How important is mindset in diabetes management? What difference can it make? 🤔
It took me so long before I realized just how big of a deal mindset work is when it comes to diabetes management. How do you react when you see an undesirable number on the display? What are you thinking when you’re faced with a meal you know you won’t feel good eating? And what can you do to help your diabetes management be a success in the long run?
It’s time for Type 1 Thursday!
And – if you want the whole presentation on this topic from me, why don’t you join me at The Low Carb Universe in Mallorca, 12-17 November 2019? Check it out!
And 2 – I do a live every week on Facebook and Instagram to discuss a topic about Type 1 Diabetes that maybe you haven’t discussed with your doctor or healthcare crew. Join me at 6pm CET on Thursday’s!
Have you noticed a shift in your mindset? Or do you need one? Talk to me! 😊
If you prefer to read rather than watch a video about mindset, here is a text version of the points I made above:
How can mindset can help your diabetes management? How he can help it and what difference can it make, or how can it hinder you?
As I define it, these are my own figures, not at all scientific! This is my experience and from the people that I’ve talked to about this, but I see that having success maintaining a healthy lifestyle, 30% is food and medicine, I see another 30% in other lifestyle factors, movement, hydration, sleep. To actually make your health care successful, I do see that there is a 40% need for mindset, as well. Don’t discount the mindset part because it is very important! And maybe even more important than you know! How exciting is that?
There is a fear of geting caught in a trap of constant perfection. No type 1 diabetic is always perfect. No health cares are ever completely perfect. We all make mistakes. And that’s okay. And that’s a huge part to realise when it comes to mindset! You have to be kind to yourself – that is just the starting point. And do remember that all feelings that you have, whether it’s about diabetes or something else you’re trying to get a better grip of, all feelings are completely and entirely OK! It’s okay to feel them. It’s okay to have them. They are all OK.
“Fixed” vs “Growth”
There is this theory of that we flip flop between what is called a fixed mindset and a growth mindset. (I have a full length presentation on this, join me in Mallorca to find out more!) What I’ve seen from my research, we basically flip flop between these two mindsets depending on the situation, depending on what we’re faced with, actually depending on a lot of factors. As a sort of rule of thumb, a fixed mindset is that you avoid challenges, and that you give up very easily. Making effort is actually a bad thing for you, in the specific situation. You’re “just not talented”. A “why me” mentality usually goes into the fixed one. Running away from critique is also common. Other peoples success is threatening, too. I’m sure we can all recognise some parts of this in ourselves in what we were doing and how we’re reacting to things!
On the other side of the fixed mindset is the growth mindset. A growth mindset is where you seek challenges, you keep trying, even though you maybe fail sometimes and you see making an effort as the key to actually making something a success. You ask yourself, “what can I learn from this situation” rather than, you know, “why me” and “I’m not talented”. Your motto is basically “I can do it”, and other people’s success is inspiring to you.
These are the two mindsets that we flip flop between, depending on how we how we react to things. Also, I think that we are many who can recognise ourselves in the growth mindset. So it’s not all bad! We’re not only, you know, “everything is shit” and “why me” and “I don’t want challenges”. I think we all have parts of both! I find it very interesting when we start paying attention to this. And I’m sure this is something that you can do, for example, in your diabetes management. How do you react to, for example, that blood sugar reading? Is it “why me” or is it “okay, what can I learn from this?”, for example.
Mindset is not…
Mindset is not a magic bullet of motivation. It is definitely not a shortcut to success, if anyone got that, and mindset is nothing that we’re born with, it’s something that we learn. Mindset is not the same as positive thinking, either. It’s also not fixed in these two categories I talked about above. You’re never stuck in one, as I said, we flip flop between both of them.
Added to this, more specifically to food, is actually the diet mentality, or diet mindset. I wanted to highlight it, because I think it’s so terrible for lots of people with diabetes, and for anyone really who tries to look out for their health.
A diet mentality is where you see food as the enemy and you’re focusing on your bad habits – that you would have bad habits to break somehow. You’re looking for temporary fixes. And you’re focusing on what you don’t like about yourself, how silly is that? That’s not the way forward, the way forward is to focus on things that you do like about yourself and increase those and then the other ones will follow. Diet mindset is where you’re really focused on the scale. I don’t feel like that is a good measurement of anything really, the scale. I threw out my own scale very many years ago, and I only weigh myself at the doctor’s office, because they require it. Otherwise, I don’t really care what it says. It’s some sort of arbitrary number on a piece of electronic machinery (or even if it isn’t electronic) – it doesn’t really matter that much. Try to step away from the scale! Also in a diet mentality, you think that you have a finish line, that you will have arrived at some point, whatever that means. And I’m only highlighting this because I think it can offset the rest of your mindset work, which can be quite crucial in type one or diabetes management in as a whole.
How do you view setbacks? Are setbacks something informative to you? Do you draw information out of it? Basically, going back to the growth mindset of “what can I learn”? Or are setbacks a label on you as a person? It’s also silly, but we all get to that point at some points of our lives, and that’s fine. It’s not a bad thing. It’s just something to be aware of!
Success = Mindset + Learning
Success whether within health, whether it’s in sports, whether it’s in life in general, it is mindset, plus learning and the willingness to learn new things. No one can do everything from the beginning. So we do need to learn, in addition to our hopefully, majorly growth mindset work.
How do you change your mindset? This can be a tricky one, but a few short tips is to start small. If you know the analogy of chopping up the elephant into small bite sized pieces, basically eating the frog first? That’s how you get forward so you look at the whole picture first and try to accomplish all of it at once. You have to start with the very smallest goal that you can imagine. Also, you have to think forwards. “How will I feel in a week of doing this?” (or in a day, and a month, in a year, in 10 years?) How will it feel making this change for me? Provided that it is for you, but I would hope so because otherwise it’s not going to be motivating for very long. You have to find what motivates you? No one else can tell you what motivates you, you have to find that within yourself. And that’s a very big part of mindset work!
And also, don’t make excuses. It’s all about prioritising. You can say that, “oh, I don’t have time to check my blood sugar”, but today, especially with CGM’s and these very fast blood sugar meters, it’s really quick. It’s just that you don’t want to do it. It’s that simple. So please don’t make excuses for yourself.
And now I would actually love to hear from you, have you noticed a change in a change in your mindset? Or perhaps you need a change of mindset? Talk to me in the comments below and I’d be happy to chat with you more there.
How 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!
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.
https://hannaboethius.com/wp-content/uploads/2019/03/T1Thursday.png10801080Hanna Boëthius/wp-content/uploads/2016/04/HannaDiabetesExpertLogo@2x.pngHanna Boëthius2019-02-14 09:00:112019-03-29 11:07:46Type 1 Thursday – How to Low Carb with T1D
How do you feel when you find out that someone has been lying to you?
You feel cheated, stupid and end up having trust issues.
It doesn’t even have to be full-on lying, it can also be a few mis-truths, or not telling you the whole story so that you can’t put things into context.
For 26 years I believed a lot of things about diabetes that I now know are untrue. For 26 out of 30 years I believed that I knew less than my doctors, that I couldn’t trust my instincts and that I was just doing it all wrong.
And all along my mother has said that “you’re always your own best doctor”. Boy, oh boy is she right! But when you’re told, repeatedly by people who “know better” that this isn’t the case and that you should really be doing it their way, which is usually straight out of a medical textbook, you start losing faith in your own thinking, reasoning and ways. What about what works for YOU as an individual? We both know that diabetes is a very individual disease and there are as many options to manage it well as there are people who have it.
It wasn’t until I was finally brave enough to look my own health in the eye and decide to take it into my own hands that I noticed that I truly had the power to change my own health destiny. This was an incredibly difficult step to take, not to mention scary.
I had been told for far too long, and far too many times, that what I was about to do I would probably die from. Straight away. This was clearly a blatant lie, I’m still here and I’m doing better health-wise than ever.
But what I’m really here to do now is to stop the lies. Stop the untruths that are clearly ruining more people’s lives than they have to. They’ve had their time on stage, it’s time for the truth.
Do you ever feel like there has to be more to it than just “eat like everyone else and take more insulin”?
Have you lost a little hope to ever get diabetes more controlled?
Diabetes can often put you in a life or death situation. Sometimes more often than you’re willing to give it credit for. This is why it’s so important to stop being lied to, to trust your gut feeling and to realize that more insulin isn’t automatically the only answer there is for you to control diabetes better.
I know what it’s like to being close to giving up completely, just do what the doctors tell you (because-they-know-best) and deep down wonder “why me?”. To play a game of Russian roulette with your life at stake – every day. It sucks. It feels so hopeless and there’s no end in sight. At the same time, you don’t have the energy to do anything about it, either. Mainly due to your fluctuating blood sugars, where curves closely resemble something like a roller coaster. You’re stuck in a well, looking for the rope you need to get out.
In order for you to actually get out, and here comes the major suckage, you have to take responsibility for your situation AND your own health. You need to look your own health in the eye and show it who is boss. Plainly put, it’s about going from not giving a shit to giving tons of shits.
But you can only get there if and when you know the true facts. The real things that will help you feel better, be healthier, happier and more blood sugar stable. The information that takes you off the roller coaster and puts you in the spinning tea cups, if you will.
Diabetes will never be completely at bay, especially not if you have Type 1. But with a few changes of food, simple tricks and lifehacks it can get so much better.
You just have to realize how to make the shift of going from doing-it-by-the-book-but-it-doesn’t-work to ah-this-is-awesome. With this shift, you choose to be healthy and happy.
A great first step could be to join the webinar I’m hosting on Monday, 13th July 2015, where I’ll be talking about 5 major lies your doctor tells you about diabetes. This is your chance to learn how to help yourself to a better life with diabetes. It’s not hopeless, if I can do it, so can you.
How am I supposed to summarize a wonderfully magical week full of meeting amazing people, seeing paradise islands and learning superinteresting new information? Perhaps just like that?
This years Low Carb Cruise in the Caribbean at the end of May was a complete success. We were about 200 participants, with a wonderful mix of backgrounds and reasons for being there, that set sail on the 24th May 2015.
Our ship, “Independence of the Seas” is one of the biggest cruise ships in the world, with over 4000 passengers. This made our group of low carbers pretty small, but at the same time feel closer together.
With that big of a ship, the food was definitely not low carb adapted. The sheer mix of sugar, grains and other stuff we know we donät do well with was at times overwhelming before seeing the options before my eyes. Every night was a sit down dinner in the glamourous 3 floor dining room, where you could choose freely what to have to eat from a menu that changed each night. A certain knowledge of how to navigate a menu was required, at least if you are handling food insensitivities (like most of our group are). This sometimes meant that you had to choose something else than what you really wanted from the menu, although the staff were amazing at meeting every single request of special orders that they possibly could.
Food on the ship (and mainland USA, too) is still very calorie based. “Low-fat” and “sugar-free” are still considered “words of wisdom” for most people, without a care in the world that these removed items have been replaced with chemicals and additives that I would prefer not to have in my body.
Lobster Night at the Low Carb Cruise 2015
As for the Low Carb Cruise itself, we were listening to presentations by the speakers when the ship was in transit at sea. The days on the islands of Puerto Rico, St. Maarten and St. Kitts I spent with other low carbers that had chosen to go on the group excursions as well. It was wonderful to see all these places of paradise that I’ve previously only heard about!
The first seminar day of the Low Carb Cruise had a clear theme: diabetes. This was the whole reason for me to initially actually click “book” on the cruise, so my expectations were high to say the least. Especially with speakers such as Dr. Eric Westman, Dr. Keith Runyan, Jimmy Moore, Jackie Eberstein and Sweden’s own Diet Doctor, Dr. Andreas Eenfeldt.
Both Dr. Runyan and Dr. Westman talked about how eating low carb high fat helps in the treatment of diabetes, the former focused on both Type 1 and Type 2, the latter more focused on Type 2. These presentations were, for obvious reasons, particularly interesting to me! But it can’t be denied that Diabetes was mentioned in a vast majority of the other presentations as well.
Dr. Westman and I at the Low Carb Cruise 2015
Dr. Runyan and I at the Low Carb Cruise 2015
Amongst other highlights from the first seminar day was Dr. Justin Marchiagiani’s presentation on hormonal imbalances and the blood sugar connection, where thyroid issues were lifted forward as well. And Dana Carpender’s colorful presentation about ADHD and low carb eating. And, brilliant as always, was also Dr. Eenfeldts presentation about the Food Revolution.
For the following 3 days there was socializing and excursions on the menu:
Amazing view on St. Kitts
Orient Beach, St. Maarten
Yummy fresh coconut in San Juan, Puerto Rico
San Juan, Puerto Rico is one happy place!
Once we had all gotten some sunshine on our noses, fresh ocean breeze in our hair and were many smiles and laughs richer, it was time to continue the seminars. By this point, the ship was already on her way back to Fort Lauderdale in Florida.
This seminar day was nothing short of amazing, either. Speakers such as Dr. Ann Childers, Jackie Eberstein, Cassie Bjork, Dr. Jay Wortman, Emily Maguire, Jimmy Moore and the founder of Ketonix, that measures the ketone level in your breath, Michel Lundell were responsible for masses of great information, laughs and well-made presentations.
Perhaps not surprisingly, Diabetes got a lot of attention here as well, although it wasn’t explicitly on the agenda. The BIG focus was on Type 2, and how it often comes hand in hand with other health issues.
We were taught about the misunderstandings of a ketogenic diet, why you won’t lose weight although you’re eating low carb, how women’s hormones relate to weight loss and how LCHF is seen in the rest of the world.
The final day of the Low Carb Cruise 2015 was featured by Dr. Michael Fox, who spoke about women’s hormones, fertility and how low carb eating ties into it. As well as Dr. Jose Lozado’s presentation on how certain forms of cancer can be prevented by eating low carb high fat and other lifestyle choices. After that the whole intensively awesome week was wrapped up with a great Q&A session with all the speakers (and a private cocktail party after that).
The whole experience was absolutely phenomenal! I’ve met so many amazingly warm and open people (see some of my heroes that I met below! (I’m still kicking myself that I didn’t get a proper picture with Mr. Moore…)), made new friends, learned so much of the latest research and had such a fun week!
Even if this week definitely wasn’t just fun in the sun and beach life, I’ve gotten to see and experience new knowledge, new places, new food and new, lovely people.
I really can’t wait for next years Low Carb Cruise!
Dr. Andreas Eenfeldt, Sweden’s Diet Doctor, and I at the Low Carb Cruise 2015
Jackie Eberstein and I at the Low Carb Cruise 2015
Emily Maguire and I at the Low Carb Cruise 2015
Cassie Bjork, aka Dietitian Cassie, and I at the Low Carb Cruise 2015
Maybe you’re planning a trip soon and would love a travel checklist for diabetes?
(I made you a travel checklist for diabetes below, make sure to check it out!)
What is necessary to bring along on a long trip with diabetes?
Sometimes I feel like diabetes just has it’s own luggage to bring along, physically as well as emotionally.
The emotional luggage we’ll have to discuss another time, because this time I want to talk about the physical luggage Diabetes brings along. Especially when traveling.
As if packing for a trip isn’t stressful enough (“what shoes should I bring?”, “does this dress go with that jacket?”, “what make up should I bring?” and “WILL IT ALL FIT IN MY BAG?!” – you get the point…), as an added bonus, you also have to haul around on all the stuff that you need for diabetes to keep in line.
I always bring all my supplies in my carry on bag when I fly. That way it’s harder to lose it, and the insulin stays at the right temperature throughout my trip.
The size of said carry-on bag has changed, though, in favour of trying to save my shoulder from falling off from carrying all the heavy stuff. Now I bring along a small, cabin sized wheelie bag where I have all my supplies, from insulin, to pumps, to test strips, to hypo treatment.
I also deposit a few things in my traveling buddy’s, usually my husband’s, bag. At least that way, if I lose my carry on, I’m not completely stranded in terms of diabetes. He has an extra blood sugar meter and test strips, and insulin with emergency-syringes. And glucose tabs. One can never have enough of those.
While I make sure to bring along most things on my travel checklist for diabetes, I don’t always bring everything.
Like ketone sticks, for example. I don’t usually bring those, unless I’m traveling somewhere really remote with no pharmacy within the next hour or so of driving. I figure that I can buy them pretty much anywhere I go.
On the other hand, insulin and BG test strips can get really darn expensive, not to mention inaccessible without a prescription, unless you prepare properly and take enough with you for your whole trip. “Enough” here means way too much, by the way. You never know what might happen, so it’s better to be prepared for most things that may happen.
And, pretty please, get organized and bring your own snacks. Food on the road is generally beyond terrible, and like that you know you can at least eat something. I bring things like nuts and dried meat and other cutleryless foods on the plane, whilst in a car or on the train you can get a little more creative. This time around I’m going to make low carb pancakes and wrap them up in foil to bring along on my long flight, as I know from experience that food on flights is never good.
Another note regarding food, please don’t get fooled by the “need” to snack, which is most commonly masking the fact that you’re bored out of your brain.
Traveling by plane is like sitting in the middle of the desert, although maybe not quite as warm. It’s dehydrating like nobody’s business! Being hydrated can really be one of the keys to better diabetes management, so please do us both a favor and DRINK A LOT OF WATER! (and skip the booze up in the air, but that one is evident, right?)
Getting through airport security can be a lot easier than it’s made up to be. This is of course assuming that you don’t meet an a-hole security agent.
In my 30 years of living with diabetes, having traveled to many different parts of the world (although I have MUCH left to see and visit!), I’ve been stopped exactly twice at security. Once for my test stripes (what, you didn’t mind the syringe full of potentially very deadly stuff in my bag? Ok, then.) And once because my pump set the alarm off. In both cases it was easy to explain, and I didn’t even have to show my medical certificate. Security agents see so many diabetes supplies on a daily basis; they’re barely phased by them anymore. At least within Europe.
Now, I’ve heard that US TSA agents can be a little trickier to handle. For example, they have no problem jeopardizing your super expensive medical equipment and tell you to go through the full body scanner wearing your insulin pump, for example. I would insist on the pat down, not risking any breakages or malfunctions. This of course means that it might take a little longer for you to get through, but it’s worth it, and as long as you know about it, you can plan for it.
The bottom line is, as long as you’re nice and cooperative (enough) to them, they’ll usually treat you with the same respect.
Anyway, let’s check out the goodie in this blog post, my Travel Checklist for Diabetes.
These are the absolute essentials that you need to bring with you (or at least ocnsider bringing with you). If you think “I’ve never needed that before”, you should probably take it along anyway, as traveling can make your body do some funky stuff.
Enough insulin to cover the days you’re gone (this should be a no brainer!) Make sure you bring both basal and bolus insulin, even if you’re using an insulin pump. You just never know…
Blood glucose meter & enough test strips, extra batteries (it might even be good to bring an extra BG meter.)
Keto sticks (As I said, I don’t always bring them)
Glucose tabs (or whatever you use to treat a hypo) (Bring too much of this, you never know what your body think of your new location.)
Snacks. (See above)
Glucagon Kit (most airlines don’t have these on board their planes. Better be safe than sorry!)
Alcohol wipes (these are great, not just for setting infusion sets and cleaning fingers, but also for wiping surfaces like tables, handles or cutlery that seems unclean.)
Other prescription medication and supplements you may be taking (easy one to forget, trust me. I’ve done it before.)
Travelling with diabetes requires quite some extra effort.
And planning. And “in case of” and “in case shit happens” preparation.
Especially if you’re planning to travel far, across the oceans and time zones.
Travelling with diabetes isn’t impossible by any means. I’d say it’s actually the opposite. You just have to know and prepare properly for it.
As I’m leaving on a longer-than-usual trip soon, and as it is my first trip that far with the pump (I really don’t travel enough, clearly!), I went to see my lovely diabetes nurse for some tips and tricks and general good advice.
It turns out A LOT has happened in terms of handling diabetes on the long-go, at least if you’re wearing a pump.
Last time I crossed continents, I was still on Lantus and had very little idea of how to handle it all, with the time zones, different rhythms and change in exercise level. Let’s just say I didn’t handle it optimally well. Partially because I didn’t know how to, partially because I frankly didn’t care about it then as much as I do today.
As a result, my blood sugar levels were all over the place, I was exhausted, not only because of the time zone change, but also because of the rapid blood sugar changes. Add on to that arriving in a bustling city where I had never been before (NYC that time) and wanting to explore it ALL in the few days we had there…
Let’s just say that that equation didn’t really add up to work in my favor.
Which is why, this time around, I’m taking much more thorough precautions before setting off.
Hence, I scheduled an appointment with my diabetes nurse.
First of all, I wish everyone had the opportunity to work with a diabetes nurse as awesome as mine is. She has a safely secured spot in my Dream Health Care Team, that’s for sure.
Secondly, she had a really nifty trick up her sleeve for me to use while in transit.
She suggested that I’d set up another basal program on my insulin pump, with a constant basal rate for the first (few) days. Basically as long as it takes me to get over the biggest jetlag factor.
I have pretty low basal rates throughout a 24 hour time period, between 0.4-0.55 units per hour, giving me a total of 11,3 units per 24 hours. Her suggestion was to set up a basal profile with a constant 0.45 units per hour for the first 24 hours, to give my body a chance to acclimatise quicker, and then turn on my normal basal profile (and change the time on my pump) when I either realize weird spikes in blood sugar, or I feel like I’ve caught the worst of the jet lag wave. (Lowering my basal while travelling seems to generally be a fantastic idea…)
This was completely new to me. And, granted, I haven’t tried it out yet, so I can’t tell you how well it works (or not). But it seems a lot easier than the old ways of changing basal injection times and dosages along as your jet lag diminishes…
Perhaps is travelling with diabetes just that much easier with an insulin pump?
This wasn’t of course the only advice she had for me. Along with the “usual” tips of bringing (much) more supplies than you need, a doctors note for security checks, an extra blood sugar meter & test strips for it, staying hydrated, getting sleep during night time, paying close attention to blood sugar, bring a glucagon kit and snacks, snacks, snacks, she also showed me the “device” (aka chart on a piece of paper) that she uses to calculate a possible return to Lantus dose.
This is excellent information to have if I ever want to go on a pump-cation (a break from my insulin pump), or, if by any chance against all odds, my whole pump system breaks and I need to take Lantus until a replacement arrives. Because I take on average a total of 18 units of insulin per day, the chart showed that my Lantus dose should be around 20 units per 24 hours. I have no idea about the conversion calculation that is used here, so if you do, please leave a comment below!
I feel really relieved and happy that I’m doing all this preparation work for my trip. Now it’s just to keep fingers crossed that the actual trip itself goes as smoothly as the preparations have done so far.
How do you travel with diabetes? What tricks and tips do you use? Please share them in the comment below!
It’s been widely proven by now that eating fat isn’t bad for you.
But just how much fat is too much fat? And especially on a low(er) carbohydrate eating plan?
Let’s go back a couple of steps first…
When you eat something, your body starts digesting it in your mouth with enzymes. Starting with the sugars, as the food moves along the digestive path, other carbohydrates, proteins (amino acids) and fats are all digested and broken up into little, usable parts for the body. The body uses these small parts to rebuild itself, give you energy and make sure every single cell works just like it should, from your hair follicles to your intestine wall. If you’re eating the right things, that is…
So what should you eat, whether or not you have diabetes?
Essentially, it’s pretty simple: proteins, fats and carbohydrates. But whether or not you’re eating too much fat majorly depends on what else you’re eating.
But I guess you were looking for a more detailed description?
The issue with carbs is that it’s really a double-edged sword.
On the one hand, they provide you with lots of energy that your cells know exactly how to use.
On the other hand, it’s way too easy to over-load on said energy, which your body will only turn into saturated fat in your fat cells.
And then we add in where the carbs come from.
Phew, no wonder everyone seems confused about this and keep arguing about what’s right and what’s not!
What’s true in terms of how the body works is that every type of carbohydrate you eat is eventually split up into a simple form of sugar (aka glucose). This means that all that bread, pasta, cereal, potatoes, rice, fruit, dessert, candy, and sodas (to mention a few) you eat and drink eventually end up as glucose (sugar) in your body.
While sugar is indeed energy, and your body needs some to survive, it is actually quite toxic in large amounts. The cells in your body has an amazing capability of burning (and also storing) this energy, but for that the sugar needs the key to get in. The key is called insulin. And what don’t we produce (enough of) if we have diabetes? Yep, INSULIN.
In super simplified terms, insulin stores sugar as fat in your fat cells. And if you’re insulin resistant (Type 2 Diabetes), or not producing insulin (Type 1 DIabetes), it prevents sugar AND protein (amino acids) from entering muscle cells, so you can’t build or maintain your muscle mass. Joys of diabetes, hey?!
I think we can all agree that knowing this makes it a good idea to make sure we don’t get too many carbohydrates. And I haven’t even mentioned high blood sugar yet!
How many carbs you can eat is quite individual, but if you have problems with your blood sugar (diabetes of any kind or type) or insulin resistance/hyperinsulinemia, your carb count should stay low. How low is up to you, but I’m sure you’ve figured out that the mentality of just “eating whatever you want and cover for it with insulin” doesn’t exactly work flawlessly for many of us…
Which carbs are good for you and which are not?
It comes down to processed versus natural carbs, really.
All of the ones I mentioned before (bread, pasta, cereal, potatoes, rice, fruit, dessert, candy, sodas…), I wish would just disappear from our food supply. They’re all highly processed, made in a plant with ingredients that have little or no resemblance to the natural, nutrient dense foods we used to eat. Making them easy to overdose on.
What you’re left with is basically vegetables. Organic, if you can. Some berries. And sometimes fruit (but they have quite a lot of carbs, so watch out if you have diabetes!).
But, if you eat less of the carby stuff, what is left?!
Proteins are really important for your body.
They are the building blocks that your body uses to repair itself.
How much protein is good to eat, then?
A great rule of thumb is to calculate about 0.8-1.0 grams of protein per kilogram of body weight a day. If you’re looking to lose weight, this should be 0.8-1 g per kilogram of your goal weight.
Let’s put this into practice!
So, if a person weighs 60 kg, they should be eating somewhere in the range of 48-60 grams of protein a day. That does NOT mean 48-60 grams of meat, for example, as meat only has 20% protein. This means this awesome person should be eating between 240 and 300 grams of meat a day (if meat is the only protein source, of course).
On the other hand, if a person weighs 100 kg and wants to weigh 90 kg, they should be eating around 72-90 grams of protein a day, meaning 360-450 grams of meat a day.
Keep in mind that there are other protein sources as well, and I’m only using meat as an easy, accessible example.
Eating more than this runs the chance of your liver (mainly) turning the excess protein into glucose through gluconeogenesis anyway, which you really don’t want, especially if you have diabetes.
To summarize it so far, less carbs and moderate protein. Are you with me?!
Lastly, but most gloriously, we have fats.
The fear of fat is really outdated by now, being started by a scientist that turned data into what he wanted it to show (Ancel Keys).
Today we luckily and happily know a lot better! Now we know that eatingfat is necessary, there are essential fatty acids we need to get in order for our bodies to work properly.
Generally, there isn’t really an upper limit for fat intake. You just eat the rest of your food in the form of fat when you’ve fulfilled the carb and protein ratios.
Again, there’s a difference on fats and fats, just like i mentioned for the carbohydrates.
The key really lies in starting with the cleanest saturated fats (butter, coconut oil, dairy (if you can handle it), meat, cocoa butter) you can. Everything gets better with butter! Secondly, choose your monounsaturated fats (nuts, olives and avocados). Lastly, choose your healthy polyunsaturated fats like certain nuts, seeds, avocado oil and fish oils (omega 3).
It’s not more complicated than that, really.
Of course, if you’re eating lots of fat, keeping your carbs and proteins where they should be, and STILL gaining weight, you could be eating too much of it for your individual needs.
Another way of telling that you’re eating way too much fat is by looking at what comes out, i.e. your poop. What you put in is what you get out! If your poop sticks to the toilet (you have to use the brush a lot), it’s a sign your body can’t use all the fat you’re eating.
To sum these shenenigans up: figure out your carb count, then your proteins, fill the rest up with fats. Simple, right?
But whether or not you’re eating too much fat majorly depends on what else you’re eating.
And the other way around, too. But that’s the topic of another story.
Being such a big part of our lives, it would be weird if it didn’t mix in and mash up your plans sometimes.
Sometimes we’re talking about interrupted sleep, another time it’s an unplanned meal on the menu. And sometimes it’s about being so tired, simple chores can be compared to climbing Mount Everest. At least. Not to mention the guesstimation game we play with the pancreas on our hip, in a pen or syringe. Up? Down? A little up and then down? The other way around? Or even *gasp* stable and level? (Watching your blood sugar do a salsa dance on a cgm is sometimes entertaining, as long as you don’t put too much personal attachment to the numbers)
You can almost never tell with 100% accuracy where your blood sugar will end up after a meal, some insulin or just by plain old living.
And sometimes you can’t let the stubbornness of diabetes get in the way, either.
Like the other morning, when I had to get to an appointment I had.
I woke up at 4.4 mmol/l (79 mg/dl), which I was happy about. My cgm curve looked smooth from the night and I was even more happy about that.
I jumped in the shower, washed my hair, moisturized and brushed my teeth. I was feeling a little sleep-groggy, but nothing else.
I went to put on my clothes, got dressed and noticed an odd, fuzzy thought popping up in my head that usually stems from the low-blood-sugar-drawer in my brain.
Nevermind that right now, I had other things to do, like taking my morning medicine (thankfully not insulin) and supplements.
When I got back downstairs from the kitchen, my next task was to do my make up. But I decided to check my cgm first, which showed 4.1 mmol/l (73 mg/dl).
Ok, I thought, that’s not bad, although I’m dropping. More of the odd, fuzzy thoughts popped up, and I decided to check my blood sugar on my blood sugar meter, if only to ensure myself that I wasn’t low.
3.4 mmol/l (60 mg/dl) “treat your low BG!”, my d-companion Doris (OmniPod) was telling me.
“Ahh, eff-word”, I said out loud. “I don’t have time for this!”
I usually don’t treat lows until below 3.5 mmol/l, as I find they usually recover fine from there with just the help of lowering the basal on my pump. But as I was leaving, and it was 0.1 mmol/l lower than my usual threshold, I decided to pop a glucose tablet and shut of the basal on my pump for 30 mins.
Knowing I’d be completely OK within 15 minutes, but had to leave the house in 20, I had little choice but to continue with my morning routine and my make up, which is a fairly effortless task.
If you’ve never experienced a low blood sugar before, let me tell you that it can be quite “interesting”. It feels a bit like being tipsy, without having had anything fun to drink. Or like being in a very fast, accelerating car while standing on the ground. It can be dizzy, vertigo, confused and temporary vision problems all in a big merry go round that doesn’t want to stop right now. (It can also feel a gazillion times worse than that, but thankfully that wasn’t the case this time.)
Having to think twice if you’re *actually* using foundation and not the bright pink blusher heavily all over your face is a challenge I’m usually blessed from. I usually know where things go in terms of make up…
Or double-checking that the eyebrow pencil is still brown and you didn’t accidentally reach for the turquoise eyeliner to fill in your eyebrows instead. Or concentrating so hard on getting mascara ON my eyelashes and not only underneath my eye. Not to mention actually getting that blusher semi-equally distributed. Or checking that the foundation isn’t blotchy anywhere.
This can, but probably shouldn’t, be compared to doing your makeup after a good after work drinking session with your colleagues. In short, no bueno.
Throughout this particular mornings routine work, I kept thinking if I actually managed that well with everything, or if, once I was back on track again, would find myself looking like some Cubist rendition of myself. Or like a clown. Or like Gene Simmons from Kiss.
All I could imagine seeing once the low blood sugar fog had lifted was some weird version of myself, as it would have been painted by Pablo Picasso himself. Or something equally scary.
This time I was lucky, though.
When my blood sugar was back in normal range again, I saw that I looked more or less like myself, if only ever so slightly more tired.
What do you do when your blood sugar drops low, do you keep going or stop and wait? What does your decision depend on?
https://hannaboethius.com/wp-content/uploads/2015/04/blog_low_makeup-1.png1200800Hanna Boëthius/wp-content/uploads/2016/04/HannaDiabetesExpertLogo@2x.pngHanna Boëthius2015-04-22 15:02:092015-04-22 15:02:09The Low Blood Sugar Make up
Being an expert, you have to be perfect, don’t you?
You need to be able to juggle anything that is thrown at you, know every single little detail about your topic and preferably have 67 Masters, PhD’s and other qualifications to be one.
I used to think so. I really did. “Experts” in my life used to be my doctor and endocrinologist, for example. And these people know a lot, they definitely do. But they usually have zero training in nutrition, for example.
And they may not know or understand everything about YOU and YOUR individual case. You’re always going to be your own best doctor, because you know YOUR body, your situation and your case the best.
So, who am I to call myself a Diabetes Expert?
It’s true, I don’t know everything about you, your life and your case. Yet. But I am willing to listen, learn and help you on your road to become a healthier you.
It’s really my passion in life, to get to help you through what I’ve already been though. To share all the tools, tricks and food that I’ve found has helped me and many others.
But what happened to GrainBrain? I’m sure you’re curious!
GrainBrain has been a fantastic stepping stone on my journey of becoming healthier, happier and more experienced. And it has served me very well when I was only about eating healthier (i.e. grain free).
Now that I’m fully focusing on helping people with diabetes to become healthier, lower their A1c’s and feel more confident, I feel that the name GrainBrain has run it’s course in my business.
I don’t want to hide behind a brand anymore, I want to show even more of myself, my journey and how I can help you on yours. Become even more authentic, if you want.
Which is why I’ve decided to change the name of my business, refurbish the website and get a fresh breeze in here! So please help me welcome Hanna Diabetes Expert!
In light of this, I looked up how a few people define what an expert is. And their answers made me smile.
Warning – there’s some self-assessment coming up! 🙂
“What qualifies anyone to be an expert? I view an expert as someone who has considerable intellectual knowledge and real world experience in a particular field, area of study, process, or activity. They possess knowledge and experience in greater measure than a majority of others in their field. And they can express their expertise in order to help others understand and implement any appropriate ideas and actions based on that information. (…) Today, I would venture to say experience builds expertise faster and stronger than education. For education not applied is merely knowledge locked in the brain and not tested in the real world.”
Well, if 30 years of trials, errors, successes and blood, sweat and tears aren’t experience enough, I’m not sure what is?
I thought this was a really interesting point of view. Another article I found, listed 5 quite similar characteristics of being an expert as states above:
“Knowledge: Clearly being an expert requires an immense working knowledge of your subject. Part of this is memorized information, and part of it is knowing where to find information you haven’t memorized.”
This is one of my favorite parts of doing what I do – I learn new things every day. Whether it’s about myself, a client, or diabetes in general, I make sure there’s an ongoing addition to my knowledge.
“Experience: In addition to knowledge, an expert needs to have significant experience working with that knowledge. S/he needs to be able to apply it in creative ways, to be able to solve problems that have no pre-existing solutions they can look up — and to identify problems that nobody else has noticed yet.”
Having a coaching background that has taught me a trick or two throughout the years is certainly beneficial. Experience and knowledge go hand in hand. And, the whole reason you work with someone, be it a coach, mentor or expert of some sort, is to get another perspective on your situation. It’s so easy to get stuck in your own bubble and lose view of the Big Picture. Working with someone on the “outside” of that bubble can really help you regain your aerial view.
“Communication Ability: Expertise without the ability to communicate it is practically pointless. Being the only person in the world who can solve a problem, time after time after time, doesn’t make you an expert, it makes you a slave to the problem. It might make you a living, but it’s not going to give you much time to develop your expertise — meaning sooner or later, someone with knowledge and communication ability is going to figure out your secret (or worse, a better approach), teach it to the world, and leave you to the dustbin of history (with all the UNIX greybeards who are the only ones who can maintain the giant mainframes that nobody uses anymore).”
Yes, communication is definitely key. In any relationship. But there’s also a huge difference between talking to someone and talking at someone. The latter is usually a waste of everyone’s time. And you can only communicate your solution to someone who is ready to hear it.
“Connectedness: Expertise is, ultimately, social; experts are embedded in a web of other experts who exchange new ideas and approaches to problems, and they are embedded in a wider social web that connects them to people who need their expertise.“
I aim to help as many people with diabetes as possible. To get new input and not get stuck in old ways, I make sure to stay connected to different other experts within fields of interest to my clients.
“Curiosity: Experts are curious about their fields and recognize the limitations of their own understanding of it. They are constantly seeking new answers, new approaches, and new ways of extending their field.”
One fatal mistake would be to get stuck in my thoughts, my ways and in what has worked for other clients. Every client is a new, exciting opportunity to help someone with a problem (or many).
I want you to know something though…
Being and calling myself a Diabetes Expert definitely doesn’t mean that I have perfect values all the time, endless amounts of energy, smooth cgm curves and my A1c keeps effortlessly where it should be. I have catastrophical days, too. Because there is no such thing as a perfect diabetic.
Diabetes is a lot of hard work. Sometimes grueling hard work. But it’s also about perspective and wanting to find a solution. Finding YOUR solution, how you can cope with it and how you can turn it into the very best you can.
What are you an expert in? How do you share this with the world?
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