Tag Archive for: insulin

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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 – Medication

Are you taking the right medication, or medications, to manage your diabetes?

We often just “take what we’re prescribed” in terms of medications. But is this always the best strategy? Is there anything you can do as a patient to influence your medication?

In this week’s Type 1 Thursday, this is exactly what I’m talking about, how we as patients can get more of an insight and clue into what we’re actually given, and should be taking.

Type 1 Thursday – Medication – Hanna Boëthius

Are you taking the medication you need to manage your diabetes as well as you can? Is there anything you should perhaps check with your health care professional? Let us know in a comment below!

Transcription

If you prefer to read this information, please find a text version below:

I can’t wait to discuss today’s very important, but this may be my shortest Thursday ever. The topic today is medication and although this is a super important thing when managing your diabetes, I am unfortunately not a medical professional. Ergo I am not allowed to give you any advice on this. (This is why this might be my shortest type on Thursday, ever.) But what I will give you are some general tips and tricks of what you can do and what you should look out for and when it comes to medication and your diabetes management, whether this is Type 1 or Type 2, it doesn’t really matter. Most of us need to, unfortunately, be on medication anyway, Type 1’s, of course, forever and ever until the day we die, we need to be on insulin, at least, if not other medications. Type 2’s can get away with not being medicated, in some cases. But in case you are, then this could be something for you as well.

The first thing to really make sure that you have is a great cooperation with your healthcare professional, because they, in comparison to me, can give you advice on medication, and medical issues in your management. I can only give you results, tell you things that I’ve done and that has worked for myself and that I know from other people’s experience, nothing else (glad we got that covered!) With your healthcare professional, you need to find out whether or not your medications are actually what you need. In many cases that I know of, are actually not given the correct medication, which they find out in hindsight. This is where you really have to speak up as a patient and tell your health care provider, whether that’s an endocrinologist, or CDE, or nurse or nurse practitioner – whatever you prefer to go to. You have to have an open conversation with them in terms of how you feel, how it’s affecting you, how it’s affecting your lifestyle, your energy and what your blood glucose values are, if you live with diabetes. This can both relate to the amount of a medicine that you’re already taking, or a type of medication that you’re taking. Do have someone that you can really trust on your team so that you can get the help that you need in terms of medication.

This medication, as I touched upon a little bit before, needs to fit into your lifestyle, as well. If it doesn’t fit you to feel sluggish, not energetic slow and just generally crappy, then definitely speak up, do something about it! There’s always, always, always something that you can do to feel better, as I usually say. And there’s most often another medication that you can try instead. Make sure that you get what is right for you for your lifestyle, for your body type, for everything that can have a an influence.

Let’s go more into insulin. Have you been given the correct types of insulin, for example? There are many types of insulin, of different efficacies, and how long they last in the body. How long insulin works in your body is very individual. For me, for example, my short acting insulin, that I’m on all the time through my insulin pump, last quite short in my body, it’s only two hours. That being said, the same insulin can last a lot longer in someone else’s body, even up to four or five hours. That’s something that you have to find out. Do you have the right type of long acting insulin, for example, for your life, for your diabetes, for the way that you want to feel? There are many different types of long acting insulin, and they have different aspects and attributions to them. Check out if you may be need to change yours or try another one for a while. In most cases you can try if you want and then go back to your normal routine if it doesn’t work out for you. I think, as patients, it’s very important that we have that choice. There are also different types of short acting insulins, rapid acting ones, which you need to find out which one works the best for you. We also have, for example, regular insulin, which covers, for example, protein very well. It can be a great tool to use if you are willing to try it. It doesn’t act like the other insulins, so don’t expect it. But it can be very helpful in certain cases, especially with a more protein rich way of eating.

When was the last time you did some basal testing? When was the last time you did a proper basal test to check your basal insulin? Whether that comes from a pump, or long acting insulin is accurately dosed for you, your life, and your diabetes. For example, someone maybe more insulin sensitive at times of the day or more insulin resistant at other points of the day. We have to make sure that the basal insulin is the correct amount for you. This is best done with through fasting and you check your blood sugar every hour throughout a 24 hour time period, this can be split up in different days, as well. Anyway, I’ll get to that in a different chapter in a couple of weeks time. Basal testing is very important to figure out if you’re doing the right thing with the insulin.

Another thing is to pre bolus. Do you need to pre bolus for your meals? Maybe check it out, if you feel comfortable with it, you can try around a little bit with pre bolusing before meals, and see if you get better blood sugar results through that.

Other, not directly diabetes related medications, that you may or may not be prescribed. Again, you have to work with your healthcare provider and see what can be maybe improved, maybe added, maybe taken away. Being diabetic, one of the milder complications can be high blood pressure. Maybe you are on blood pressure medication already, maybe you need to be on one? Maybe you need to be an ACE inhibitor, which has been shown to sometimes protect the kidneys from damage, for example. And it’s a statin really necessary in your specific case? Discuss with your doctor, and bring papers, bring your research along and they usually try to accommodate, or, rather, should try to accommodate you. But it doesn’t mean that everyone does, of course. A medication like Metformin, for example, maybe it could be beneficial for you? Maybe you don’t need it anymore?

Again, you have to have an open dialogue with your healthcare provider. That’s my main point when it comes to medications. I can give you ideas of things to think of and bring forward to your doctor, but I cannot give you advice on exactly how to do it.

Are you taking the medication you need to manage your diabetes as well as you can? Is there anything you should perhaps check with your health care professional? Let us know in a comment below!

Ps. Do you want to learn from amazing medical professionals at Europe’s healthiest event? Join us in Mallorca, Spain in November at The Low Carb Universe 2019!

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Type 1 Thursday – Hydration, why so important?

How important is hydration for diabetes? What can it cause if you’re not hydrated?

I’ve noticed it myself. Sometimes, if I have a particularly stubborn high (or event borderline high) blood sugar that won’t come down with my usual line of care, it may very well be that I’m a bit dehydrated.

But is that the whole story? In this weeks episode of Type 1 Thursday, I go over the main factors why hydration is important, what signs of dehydration is, the causes, and how all this can impact your blood sugar management.

Type 1 Thursday with Hanna – Hydration, why so important?

Do you consider hydration an important part of your diabetes management? Why, or why not? Let me know in the comments!

Transcription

If you prefer to read about hydration instead of watching the video, here is a transcribed text version for you:

We all do it every day, hopefully. And we may not be paying enough attention to it though, which is why I wanted to make a point of it today: hydration, and how important hydration is to a diabetic or person with diabetes, depending on which you prefer.

What causes dehydration, and what can it cause if you’re dehydrated? Dehydration is a higher risk for people with diabetes, because of high blood blood sugars being dehydrating for the body. Even if you don’t have super high blood sugars, or maybe you are someone who is up in the 70 to 90% it time in range of blood sugar. But even then we do have those few circumstances when the blood sugar does go up so that we have to pay attention to our hydration.

High blood sugars don’t just cause dehydration, dehydration can also cause high blood sugars. I know this for myself, for example, if I have a more stubborn, higher blood sugar than I would like insulin is not really taking as it should, movement doesn’t help, insulin neither, all my normal strategies of trying to get my blood sugar down. Sometimes, it can actually be that you are a bit dehydrated! In that case, that’s why your blood sugar has gone up as well, because the body doesn’t have enough liquid to actually keep that blood sugar moving in the body. One doesn’t necessarily cause the other, they can both cause each other. It can be a vicious loop, unless you pay attention to it.

What are the symptoms of being dehydrated? The obvious thing is thirst. If you’re thirsty, you’re probably quite dehydrated and you should fuel up with some water. You can have a headache, often a creeping on headache can also be a sign of dehydration. Dry eyes and dry mouth, I know for myself when I have a higher than normal blood sugar, I can definitely feel my eyes being like a little bit sandy, and my mouth feels like it’s been swiped with about 15 cotton balls! You can become dizzy, especially in hot weather, for example if you’re dehydrated. You can become tired and sluggish. And, if you when you go to the bathroom and your urine is dark, that can also be a sign of dehydration.

What causes dehydration? One I already mentioned was high blood sugars. But as you remember, high blood sugars can cause dehydration, but the dehydration can also cause high blood sugars. Yhe jury’s still out on which one is which! Other things are you simply drink too little water, that is very likely one of the causes. Hot weather or strenuous exercise, so if you’re sweating more than normal, can be a contributing factor. It can be alcohol, for example, that dehydrates your body. Diarrhoea or that you’ve been vomiting can also dehydrate your body.

Why does dehydration happen? And why in relation to high blood sugars? When our blood sugars are high, the kidneys try to filter as well as much of it out as possible. This means that you actually filter a little bit more of blood through your kidneys at that point, which also brings with it water. In a simplified explanation, that’s why we get dehydrated and can feel dehydrated when our blood sugars are higher. Actually, the main point in diabetic ketoacidosis is not necessarily the ketones, for example. Ketones are not bad in limited amounts. It’s also not necessarily the high blood sugar, but it is the dehydration. The really dangerous part of a DKA, and especially if it has come to vomiting and other symptoms of DKA can bring with it, it is the dehydration that makes it dangerous. Please watch out so that you don’t become too dehydrated, as it can also be a contributing factor to the diabetic ketoacidosis. And, I can’t forget, every time I talk about DKA, I cannot miss the fact that it can only be caused by a lack of insulin in the body! This can be a relative lack of insulin in the body, when the body is simply not getting the insulin that it needs and requires to work properly. That is why DKAs happen – it’s not necessarily just because of the high blood sugar – the root cause is always too little insulin. Diabetic ketosis is not the same as ketosis, they are two completely different things. You can see and read my further thoughts on DKA av ketosis here!

Anyway, back to the topic! Dehydration can also cause a lack of electrolytes. If you’re severely dehydrated, you should and may have to go to the hospital to get IV fluids with electrolytes.

How much to drink is another question I often get and that is a little bit of a tricky one, because it is very individual. It entirely depends on how active you are, on what you do and depends on what shape your body’s in. It depends on so many factors! As a rule of thumb, I personally try to drink about two litres of water a day. This also helps me flush out any things that aren’t supposed to be there and also help to stabilise my blood sugar.

Thank you so much for watching. I can’t wait to chat with you more in the comments! If you have any questions, comments or experiences that you want to share with me, please leave them in a comment below, and I’ll happily chat further on over there.

Just remember kids and sweet friends, drink your water and keep hydrated!

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Type 1 Thursday – Weight Loss & Type 1 Diabetes

Today’s topic is T1D & weight loss, a hot topic!

I asked on Instagram what topics you wanted me to cover on Type 1 Thursday, and a good amount of people said WEIGHT LOSS!

So I took the opportunity to gather my thoughts on weight loss and Type 1 Diabetes in a short video for you! If you prefer to read about weight loss and T1D, I’ve transcribed it for you below.

Hanna Boëthius – Weight loss & Type 1 Diabetes

What are your experiences with Type 1 Diabetes and weight loss? What worked for you, or what didn’t work for you? Let me know in a comment!

Transcription

If you prefer to read this, please go ahead:

Weight Loss & Type 1 Diabetes

This is the moving party of a Type 1 Thursday! I have been doing Type 1 Thursday for 17 episodes over on The Low Carb Universe (my other project). I’m very, very happy to welcome Type 1 Thursday back to where it belongs – on the diabetes page (that would make more sense, right?!)

I am a Type 1 Diabetic since 34 years, and I am very, very happy that you are here with me, because today’s topic is super interesting. And it turned out to be a really hot topic! When I asked on Instagram a couple of days ago what I should talk about, a good few people said this topic. I am very happy that I have the chance to cover that for you today. And the topic is, not maybe completely unexpectedly, Type 1 Diabetes and weight loss and how that works together.

It can be really tricky when you are taking a lot of the fat storing hormone, insulin. The more insulin you take, the more weight you gain. It’s not always easy to lose weight with T1D. I wanted to try to describe a little bit what is going on in your body and how it could work for you as well. (And please, please, please do share your experiences with T1D and weight loss, or weight loss at all in the comments! I am very, very happy to talk to you more there!)

Weight loss has many reasons, there can be a gazillion reasons as to why you want to lose weight. There are two main ones, with the first one being you want to improve your health. And that can be of course a reason to lose weight, which is good, that’s great. Secondly, it can also be vanity. So I think, first of all, anyone who wants to lose weight needs to be honest with themselves as to why they want to lose the weight. Is it because of health reasons? Or is it simply because it would feel great to have those last 5 kg/10 pounds, or whatever else off the body and feel accomplished? It’s definitely an important thing to consider.

There are also two main weight loss theories. The first one is the hormone theory, which is that weight gain and weight loss is all about the hormones. It’s all about insulin, and it’s all about how insulin is the master hormone, and how that then impacts the other hormones. The other theory is the the old one, to eat less and move more, the kcal theory, which I feel like we’ve disproven this one? In my humble opinion, I feel that it is actually a combination of the two. Yes, your hormones have to do with weight loss, absolutely. But so do calories, I don’t believe that you can eat 15,000 calories in a day and still be losing weight. Unless that helps to regulate your hormones in some way. Your hormones need to be balanced for you to lose weight. And that actually requires a certain amount of calories, and a certain amount of the right macronutrients. Enough amino acids, enough fatty acids, because those are both essential for the body, there’s no essential sugar for the body. There is essential protein, and there is essential fat so that the hormones can become regulated. Those two for me (not saying anyone else!) but for me really go hand in hand. So it does require both of them to work to get there!

The old saying “abs are made in the kitchen” is true! I’ve heard several numbers on this, but there is an 80/20 thing going on, that 80% is the food and 20% is the exercise. So there you have this again: both go together for weight loss. And if you’re really overweight, if you just start eating the right things, you perhaps don’t even have to exercise in the beginning. That’s great, right? Generally, if abs are made in the kitchen, movement does also play a part in regulating your hormones.

What do I eat if abs are made in the kitchen? Well, there are, like I said, essential protein to the body, amino acids are essential. Focus on that. That is also what, for example, Dr. Bernstein talks about in his “Diabetes Solution” – to focus on the protein. And if you see someone really ripped, there’s a good chance that they are eating a good amount of protein. That’s also because protein is thermogenic. It actually it burns calories when the protein is processed in the body, shortly explained. Also have some fat for good measure, and to regulate your hormones. It may be difficult to get up to an OK calorie count in terms of protein only. So do have some fat. But when you get to stable hormones, and become a fat burner, you will use the fat that you already have on your body, which is actually a very simple way of weight loss, right? Then, of course, carbs; keep them to a minimum, mainly leafy greens. This also really helps your blood sugar, which does help in weight loss, as well. It’s incredible how much goes hand in hand in this!

What does this kind of eating, focused on protein, some fat, a little bit of carbs, what effects does this have? Well, it’s clearly that if you lower the amount of carbs, you lower the amount of insulin that you’re taking. And because insulin is the fat storing hormone, and the master hormone, if you use less of it, there’s a good chance that you will store less fat, as well. And, like this, you won’t really add too many calories on to your diet, which is also goes back to one of the two theories that the calorie, “eat less and move more”, (the 80s called and they wanted their nutrition advice, or weight loss advice back!). I do think it does play a role, I just don’t think that is the only thing that plays a role. Protein does repair your body and it helps to build muscle, which really does help you in losing weight, as well.

In order to lose weight, you also have to be motivated, and you have to find your WHY? Why do you want to lose weight? This is where my background as a coach comes in quite handy! Ask yourself why in three levels; why do you want to lose weight? And the answer to that ask why again? And then the answer to that as why again, so that you really know what is behind your choice of losing weight.

But could it be something else? Why did you gain the weight in the first place? And did you gain it overnight? Or did it take a while to accumulate? Because there is no overnight solution to losing weight. It is hard work! And it is a lot of trial and error, just as getting a grip of diabetes is, so is the weight loss process. Could it be something else than just “random” weight gain? Could it maybe be your thyroid? That also has a lot to do with hormones! Could it be stress, which is the hormones cortisol, adrenaline, and can really drive weight gain. Can be fluid retention? Are you retaining fluid for some reason? Maybe not enough salt? And could you be pregnant? Could it be some sort of medication that you’re on? For example, antidepressants are usually causing weight gain, so it’s corticosteroids. Antipsychotic medications and birth control pills can really, really make you gain weight because that also goes back to the hormone theory.

Please do share your weight loss success or questions in the comments, and I’ll be happy to chat with you there.

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Type 1 Thursday – Unexpected high blood sugars? 🤔

…it could be THIS!

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

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

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

Watch the video or read the transcription below:

https://youtu.be/qafwdTm4tqQ
Type 1 Thursday – Hanna Boëthius

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

Transcription

If you prefer reading the information, here it is:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Type 1 Thursday – Injections vs Insulin Pump?

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

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

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

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

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

Transcription

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Type 1 Thursday – Type 1 vs Type 2 Diabetes

It’s Thursday – time for another Type 1 Thursday! 

Today’s topic is Type 1 vs Type 2 Diabetes. What are the differences? What are the similarities (if any)? And what about management and treatment, what are differences and similarities there?

Type 1 Thursday – Type 1 vs Type 2 Diabetes

What are your take aways from this video? Share in a comment!

Transcription

If you prefer to read, here it is:

For today’s topic, I wanted to explain and go through the differences between the two main types of diabetes. So that is, Type 1 Diabetes, as I have, and also Type 2 Diabetes that is the more common version. There are also many other versions of diabetes together with it.

I wanted to draw the outline of the sort of differences between these two, and perhaps if there are any similarities. And what about management? How does that work between the two different types?

So basically, Type 1 Diabetes, as you may or may not know, is an autoimmune disease. That means that my beautiful immune system decided that those insulin producing cells looked a little bit dodgy when I was two years old, and kick them out of commission, which is not great because that means that I am all other type 1’s will have to inject insulin for the rest of our lives no matter what we do, no matter whether we go low carb and no matter if we go carnivore – we will always have to inject some insulin. Perhaps not as much as when on the standard American or Western diet, but still a bit so that we keep our engines running, as insulin is the master hormone. And it’s very much needed. So if you don’t produce any, you have to add some.

It is, as I already said, it’s the pancreas that get or a part of the pancreas that gets kicked out. That means that I produce no insulin, but other Type 1’s may produce some, but it is nearly not enough insulin. This can be hereditary, but Type 1 doesn’t have to be hereditary. I, myself, am an example of that. I have no history of Type 1 Diabetes in my family, I am the lucky chosen one. How great is that?

Type 1’s are about 5% only of all diabetes cases. Considering there are over 420 million diabetics in the world, that means that we are very small minority. And I’m not sad about this, because I don’t wish this on anyone. It does explain that we have to do a little bit more advocacy for our type of diabetes because we are not represented as much as Type 2’s.

The onset of Type 1 Diabetes can be very sudden, and it’s usually discovered within weeks. If it’s if it’s not LADA or other side types of Type 1, you will be very, very sick very suddenly. Symptoms include frequent urination and thirst, incredible unquenchable thirst, falling asleep everywhere, because your blood sugar is skyrocketed high. There are few warnings to look out for, that can also be mistaken for the common flu. Don’t wait in case you have this suspicion, go and check it out, if it happens to a family member, for example.

There’s no cure for Type 1 Diabetes. We do have better management possibilities than we’ve had in the past 34 years that I’ve been living with the condition, but there is to date, no cure, and I’m not positive about one happening anytime soon. I secretly, or not so secret, I do wish for it every single day of my life, even if it is easier to manage with lifestyle choices, it’s not as easy as maybe it would have been without having to act as your own pancreas.

Type 2 Diabetes, what is that? That is basically a severe insulin resistance. So your body is still producing insulin. In fact, it’s actually producing tons and tons and oodles and oodles of insulin. But the problem is that your cells don’t recognize the insulin that you’re producing, making you insulin resistant, making you not be able to take up the sugar from the blood stream, making it hang around in the blood stream. That is why you have higher blood sugar in Type 2 as well. Basically, the body does not recognize its own insulin. And this can be very tricky, but there are a lot of things that you can do to improve insulin resistance even as a Type 1, but definitely as a Type 2.

Type 2 can be lifestyle related, or it can also be hereditary. But the lifestyle part is a majority of the cases.

Diabetes cases that are Type 2 in comparison to Type 1 are basically the remaining 95% (and 5% are Type 1.) This can take years to develop, although the symptoms are just the same as in Type 1, just maybe not as severe from the beginning. You might notice a need for more water over a while or you might notice that you’re more tired than usual. But that can also be attributed to stress and all these kind of things that are lifestyle related, as well. The lucky thing with Type 2 is that many cases actually can be reversed with the help of lifestyle measures, like changing your diet, movement, taking supplements, all these things that you can do with your lifestyle is to alleviate and also perhaps reverse Type 2. Even if your Type 2 has so called been turned into Type 1, which it can’t, Type 2 can only become insulin dependent, but it can never be Type 1, because it’s not an autoimmune attack on your insulin producing cells.

What are the commonalities of these two types of diabetes?

Both of them lead to the same complications. These includes retinopathy, potentially blindness, that leads to nerve damage, potentially neuropathy, and/or amputations. And it also can lead to kidney problems and nephropathy. It can lead to cardiovascular disease, it can lead to stroke… All of these things that aren’t so nice with diabetes can actually be attributed to the high blood sugars or the constant constant fluctuations in blood sugar and not the diabetes itself. If you manage to keep your diabetes at bay and keep your blood sugars at a normal, healthy level, then the risk of complications, DKA and all these things, it’s very much smaller than if you don’t and you go between minimum and maximum at all times.

A second similarity is that you have the same goals of achieving normal, healthy, stable blood sugars. Make those continuous blood glucose monitor things look like lines, not roller coasters, but lines. That goes for any diabetic, independent of type.

Thirdly, the want to reduce insulin. Before before people get angry with me here, let me explain why.

In Type 1, if you keep adding lots and lots of insulin the whole time, the risk is that you’re going to be a double diabetic. That means that you, in addition to your Type 1 Diabetes, develop severe insulin resistance so that you have both types of diabetes. For me personally, and I know very many with me, this is something that we definitely want to avoid. You can’t think of insulin as a free for all thing that can make you eat anything that you want. For those of you who works for, great! For those of us who maybe it doesn’t work for, and we need more insulin than necessary, it’s not maybe the best idea. The risk is there, and I was there myself a couple years ago, I am very sure that I had double diabetes, because I was on so much more insulin than I am on now. But it wasn’t confirmed. So I can’t say with security.

Why you want to reduce insulin as a Type 2? If there isn’t that much insulin to not react to for the cells, then maybe they start listening a little bit. It’s like a small toddler, when you scream at them, and try to reinforce your power and try to make them understand… Do they ever listen? No. If you, on the other hand, just keep calm and really give it instructions with a point and and with direction, there is at least a chance that they might listen. It’s similar with Type 2 and insulin, in my opinion.

How can you reduce the amount of insulin needed or used? How can you get stable normal blood sugars? And how can you, as a Type 1 diabetic, not get double diabetes? Lifestyle measurements. As a Type 1, as I said, you will always have to take some insulin, but it will it can be reduced. The power of nutrition in diabetes is just so immense. You can eat a sugar free, low carb, real food kind of diet (and I hate the word diet but there’s no other way of explaining it). If you eat real food, if you if you eat sugar free and if you low carb, chances are that you will be able to improve your health a lot.

This doesn’t just go for people with diabetes – this goes for everyone. Whether you have diabetes or not, if you’re healthy, if you have no health issues at all, you are always going to be better of health wise, if you eat a sugar free, low carb, nutrient dense, real food diet. That’s just it. That and of course, movement, exercise, make sure that you feel joy in your life, make sure that you take supplements if you need them. Make sure to hydrate, make sure that you have a routine that works for you. Make sure that you alleviate your stress. All of these lifestyle measurements are good for both diabetics and non diabetics.

If you have any takeaways or any ideas or any comments, let me know below and I will be happy to chat with you there.

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Type 1 Thursday – How to eat at restaurants

Is eating at restaurants difficult while trying to maintain normal blood sugars?

Not necessarily!

This is my little guide of how to eat at restaurants while maintaining the normal blood sugars all Type 1 Diabetics deserve and should strive for!

I share my top six tips for successfully dining out, what to focus on and how to build a meal. Check it out here:

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

What are your best tips for dining out with Type 1 Diabetes (or if you’re mindful of your sugar consumption over all)? Let me know in a comment!

Transcription

If you prefer to read, here’s an unedited version:

Hello, hello, hello and welcome to another episode of type one Thursday with me Hanna which is one of the founders of The Low Carb Universe. We organize Europe’s truly healthy hundred percent real food events. But that’s not what we’re here to talk to you about today.

Today is, of course, another episode of Type 1 Thursday, where we discuss all things, type one diabetes, and low carb and healthy food and healthy eating and all of that stuff that may not be talked about as much in other places. So I thought, hey, why not? Let’s do it.

I am a type one diabetic since 34 years this year, which is yay, you know, alive and stuff. Today, I will be sharing with you you how to navigate restaurants, and eating outside of your home with type 1 diabetes, and how to maintain normal glycaemic blood sugar levels throughout this. And do stay tuned, because I will be revealing my top six tips on how to actually make this happen properly, after a bit of an introduction and stuff like that.

Why are normal blood sugars so important?

This is I don’t know, like the 13th video I think I’m making in this series. So if you watched any of my previous stuff, I think you know why normal blood sugars are so important. And so also, of course, whether you are either treating yourself or don’t have another option, but to eat at a restaurant, where it is more difficult to figure out what they have added to your meal, which you may not have added at home. Yes, healthy normal blood sugars. All diabetics are deserve them. All diabetics should strive for them. And we should not be content and happy with anything else but normal levels.

That’s my opinion. And I’m sticking to my guns. And that’s why I’m making all of these videos. And of course, why it is so important is of course that you have to, well, I assume if you’re anything like me, you want to live a long, happy, healthy life with diabetes, despite diabetes, thriving in your life. And then normal blood sugars will keep you there for longer. Let’s just keep that as at as a baseline.

I am very, very happy now because this wasn’t the case before. But healthier options at restaurants are becoming more available more readily available. Just things like for example, a big normally very pasta focused chain has recently brought out noodles as an option. And that is great, of course for us who are trying to mind our glucose and trying to mind the sugar intake in our foods. For example, there’s a lot more vegetables on the menus, there’s a lot more that you can get sauces on the side and no one looks at you weirdly, you can substitute a lot of the the sides with vegetables, and no one looks at you weirdly, and side salad is a huge thing, which you can also of course, when you are fueled by other things but sugar in your body, then you can have that too without a problem and not feel deprived or anything.

So there are three things: first of all, when you see go to a restaurant, that is important that is of course, as always, no matter where if you’re all at a restaurant, but focus on the protein and vegetables, which can be solved, they can be changed. All the pasta, rice, potatoes, fries, all of these things that you know, don’t leave you feeling your absolute best when you eat a restaurant, substitute them for different types of vegetables. Here is a great tip actually, that I found out a couple years ago is that when you look at a restaurant menu, and you see, let’s take an example, a sirloin with mashed potatoes. “okay, well, the mashed potatoes aren’t great for me, but I see here with the with the seven on this menu, you serve asparagus, do you think I could swap the mashed potatoes for these asparagus?”, for example. Check what they have on the menu in other dishes, and what type of vegetables they have there. And maybe you can find your favorite there or something that is at least better for you than mashed potatoes that are currently being offered. And of course, then number three is keep all or most sauces on the side. Make sure that you get the source in a little couple of sites so that you can first of all taste how much sugar there’s in there. Even if someone tells you that they’re Oh no, it’s completely sugar free, there’s no sugar, you can taste it very quickly. And you can make your choices after that.

Easy restaurants to go to when you are minding your sugar intake and you do not have the metabolic capability of breaking these things down as effectively as maybe other people do.

This includes but is not limited to, for example, steak houses, burger places. Seriously burgers without buns with all the good cheese and bacon and maybe an egg on top and a side salad, you’re going to be full four hours. When your friends who ate a normal burger menu starts going on about “I could go for like a coffee and cake”, you know, just fueling up again, you’ll still be full, “I am winning at this game”.

Also, Italian places are fantastic for low carb you wouldn’t think it but and very very little of the Italian cuisine is actually pasta, pizza, all these heavy things. It’s more like fresh meats, fish, seafood, and a lot of vegetables. Italians eat a lot of vegetables, and the yummy yummy olive oil, of course. And that is a great tip for if you are out and about and see an Italian restaurant, if it is authentic enough, and hasn’t zoomed in on the pizza thing, because then you can just scrape off the toppings, but it’s not a great experience for anyone. So let’s not go there!

You can also go to salad bars, that’s a given. Or deli places, maybe somewhere that makes sandwiches and you can ask to have the sandwich feelings on a salad or on a plate instead.

Brazilian steakhouses are fantastic. You won’t be lacking protein after going to a Brazilian steakhouse, I can assure you that. French places are great, not as much bread as you would think. And also Greek places are fantastic, all the Mediterranean really Greek, Italian, Spanish, of course with all the tapas, and it’s fantastic. And then of course Italian as I mentioned before.

Mexican is also surprisingly good, because there you can have things like fajitas without the bread and the beans and all this stuff and the rice. You can have all of these things that are really, really yummy that people don’t quite realize are yummy, because they cover it up with all these carby things so that they don’t actually get the flavor of the real thing, which is the protein of course.

Even sushi places actually are quite great for low carb because, and bear with me, you can have a few edamames and you can have a whole plate of sashimi, which is of course the sushi without the rice, so if you’re minding your sugar intake, don’t despair if you only have sushi place at hand. There’s always always things that you can do. And I’ve seen now actually sushi places who make rice out of cauliflower rice, there is one place for example in Stockholm. I think it’s spreading, too, and this trend of maybe not wanting sugary rice is becoming bigger.

Alright, I promised you my six top tips on how to manage restaurant but the restaurant visit with type 1 and wanting to keep your blood sugar’s at a normal level, because this is what we’re striving for.

As I said before, number one, if you can do research the menu online so that you want you know what you’re handling, you can already make a couple of choices, you can have an overview of what the actually have, you can check the starters, the mains, the deserts, but seriously don’t have too much hope for the desert, because you probably won’t find much apart from maybe a cheese platter, which also is a fantastic dessert. This also helps you if you are a bit conscious about your spending.

Number two, of course, stay away from the starches. If you get offered a bread basket and you know you can’t resist it, ask them to take it away. Make sure that your dish does not contain rice, pasta, potatoes, fries, or mashes if you know you can’t navigate around them. And I’m not saying that you always have to be 100% – you do what works for you. And if tasting a bit of these things works for you, then good, keep doing that. But if you know that you can’t keep away from them, make sure you stop them from the beginning.

Number three, which I already mentioned in the beginning, but it’s very, very important: focus on the protein and the vegetables. That is the easiest thing that you can do. Even at a restaurant or at home or anywhere you are. If you’ve been invited to a dinner somewhere at a friend’s place, that is sometimes a little bit tricky. But always focus on the protein and the vegetables, and then don’t pay so much attention to the things that you can’t have. Of course, this is as much a mind game for you as anyone else. Instead, pay attention to things that you can have. Take it as a positive thing that you are doing something good for you, your body and your health. Because you want to stay healthy for as long as you of course, possibly can.

Number four, which is something I struggled with a lot. In the beginning, when I first went low carb, I’m often said, “oh, it’s okay. Don’t worry. Just bring this and this and whatever else. Like, take everything out of it. It’s fine!” No, no, no, actually, the proper way of doing it is Dare. To. Ask., make sure that you do find the option that works the best for you. Because no one else is going to be looking out for you. Dare to ask “what do you put in that sauce?” “Oh, is this gluten free?” (If gluten is a problem for you.) “Oh, is this sugar free?” Waitstaff should know this. If they don’t, they are very welcome to run back to the kitchen and check with their colleagues. It’s really important for you to know what the food that you eat actually contains. “Oh, is this thing breaded?” “Do you have bread crumbs in your Parmesan Melanzane?” There are so many ways of cooking food that should be “free food”. Not everyone does it the same way. Dare to ask. As I mentioned before, if you see a vegetable in some other dish, maybe you know they’re willing to swap that for the thing that you don’t want in the dish that you want, or with the protein that you have chosen. Dare to ask what’s in your food. How can you swap it? What can you do to make this work for you? At the end of the day at a restaurant, you are a paying customer and they generally would very much want happy, healthy customers that keep talking about their wonderful establishment and the fantastic service that they got. They will very rarely rarely be snarky about your dietary restrictions, because they want repeat customers too.

Alright, number five, you know what, if it doesn’t go perfectly fine, if something goes wrong, like you have a glass of wine too many than you expected, or if you’re eating a bit more of the starch than you expected – just don’t panic. It’s alright. You’re not going to die from screwing it up once, but it is a learning curve. So don’t panic, make sure that you remember it so that you know next time what not to do and what didn’t work for you. Work with the things that do work for you, and what you leaves you feeling the healthiest, best version of yourself.

And then number six, which is actually something that I did for myself, in the beginning. Now it’s just second nature, but in the beginning, I made every restaurant menu a game for myself. Everywhere I went, whether it was Chinese, (that is a tricky one, though, because they mix everything in sauces), or a pizza place, or Italian or burgers or whatever. Wherever I saw a menu, I made it into a game for myself to make a nourishing, sustainable dish for myself from any menu. That is my tip number six, make it a game. Oh, what can I eat at this restaurant? Uh huh. Okay, but if I swap that, with that, and then, instead of that I have that, and then I get a meal that works for me and leaves me healthy, happy and feeling fantastic. Even after my restaurant visit.

Those were my quick tips for you. Actually, let’s call it the little guide of eating at restaurants with Type 1 Diabetes. I hope you have enjoyed this video!

I want to know from you what your best restaurant tips are with type 1, or even without. If you’re just minding your sugar intake, what are the best tips that you have figured out they’ve seen someone else do that you’ve heard someone else do?

Share them with me in a comment and I’ll be happy to chat with you. Until next time!

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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!

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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!

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