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Type 1 Thursday – Why the Dietary Wars?

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)? 

Type 1 Thursday with Hanna Boëthius – Why the Dietary Wars?

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!

Transcription

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.

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Type 1 Thursday – How to eat at restaurants

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

Not necessarily!

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

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

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

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

Transcription

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

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

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

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

Why are normal blood sugars so important?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Type 1 Thursday – 5 Lies Your Doctor Tells You About Diabetes

Today, we’re talking about 5 lies your doctor has told you about Diabetes.

It’s not your fault that you’ve been told these lies. Or that you believed them, either! Do these sound familiar to you? Do you need carbs? “Eat and cover for it with insulin”? DKA? Complications? A cure for Type 1 Diabetes?

Check out this episode of Type 1 Thursday and see what is really going on with these lame excuses!

Which ones have you believed? Are there any you still believe? Or have you been told other ones? Share in the comments and let’s talk about it!

Transcription

If you prefer to read, here’s the whole (pretty much unedited) text:

Hello, and welcome to this week’s episode of Type 1 Thursday with me Hanna Boëthius, one of the founders of The Low Carb Universe, as well as a type one diabetic for the past at least 34 years. I have a few years of experience with this chronic disease, and I am now happy to share some of my knowledge with you all in this series that we call Type 1 Thursday. I have a whole thing planned for you guys, and it’s a presentation that I have done in the past but I thought it’s very important information and so that you should know it as well.

This is the five lies that your doctor has told you about diabetes. And I cannot wait to get started. Because these are quite fundamental things that a lot of medical professionals or even doctors have troubles realizing and that I’m quite sure that you have been told as well. So let me know in the comments which lies you believed or which ones you’ve been told, so that we can get those straight and maybe not believe them anymore.

My number one lie that your doctor has told you about diabetes is you have to have carbs. This sounds very, very silly to me now, after eight years of low carbing my way through life, as a healthier, happier, better human being. So that sounds really weird to me now, but it didn’t sound weird to me then, which is when I believe this and I was told it that, yes, your body needs carbs.

This is partially true, your body does need some carbs and some sugar. But your body’s also clever enough so that it can sort that mess out on its own and you don’t actually have to add any, if very, very few carbs from the outside to maintain that equilibrium of carbs versus rest of stuff in the body.

The carbs and insulin are not a match made in heaven. injected insulin is first of all, not by any means as precise as endogenous insulin so if a human being produces insulin on his or her own, that is a lot more effective than the injected insulin that you as a type 1 diabetic will have to inject. And, of course, the disparity between these, you can never chase a lot of carbs with a lot of insulin because the equation very rarely will match. This goes back to apparently my favorite topic in this, which is the law of small numbers. So if you work with small numbers, small levels of sugar, and work with small levels of insulin, they are easier to make happen and make that into an equation that actually adds up.

Also, of course, this makes me wonder why the official recommendations are still 45 to 60 grams of carbs per meal for diabetics? I think that is ludicrous, I don’t understand why because clearly, clearly, clearly, you can survive on almost none carbs because your body is so beautifully clever in that way, so you don’t need carbs is the conclusion for line number one. And there are alternative fuel sources for your body to function.

Lie number two, hey, just eat what you want and come in for it with insulin, that will work. Right?

Well, it does work for some, it just doesn’t work for myself, and many, many, many other type 1 diabetics out there. It is, as I already mentioned, too difficult to match a lot of sugar with a lot of insulin. So it isn’t the ideal treatment. I mean, it is the best treatment we have out there but it’s not the ideal treatment because it doesn’t work with injected insulin and with carbs. So don’t be fooled that you can just eat anything and just cover for it with insulin because in very many cases it doesn’t even work.

Hyperinsulinemia has been shown also to cause an array of crazy things in the body. It has been linked to certain cancers, to coronary heart disease, to Alzheimer’s, it’s been linked to a lot of things. So if you can help it, maybe it’s not the best idea to put a lot of insulin into your system if you don’t have to, what is the point of that. Also, insulin toxicity is of course, another thing to mention here. That is something that we need to of course, have a lot more research on but for now, I don’t want to jinx anything and I don’t want to be playing with uncertainties, when I have another way of doing it.

It also of course, when you eat whatever you want and cover for it with insulin, it does make the margin of error way to big for comfort, and that is one of my main points of eating low carb as a type 1 diabetic, it is the margin of error or just too large to handle for me. This sends your blood sugar on a roller coaster rocket ride, it goes up and it goes down and you have to treat with insulin, you have to treat with sugar you have to treat treat, treat. You still have to have a normal life. But all you’re going to do if you are on that roller coaster is to manage diabetes, and that is not what I want for you. That’s not what I want for myself. That’s not what I want for any type 1 diabetic. This is why I call it a lie because it’s not sustainable for very, very many of us. For those who it is sustainable for, yay, good for you! Awesome that you found what works for you. But for us that it doesn’t work for I want you guys to know that there is another way of managing diabetes. So conclusion for number two; too much insulin isn’t good, either.

All right, and then I have a sneaky lie, number two and a half. Without masses of insulin in your body, you’re gonna go into diabetic ketoacidosis (DKA). I did a whole video about this a couple of weeks ago, and I think I, well, at least I aimed at trying to explain to you that this was not the case. This has nothing to do with how much insulin you have in your body, it has to do with that you have enough insulin in your body, but it doesn’t mean that you need masses of it.

There are many, many factors that that are needed for a diabetic ketoacidosis to happen. High blood sugars, dehydration, there are large ketones and not like the large ketones that they mentioned in these nutritional ketosis graphs. No, no, like really high ketones like 10 mmol/l and upwards for it to be a DKA.

A DKA requires, what did we learn a couple weeks ago, we learned that it requires a lack of insulin in the body and nothing else. Nothing else can actually push you into DKA apart from the lack of insulin or being dehydrated.

There are very many ways that you can avoid a decay even if you’re a type 1 on a ketogenic diet. Normal glycemia (normal blood sguars) has been shown to actually have less occurrence of DKA. If your blood sugars are normal, stable, healthy blood sugars that all diabetics deserve and should aim for, the risk of going into a DKA is pretty small.

This is leads me shamelessly onto my third lie, which is all ketones are bad. Even trace ketones are bad for every single diabetic.

It feels like I also did the video a couple weeks ago on this topic, because this is of course, when diabetic ketoacidosis isn’t at all the same as nutritional ketosis. They’re two completely different things. And what’s needed in between is of course, the lack of insulin we come back to this again. So, trace ketones may be a danger if you are a sugar burning diabetic, who is not receiving in either way, the insulin that the body is needing or that you actually just don’t have control of your diabetes that then trace ketones can be bad. Yes, absolutely. But if you are a controlled fat burning machine of a diabetic, there won’t be a DKA. As long as you keep taking the insulin the body’s needing, you keep hydrated and you keep an eagle eye on your blood sugars, it’s not harder than that. So keep at it.

Ketones are a great fuel, if you know how to use them. So the conclusion for line number two and a half and three is DKA is easy to avoid even as a type one on a ketogenic diet.

Lie number four, complications are a natural progression of diabetes. This one actually really annoys me because not only is this said widely and freely and by everyone who is educating diabetics around the world, but it also comes with the terrible advice of eating 45 to 60 grams of carbs per meal, how is that possible? Those two things are absolutely are correlated, because high HbA1c, above the normal, healthy level and ranges, has been shown to cause more diabetic complications.

I know I don’t have to, but I’m going to anyway, diabetic complications are things like retinopathy, potentially blindness, amputations, nerve damage, renal failure, heart problems, high blood pressure, all of these things that can be correlated with high blood sugars, and of course, you get high blood sugar if you keep eating all that sugar!

Furthermore, a healthy A1c is nax 5.5%, which I think is very interesting because for a diabetic is anything between 6.5 to 8% of HbA1c. Why is that? Why do they think that diabetics are going to be healthier at a higher level than normally healthy people? That is an equation that I can’t make work in my mind. So that is why I also call this a lie because, of course, when the goal is set so high for diabetics, they are more prone to complications. Then it becomes a natural progression.

Stable, normal, happy, healthy blood sugars are the leading cause of absolutely nothing. Then you can live a healthy happy life with both type 1 and type 2 diabetes, and all the other types as well. But that does have the prerequisite that you do get the chance to get the information that this is a possibility, which of course a lot of people don’t today. That makes me sad.

Conclusion from lie number quatro is stable, low blood sugars will keep you safer from complications, then the high blood sugars that are set as the goal for us today.

Lie number five is a cure is just around the corner. And I bet if you do live with Type 1 Diabetes, you have heard this at least a gazillion times. Every time I went to my endocrinologist as a child, every time, and I can’t even imagine how many times my parents have heard this too.

Back in the day, and it’s always in five to ten years. Yeah, listen up people. It’s been 34 years, and I’m still waiting for this cure to happen. So, I’m sorry, but I’ve lost a bit of faith in this statement, which is what is causing me to also call it a lie.

There have been fantastically promising advancements made in terms of managing diabetes. We have, we have insulin pumps, we have continuous blood glucose monitors, we have got blood glucose monitors that need a lot less blood, they’re a lot less invasive. We have so many treatment options now and especially super exciting with the closed and open loops that are coming out on the market. And that is going to be fantastic. But I have to be a little bit pessimistic when it comes to cure because I don’t think that that is actually even on the horizon, although there are a lot of attempts going on. But there’s not that much progress being made. So the conclusion from why number five is, there’s going to be a lot more done for diabetes management, but maybe not as much as we hope for a cure in the foreseeable future. At least, I hope someone proves me wrong. I really, really do hope someone proves me wrong, but from what I can see right now, this is not the case.

Which one’s of these lies have you believed? Have you been told maybe or have you been told any other lies that I didn’t have time to bring up in today’s live session? Let me know in a comment, and I will be happy to discuss it. There. have fantastic rest of the day. And I will see you next week with a new episode of Type 1 Thursday. Bye!

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Type 1 Thursday – How to treat hypos

Let’s talk about treating hypos/low blood sugars in today’s Type 1 Thursday!

How do you treat your lows? What do you use?

Comments and questions are, as always, welcome!

Transcription

If you prefer to read:

Hello and welcome to Type 1 Thursday with me Hanna Boëthius, one of the cofounders of The Low Carb Universe. And of course, also a type one since 34 years this year. Yay. Let’s celebrate. That’s a question actually for an other T1T about dia-versaries. Do you celebrate your dia-versary? Or do you not? I tend to not really because I don’t really see the point. But let’s keep that for another live.

Today, we are talking about hypoglycemia. And that is, for those who maybe aren’t as in with the diabetes lingo, low blood sugars, so when your blood sugar level drops too low, and you maybe won’t be able to carry on as usual.

Yes, this will also happen, of course, when you are low carb, this is no guard against lows and hypos, but I will tell you this, it will happen less, because of the of course now legendary law of small numbers. Because you’re not adding tons of insulin and tons of sugar, you don’t have the that huge error margin. So you’re playing with small amounts of sugar and small amounts of insulin, so that you don’t ever really dip that low. Anyway, so hypos do happen and they still happen on and off for me.

What has changed for me, of course, from when I was high carb to eating low carb, and therefore took a load of insulin is that the amount of carbs needed to treat a hypoglycemic episode is, of course, a lot less. And I will go through this in a little bit to show you the comparison.

Hypoglycemia has different symptoms, you can be shaky, you can have a bit of brain fog, you can’t really think clearly your vision can go blurry. And you can, there’s so many different things that for example, at times, I’ve had that my nose get goes tingling, or my lip. But now I rarely experience these episodes. And when I do they’re not as low like my blood sugar level is not as low as it maybe it has gone before.

What happens when you have a hypoglycemic episode is that you’ve taken too much insulin, there’s nothing in the world that can cause you to hypo and but actually taking too much insulin for the required thing that you took more insulin than you needed in that in that specific example.

So for example, maybe you took a little too much for the meal that you just had, or maybe because of exercise, you got extra insulin sensitive, there’s so many variables that can make you sort of overdose on insulin, but you know, apart from just shooting up too much. So yes, there are many, many reasons for why but there’s only one sort of correlation as to why you get a hypoglycaemic episode, and that is taking too much insulin for in comparison to your needs. And that’s it.

What I think is very, very interesting, when you do go low carb and high have lower blood sugars than desired is actually that ketones, and this has been proven in some fancy study or another, actually seem to have a cognitive protection for your brain. So even if your your blood sugar is low, and you don’t have enough, well enough, let’s call that sugar in your system, your brain will still function, because it is also fueled by ketones, so it always has fuel rather than relying on only sugar, which is of course, a little bit, well, maybe not ideal. It’s always nice to have double, and fuel sources for your pretty little brain to keep busy with.

What is the definition of a hypoglycemia?

This is something that we can debate forever, because it is very, very individual. So for me, for example, I think the official one is under 3.9 mmol/l, which is about 60 mg/dl, is the lower limit. Anything under that should be treated as a low blood sugar.

According to the conventional method, one should treat hypoglycemia with eating 15 grams of carbs, wait 15 minutes, measure again, and repeat if necessary. That is what it’s taught to all of us diabetics out there. I have figured out that I maybe need something a little bit different than that specific method. But then again, I don’t do things by the book anyway, do I so no surprises there.

Because my carb sensitivity has gone up so much. I’m so sensitive to carbs now because I don’t need them too often. So that’s something I’m happy about. Because in return, my insulin sensitivity has gone up like crazy.

What I usually do is I if I measure a low or if my CGM tells me that I have a low, I will take, listen to this, two grams of glucose. And maybe four grams, if it’s really, really low, and then I will be fine within about half an hour. And because I can keep cognitive for longer, how do I say this without getting into trouble, at relatively low measurements, I can still stay cognitive. And I don’t mind waiting instead of shoving everything in my face, like have done many, many times. When I was high carb, I sometimes needed 25 to 50 carbs to treat a low because I simply had that much insulin swerving around in my system and it being too much for me, of course. So that’s why I needed so many carbs to treat back then. And now I need to for maybe if it’s a really bad one, I will need six grams of glucose.

What is low for me? I don’t generally treat until sort of around the 3.0 mmol/l, about 60 mg/dl. And that also depends on if I’m at home or if I’m out and about. If I’m at home, I can take my time treating it, I don’t have to hurry up and get into a safe zone. But that’s different if I’m out and about, and then I take two grams of glucose, I will minimize the basal on my pump, so that it is at 10 or 20%. So that doesn’t keep giving me insulin during my low as well. That’s usually is enough to get me up to a safe sort of 4.0 mmol/l, so 80 mg/dl to 5.0 mmol/l. And this is where I feel the best as well.

I don’t want to overcorrect it either, because this is not comfortable. This is where the most damage happens to your to your system, with either continuously high blood sugars or jumping blood sugars. I try to avoid that those two things as much as possible, which is why I don’t, or I try not to, over treat my hypos when they do happen, which is not very often anymore. I do not read my kitchen over there to find whatever I want to eat, because this is the opportunity to just eat all these things that I normally can’t, because then I would be over treating it. Anyone who has had a hypoglycemic episode or a low blood sugar knows that it’s a terrible feeling. It’s an absolutely terrible feeling. And your natural instinctive is to just stuff your face with as much food as possible, to be safe, and to be to get your blood sugar into a safe range.

I have relearned this. I actually had a period of my time of my life where I was really really afraid of hypos. So I knowingly kept my blood sugar at a higher rate, which I don’t recommend either, because that didn’t work out, as everything else that I tried back then. What I do now is I keep my calm because I know I have this alternative fuel source that will keep fuelling my brain, which are of course ketones. But if it does happen, and this is not a sponsored post, I pay with my own little cents and dollars for these, I take one or two of these, which I can find in any pharmacy. One of these is 2.2 grams of pure glucose. I take one of these, and then I put my pump on a minimum basal rate. And then I retreat after 25 to 30 minutes, if the level hasn’t changed. I want to show you my favorite flavor as well, which is blueberry yogurt. If you’ve had to use them, you know that the taste of glucose tabs isn’t fantastic, ever. They do taste like chalk. They don’t have very imaginative flavors, but this one is actually the best one out there.

Glucose tablets are just another medicine that I need to actually save my own life at times. So I don’t see it as an opportunity to stuff my face or or treat myself to anything. It’s just another part of medicine that I need to in order to be well. That is how I treat my normal hypos.

I have to touch wood here, I haven’t had hypoglycemia where I need help from other people. in very many years, since I actually started low carbing, those have completely disappeared. Before, it used to be a lot more, as I was playing with a lot of active insulin in my system. And that is sometimes a recipe for disaster. I also have, as I spoke about in the previous episodes, a glucagon kit in the kitchen so that it’s easily easily reachable for my husband, for example, and who is mostly the one who’s here with me, or for myself, if I would really need it. And this could be a case of life and death. This is where the glucagon does so, it activates the liver to push out its extra sugars, and glycogen storage. And that’s how the blood sugar raises itself. Well, not by itself, but how it’s prompted to raise with a glucagon kit. And those are always good to have around, because you never know how you’re going to react to something. In case something isn’t going to plan, then it’s good to have one of those. And you can actually, which is in emergency cases, you can also micro dose these. So for example, if you have a stomach bug or something and can keep anything down, not even liquids, although going to a hospital is a very good idea if you can’t keep down liquids. GLucagon could be a treatment option then, as well. I also read that they’re working on a nasal glucagon, like a nasal spray to activate the glycogen storage in that way, which I think would be fantastic. Because that mechanism of filling a glucagon kit can be quite intimidating. Luckily, I have drilled this into my husband’s brain, so he would be able to do it in the case of an emergency. But normally, I can do with one or two or maybe three glucotabs if it’s really bad, and I am happy.

As I said, this is not a fun topic because hypoglycemia are very, very, very uncomfortable. And even more so when you are maybe with people who don’t quite understand what is going on. But as long as you know that you can treat your own hypos, then you are pretty much all right to go and enjoy everything.

Anyway, I love that you were here with me today that you’re watching that you are sharing successes, writing all of these things. Thank you so much for the hearts and the likes and loves.

I’ll be back next week with another episode of type one Thursday. I’ll see you then. Bye!

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Type 1 Thursday – Traveling with Diabetes

Today we’re talking about traveling with diabetes on Type 1 Thursday!

What are some tips and tricks you should bear in mind when traveling? And what shouldn’t you do?

You can find my travel check list for diabetes here!

What are your best tips for traveling with diabetes? Let me know in a comment!

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Type 1 Thursday – Total vs Net Carbs?

Today, I’m talking about total carbs vs net carbs – which one should you count?

Carb counts are sometimes difficult to bolus the right amount for, so also on low carb/keto. Especially since food manufacturers love to state “net carbs” instead of total carbs on their products…

Find out more about what I think of this, and, more importantly, what you should do, here:

If you want to learn more, why don’t you join us at diabetes. in Sweden in June? bit.ly/dia2019

How do you bolus on low carb, for total or net carbs? Let me know in a comment below!

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Type 1 Thursday – DKA vs Ketosis: are they the same?

This is one hot potato (ha!) in the diabetes world: ketosis and DKA.

How do you get DKA, diabetic ketoacidosis? what is it, what’s dangerous? And ketosis, what is that? How do you get there, and is it dangerous, even for a Type 1 Diabetic? Check out the latest episode of Type 1 Thursday to find out:

  • Please note: This information is based on my personal experience and should not be understood as medical advice.

Andrew Koutnik is a fantastic researcher and T1D, who has summarized the difference between DKA and ketosis in a handy chart:

Physiological Differences Between Ketoacidosis and Very-Low Carbohydrate Diet.
Source: https://www.andrewkoutnik.com/blog/2018/9/8/part-3-optimal-blood-glucose-control

Andrew writes:

Ketoacidosis involves dangerously low or absent insulin which causes glucose and ketone levels to rise. A VLCKD has low to moderate insulin which is sufficient to control blood glucose in the homeostatic range while allow low to moderate elevations in ketone bodies. This pathological (ketoacidosis) versus nonpathological (VLCKD) physiological states are vastly different.

Andrew Koutnik, “Part 3: Can you Achieve Optimal Blood Glucose Control as a Type-1 Diabetic?”

I highly suggest you read the rest of Andrew’s blog post here, there is a magnitude of great information in there!

Jon us for more discussions like this at diabetes. by The Low Carb Universe in Sweden in June 2019!

What are your experiences with ketosis or DKA? Leave a comment!

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Type 1 Thursday – Fasting and T1D?

Join me for another Type 1 Thursday, ahead of our Diabetes. by The Low Carb Universe event in June (bit.ly/happydiabetes)

Today, we’re talking about fasting and T1D. Is it possible? Should you do it?

Do you do some kind of intermittent fasting? Have you noticed any benefits as a T1D? Questions and comments are welcome! 🙂

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Type 1 Thursday – How Many Carbs?

It’s time for another episode of Type 1 Thursday!

Today, Hanna talks about how many carbs one “should” eat as a T1D?

Learn about this, and much, much more at the world’s first diabetes and low carb event: diabetes. by The Low Carb Universe in Stockholm, Sweden, June 19-23!

How many carbs do you eat per day? Is that more or less than you “should”? Questions or comments are greatly appreciated!

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Type 1 Thursday – Hanna’s Story

Join me for this week’s Type 1 Thursday!

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

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

What is your story with diabetes? Leave a comment!