?

Sometimes I feel like diabetes just has it’s own luggage to bring along, physically as well as emotionally.

The emotional luggage we’ll have to discuss another time, because this time I want to talk about the physical luggage Diabetes brings along. Especially when traveling.

As if packing for a trip isn’t stressful enough (“what shoes should I bring?”, “does this dress go with that jacket?”, “what make up should I bring?” and “WILL IT ALL FIT IN MY BAG?!” – you get the point…), as an added bonus, you also have to haul around on all the stuff that you need for diabetes to keep in line.

I always bring all my supplies in my carry on bag when I fly. That way it’s harder to lose it, and the insulin stays at the right temperature throughout my trip.

The size of said carry-on bag has changed, though, in favour of trying to save my shoulder from falling off from carrying all the heavy stuff. Now I bring along a small, cabin sized wheelie bag where I have all my supplies, from insulin, to pumps, to test strips, to hypo treatment.

I also deposit a few things in my traveling buddy’s, usually my husband’s, bag. At least that way, if I lose my carry on, I’m not completely stranded in terms of diabetes. He has an extra blood sugar meter and test strips, and insulin with emergency-syringes. And glucose tabs. One can never have enough of those.

While I make sure to bring along most things on my travel checklist for diabetes, I don’t always bring everything.

Like ketone sticks, for example. I don’t usually bring those, unless I’m traveling somewhere really remote with no pharmacy within the next hour or so of driving. I figure that I can buy them pretty much anywhere I go.

On the other hand, insulin and BG test strips can get really darn expensive, not to mention inaccessible without a prescription, unless you prepare properly and take enough with you for your whole trip. “Enough” here means way too much, by the way. You never know what might happen, so it’s better to be prepared for most things that may happen.

Food

And, pretty please, get organized and bring your own snacks. Food on the road is generally beyond terrible, and like that you know you can at least eat something. I bring things like nuts and dried meat and other cutleryless foods on the plane, whilst in a car or on the train you can get a little more creative. This time around I’m going to make low carb pancakes and wrap them up in foil to bring along on my long flight, as I know from experience that food on flights is never good.

Another note regarding food, please don’t get fooled by the “need” to snack, which is most commonly masking the fact that you’re bored out of your brain.

Water

Traveling by plane is like sitting in the middle of the desert, although maybe not quite as warm. It’s dehydrating like nobody’s business! Being hydrated can really be one of the keys to better diabetes management, so please do us both a favor and DRINK A LOT OF WATER! (and skip the booze up in the air, but that one is evident, right?)

Security

Getting through airport security can be a lot easier than it’s made up to be. This is of course assuming that you don’t meet an a-hole security agent.

In my 30 years of living with diabetes, having traveled to many different parts of the world (although I have MUCH left to see and visit!), I’ve been stopped exactly twice at security. Once for my test stripes (what, you didn’t mind the syringe full of potentially very deadly stuff in my bag? Ok, then.) And once because my pump set the alarm off. In both cases it was easy to explain, and I didn’t even have to show my medical certificate. Security agents see so many diabetes supplies on a daily basis; they’re barely phased by them anymore. At least within Europe.

Now, I’ve heard that US TSA agents can be a little trickier to handle. For example, they have no problem jeopardizing your super expensive medical equipment and tell you to go through the full body scanner wearing your insulin pump, for example. I would insist on the pat down, not risking any breakages or malfunctions. This of course means that it might take a little longer for you to get through, but it’s worth it, and as long as you know about it, you can plan for it.

The bottom line is, as long as you’re nice and cooperative (enough) to them, they’ll usually treat you with the same respect.

Anyway, let’s check out the goodie in this blog post, my Travel Checklist for Diabetes.

These are the absolute essentials that you need to bring with you (or at least ocnsider bringing with you). If you think “I’ve never needed that before”, you should probably take it along anyway, as traveling can make your body do some funky stuff.

Travel checklist

  • Enough insulin to cover the days you’re gone (this should be a no brainer!) Make sure you bring both basal and bolus insulin, even if you’re using an insulin pump. You just never know…
  • Blood glucose meter & enough test strips, extra batteries (it might even be good to bring an extra BG meter.)
  • CGM sensors
  • Keto sticks (As I said, I don’t always bring them)
  • Glucose tabs (or whatever you use to treat a hypo)  (Bring too much of this, you never know what your body think of your new location.)
  • Snacks. (See above)
  • Glucagon Kit (most airlines don’t have these on board their planes. Better be safe than sorry!)
  • Alcohol wipes (these are great, not just for setting infusion sets and cleaning fingers, but also for wiping surfaces like tables, handles or cutlery that seems unclean.)
  • Other prescription medication and supplements you may be taking (easy one to forget, trust me. I’ve done it before.)
  • If you’re going somewhere really warm (lucky you!), bring something like the FRIO bag to keep your insulin in. (http://www.frioinsulincoolingcase.com)
  • Medical Certificate (This can save you at security checks!)
  • Diabetes ID (If you’re found unconscious somewhere, I’m sure you’d prefer that the EMTs knows what you’ve got.)
  • If you’re going somewhere remote, bring a glucagon set. (Again, you never know.)
  • Your BG diary, if you use one. (Otherwise there’s some great apps for that, for example www.glucosebuddy.com or www.mysugr.com)
  • Address and telephone number of your doctor’s office.

If you are on injections, also bring:

  • Insulin pens, plus back ups
  • Pen needles

If you’re on a pump, also bring:

  • Your pump, as well as possibly getting a back-up pump. (This can be ordered from your pump manufacturer.)
  • Batteries/Power adapter
  • Cartridges (if your pump uses those)
  • Infusion sets, or just enough of patch pumps
  • Syringes/pen for emergencies
  • Basal insulin for emergencies

If you’re planning a pumpcation (vacation without your pump):

  • Your action plan, that you’ve talked to your med-team about
  • Pens and needles
  • Basal and bolus insulin

It’s better to take too much than too little!

I’ve made a pretty print out of this list that you can print out and tick off the boxes as you put the items into your bag.

travel checklist diabetes

travel checklist diabetes

 

Click here to download the list: travel checklist diabetes

What are your best traveling tips? What can’t you travel without? Let me know in the comments!

Travelling with Diabetes

Travelling with diabetes requires quite some extra effort.

And planning. And “in case of” and “in case shit happens” preparation.

Especially if you’re planning to travel far, across the oceans and time zones.

Travelling with diabetes isn’t impossible by any means. I’d say it’s actually the opposite. You just have to know and prepare properly for it.

As I’m leaving on a longer-than-usual trip soon, and as it is my first trip that far with the pump (I really don’t travel enough, clearly!), I went to see my lovely diabetes nurse for some tips and tricks and general good advice.

(Where am I going, you’re wondering?! You’ll find out soon, if you follow me here!)

It turns out A LOT has happened in terms of handling diabetes on the long-go, at least if you’re wearing a pump.

Last time I crossed continents, I was still on Lantus and had very little idea of how to handle it all, with the time zones, different rhythms and change in exercise level. Let’s just say I didn’t handle it optimally well. Partially because I didn’t know how to, partially because I frankly didn’t  care about it then as much as I do today.

As a result, my blood sugar levels were all over the place, I was exhausted, not only because of the time zone change, but also because of the rapid blood sugar changes. Add on to that arriving in a bustling city where I had never been before (NYC that time)  and wanting to explore it ALL in the few days we had there…

Let’s just say that that equation didn’t really add up to work in my favor.

Which is why, this time around, I’m taking much more thorough precautions before setting off.

Hence, I scheduled an appointment with my diabetes nurse.

First of all, I wish everyone had the opportunity to work with a diabetes nurse as awesome as mine is. She has a safely secured spot in my Dream Health Care Team, that’s for sure.

Secondly, she had a really nifty trick up her sleeve for me to use while in transit.

She suggested that I’d set up another basal program on my insulin pump, with a constant basal rate for the first (few) days. Basically as long as it takes me to get over the biggest jetlag factor.

I have pretty low basal rates throughout a 24 hour time period, between 0.4-0.55 units per hour, giving me a total of 11,3 units per 24 hours. Her suggestion was to set up a basal profile with a constant 0.45 units per hour for the first 24 hours, to give my body a chance to acclimatise quicker, and then turn on my normal basal profile (and change the time on my pump) when I either realize weird spikes in blood sugar, or I feel like I’ve caught the worst of the jet lag wave. (Lowering my basal while travelling seems to generally be a fantastic idea…)

This was completely new to me. And, granted, I haven’t tried it out yet, so I can’t tell you how well it works (or not). But it seems a lot easier than the old ways of changing basal injection times and dosages along as your jet lag diminishes…

Perhaps is travelling with diabetes  just that much easier with an insulin pump?  

This wasn’t of course the only advice she had for me. Along with the “usual” tips of bringing (much) more supplies than you need, a doctors note for security checks, an extra blood sugar meter & test strips for it, staying hydrated, getting sleep during night time, paying close attention to blood sugar, bring a glucagon kit and snacks, snacks, snacks, she also showed me the “device” (aka chart on a piece of paper) that she uses to calculate a possible return to Lantus dose.

This is excellent information to have if I ever want to go on a pump-cation (a break from my insulin pump), or, if by any chance against all odds, my whole pump system breaks and I need to take Lantus until a replacement arrives. Because I take on average a total of 18 units of insulin per day, the chart showed that my Lantus dose should be around 20 units per 24 hours. I have no idea about the conversion calculation that is used here, so if you do, please leave a comment below!

I feel really relieved and happy that I’m doing all this preparation work for my trip. Now it’s just to keep fingers crossed that the actual trip itself goes as smoothly as the preparations have done so far.

How do you travel with diabetes? What tricks and tips do you use? Please share them in the comment below!

Too Much Fat?

Is there such a thing as eating too much fat?

It’s been widely proven by now that eating fat isn’t bad for you.

But just how much fat is too much fat? And especially on a low(er) carbohydrate eating plan?

Let’s go back a couple of steps first…

When you eat something, your body starts digesting it in your mouth with enzymes. Starting with the sugars, as the food moves along the digestive path, other carbohydrates, proteins (amino acids) and fats are all digested and broken up into little, usable parts for the body. The body uses these small parts to rebuild itself, give you energy and make sure every single cell works just like it should, from your hair follicles to your intestine wall. If you’re eating the right things, that is…

So what should you eat, whether or not you have diabetes?

Essentially, it’s pretty simple: proteins, fats and carbohydrates. But whether or not you’re eating too much fat majorly depends on what else you’re eating.

But I guess you were looking for a more detailed description?

Carbohydrates

The issue with carbs is that it’s really a double-edged sword.

On the one hand, they provide you with lots of energy that your cells know exactly how to use.

On the other hand, it’s way too easy to over-load on said energy, which your body will only turn into saturated fat in your fat cells.

And then we add in where the carbs come from.

Phew, no wonder everyone seems confused about this and keep arguing about what’s right and what’s not!

What’s true in terms of how the body works is that every type of carbohydrate you eat is eventually split up into a simple form of sugar (aka glucose). This means that all that bread, pasta, cereal, potatoes, rice, fruit, dessert, candy, and sodas (to mention a few) you eat and drink eventually end up as glucose (sugar) in your body.

While sugar is indeed energy, and your body needs some to survive, it is actually quite toxic in large amounts. The cells in your body has an amazing capability of burning (and also storing) this energy, but for that the sugar needs the key to get in. The key is called insulin. And what don’t we produce (enough of) if we have diabetes? Yep, INSULIN.

In super simplified terms, insulin stores sugar as fat in your fat cells. And if you’re insulin resistant (Type 2 Diabetes), or not producing insulin (Type 1 DIabetes), it prevents sugar AND protein (amino acids) from entering muscle cells, so you can’t build or maintain your muscle mass. Joys of diabetes, hey?!

I think we can all agree that knowing this makes it a good idea to make sure we don’t get too many carbohydrates. And I haven’t even mentioned high blood sugar yet!

How many carbs you can eat is quite individual, but if you have problems with your blood sugar (diabetes of any kind or type) or insulin resistance/hyperinsulinemia, your carb count should stay low. How low is up to you, but I’m sure you’ve figured out that the mentality of just “eating whatever you want and cover for it with insulin” doesn’t exactly work flawlessly for many of us…

Which carbs are good for you and which are not?

It comes down to processed versus natural carbs, really.

All of the ones I mentioned before (bread, pasta, cereal, potatoes, rice, fruit, dessert, candy, sodas…), I wish would just disappear from our food supply. They’re all highly processed, made in a plant with ingredients that have little or no resemblance to the natural, nutrient dense foods we used to eat. Making them easy to overdose on.

What you’re left with is basically vegetables. Organic, if you can. Some berries. And sometimes fruit (but they have quite a lot of carbs, so watch out if you have diabetes!).

But, if you eat less of the carby stuff, what is left?!

Proteins

Proteins are really important for your body.

They are the building blocks that your body uses to repair itself.

How much protein is good to eat, then?

A great rule of thumb is to calculate about 0.8-1.0 grams of protein per kilogram of body weight a day. If you’re looking to lose weight, this should be 0.8-1 g per kilogram of your goal weight.

Let’s put this into practice!

So, if a person weighs 60 kg, they should be eating somewhere in the range of 48-60 grams of protein a day. That does NOT mean 48-60 grams of meat, for example, as meat only has 20% protein. This means this awesome person should be eating between 240 and 300 grams of meat a day (if meat is the only protein source, of course).

On the other hand, if a person weighs 100 kg and wants to weigh 90 kg, they should be eating around 72-90 grams of protein a day, meaning 360-450 grams of meat a day.

Keep in mind that there are other protein sources as well, and I’m only using meat as an easy, accessible example.

Eating more than this runs the chance of your liver (mainly) turning the excess protein into glucose through gluconeogenesis anyway, which you really don’t want, especially if you have diabetes.

To summarize it so far, less carbs and moderate protein. Are you with me?!

Fats

Lastly, but most gloriously, we have fats.

The fear of fat is really outdated by now, being started by a scientist that turned data into what he wanted it to show (Ancel Keys).

Today we luckily and happily know a lot better! Now we know that eating fat is necessary, there are essential fatty acids we need to get in order for our bodies to work properly.

Generally, there isn’t really an upper limit for fat intake. You just eat the rest of your food in the form of fat when you’ve fulfilled the carb and protein ratios.

Again, there’s a difference on fats and fats, just like i mentioned for the carbohydrates.

The key really lies in starting with the cleanest saturated fats (butter, coconut oil, dairy (if you can handle it), meat, cocoa butter) you can. Everything gets better with butter! Secondly, choose your monounsaturated fats (nuts, olives and avocados). Lastly, choose your healthy polyunsaturated fats like certain nuts, seeds, avocado oil and fish oils (omega 3).

It’s not more complicated than that, really.

Of course, if you’re eating lots of fat, keeping your carbs and proteins where they should be, and STILL gaining weight, you could be eating too much of it for your individual needs.

Another way of telling that you’re eating way too much fat is by looking at what comes out, i.e. your poop. What you put in is what you get out! If your poop sticks to the toilet (you have to use the brush a lot), it’s a sign your body can’t use all the fat you’re eating.

 

To sum these shenenigans up: figure out your carb count, then your proteins, fill the rest up with fats. Simple, right?

But whether or not you’re eating too much fat majorly depends on what else you’re eating.

 

Do you eat enough fat?

The Low Blood Sugar Make up

Diabetes gets in the way of life sometimes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This time I was lucky, though.

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

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

Diabetes Expert

Diabetes Expert – that’s a bold statement!

Being an expert, you have to be perfect, don’t you?

You need to be able to juggle anything that is thrown at you, know every single little detail about your topic and preferably have 67 Masters, PhD’s and other qualifications to be one.

Right?!

I used to think so. I really did. “Experts” in my life used to be my doctor and endocrinologist, for example. And these people know a lot, they definitely do. But they usually have zero training in nutrition, for example.

And they may not know or understand everything about YOU and YOUR individual case. You’re always going to be your own best doctor, because you know YOUR body, your situation and your case the best.

So, who am I to call myself a Diabetes Expert? 

It’s true, I don’t know everything about you, your life and your case. Yet. But I am willing to listen, learn and help you on your road to become a healthier you.

It’s really my passion in life, to get to help you through what I’ve already been though. To share all the tools, tricks and food that I’ve found has helped me and many others.

But what happened to GrainBrain? I’m sure you’re curious!

GrainBrain has been a fantastic stepping stone on my journey of becoming healthier, happier and more experienced. And it has served me very well when I was only about eating healthier (i.e. grain free).

Now that I’m fully focusing on helping people with diabetes to become healthier, lower their A1c’s and feel more confident, I feel that the name GrainBrain has run it’s course in my business.

I don’t want to hide behind a brand anymore, I want to show even more of myself, my journey and how I can help you on yours. Become even more authentic, if you want.

Which is why I’ve decided to change the name of my business, refurbish the website and get a fresh breeze in here! So please help me welcome Hanna Diabetes Expert!

In light of this, I looked up how a few people define what an expert is. And their answers made me smile.

Warning – there’s some self-assessment coming up! 🙂

“What qualifies anyone to be an expert? I view an expert as someone who has considerable intellectual knowledge and real world experience in a particular field, area of study, process, or activity. They possess knowledge and experience in greater measure than a majority of others in their field. And they can express their expertise in order to help others understand and implement any appropriate ideas and actions based on that information. (…) Today, I would venture to say experience builds expertise faster and stronger than education. For education not applied is merely knowledge locked in the brain and not tested in the real world.”

Well, if 30 years of trials, errors, successes and blood, sweat and tears aren’t experience enough, I’m not sure what is?

I thought this was a really interesting point of view. Another article I found, listed 5 quite similar characteristics of being an expert as states above:

“Knowledge: Clearly being an expert requires an immense working knowledge of your subject. Part of this is memorized information, and part of it is knowing where to find information you haven’t memorized.

This is one of my favorite parts of doing what I do – I learn new things every day. Whether it’s about myself, a client, or diabetes in general, I make sure there’s an ongoing addition to my knowledge.

“Experience: In addition to knowledge, an expert needs to have significant experience working with that knowledge. S/he needs to be able to apply it in creative ways, to be able to solve problems that have no pre-existing solutions they can look up — and to identify problems that nobody else has noticed yet.”

Having a coaching background that has taught me a trick or two throughout the years is certainly beneficial. Experience and knowledge go hand in hand. And, the whole reason you work with someone, be it a coach, mentor or expert of some sort, is to get another perspective on your situation. It’s so easy to get stuck in your own bubble and lose view of the Big Picture. Working with someone on the “outside” of that bubble can really help you regain your aerial view.

“Communication Ability: Expertise without the ability to communicate it is practically pointless. Being the only person in the world who can solve a problem, time after time after time, doesn’t make you an expert, it makes you a slave to the problem. It might make you a living, but it’s not going to give you much time to develop your expertise — meaning sooner or later, someone with knowledge and communication ability is going to figure out your secret (or worse, a better approach), teach it to the world, and leave you to the dustbin of history (with all the UNIX greybeards who are the only ones who can maintain the giant mainframes that nobody uses anymore).”

Yes, communication is definitely key. In any relationship. But there’s also a huge difference between talking to someone and talking at someone. The latter is usually a waste of everyone’s time. And you can only communicate your solution to someone who is ready to hear it.

“Connectedness: Expertise is, ultimately, social; experts are embedded in a web of other experts who exchange new ideas and approaches to problems, and they are embedded in a wider social web that connects them to people who need their expertise.“

I aim to help as many people with diabetes as possible. To get new input and not get stuck in old ways, I make sure to stay connected to different other experts within fields of interest to my clients.

“Curiosity: Experts are curious about their fields and recognize the limitations of their own understanding of it. They are constantly seeking new answers, new approaches, and new ways of extending their field.”

One fatal mistake would be to get stuck in my thoughts, my ways and in what has worked for other clients. Every client is a new, exciting opportunity to help someone with a problem (or many).

I want you to know something though…

Being and calling myself a Diabetes Expert definitely doesn’t mean that I have perfect values all the time, endless amounts of energy, smooth cgm curves and my A1c keeps effortlessly where it should be. I have catastrophical days, too. Because there is no such thing as a perfect diabetic.

Diabetes is a lot of hard work. Sometimes grueling hard work. But it’s also about perspective and wanting to find a solution. Finding YOUR solution, how you can cope with it and how you can turn it into the very best you can.


What are you an expert in? How do you share this with the world?

HbA1c, just a number?

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

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

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

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

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

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

I know. This is crazy cakes.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Don’t get me wrong.

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

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

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

 

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

Diabetes Sweet Spot

When you start on a new journey, you ideally want to know what the eff you’ve gotten yourself into.

Not least when it’s about your health, well-being and future life.

I get that. I totally do.

And I’ve got something really special up my sleeve for you today!

This is one of my biggest secrets in doing what I do. You could see it as a 4-year short cut, as that’s how long it took me (well, plus 26 years…) to get to where I am today.

 

Diabetes Sweet Spot

Diabetes Sweet Spot

 

Let me explain this diagram a little (?) more in detail…

First up we have

  1. Sexy Food and Water

What I mean by this is real food that makes you feel your absolute best, fuels your body, your mind and your soul whilst not jerking your blood sugars around.

In my experience, and many others that I’ve helped and talked to, the mentality of “eating and covering for it” simply doesn’t work.

Eating a lower amount of carbs than we generally do today is very beneficial to most people. Even more so if you’ve got diabetes as a constant companion.

Picture this, a doctor tells their patient, who is lactose intolerant, to drink 1 liter of milk a day, “because it’s good for them”… Do you see the flaw in logic here?

If that patient does drink that milk, “like the doctor said”, they will be in a world of pain, discomfort and also spend too much time on the porcelain throne. Because their body is unable to process lactose properly.

All clear?

Now, picture this; a doctor/CDE/nutritionist tells a person with diabetes to eat 60% grains and carbohydrates with every meal, “because they need it”… (Wait, where have I heard this before…?!)

Carbohydrates, no matter in which form (pasta, rice, bread, cereals, pastries, cookies, ice cream….) turn into pure sugar (glucose) as soon as it hits your mouth and the enzymes in your saliva.

And what do people with diabetes not produce (enough of)?! The hormone that lets energy, in the form of sugar, into the cells, namely insulin. And if we can’t produce it ourselves, we have to add it in a much less precise and guesstimating way in comparison to our well-oiled-running-like-machines-bodies.

Ergo, removing some (or even all) of those sugar-shape shifter-carbs from what you eat is a great idea.

That would be the same logic as for our lactose intolerant friend I mentioned before – to take away what your body can’t process properly to reduce pain, discomfort and make life easier.

(I’ll happily talk more about this, if you don’t agree, let me know in the comments below!)

And water. Tons of clean, clear water infused with alpine air (in a best case scenario).

You need water not only for hydration, but also for moving energy/sugar around, to keep the insulin you take active and to flush your system of toxins and other stuff slugging around.

  1. Medications & Supplements

Even if you do everything else right, it doesn’t disguise the fact that you’ll still need insulin. Just a lot less of it, which in my books is a definite winner! Today, I’m taking 1/3 of the amount of insulin that I used to a couple of years ago.

When you start taking better care of the other areas in your life, you’ll usually get the privilege to cut down on, or even completely stop taking, other medications you might be on.

For me it was the case with my blood pressure medicine. I could cut my dosage with 75% after I started eating better, relaxing and taking better care of myself. But just because I was able to cut down, it doesn’t mean I don’t have to take them at all, I still do. Just a much smaller dosage.

And I still haven’t needed medication for my Hashimoto’s Thyroiditis, which is usually treated with hormones.

I generally recommend a series of supplements, which I’m currently taking myself as well. Yep, all of them:

Vitamin D3, Omega 3, Antioxidants (in the form of green powders), Probiotics, Vitamin B Complex, Magnesium and Zinc. Sometimes I add Chromium to the mix as well.

But these aren’t set in stone; it really depends on you and your own journey.

  1. Self-love & Attitude

Oh, how I can go on about the importance of self-love!

The fact is though, that when you start seeing yourself, your body, mind, soul and brain (and every little cell in between) as one Team, shit starts to shift.

This means that you don’t think of your pancreas (for example) as the bad guy for having applied for (way too) early retirement. Or hate your immune system for attacking your pancreas, thyroid, skin (or whatever else it’s decided you could do without).

And how do you get to your Team Me status?

A lot of it comes from self-love, making sure you feel good and love yourself.

What is self-love then? Here are some ideas:

  • Eating well. Healthy, healing real food full of happiness and love.
  • Water! It purifies you, makes sure you get energy to your cells and hydrates every part of you.
  • Meditation
  • Exercise
  • Breathe deeply, truly and all the way into your toes.
  • Stretching or going to that yoga class you know you love.
  • Rocking it out to your favorite tune is the pure definition of self-love!
  • Make Gratitude your Attitude! Tell yourself what you’re grateful for every day, either just mentally, or write it down in a journal, or make a gratitude jar.
  • “Do nothing” days
  • Essential Oils
  • Reading your favorite magazine with a cup of tea/coffee/or hey, even bubbly.
  • Treat yourself to a massage or a mani/pedi.
  • Treating yourself to that one thing you’ve been eyeing up lately. It’s ok to be materialistic, too!
  • Putting up boundaries. What’s ok for you and what isn’t? Break up with those things that aren’t.
  • Prioritizing good sleep is good self-care. (Danielle LaPorte said that, and I know she’s right!)
  • Put. Away. Your. Phone. I promise you, you don’t need to know what is happening on Facebook every second of the day.

But how can you make sure you don’t forget about loving yourself?

Here are my Top 3 Tips:

  • Schedule it. Otherwise it’s the easiest part to neglect for me (even though I really know I can’t afford to).
  • Make it a daily practice. Can you feel the benefits of it when you meditate? Make sure you practice it regularly. Does a long walk in the sunshine do you worlds of good? Get hooked on them!
  • Make yourself your first priority. It sounds really selfish, but it’s not. Think about it, how can you be there for others if you’re not feeling well yourself? Make a team out of your body and yourself, call it “Team Me”. This team always has priority over everything and everyone else. Fact.
  1. De-stress & Movement

This point goes much hand-in-hand with the previous one.

If you’ve changed your attitude about yourself and diabetes, you will have a lot less stress in your life. That’s a promise.

Meditation, eating well, and all of the others I mentioned above help de-stress you and your life.

As does exercise, for example.

I’m not saying you have to turn into an instant iron man competitor, ultra marathon runner or Olympic-grade swimmer right now. (Although if that’s what you want, then by all means go ahead! You have all of my awe and respect)

Start s l o w l y, gently and build on your exercise and fitness level every day. It’s not more difficult than starting with a short, brisk walk outside.

After a while, the walk will automatically become longer or more intensive, as your body feels it can perform better. Before you know it, you might even want to try jogging or hiking in the mountains.

And all of this while not even thinking about your daily walks as exercise! How flipping great is that?!

It doesn’t have to be a walk though, anything exercise-y that floats your boat is awesome, be it yoga, zumba, dancing on your own to your favorite tunes, body exercises, stretches, skiing, swimming, or a royal mix of them all.

The most important point is that it shouldn’t feel like exercise – you should do it by yourself, without thinking “this is hard”.

  1. Daily Rituals

The rituals you set up for yourself is what you can lean back on when times get a little less rosy and sunny, for example.

If you feel a little lost, you know that your ritual (or routine, but that’s a boring word) can be a saving grace.

Also, if your body knows approximately when or in what order something will be given to it, it knows to prepare for it.

My daily ritual looks a little something like this…

I wake up at 7:30am, find myself a centering thought for the day, after which I check my blood sugar (both on my cgm and manually). Then I check the main notifications on my phone (I want to change this)… Then I get up, take my supplements and proceed to my morning meditation. After a shower and putting some clothes on, I open my laptop and work until lunch, before which I check my blood sugar manually again. It’s a healthy, happy meal. After checking the notifications again…. I go back to my computer and work for another 2 or so hours. Then I go out for a walk (my daily walks are holy) as an afternoon break, after checking my blood sugar. Back to work (client/computer/meeting) until it’s time to make dinner and check my blood sugar. After dinner, my husband and I talk, go out for a date or do something productive. Before bed time there’s the last batch of supplements, taking my make up off with coconut oil, checking my blood sugar and showing gratitude for the day I’ve just experienced. Lights out, sleep.

Of course this differs when I have something special to do, but this is my ground framework.

But this way things like checking my blood sugar becomes part of my routine and it doesn’t feel as difficult or even impossible to do it. I even miss doing it if I somehow skip it in my routine, or have ran out of test strips… (I know, I’m a little weird. But I’m happy that I am, life is that much easier when you’re a little weird.)

 

 

Et viola, if you get these areas right for YOU, you’ve entered into what I love to call the Diabetes Sweet Spot.
This diagram is essentially a summary of the last 30 years of my own research and experience, and if you do need some help on the way here, I’m all ears and would love to help you.

 

Have you found your Diabetes Sweet Spot? How did you get there? And how long did it take you?

Make A Change – 4 Steps How To

It’s never too late to start a positive change.

 

“The time for action is now. It’s never too late to do something.” Antoine de Saint-Exupery

 

It’s easy to think that “you’re too far gone/old/overweight/addicted/stuck” to make a change for yourself and your life.

I know where you’re at right now. I really do.

If you’ve read some of my previous posts, you know how I’ve struggled with making changes in the past…

Having spent a gross majority of my life (26 years), trying to make the right choices for me and my health and having learned lessons from each and every time, whilst not getting anything right.

Seeing different doctors, nutritionists, nurses and experts, even psychologists. And no one could tell me or even give me a clue of what I really needed to do.

I’ve basically ran on wild goose chases in terms of my health my whole life. Different medications, different diets, different motivators and different dream health care teams (of varying success).

This tires a person out, and can even wipe them out completely. What you’re left with is zero motivation, zero patience, zero happiness and 100% wanting to sleep through it all.

At this point I really started feeling like a pre-programmed robot, dreading the future and being sure I wouldn’t see past the age of 30. I was following all of the books, one at a time, and NONE of them made anything better. At all.

It was after that I started studying again, this time to become a nutritionist. And thank the Universe I did.

Somewhere, somehow I found the motivation of giving it (and myself) One. Last. Try. with all the stuff I was learning at school.

And that’s when the proverbial hammer hit the head of the nail – I managed to create something so much more beautiful that I had ever imagined for myself. More health, more freedom, more wealth, more pride, more self-esteem.

This, amongst many others of my stories, taught me a Big Lesson: It’s in the big hurdles that we gain the most insight into ourselves and the most experience in life.

 

“Nobody can go back and change a beginning. But anyone can start today and make a new ending.” Maria Robinson

 

Even if you’re 96 years old and realize that, hey, smoking doesn’t serve me like it once used to, it’s better to stop the nasty habit and move on. It doesn’t matter if your last day on earth is tomorrow or in, well, 96 years, there’s always, always, always space to make new positive beginnings.

This is especially true if it comes to improvements in your health and well-being. As we both know, there’s nothing left unless we have this very founding principle in place.

So, what can you do if you realize that there is a change (or even two) you would LOVE to make for yourself?

  1. Realize that you’re not stuck.

You never were, you never will be. I know it’s not easy to break free from old habits, after all our lizard brains make sure that it’s very comfortable right there. But: getting out of your comfort zone and sniffing a bit of fresh air is essential to making a change. How can you get a breath of fresh air today? How can you move out of that couch potato state of mind? It does take making a plan of action for yourself, and not let said plan be defined by your age or held back by your current situation.

  1. What are you afraid of?

What’s stopping you from making the ultimate commitment to invest in yourself, your health and your future? Spend some time identifying what might be holding you back. Then find a way to work through them, or get help from a coach or practitioner who knows exactly in what kind of deep ditch you’re currently sitting.

  1. Find your ultimate motivation.

And make sure this goal is for you and no one else. This is just as true for general goal setting as it is for a lasting life-style change. Why do you want this change? How will you feel once you’re there? What will others think of you?

  1. What’s the one baby leap you can make today to start it all off?

Take one little step a day, but make sure you take one every day. Help yourself to make an easier transition in the not-too-distant future. It definitely helps to set a deadline for yourself, and work toward that, step by step.

 

There’s always, always, always something to be grateful for. So why not make one of those things to be grateful for that you made a decision to invest in yourself and your health?

The bottom line is, you don’t need to wait for the “perfect moment” to make things happen. You can decide any time you want to that the time is right for YOU to make a change.

 

“It’s never too late. Don’t focus on what was taken away. Find something to replace it, and acknowledge the blessing you have.” Drew Barrymore

Diabetes & The Long Run

When you’re first diagnosed with Diabetes, it’s a major shock to the system.

The questions are endless. What do I eat? What medications do I have to take when? I have to inject myself several times a day?! What the what? I didn’t sign up for this!!

But what happens after living with diabetes for a long time? How does it feel? How does one cope? Why doesn’t one just give up?

Technically, this year marks a series of “jubilees” for me and Diabetes.

It’s been 30 years since my diagnosis this year. 26 of those I spent on a clueless treadmill/roller coaster without a mission and without a cause. The last 4 have been the best ones, so far, starting with me radically changing the way I ate. I’ve spent 28 years with around 10 injections a day, 2 years on the pump. 1 year with my BFF Dexter (my Dexcom CGMS).

Anyway, I want to focus on the first one of these – 30 years with diabetes.

Living with diabetes for 30 years is like living with the most loyal companion (or enemy, depending on the day) you’ve ever encountered. It never leaves your side, and you never get even a second to yourself.

It takes a lot to get used to living with it being a part of you. And, because it’s always evolving, dynamic and on the move, it’s sometimes difficult to keep up with it. Oh, you don’t react well to gluten anymore? Ok, let’s change that. No dairy either? Ok, well, bye bye cheese. Caffeine makes you hyper react? Ok, decaf it is. And that’s just talking about a few food things, completely disregarding certain forms of exercise, timing of medications, or reactions to certain situations.

It’s a silent friend that never talks until it screams. And when it does, it screams loudly. Scary lows, annoying highs, and the possibility of losing a limb or your vision.

The awful feelings and the taste of glucose tablets (or orange juice when your life depends on it, for that matter). Lengthy doctors appointments and the endless needles. Hospitalizations. Advice you should have never followed, other advice you should have followed from day 1. To mention a few.

There are so many things that are so bad with this disease. Horrible, in fact. But there are also things I would have never learned if I hadn’t had this Constant Companion of mine.

It has taught me discipline, timing and humility. It has shown me that life is here to be lived, not to be wasted. Life is fragile, don’t take it for granted. It has taught me about the importance of self-love, no matter what happens. It has helped me see how strong I truly am, “this too shall pass.” I’ve realized that being stubborn isn’t always a bad thing; it can even help you sometimes.

So, what keeps you going throughout the years?

You simply have to. You have no choice but to buckle up and try to enjoy the ride as much as you possibly can. Until that cure comes “in 5 – 10 years”.

Nothing gets better by ignoring diabetes. Trust me, I know.

The mental part of living with diabetes is difficult from time to time. There’s no point trying to sugar coat (ha!) that.

In my teenage years, I didn’t want to have diabetes. I was angry, disappointed at life and everything felt like a huge burden without any light in any tunnel.

Crap endocrinologists, the wrong advice and general teenage turmoil made me ignore diabetes “for a while”.

This “while” made me loose almost everything; my parents, family, friends and myself. And it almost cost me my life.

“Nothing works, why bother?”, I remember thinking. But it didn’t make diabetes go away. Rather the opposite.

Time and again diabetes would show up, scream loudly at me for ignoring it and smack me straight in the face. I was in the hospital from passing out on the street, and other times because I was in a diabetic ketoacidosis (DKA), close to death. And everything in between.

Once I got my proverbial shit together, it still took me years to get back to the excellent care my parents had once given me. Many, many trials and errors, wrong paths and terrible turns followed. As soon as I finally thought I had a foot firmly on the ground, the carpet was pulled out under me once again.

Luckily, I managed to find a road leading towards my path.

Diabetes IS a part of you, whether you want it to be or not. And it’s up to you to find a way to work with it in a way that works for YOU. It has to become second nature to you to check blood sugars, (gu)es(s)timate carbohydrates in a meal, take your medications and to accept your (new) reality. Not to mention finding the small things that make you feel better.

For me it was a long-winded road, the batter part of 26 years, to get to the point where I am today. And I still regularly find out new things about my life with diabetes. It’s a disease that keeps you on your toes, that’s for sure.

You cope because you have to. You don’t give up because it’s not an option. And just for being in this position, you deserve a huge medal! But along the way, you may just find a wonderful path through it all that is made just for you.

What are your biggest struggles and questions when it comes to diabetes? Let’s discuss in the comments below.