Tag Archive for: type 1 diabetes

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 – Why Movement?

Why should you focus on movement as a person with diabetes? Isn’t exercise just boring, but has to be done and potentially raises your blood glucose?

Not necessarily! It’s time for Type 1 Thursday, my Sweet Friend, where I explain why moving our bodies is a GREAT THING, what we need to focus on and how to do it.

Why Movement? – Type 1 Thursday with Hanna Boëthius

How do you move your body?

Transcription

If you prefer to read about why movement is so good for us people with diabetes, here’s a text version:

Movement – I’m talking about another lifestyle factor that you can do to perhaps help your diabetes management along. I call it movement, because exercise sounds like a lot of work, quite honestly. And I don’t like it to be seen as a burden for myself mainly, but perhaps also for someone else out there. So that’s why I call it movement. It should be fun!

Why should we pay extra attention to movement as people with Type 1 or Type 2, (or actually any kind of diabetes at all)? This is one of these power tools that we can use to get better diabetes management and results. Number one is that it helps our blood sugar management, even if we do perhaps spike during the the movement that we have chosen. The general rule of thumb is that heavy lifting and and anaerobic movement will raise your blood sugar, whereas cardio and aerobic movement will lower your blood sugar. This is, of course, as usual, individual, it’s just a rule of thumb. But it is just something that you can bear in mind when you are trying to get moving. With the fact that it helps blood sugar management, it also can help you lower your HbA1c. This is something that I have recently managed to do, again. That can be a good motivator for moving your body.

Movement raises your well being , to use your body the way it’s intended to, are not meant to sit (like I’m doing right now) we are meant to be moving around and enjoying using our bodies. The risk of cardiovascular disease is lowered with exercise. Also a potential weight loss tool if that is needed and wanted. Then it can be a huge benefit to move your body! Also more biochemically, the engines in your cells, called mitochondria, they actually increase in the cells with movement. The cells have bigger engines, essentially, when we move our bodies. This is a really good thing, as it keeps the mitochondria young, which is part of staying young in mind, body and soul. Movement can also lower your triglycerides, if that is a problem for you, and it can also lower your blood pressure. Movement raises our immune function, which is really great in times, like now, when the fall “nasties” are here. It also, first and foremost, raises our insulin sensitivity (I will get into why that is in a little bit). First, movement increases our muscle strength, and also our bone density, which is really great to prepare our bodies for maybe higher age. And yeah, those are some of the main benefits of moving your body. There are of course many more, you get out in nature, perhaps you feel and a sense of accomplishment, along with many mental factors that are really good when it comes to moving your body.

Why is movement helping our insulin sensitivity? Because the main part of our glucose storage is actually in our muscles. In our liver, too, absolutely, but it’s mainly in our muscles. We can use movement to help with sensitivity and blood sugar management. Insulin is key number one, of course. But movement can help control your blood sugar levels. The glucose in your blood goes into the muscles and is stored there. In a very short explanation, we become more insulin sensitive because the blood sugar isn’t in the blood anymore. It’s stored in the muscles.

Exercise does so much! But how do you do it? Well, it’s easiest to work it into a routine, it’s easiest to do daily movement, to have set times when you do it. What type of movement is best? It’s quite simple – choose something that you think is fun! It shouldn’t be a chore, it shouldn’t be feeling like a burden. It shouldn’t feel like that at all! It should actually feel like fun, like something you are rewarding yourself with, something that you’re giving your body as a treat. So the type of movement can be whatever you want, whether that’s dancing along to your favourite song, yoga, or maybe something on YouTube. I found a really great resistance band workout, for example, my muscles can feel it… Or you can go for a walk in nature, or you can run if you think that’s fun, you can go lifting if you think that’s fun. Play, for example, Primal play with Daryl Edwards is a fantastic way of moving your body without you actually realising that it’s proper exercise (and your muscles will be hurting afterwards). The key is to have fun when you are moving your body!

How to get started, it really is easiest to start small. It don’t take on too much, “I have to go to the gym three or four times a week, starting now”. NO! Start small, start moving more in your everyday life, take the stairs instead or the elevator or escalator, get off the bus stop earlier, park further way at the parking lot – all of these things that that are cliches by this point, BUT they actually do work! It gets your body moving. Slowly start to increase your muscle mass because muscles are our main glucose storage devices. The more glucose that is stored in there, less is in the blood. A really easy way to do this is, and this is something that I’ve been doing myself. Recently, I was inspired by a few people that I follow online, and I started the 100 push ups a day challenge I thought it was ridiculous, I thought I could never do it. I thought I was one of the weakest people on the planet! I started actually doing push ups against my kitchen counter, because I couldn’t do them on the floor. But very quickly, within those first 30 days, I could move on to lower and lower surfaces, until I now am doing all 100 (not in one go, I do them in sets of 15, and then 10 at the end) on the floor on my yoga mat. I’m very happy about it! It feels like an accomplishment. I really like that it also builds muscles, works many big muscle groups in your body. The bigger the muscle groups, the more effect you have. The other one that I added was squats. So I do 100 pushups and 100 squats, which takes me about 15 minutes or so to do this. It’s not a lot of time that you actually give up from whatever else, whether it’s 15 minutes or social media, 15 minutes of TV watching a day… It’s not a lot of time you give up in order to get the benefits of getting a bigger muscle mass.

Before you start anything like this, whether it’s yoga, the 100 pushup challenge, dancing – anything, do check with your doctor if you are okay to start exercising. In some cases, maybe not. So check with them.

Generally, movement can be a great tool for our diabetes management, all of us. I would love to hear from you, how do you move your body? What do you think is fun? Let me know in a comment.

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Gratitude

Reflecting on all the things we have to feel gratitude for is sometimes overwhelming, even if they’re all little individual sparks of joy in our lives.

Sitting here, being so overwhelmingly grateful that I have the chance to start yet another year. A year that I can choose to shape and form in exactly the way that I want to. A year where I’m more determined than ever to inspire those around me to become healthier, happier and feel more joy (not unlike my own goals!)

Throughout my life with T1D as my constant companion, starting a new year of life hasn’t always been a given. Yet, for many years I took it completely for granted. No more.

I found this great quote, which I think is very fitting today:

“I know as a woman I’m supposed to be afraid of getting older but I love this shit so much. Every year I sink deeper into this bath of unapologetic realness and it’s amazing.”

Bunmi Laditan

No matter how bad the world may look today, there’s always, always, always something to be grateful for. So much gratitude in the world!

What are you grateful for today? 🌟

(Post originally posted on my Instagram account – @hannadiabetesexpert

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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 – Why Real Food?

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!

Type 1 Thursday with Hanna Boëthius – Why Real Food?

Do you eat mostly real foods?

Transcription

If you prefer to read to learn, below is a text version of the video about real food above. You can also read why low carb is a great option for Type 1 Diabetics here!

Why Real Food?

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.

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Type 1 Thursday – Period & Blood Sugar?

Type 1 Thursday is back!

This one is for the ladies – managing blood sugar before and during your period, HOW?! 🥵

I was asked on Instagram about how I handle my blood sugar during my cycle, and I wanted to share my four best tips on what to do. It can certainly be tricky and requires extensive trial and error in order to find what works for you, but it’s definitely worth it.

Watch the recording of my Facebook live session here:

Type 1 Thursday with Hanna Boëthius – Period & Blood Sugar?

How do you manage? Share in a comment!

Transcription

If you prefer to read about period and blood sugars, here’s a transcribed version of the video above.

Welcome to the return of Type 1 Thursday! Type 1 Thursday has been enjoying a beautiful summer break. But we are now back and more than happy to share thoughts, concerns and everything else regarding Type 1 Diabetes, and blood sugar management, food, nutrition, all of these things that really bother us in our everyday life.

I am Hanna Boëthius, the founder of Hanna Diabetes Expert. I am also a Type 1 diabetic since 34 years, I was diagnosed in 1985. And I have a fantastic topic for you today! This one is for the ladies, so if any guys are watching, please, you’re welcome to stay. But it’s going to get a lot with female hormones and so on. If you’re interested, please tag along. If not, I completely understand if you choose to maybe not stay around for it this particular episode.

Today we are talking about how to control blood sugar, before your period during your period, as that can be really difficult especially when you do live with Type 1 Diabetes. It’s not just one hormone that is fluctuating at same time, and remember that you don’t even produce one of the key hormones. That’s why maybe don’t have as easy of a time as other ladies have.

Fluctuating hormones ahead of your period will, in most cases give you a very bumpy ride when it comes to your blood sugar. Our blood sugar is impacted by everything, not just insulin, movement and nutrition, those things that are commonly known as influencers of blood sugar. Beautiful hormones such as estrogen and progesterone definitely have a big impact on what happens to your blood sugar’s during, or ahead of that time of the month.

Estrogen and progesterone are the two biggest female hormones and are made in the ovaries, which is a really important thing for our bodies to do. It’s a natural thing that should be there and we shouldn’t suppress them, like some may suggest. They essentially prepare the uterus for the upcoming pregnancy, and if it doesn’t happen, that’s when you have your period. That is the whole point of those two hormones. So PMS or PMD, or whatever you want to call it, is all about the changes in hormone levels. That’s why you sometimes feel cranky, sometimes you want to cry about it, sometimes you are really hungry, and sometimes you crave weird foods that you didn’t have any clue that you were even eating anymore.

A lot of things can happen when your hormones are at play. This is also what causes the erratic blood sugars ahead of your period. Female hormones can also call cause insulin resistance, which is why we get fluctuating blood sugars. The body doesn’t react to the insulin like it should, because it’s impacted by the other hormones.

What can you do to make this better, to improve this for yourself? And what are the tips and tricks that maybe you can can do to to help your time of month get a little bit easier?

(I’m of course super happy to hear your experiences. Please share those with me in a comment somewhere on the internet, and I will continue the discussion with you there.)

Before I start the what’s and the how’s, remember that very often, in very many cases, insulin sensitivity returns on day one, or two of your period. Be careful and do not push too hard on the insulin dosing.

Number one of what you can do is to track. Track your cycle, when you have what symptoms and also track your blood sugar. There are beautiful apps for this! If you know of an app that combines period tracking or cycle tracking with your blood sugar, please let me know because I’m looking for one of those myself. What you do is to look at the trends from both of these trackings, and compare them and see where and when when you can expect to see the pattern of insulin resistance increasing. Then you know exactly on which day, at which point of time in your cycle, you have to start reacting. This can be done by on paper, as well. But I like to keep as much as I can digitalized, I would prefer to have an app to track both of these at the same time.

In terms of tracking, this is where a CGM really, really does pay off. You can see exactly when the blood sugar went up, and not have to wait for the finger prick to show you. CGM is the movie of your blood sugar, and the finger pricks are the photographs you take every once in a while. You simply get a more complete overall picture. I recommend every single Type 1 diabetic, who has the possibility, to get a CGM of some kind, so that you have a better overview of what’s going on in your body. We’re all individuals and all react differently.

Number 2, this goes hand in hand with the tracking – find out how insulin resistant you become so that you can change your insulin dosages in time. Or even before even the blood sugar starts going up. You can change your basal dose if that’s what’s needs tweaking and tracking during that time, or bolus, or maybe both need to be increased a little bit in the week or days before your period? Some women also experience a few days of insulin resistance when they ovulate in the middle of their cycle, but not everyone. And so that’s also a good reason for tracking, so that you can find out how much more insulin you need.

Number 3 is be ahead of the curve. Make sure that you do find the patterns through your tracking, so that you know what is happening when, to empower you to act before anything really happens at all. You have to go through how much you should increase your doses when you become insulin resistance ahead of your period with your healthcare professionals. Or if you feel comfortable doing it alone, then you know what, that’s fine. I suggest that you talk to health care professional, like your doctor, your CDE or nurse, who can help you figure this out and how to play with the dosages if you’re not comfortable doing it yourself.

Number 4, I know it’s difficult in many cases, but keep to your healthy lifestyle. Try to keep to your nutritious and nutrient dense foods that you’re eating, make sure that you move your body (that also helps the cramping), make sure that you de-stress because this is an additional stress on the body (which could also cause insulin resistance and your blood sugar’s to be wonky).Make sure that you have the supplements that you need, for example Magnesium can be really good for relieving cramps and also for de-stressing. Hydrate properly.

The reason why I chose this topic today is because I was asked on Instagram how I handle it in my own case. I have to say that I used to have huge problems with insulin resistance ahead of my cycle a couple years ago. My blood sugars would be up in the 200’s mg/dl, or 10-11 mmol/l, without me doing anything differently. I tried to handle it with these tips and tricks that I’ve just given you, I tried to work with insulin dosages, tried to work with all these tools that I have in my toolkit. Frankly, it was a hit and miss. I didn’t really know if I was going to be successful, if I increased the dose too early so that I would go low, for example. It was really difficult. But actually, and I know this sounds stupid, but the longer that I have stayed low carb and keto and not have eaten that much sugar, the more my hormones have, all together, regulated so that I don’t really have a problem today at all. Maybe it could be an age thing, as well. I’m older now, and I have a different body than I did a couple years ago. I really believe strongly that eating healthy, nutritious food can really help regulate your hormones, even the female hormones. Today I maybe notice a day ahead of my cycle that “oh something is off, I’m a little bit insulin resistant today”, followed by “oh yeah, of course”.

What are your experiences wit hormonal fluctuations and blood sugar? Leave a comment below and I’ll be happy to chat with you there.

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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 – Jet Lag and Blood Sugar Impact?

How does jet lag affect blood sugar? And how can you ease the burden? 

Last week, I attended the most incredible of events, KetoCon 2019, in Austin, TX (awesome city, btw! If you haven’t been yet, you gotta go!). With closer to 3 000 people attending the event, it was amazing to talk to people, connect, share stories and experiences, meet new friends, listen to mind blowing talks with tons of new knowledge. I also had the incredible honor of being a speaker at #ketocon2019, which was an unforgettable experience! (Universe, please send me more speaking gigs! Kthx!) It really is an amazing community, and I’m so proud and honored to be a part of it.

With traveling that far, however, comes a certain amount of jet lag. 7 time zones back and forth within a week is a little…. intense. So I wanted to tell you about how jet lag impacts blood sugar, and share some of my tips on how to make the jet lag easier on you.

What are your best jet lag tips? Let me know in a comment!

Transcription

If you prefer to read, here is the typed up version of the video above:

Today’s topic has been a part of my life for the past week or so. So I thought if it affects me, then it may affect someone else out there.

I recently attended KetoCon 2019, in Austin, Texas, where I was also fortunate enough to be a speaker. I was very, very touched and humbled by that. I had a fantastic time! The amount of people that I met, the awesome storys that I heard, connections, some of the samples I tried… Everything was amazing! So many people were there, it was a huge event this year, closer to 3000 people. I was very, very fortunate to be there! I really hope that I get to go back to KetoCon next year, and I hope that you will join me there as well.

I love travelling! Sometimes with the travel comes changing time zones, perhaps not all the time. But when it does, meaning that your body might be stuck in one time zone, where as you have moved on to the next. That discrepancy between what your body feels like and what it actually what time it actually is, where you are is called a jet lag. This time, we did a very short trip to the States, it was only a week back and forth. It was a little bit intense. Usually, there is a way or direction that it’s easier for us. For me, it’s going to the east, which is apparently uncommon, I have a lot easier to come home from the States to Europe, then going to the States. This will be taken into account for future trips, believe me…

Jet lag can also affect your blood sugar because your body feels like it is in a different time zone than you are and your insulin pump settings are not in tune with your body’s needs. This is despite that you have changed your insulin pump settings by the time you touch down on the new ground. Your body might need a different amount of insulin than what you are giving in at that point in time. This also happens with basal insulin, or long acting insulin, it’s not novelty for insulin pumps.

It is also a huge stress for the body to change time zones. It gets all confused about times and when to sleep and when to stay awake and when you’re hungry and when you need to drink. And when you have insulin, for example. We also know that stress is a blood sugar killer. Because this is such a stress for the body, this can really cause havoc on your blood sugars. (It wasn’t too bad for me personally, this time. I suffered more from a terrible pump site, than the jet lag itself.) And it didn’t help that I was travelling very quickly back and forth, across 7 timezones within a week.

I was going to share a couple of my best jet lag tips. Although they’re not 100%, clearly, but they may alleviate a little bit so that you don’t have to have such a bad time as you may think it might. So first of all, I wanted to clarify that actually a lot of jet lag is a mindset. If you decide that it’s going to be a terrible time being jet lagged. Guess what? It’s going to be a terrible time to be jet lagged for you! That’s not really any magic. If you decide that hey, yes, okay, admit to yourself, yes, it’s not going to be great. But at the same time, it’s going to be worth it for what I’m doing. You’re already halfway there. If you then also add to it that I’m really excited to go and I can’t wait to see what awaits me where I’m going.

Change the timezone already before you leave. That way you are a little bit more acclimatised to the new time zone even before you leave home. That can involve blocking sunlight, when it’s supposed to be night in the new time zone, or it can be being in front of really bright lights when it’s going to be sunshine and it wasn’t at home. Or it can be regulating caffeine intake, all kinds of things. And there’s a lot you can do yourself. But of course, there’s also apps and I just did a quick search on App Store, and there are so many jetlag apps that you can use. Go explore and find what works for you.

Also, hydration is super, super important for trying to prevent as much as possible of jet lag. First and foremost, this is very important while you’re up in the air, because being that high up anyways dehydrates your body. Don’t make it worse for yourself, as dehydration can cause even more problems. A little bit of electrolytes might not be the worst thing to keep your body fully hydrated, healthy and happy throughout your journey.

Make sure that you expose yourself to sunlight when you’re supposed to. When you have arrived go outside, hopefully it is during daylight time, so that you and your brain and your eyes and all this stuff that works together gets used to when it’s supposed to be dark, when it’s supposed to be light. Sunlight is healing, as we all know, lots of vitamin D, that’s great. Also the fresh air helps to maybe keep you awake rather than stuffy indoor air, when you’re not supposed to sleep.

Stay awake until at least 10pm local time, or whatever your bedtime is, so that you are least a little bit more on to the new time zone. There’s also of course includes no napping, do try to stay awake as much as you can until as late as you can or until your bedtime, whatever hits first. And then hope for a really, really good night’s sleep. If you can’t sleep through the night, which may have been my problem going to the US, definitely do a lot of meditation, a lot of snoozing until you feel ready to fall asleep again. You can also add supplements, such as melatonin and that can really help at least to go to sleep. It’s still debated on whether it helps you to stay asleep but it may help to go to sleep. You can also try things like over the counter histamine drops. Check with your doctor first. CBD oil can also help you sleep when you’re supposed to sleep, as does double magnesium.

Being in nature in the time zone that you’re not used to yet and enjoy the walk. That also keeps you from sleeping when you shouldn’t sleep. Do some yoga doors perhaps, there’s also a lot of jet lag yoga on YouTube, for example, that was very helpful for me, as well. But forest bathing definitely does help.

Keep busy. When I got home yesterday morning, I made sure to unpack my whole bag, put on the washing, so that I had something to do the whole time so that I wouldn’t fall asleep. Today, I feel a lot better, probably also thanks to my hydration plan and my forest bathing and meditation and all these things that I do implement for in order to help my jet lag along a little bit quicker and not just suffer from it.

What are your best jetlag tips I can’t wait to talk with you more in the comments below.

And wherever you are exploring next, enjoy and hope the jet lag is not too bad.

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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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