How important is mindset in diabetes management? What difference can it make? 🤔
It took me so long before I realized just how big of a deal mindset work is when it comes to diabetes management. How do you react when you see an undesirable number on the display? What are you thinking when you’re faced with a meal you know you won’t feel good eating? And what can you do to help your diabetes management be a success in the long run?
It’s time for Type 1 Thursday!
And – if you want the whole presentation on this topic from me, why don’t you join me at The Low Carb Universe in Mallorca, 12-17 November 2019? Check it out!
And 2 – I do a live every week on Facebook and Instagram to discuss a topic about Type 1 Diabetes that maybe you haven’t discussed with your doctor or healthcare crew. Join me at 6pm CET on Thursday’s!
Have you noticed a shift in your mindset? Or do you need one? Talk to me! 😊
If you prefer to read rather than watch a video about mindset, here is a text version of the points I made above:
How can mindset can help your diabetes management? How he can help it and what difference can it make, or how can it hinder you?
As I define it, these are my own figures, not at all scientific! This is my experience and from the people that I’ve talked to about this, but I see that having success maintaining a healthy lifestyle, 30% is food and medicine, I see another 30% in other lifestyle factors, movement, hydration, sleep. To actually make your health care successful, I do see that there is a 40% need for mindset, as well. Don’t discount the mindset part because it is very important! And maybe even more important than you know! How exciting is that?
There is a fear of geting caught in a trap of constant perfection. No type 1 diabetic is always perfect. No health cares are ever completely perfect. We all make mistakes. And that’s okay. And that’s a huge part to realise when it comes to mindset! You have to be kind to yourself – that is just the starting point. And do remember that all feelings that you have, whether it’s about diabetes or something else you’re trying to get a better grip of, all feelings are completely and entirely OK! It’s okay to feel them. It’s okay to have them. They are all OK.
“Fixed” vs “Growth”
There is this theory of that we flip flop between what is called a fixed mindset and a growth mindset. (I have a full length presentation on this, join me in Mallorca to find out more!) What I’ve seen from my research, we basically flip flop between these two mindsets depending on the situation, depending on what we’re faced with, actually depending on a lot of factors. As a sort of rule of thumb, a fixed mindset is that you avoid challenges, and that you give up very easily. Making effort is actually a bad thing for you, in the specific situation. You’re “just not talented”. A “why me” mentality usually goes into the fixed one. Running away from critique is also common. Other peoples success is threatening, too. I’m sure we can all recognise some parts of this in ourselves in what we were doing and how we’re reacting to things!
On the other side of the fixed mindset is the growth mindset. A growth mindset is where you seek challenges, you keep trying, even though you maybe fail sometimes and you see making an effort as the key to actually making something a success. You ask yourself, “what can I learn from this situation” rather than, you know, “why me” and “I’m not talented”. Your motto is basically “I can do it”, and other people’s success is inspiring to you.
These are the two mindsets that we flip flop between, depending on how we how we react to things. Also, I think that we are many who can recognise ourselves in the growth mindset. So it’s not all bad! We’re not only, you know, “everything is shit” and “why me” and “I don’t want challenges”. I think we all have parts of both! I find it very interesting when we start paying attention to this. And I’m sure this is something that you can do, for example, in your diabetes management. How do you react to, for example, that blood sugar reading? Is it “why me” or is it “okay, what can I learn from this?”, for example.
Mindset is not…
Mindset is not a magic bullet of motivation. It is definitely not a shortcut to success, if anyone got that, and mindset is nothing that we’re born with, it’s something that we learn. Mindset is not the same as positive thinking, either. It’s also not fixed in these two categories I talked about above. You’re never stuck in one, as I said, we flip flop between both of them.
Added to this, more specifically to food, is actually the diet mentality, or diet mindset. I wanted to highlight it, because I think it’s so terrible for lots of people with diabetes, and for anyone really who tries to look out for their health.
A diet mentality is where you see food as the enemy and you’re focusing on your bad habits – that you would have bad habits to break somehow. You’re looking for temporary fixes. And you’re focusing on what you don’t like about yourself, how silly is that? That’s not the way forward, the way forward is to focus on things that you do like about yourself and increase those and then the other ones will follow. Diet mindset is where you’re really focused on the scale. I don’t feel like that is a good measurement of anything really, the scale. I threw out my own scale very many years ago, and I only weigh myself at the doctor’s office, because they require it. Otherwise, I don’t really care what it says. It’s some sort of arbitrary number on a piece of electronic machinery (or even if it isn’t electronic) – it doesn’t really matter that much. Try to step away from the scale! Also in a diet mentality, you think that you have a finish line, that you will have arrived at some point, whatever that means. And I’m only highlighting this because I think it can offset the rest of your mindset work, which can be quite crucial in type one or diabetes management in as a whole.
How do you view setbacks? Are setbacks something informative to you? Do you draw information out of it? Basically, going back to the growth mindset of “what can I learn”? Or are setbacks a label on you as a person? It’s also silly, but we all get to that point at some points of our lives, and that’s fine. It’s not a bad thing. It’s just something to be aware of!
Success = Mindset + Learning
Success whether within health, whether it’s in sports, whether it’s in life in general, it is mindset, plus learning and the willingness to learn new things. No one can do everything from the beginning. So we do need to learn, in addition to our hopefully, majorly growth mindset work.
How do you change your mindset? This can be a tricky one, but a few short tips is to start small. If you know the analogy of chopping up the elephant into small bite sized pieces, basically eating the frog first? That’s how you get forward so you look at the whole picture first and try to accomplish all of it at once. You have to start with the very smallest goal that you can imagine. Also, you have to think forwards. “How will I feel in a week of doing this?” (or in a day, and a month, in a year, in 10 years?) How will it feel making this change for me? Provided that it is for you, but I would hope so because otherwise it’s not going to be motivating for very long. You have to find what motivates you? No one else can tell you what motivates you, you have to find that within yourself. And that’s a very big part of mindset work!
And also, don’t make excuses. It’s all about prioritising. You can say that, “oh, I don’t have time to check my blood sugar”, but today, especially with CGM’s and these very fast blood sugar meters, it’s really quick. It’s just that you don’t want to do it. It’s that simple. So please don’t make excuses for yourself.
And now I would actually love to hear from you, have you noticed a change in a change in your mindset? Or perhaps you need a change of mindset? Talk to me in the comments below and I’d be happy to chat with you more there.
How did I turn my double digit HbA1c nightmare into a healthy 5.0% habit? Find out all about my 12 step formula in this week’s Type 1 Thursday!
What is your goal A1c? Or healthy goal in general? Let me know in a comment below!
If you prefer to read about my HbA1c Formula, here you go:
Getting your HbA1c down as a Type 1 Diabetic is hard! It’s really, really hard and requires a lot of work and effort. So how did I turn my HbA1c from a double digit nightmare to a 5.0% healthy habit?
In this week’s Type 1 Thursday, with me Hanna Boëthius, one of the cofounders of The Low Carb Universe, as well as a Type 1 Diabetic since 34 years. I don’t know if you know, but I reached something magnificent. I have had a long, long standing dream of reaching a HbA1c of 5.0% (31 mmol/mol) in the “other scale”. This week, I finally got confirmed that this was the case and I couldn’t be happier! But what you may not know about me, yet, at least is that not that many years ago, I was a total diabetic mess. I failed to take care of myself. I had terrible blood sugars and very little knowledge of how to actually manage diabetes. So my A1c not too long ago was in the double digits, which is not good for anyone who knows anything about blood sugar. At the same time, I was so hopeless because I was clearly not given a the proper tools of taking care of my diabetes.
It’s what I have done to bring my HbA1c from double digits to a healthy, happy 5.0 habit. I’ve actually been under 5.5% for more than three years now, something I’m very happy about! That means that it’s stable, that means that I have found out a few things that work for me. That doesn’t necessarily means that they work for every single Type 1 out there, but they work for me. And maybe just maybe you or someone you know will be able to draw a little bit of inspiration from what I’ve done, so that you can get healthier and to your health or A1c goal as well.
This is a 12 point plan, so buckle up and get ready, we have a lot to go through!
Number one is definitely eat low carb. I know, it’s a very heated topic in all of this. But if you have problems with blood sugar, there is really nothing else that will work as well as to lower your intake of dietary carbohydrates. This also means my favorite topic in the world, which is the law of small numbers. Instead of with a lot of carbs, you add a lot of sugar, and then you have to chase it with a lot of insulin and then the margin of error is just equally as big. Instead, you can eat a little sugar, you add a little insulin and the margin of error is smaller. This is the number one reason why low carb for diabetics is such a great idea, because it leaves out so much of the guessing work. I also incorporated intermittent fasting into my routine a good couple of years ago. This means that I skip breakfast every day, just because I’m just not hungry, and I don’t see the point of stressing my body with trying to, to digest more. Intermittent fasting that has helped me a lot, and maybe it’ll help someone out there too.
You have to find out if you are intolerant towards any sort of foods. A very common intolerance is dairy, for example, which is a big thing within low carb. If you have any issues or allergies, then maybe it’s not going to help you reach those blood sugar goals that you are so dearly after. Make sure that you find out other things, for example eggs, night shades… People have intolerances towards many foods, but you might not find out.
What is your personal carb threshold? I know this is also very widely discussed within the diabetic community. I personally eat maybe 20 grams of carbs a day, most days not even. For example, the great Dr. Richard Bernstein says that you should eat 30 grams a day with six grams of carbs for breakfast, 12 for lunch, and 12 for dinner. It’s all up to you finding out what kind of level that you should be at for the best results. This is definitely not carbs from cookies, and pasta, rice, potatoes, all this stuff. This is green leafy vegetables, vegetables that have grown above ground, as these vegetables don’t impact your blood sugar as much.
Treating the few hypoglycemia as that you still will experience, but not as many, with precision so that you don’t go up and down and down and up and up and down as we were used to on the high carb lifestyle that I was on before, but treat lows with precision. Use the exact number of grams of glucose that you need to get into back into a healthy, safe level of blood sugars. If you overshoot too often, then your average blood glucose is going to go up. If you want to bring your A1c down, then make sure that you stay in range as much as possible.
Second point is medication, whatever kind of medication you’re on. Yes, insulin, but I don’t want to discount any other sort of medications you may be on, they may have an impact on your blood sugar, please check this with your doctor. When it comes to insulin, there are two really important things that you have to do: number one, basal rate or your basal dose of insulin, the long acting insulin that should keep you stable throughout the day and night. Please test that this is correctly dosed. If it’s not, then it’s going to cause you to either slowly but surely go up in blood sugar or go down and blood sugar if you’re take too much basal. You can test this by fasting and checking your blood sugar every hour of that fasting window, you can either divide it up or do 24 hours in one go. The second part is of course, bolus insulin, the mealtime insulin. Make sure you know your ratios, and that they are properly calculated, or found out through trial and error, as they are in my case. The common ratio calculations that exists with high carb eating, don’t quite apply to all diabetics eating low carbs. So for very many of us it has to become a trial and error. With a law of small numbers, the error margin is not that big. So you’re not going to be in for a wild ride. It takes some time to figure it out.
Also pre bolus for your meals, even if they don’t contain that many carbs, just so that the insulin has a bit of time to start working before the food comes and does the same. What really helps when you’re trying to find out your medication and ratios and pre bolusing for meals, and everything else, is of course to have a continuous glucose monitor. This is either Dexcom, for example, or Freestyle Libre, or any of the other ones that are out there, whatever one fits you the best. I know they’re very expensive, and they’re very hotly debated as well. But they are a huge, huge help when it comes to really lowering your A1c, because when you see a trend you can start acting before the catastrophe is a fact, hyper or hypo.
The next point, is blood sugar levels. As a perfect diabetic, or whatever that means, you should try to aim for an average of 4.6 mmol/l or 83 mg/dl. This is what people who are healthy and have a functioning pancreas’ are on average. If you are at a much higher average right now, don’t try to get down to 4.6 or 83 in one go, do it step by step. All of the modern blood sugar meters have an average measurement of blood sugar. Depending on how often you prick your finger, it might may be representative of what it actually looks like. As soon as you see where that average is, just try to aim for values slightly below that. You will slowly but surely take it down to normal healthy levels and therefore achieve a normal healthy A1c. You HbA1c, in short, it’s the average blood sugar for the past sort of six to eight to 12 weeks.
How you correct blood sugar also matters! Don’t be aggressive about it, whether you have to correct a hypo or a hyper. That causes the large margin of error. Be careful about it, and have a little bit of patience. I’m the worst person to talk about this, as I have zero patience! Be sure that you have a little bit of patience when you do treat, as things can turn quite suddenly. Find out if you are affected by the dawn phenomenon, for example, which is when the liver kicks in and starts shooting out sugar so that you wake up in the morning. Or if you have something that is called boots on the ground syndrome, which is when you are have woken up and you put your feet on the ground and the stress of your day gets your liver going and your blood sugar consequently goes up. Those can also be fine tuned with basal insulin, which needs to be handled by a doctor.
Then number next is stress. Stress is a really a blood sugar killer! It really aggravates your whole system, and it causes your blood sugars to go up. Make sure that you can prevent and avoid as much stress as you can in your every day life. How can you reduce it? Well, you have to find what works for you. Could it be yoga? Could it be meditation? Could it be a long walk in the nature? Could it be a hobby, could it be having a pet? Stress is really something that we have to work all of us, but especially people with glucose problems need to work hard at trying to eliminate it.
Movement has a very individual reaction on blood sugar. In the long run it definitely smooths things out. But when you’re doing exercise, or you’re moving vigorously, chances are that your blood sugar is going to go up. You need to find out what strategy works best for you. There is a rule of thumb – strength training makes your blood sugar up and cardio makes your blood sugar go down. But that’s not true for everyone, that’s just a rule of thumb! You have to find out what works for you and what happens to your body in different movement situations.
Next point is planning. Make sure that you are prepared for basically anything when it comes to diabetes. If you’re traveling, carry a glucagon kit, always have glucose tabs with you, no matter where you go. And even if you’re only doing a quick run, make sure that you are prepared for anything that can happen.
No matter how great of control you have of diabetes, things still do happen. Please be prepared for all eventualities at all times. For example, also bring enough test strips for your blood sugar meter, make sure that your insulin pump or your vials have enough insulin in them for the day or the time you’re going to be away. It is all about planning. It really is about treating and treating blood sugar – if you fail to plan, you really plan to fail. Don’t get caught in that trap. That can save you a lot of “interesting” moments with diabetes.
Next point is mindset. What is your goal? Set a clear, actionable, timely goal. Also make a plan of how you’re going to get there. Without motivation and a proper mindset, you aren’t going to reach your goals.
Next one, acceptance. Accept that diabetes is what it is, life still happens with it. And you can only do the best you can, and you can only do the best that works for you. You can’t do much more than that. And please don’t hate diabetes! The more you make it your enemy, the more it’s going to lash right back at you and you’re not going to be able to work with it, which is what you have to do. You have to be kind to yourself, you have to show yourself some love, even when things go wrong. That way you’re going to get to a better relationship with your diabetes, which is also a huge point.
Find your support network, whether that is that our coaches, CDE’s and nurses, doctors, spouses, personal trainers, and other happy people around you, like your friends, family, pets – all of these people that that create the network around you. Make sure they are supportive. This is who you turn to when you have a bad day, or when you want to celebrate a fantastic achievement. You don’t have to sit there by yourself, you can turn to other people and let them help you both in good times and in bad. When it comes to the medical side of your support network, please make sure that you have a Medical Dream Team. This is a key to getting the care that you know that you need, and to try to find out what works best for you. This is where you can really get support for your lifestyle choices, and also help you with your diabetes management.
Hydration, you have to hydrate! Make sure that you hydrate properly, because this helps the body to keep all that, perhaps, unnecessary sugar at bay. The body really does well when it is well hydrated. I personally try to aim for about two liters of clean water a day. It doesn’t have to be that for you.
Finding a routine that works for you . A daily routine, as in you get up sort of the same time in the morning, you go to bed sort of the same time at night, and everything in between. Of course you should be spontaneous and have fun, too! But the main parts that could have a little bit of a structure will help you manage your blood sugars better. Perhaps this could include when you take your basal injection, if you’re on pens or syringes, or when you change your pump site. Also work into your routine when you take your supplements, when and how much you hydrate, when you eat, what you eat, when you move… Building it into a routine is great, because blood sugars, as far as I’m concerned, aren’t too happy about uneven routines, they tend to do better when there is a routine, so that you know what you’re doing.
My final point are supplements. Some potentially blood sugar lowering supplements may be of use. The ones that I take, for example, are omega 3, vitamin D (helps autoimmunity) magnesium (high blood sugars do require a lot of magnesium), also zinc for the immune system. Chromium also can help keeping your blood sugar levels a little bit more stable, as it helps with insulin sensitivity way down in the cells. Also, I’ve heard a lot of good things, but I haven’t tried it myself yet, about alpha linoic acid, ALA.
These are my 12 steps of what I did, and my HbA1c formula to lower mine from a double digit nightmare to a healthy and happy 5.0% (which actually in fact, if I get to brag for a second, is better than even some healthy people have!). I’m very very proud of myself, especially after 34 years of living with this disease and it not having been very easy at for very long periods of time.
What is your A1c goal (or if you are not focusing on A1c – what is your health goal)?
Let me know in a comment and I’ll be happy to chat with you there.
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