The only purpose of this video and website is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This video and website is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.
https://hannaboethius.com/wp-content/uploads/2020/06/T1TEP47Art.jpg7201280Hanna Boëthius/wp-content/uploads/2016/04/HannaDiabetesExpertLogo@2x.pngHanna Boëthius2020-06-25 21:05:002020-06-26 13:15:38“Why are you so harsh on yourself?” 😳
Today’s question is from Taylor, and she asks: “how to prevent high blood sugars while working from home? And not only by increasing insulin?”
Tricky, tricky indeed! And welcome back to another episode of Type 1 Thursday!
Essentially, what’s at the root of this question is how to improve your insulin sensitivity. And luckily, there are many lifestyle choices you can make to improve exactly that (even without necessarily just upping your insulin). And a lot of it comes down to prioritizing yourself.
As a note insulin requirements, however, is that you need the insulin that you need. Period. Whatever the situation, changes in routine, stress etc that makes your blood sugars run higher than normal, your body needs more insulin. I know way too well how hard this can be to accept, I’ve been there. Many times! But in order for your body to run optimally, it needs varying amounts of insulin at varying times. Try to meet this need with compassion and curiosity (and the necessary insulin, of course)!
👉🏼 What are your best tips to increase insulin sensitivity? Let’s chat! 👈🏼
Lifestyle choices that help insulin sensitivity include, but are not limited to, the following:
🌟 Stress management (try meditation, yoga, EFT, essential oils, bath…) 🌟 Movement (focus on body weight moves!) 🌟 Hydration (lots of clean water can help insulin sensitivity) 🌟 Sleep (both quality and quantity!) 🌟 Healthy and blood sugar friendly nutrition (low carb) 🌟 Any supplements? (Magnesium, Omega 3 & Vitamin D is a rule of thumb) 🌟 Find a routine that fits YOU
The only purpose of this website is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This website is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.
https://hannaboethius.com/wp-content/uploads/2020/06/46HighWorkFromHome.png7201280Hanna Boëthius/wp-content/uploads/2016/04/HannaDiabetesExpertLogo@2x.pngHanna Boëthius2020-06-18 21:00:002020-06-19 13:41:06“How Do I Prevent High Blood Sugars Working From Home?”
The only purpose of this video & website is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This video & website are provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.
https://hannaboethius.com/wp-content/uploads/2020/05/44eatweek.png7201280Hanna Boëthius/wp-content/uploads/2016/04/HannaDiabetesExpertLogo@2x.pngHanna Boëthius2020-05-28 17:49:572020-05-28 17:49:59“What do you eat in a day, Hanna?”
Do you ever keep a food log? 🤔 As you may know, if you’ve seen it on my Instagram I’ve been doing an experiment on myself with exactly that this week.
Having had to do so many, many times since my T1D diagnosis 35 years ago (including during my nutrition training…), the result is that I absolutely can’t stand it. It’s fiddly, too many numbers and honestly, I don’t even care about them (anymore).
Despite this, I decided to check that I’m eating enough, if I eat consistently and how/if my blood sugar and insulin requirements would change with changes in kcal (etc) intake. Normally, I care as little about kcal as I do about ketones, i.e. not at all. Counting calories doesn’t work, food is nutrition, which is information that the body uses.
BUT – I do believe in eating when I’m hungry/my body needs fuel, which ends up being two meals a day for me. I also believe in eating real foods from nature and minimally processed. And I believe natural fat is good for us (yes, also saturated fat). Throughout this week, I found a few patterns:
🌟 I ate somewhere between 1100-2000 kcal/day. My basal metabolic rate is around 1300 kcal. I had a few comments that that would be too little as an intake, but if you see me I’m not exactly skin and bones. I’m also a big believer in nutrition density, and I think my kcal contain more nutrition.
🌟 I seem to intuitively vary the amount of kcal according to what my body needs and tells me. LISTEN 👏 TO 👏 YOUR 👏 BODY! It’s natural that the level of hunger varies, and as long as I’m happy, full, satisfied and well nourished, I trust my body to eat what I/she needs. For example, I seem to be eating slightly less on my more active days. And I’m ok with that.
🌟 I bolus for my meals (this I already knew, of course). As bolus strategies are very individual, I didn’t see the point in announcing doses. Throughout this experiment, I’ve used a total daily dose of 17-21 units/day, with a 85% basal, 15% bolus split, just like I usually do. My blood sugars have been fantastic, too!
How do you feel about logging food? A fun experiment or personal torture? 🤔 Discuss!
As a reminder, to yourself or someone you know needs to hear/see it, this is my main point:
Would you prefer to read more about my food log experiment? Here’s a written version:
My Food Log Experiment
I have done something different this week. And I’m excited to tell you about it. I will tell you what I did, how I did it (well, that’s pretty straightforward)! But I will also reveal all the patterns that I found doing this little experiment.
As you may have seen, I have been logging my food, again for the umpteenth time in the history of my diabetes career, which has become quite long by this point, despite me only being 25 and I cannot see how that works?! 😉 But as you may have seen on Instagram, I have been logging my food again. I want to know from you, while I keep yapping on here, how about you tell me in a comment somewhere whether you are pro or contra logging food? I am very much against logging food – I really frickin loathe it, like I hate logging food. I hate it so much and this comes from my diagnosis having to do it well, I didn’t have to do it my but my parents had to do it for my diagnosis about 35 years ago this year. And also I’ve had to do it so many times since and especially when I’ve been struggling with diabetes, and it was really shit everywhere. And I yes, also of course, when I became a nutrition professional, I had to log a lot have food and I really, really don’t like it. So that’s, you know, my bias.
Despite this, I decided to do it now anyway, because I do think it’s good to sometimes check where I’m at in terms of how much I’m eating and all this stuff. I have to be honest and say that I really don’t care about calories, I really don’t care about macros, I really don’t care about the percentages here and energy percentages there. I don’t care about ketones at all, unless I’m sick, and ruling it out as a cause. I just focus on minimising the carbs because that’s what works for me. I know you’re a lot of people out there where this doesn’t work for or you don’t agree with it. But let’s just assume that we can be individual in our care and that different things fit different people. So yes, I really think it is a good idea sometimes to do check what it is that I’m eating. And you can do this with different providers such as My Fitness Pal or Cronometer.
My basal metabolic rate, as in what my body burns, when I do nothing when I sit and breathe, basically, is about 1300 calories. You can find out this in many ways, you can use manual things, or you can use online calculators or I also have my wearables calculate for me as well, and they’re always around 1300 calories. So that’s, you know, what I’m working with here.
In this week’s experiment, it has revealed itself that I eat something between 1100 and 2000 calories a day. To be honest, I don’t even believe in calorie counting. So I don’t even know why I’m keeping track. But I thought it could be interesting. I don’t see that calorie counting works, and especially not the way it has been made to seem to work. I much more believe in that nutrition is information for the body that the body can use to function properly. And I also strongly believe that our bodies are wonderful machines who can regulate this! If you dare to listen to your body, and this is my main message today; if you dare to listen to your body, it will tell you if you need more calories, less calories, more energy and in which form less energy in which not form.
I did get a few comments, not just one, about why am I eating so little calories? Again, for me, this is not really a problem because I don’t really pay attention to it, I pay much more attention to whether I’m full, whether I’m happy, whether I’m satisfied, whether I’m in a good mood, all of these things. And of course, my yearly checkup, I check if I have any deficiencies, but so far, it hasn’t been that way. So why so low calories? I really believe that I do eat food with very dense nutrition. So there’s a lot of nutrition per calorie, per gram of carb, per gram of fat and protein. There’s a lot of nutrition in the calories and the macros that I do eat. That’s why, if I’m not hungrier than 1100 calories one day, I’m not going to force feed myself just to get up to an arbitrary number for me. I am well nourished, as you can see, I’m not just skin and bones. There’s ample things to take off from here, so I’m not malnourished either. I eat however much I want, I don’t have any limits for myself, I eat however much I want until I’m full, happy, satisfied. And I really believe in that.
This experiment showed me that I intuitively vary calories according to my needs. It is something very natural for hunger to vary, and for calories to vary from day to day, depending on what you’ve done, how you feel, all of these things that have an impact. I came to the conclusion that I am quite good at intuitive eating actually, where I really listen to my body in terms of what it wants, in terms of how much it wants, in terms of what nutrition it needs on that day in that moment. Really, my philosophy is really as easy as, Eat when you’re hungry. Don’t eat when you’re not hungry. This leads me to mostly eat two meals a day, sometimes I have a snack between the meals, sometimes I don’t. It really depends on what my body is calling out for. An important point, because this is a completely different ballgame if this is your problem, but I eat without emotion. I think that food is joyous and it’s good and I enjoy food and it has to taste good. But I don’t eat because I’m sad. I don’t eat because I’m happy. I don’t eat because you know, there’s an underlying emotion. So if this is your ballgame, then there are tonnes of experts out there who can help you with this, but it’s a completely different thing to handle.
I also noticed that I tend to eat less when I have a more active day which sounds completely weird. Three days a week, I do bodyweight exercises for half an hour, I go out walking at least half an hour, and I do at least half an hour of yoga. So that’s 1,5 hours on those three days that I move my body. I do it because it feels good and not because I feel I have to do it. And again, I listen to my body, and it wants to move! On the other four days of the week, I do walking or yoga or both. It all depends on how I feel during the day. But yes, on the days I move more I eat slightly less calories, which was weird to me. But again, I don’t worry about it. I know my body can take care of itself. It’s fine.
Bolus for minimal carbs?
I also got a lot of questions if I bolus for the meals that I eat, considering there’s very little carbs in the food that I eat. Do I even bows for it? And yes, I do bolus for my food (which is what I said in my Instagram Stories very many times, “yes a bonus for this”). It is very important, of course, to keep blood sugar stable, healthy and at normal levels. This was a great success in the in that respect as well this week, my blood sugar’s have been great! I’m very grateful for that. I also corrected when I had to, and used insulin as normal.
Because bolus strategy for every person with diabetes is very, very individual, I didn’t see the point of actually disclosing any numbers or how many units I was taking or anything like that. It’s turns out to be a pretty arbitrary number, much like calories. How much bolus I take doesn’t really matter because it’s so individual. A lot of it comes down to what your routine is, what your eating habits are like, what do you usually eat? Do you eat a lot of carbs usually? Or do you eat less carbs? Usually, your bolus strategy will depend on these factors. It also depends on what kind of a role of your basal insulin, the underlying insulin, plays, along with so many other things, like what your fat and protein factors are and how much you need to bolus for protein, for example. There are rules of thumb, absolutely, for all of this, but for you as an individual, you will need to play a little trial and error to see what works for you in certain circumstances.
But as a little factoid, I used anything between 15 and 21 total units per day in my insulin pump. That means it’s both basal and bolus insulin. It works out to a ratio of 85% basal and 15% bolus. It doesn’t really tell you much, but it just shows that I do take insulin and I do take adequate amounts of insulin and I won’t go into DKA (as that is the danger of taking too little insulin, DKA is always due to at least the relative lack of insulin in your body).
Food Log Conclusion
So what is my conclusion of my (now) four day experiment, I cannot wait to finish it tomorrow. But my four day experiment so far is that I still loathe, I still hate logging food. It was a great reminder for me., It really takes away that joy for food, the joy of eating the sheer pleasure of eating and puts it too much into my head. There are too many thoughts, there’s too much planning. There’s too much of, “oh yeah, how many blah, blah blah was this and how many walnuts did I eat there?” and “how much cream was that?” It takes the complete joy out of it for me. And it also takes me out of trusting my body, listening to my body-feeling, that I find is so, so important, especially when it comes to eating. This was the quick-ish conclusion of my four day experiment of logging food!
Before I go, I wanted to ask you, what does food logging mean to you? Have you used one of these terrible chart-things that I used to get from my dietitian (when I still saw one)? Is it a fun experiment to check in on yourself every once in a while, or are you more Team Me and it’s a bit of a personal torture? Please let me know in a comment!
The only purpose of this website is to educate and to inform. It is no substitute for professional care by a doctor or other qualified medical professional. This website is provided on the understanding that it does not constitute medical or other professional advice or services. Instead, we encourage you to discuss your options with a health care provider who specializes in treating Type 1 Diabetes.
Are nutritional supplements needed for people with diabetes? And, which ones could potentially help?
Some say they can help diabetes management, others say supplements are the hugest waste of time and money. So what should you believe?
Here’s my take on nutritional supplements, and which ones may make sense for you to explore.
What supplements do you take, if any? Why?
If you’d prefer to read this information, please find a written version below:
The topic for today is supplements and nutritional supplements. Are they are needed for people with diabetes? Do they actually help at all? Is there a point of taking them? Or why should you take them at all? It’s quite a weird topic here because this one I can actually somehow give a little bit of advice on in comparison to last week’s episode where I couldn’t really say anything.
What are nutritional supplements? They can be anything from enzymes, for digestive issues, to amino acids that you may need for something specific that is not working properly in your body, vitamins, minerals. herbs, if you find that they help for something. It doesn’t have to be diabetes that you’re taking supplements for, it can also be something else. And why would you take them as a Type 1 or Type 2, as a diabetic? Well, some have been proven to increase your insulin sensitivity, for example, which we can all appreciate very much. It can also lower inflammation, some of them that have been studied on that in that department. That can also be good. because fluctuating blood sugars do cause a lot of damage, not only complications of diabetes. If you think of inflammation as rust in a chain, they can basically make your body feel like a rusty chain. And who wants that? Nutritional supplements are there to add the nutrition that you may be normally wouldn’t get or not enough.
I, myself, do take supplements. I have optimised my supplement game quite a few years ago when I really studied this and really got into what is good for people wanting a potentially healthier blood sugar management, improving your insulin sensitivity. I found that if I take the supplements in “batches”, so I buy a package of them and I eat them until they’re finish, then I have a break, then I eat them again, I noticed the most actually benefit for myself. That’s only myself and cannot be said for any other person.
What do I consider the most important supplements for blood sugar management, at least in my own case? I’ll also mention a few more that I’m currently not taking myself.
Number one of what I take myself is chromium. It helps the body to use glucose in a more efficient way. And it has also been shown to increase insulin sensitivity in that way. Chromium is one of these classic ones that I think when I was growing up, it was said to “help people with cravings”. My guess is that just means that it gets the nutrition in the form of glucose actually to be used better by the body- That’s why it would curb cravings, because cravings are sometimes (not all the time but sometimes) a lack of nutrition that is masking behind that.
Number two is another mineral that is magnesium. I swear by magnesium, I love it! I sleep better, for example. It helps the body relax, it builds up bones, it helps build and relax your muscles, and it also helps your insulin sensitivity to increase. That’s why I really, really like it. If you want a band aid of nutritional supplements, I would say magnesium is a big one of them, because it helps in so many ways! It can really be beneficial for a lot of things. Doesn’t have to be, but it is in many cases.
Vitamin D3 Supplement
Especially this time of year when is grey and crappy outside, vitamin D3 comes to the rescue. The “sun hormone” is what they call it in some publications. When the skin is hit by sunlight, cholesterol helps to build vitamin D3 to help the body with actually almost anything. That’s why they lean towards calling it a hormone, because of all the benefits it has. Vitamin D3 is unbeatable and if you have too low vitamin D, it can cause problems. Low vitamin D3 is linked to auto- immunity, that has been shown in a couple of studies. That’s my main reason why I take it, but also because I noticed it on my energy levels when my vitamin D3 is not in range. I really have to look out.
Zinc is very helpful for the immune system, which you know, if the immune system works properly, maybe I don’t have to be sick that much? That’s also what vitamin D3 does, it can also help your immune system to function properly. I take supplements that help my immune system along so that I don’t have to be sick. Being sick complicates diabetes management a lot, whether you have good control normally or not – it doesn’t really matter. Zinc does a whole lot of other things, as well, for example, it activates the insulin signalling pathways in the body so that the body can realise that there is insulin, and in that way may increases your insulin sensitivity. It can also help in the processing of insulin and very many other things when it comes to insulin in a normal, healthy body, but also for us diabetics.
Omega 3 Supplement
Omega 3 fatty acids is another supplement I take. I don’t generally eat that much fish when I am in Switzerland because I’m not close to an ocean. I’m in the middle of Europe, put a pin in the middle Europe, and you get somewhere in Switzerland. I just don’t feel that fish is that fresh that often and that’s why I normally don’t eat that much fish when I’m here. When I’m by the ocean, say on a Mediterranean island, for example, I do eat a lot more fish. There it is actually freshly caught the morning, and for me, that feels a lot better. That’s why i supplement with omega 3 fatty acids when I don’t eat that much fish. Omega 3 can act as an anti-inflammatory in the body. It has not been proven to help diabetes management, per se, but if you get the inflammation reduced, it definitely can help your blood sugar management. What it has been shown to do, though, is to lower triglycerides and raises your so called “good cholesterol”, the HDL, so it does do good things in the body.
CBD Oil Supplement
CBD oil calms you down, it is anti-stressing, anti-anxiety, and leads to better sleep. Sleep is a crucial part in diabetes management! If you don’t sleep well, you won’t have good numbers. Magnesium can also do that, of ocurse. But sometimes you need a booster in this sleep department.
Those are the ones that I take; chromium, magnesium, vitamin D3, zinc, omega 3, basically every day and CBD on and off when I have to. What else could be good for people diabetes?
I don’t like comparing a supplement to medicine, because they can’t be the same. But berberine can have a similar effect on blood sugars, as for example Metformin. It basically can make you more insulin sensitive.
Alph-Lipoic Acid Supplement
Alpha-lipoic Acid is an antioxidant, and it can increase insulin sensitivity, as well. It had also it has also been shown to help a couple of complications of diabetes, like for example, neuropathy or macular degeneration.
Also, you may find it a good idea to take care of those fancy little gut bacteria with some good quality probiotics, because we all know about the brain-gut axis and we know that we feel better when our gut flora is intact. Your gut flora can also be harmed by blood sugar’s fluctuating a little here and there.
Also, thyroid specific things, because another thing that people with autoimmune issues get… are more autoimmune problems! If you do have problems with your thyroid being a bit lazy, maybe a Selenium supplement could help? Or iodine? Do read up on that so that you know what you’re doing!
As always, do check with a healthcare professional or your doctor before you start anything new, and adding anything to your diabetes management.
So what supplements do you take? Do you feel they’re helping? And do you understand why you’re taking them? Let me know and let’s chat more in the comments below.
Real food is actual food, food that comes from nature and is not refined, made in a factory or tampered with by humans. And no matter of what way you choose to eat, be it keto, paleo, vegan or otherwise, we can all agree that real food is what is the best for our bodies, health and blood sugars.
But why is eating real food so important? And especially so if you live with diabetes? In this week’s episode, I outline a few quick points. Watch the video, or read the transcription below, and let me know your thoughts!
Ps.If you do like the concept of eating real foods, why don’t you join me and an amazing group of people at The Low Carb Universe 2019 in Mallorca, Spain in November? Incredible international health experts, amazing views, movement, joy AND 100% real food! You can book your ticket here!
Today I have quite an exciting topic, if you ask me, because my background is within nutrition. My topic for you today is the importance of eating real food.
I am so happy to hear your comments and ideas and thoughts about this topic or any other topic, actually, I’m easy that way! Jot them down in a comment below and I will be happy to chat with you there anyway, about real food.
If you ask me, that is the only topic where we can actually agree on, no matter what kind of diet we choose to follow or eat. I don’t really like the word diet, but I choose to use it anyway, as it’s normally the one used. The thing is, whether you are keto, paleo or vegan, or, well, maybe not the Standard Western Diet, actually, because the importance of real food may not be so, so big there. In any other diet that you may or may not be following, I think real food is the one thing that we can agree upon, that it is very good for us.
What I define as real foods is foods that don’t have a label. Real foods actually comes from nature, which is quite rare, if you think about the standard Western diet. It is foods like meat, poultry, eggs, fish, seafood, vegetables, and all these things that actually come from nature and from the earth and not through a factory, or from a factory or has been tampered with too much with by human beings. They’re just as clean and natural and real as possible. That’s my definition of real food, so that we’re all on the same page throughout this discussion.
The main point of this is that real food has no additives. What additives often do, is that they mess with your blood sugar. For example, maltitol is a classic example of this! It is a sugar substitute that still affects your blood sugar. Don’t be fooled and eat that, although it’s supposed to be great and “diabetic friendly”, can be labelled whatever you want to be labelled with whatever health claim. They still include things that are really not good for your blood sugar and really not good for your health. In effect, you’re not doing yourself any favours by buying these “health foods”. No additives, so that they can’t mess with your blood sugar, in this case, if you are diabetic, or live with a blood sugar problem.
If you are going to venture into that kind of a sphere with pre-made foods, I have as a rule of thumb for you. The food item can include five ingredients, and those five ingredients all have to be recognisable to me, I need to know what they are, without googling, because that’s cheating. Then, if I approve all of those ingredients, then yes, absolutely, I will buy it and consume it and enjoy it. But if that is not the case, it will most likely go back on the shelf! “I see it, I love it, I want it, I checked the carb count, put it back”, is pretty much like going to the grocery store with me. My poor husband, I mean, seriously… Anyway, 5 ingredients that are recognisable otherwise, to me, it is not worth the gamble of a possible really high blood sugar or a possible low blood sugar, because I’ve overdosed insulin. It’s just not worth the hassle for me.
What are the top my top three “watch out” ingredients for additives in food?
If you do live in the States, or a similar kind of an environment, high fructose corn syrup. Just stay away, that can really mess up so many metabolic markers within you, so much of your metabolic health can be ruined, because of the consumption of high fructose corn syrup. It’s just so highly refined and so highly tampered with that it’s not really worth it to consume in my opinion. It’s no longer food, it is just factory made.
Number two, trans fats, man made oils, trans fats, are really not good for you. They add a lot of unnecessary strain on your body and your metabolism (that you can just actually fix with eating real food). Adding real fat such as butter, avocado, olive oil, things that are actually not man made, but is made by nature, is a lot better for you than highly refined and processed fats.
Number three, and this can be a tricky one, I do admit it. So bear with me before you slam down the lid of your laptop or turn off your phone, but it’s artificial sweeteners. And with that I really mean the artificial sweeteners, the ones that have been made in a factory. Maybe stevia is fine for you, if you enjoy the the flavour of it. And monkfruit can also be fine. Erythritol to a certain extent, absolutely. But things like aspartame and things that we don’t really know what it’s doing with our bodies yet. It’s definitely not natural in any way or form, and that I would be careful with. I remember growing up, this was a huge thing, as long as there were artificial sweeteners, then, hey, this product is a go! I was raised in the 80s and 90s, when it was still a little bit more controlled what people with diabetes should be eating. I had to eat a lot of terribly sweetened things. It’s been shown in studies since that for example, fructose, which we thought back then was the holy grail for diabetics, can actually clog up your liver, so that it can’t do its job properly. Then your whole metabolism might be damaged.
There’s a lot to be said about this stuff, of course! These three things impact your gut health, they can have an impact on anxiety levels, they can, as I said, clog up your liver, so that can do its job properly. And other things like your skin and other things that are really important for us to work properly. These additives can make an impact on our health, and that’s not very good, is it?
I do want to sort of give a special warning, I did touch upon it a little bit at the beginning of this. For example, “keto foods” some of them or “vegan food” or whatever it’s labelled, heart healthy, don’t even touch this stuff is not healthy for you at all. Don’t trust the labelling on the box! Look at the ingredients, does it have five ingredients? Do you recognise them? Buy it, if you think you’re going to enjoy it, if it doesn’t, maybe you should rather leave it alone? “Foods”, such as salad sauces, sauces, spice mixes, soups, ready made things that you don’t think will have an impact can actually contain a bucket load of sugar and will impact your blood sugar. Stay with the real food is my opinion! It’s better for us, it’s healthier for us, and we’re going to feel a lot better.
If you’re just starting out from, for example, a standard Western diet, to going to more into the real food way of eating, then I really suggest you adopt the 80/20 rule, so that 80% of the time, on work days, you eat real food, and on the weekends, you can still have a bit of what you still think is fun.
I would love to hear from you. Do you eat mostly real foods? Let’s talk in the comments below and I can’t wait to see you next time.
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.
In today’s Type 1 Thursday, it’s time for a more personal comment…
Why do people disagree so strongly about what people with diabetes should eat, when we all should have a common goal (notmal, healthy blood sugars)?
What’s your opinion about this? What tools and tricks have you tried to try to manage your diabetes and what worked for you? I would love to hear in a comment somewhere and I will be happy to chat with you there. Comments and questions are welcome!
If you prefer to read, here’s the transcription of the episode above:
Hello, and welcome to another episode of Type 1 Thursday with me Hanna, one of the cofounders of The Low Carb Universe. Also, as I’m sure you’ve heard me say many, many times now, I’ve had Type 1 Diabetes since I was two years old. So for 34 years, I’ve been juggling this wonderful roller coaster that is Type 1 diabetes. And I am happy to share some of my knowledge with you that I figured out and some of the aces up my sleeve that I have gathered in these 34 years! I wasn’t always in control, as I am today. I was very uneven moment, even majority of my diabetes career…
But today, I want to talk about a topic on more of a personal comment. And this is actually something that I’ve gotten comments about before and also during this series, namely the nutrition debate for people with diabetes.
Why is it so inflamed regarding what you should eat as a person with diabetes? How can there be such divided opinions? Everyone who has an opinion seems to be going head to head with each other about this?
I’m actually sad about this, because we all should have that one common goal, which is that all people with diabetes are worthy of normal, healthy, happy healing blood sugars. How the person in question, who is living with diabetes, gets there should be less of a question – as long as they do. If someone comes to me and says, “Hey Hanna, I went vegan and since then my blood sugars are really great!” I’m like, “amazing, great! I’m so happy you found what works for you!” Or if someone says, “you know what, I’m following the Western diet to a tee, and I have amazing blood sugar’s” My response? “Great, fantastic!!
No one could be happier for you than I am in that moment, when you tell me that you have fantastic blood sugars regardless of how or what you’re eating, I, and I know very many people with me, who do advocate for a lower carb, real food, sugar free way of eating don’t want to be militant about it. It’s not that I want to convert every single person with diabetes, that’s not my point. It will never be my point.
But the point is to educate, to inform, and to make people with diabetes aware that they do have a choice.
There is a choice when you’ve tried everything else. When you’ve tried every single diet, every single insulin, every single supplement, way of eating, timing of insulin, there are still options. There’s always, always, always something that you can do in order to improve your health.
It’s not about being militant, it’s not about standing my ground and holding it tight. No,. My goal is for every person with diabetes, to know that there are different ways of managing blood sugar and diabetes, and it but it doesn’t have to be according to the standard Western diet, it doesn’t have to be a vegan approach. It doesn’t have to be low carb, it can be something completely different, as long as it works for YOU. The main point to find what works for you, you can’t look at anyone else. You can draw inspiration from other people who are doing something that is working for them, and then take the good parts. And leave what doesn’t work for you, it’s all about information.
I have had a struggling past with diabetes, it’s been very, very difficult for me to control my diabetes with the standard Western diet that I was told to eat for 26 years. Which, requires, well, recommends, 35 to 60 grams of carbs per meal, five times a day. For me that became unreasonable. It didn’t work. I couldn’t maintain good, healthy, normal blood sugars, without mountain tops and valley bottoms, in terms of blood sugars, which of course doesn’t make you feel great at all. It makes you feel terrible.
My whole point about advocating for low carb for diabetes, and I know very many with me, it is that as long as you get stable, healthy, happy blood sugars, we are all game for it. It wasn’t until I actually did start cutting down my carbs, coincidentally, perhaps, that I started to get better control of my diabetes. So I went from a double digit HbA1c, to a level of 5.1% last time. This is well within the healthy range!
I swear that I could not have done that without the help of dietary change, a change in my lifestyle, and a change in the way that I was eating. For me, I know that it’s not sustainable to do that on a standard Western diet with up to 240 grams of carbohydrate a day, I can’t chase that with insulin. We come back to the law, small numbers, this works a lot better for many, many diabetics.
I really wish I would have had the choice myself earlier to know about that there is a low carb way of eating so that I could have made the decision and try it out earlier, seeing the benefits. I would have saved myself a lot of pain, a lot of suffering a lot of worry, a lot of anxiety because that always comes hand in hand with wobbly blood sugars
This is this is why it’s become such a passion for me, and for the rest of us talking about low carb for diabetes, that every single person with diabetes knows that there is that option to try out as well. When every other option has been explored and transpired, that’s run out of time. It is so important to me that you know that there is another option. And that there are very many options beyond this, too. The main point is that this isn’t disregarded as an option.
So it’s so sad to me that the nutrition debate, especially within diabetes, but also generally, for the general population, has become so inflamed. And I really wish that we could see that we all have a common goal, all of us trying to educate people with diabetes, whether it is with different ways of eating, with exercise, with all of these lifestyle measures… I just would be so happy if we could just realize that we have a common goal, and that is that people with diabetes have normal, healthy, happy blood sugars.
If you have any questions or comments, or what’s your opinion about this? What tools and tricks have you tried to try to manage your diabetes and what worked for you? I would love to hear in a comment somewhere and I will be happy to chat with you there.
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?
What are your take aways from this video? Share in a comment!
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.
https://hannaboethius.com/wp-content/uploads/2019/03/T1Thursday.png10801080Hanna Boëthius/wp-content/uploads/2016/04/HannaDiabetesExpertLogo@2x.pngHanna Boëthius2019-05-17 09:00:012019-05-20 14:04:30Type 1 Thursday – Type 1 vs Type 2 Diabetes
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.
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