Type 1 Active - Active Living with Diabetes

It’s been a bit of a stressful week for me for numerous reasons, but instead of boring you with the details of what stresses me out I’ll just tell you that my blood sugars were definitely paying for it. This is not the first time I have experienced high blood sugar as a result of stress so I decided to feed my curiosity and find out why stress plays such a role in hyperglycaemia.

It’s quite simple really; when a person is either physically or emotionally stressed the adrenal gland releases some glucose as a response. I’m not going to pretend to be a doctor so here is the link to a Diabetes UK article that explains the whole thing much better than I could.

Pin pointing the cause of stress is probably the most useful tool you can use in stress management.

I spend a lot of time working on and thinking about my body so I feel like I’m very in tune with signals caused by a physical stress such as injury. However, it takes me a bit longer to recognise an emotional stress, especially when it is combined with high blood sugar as I would probably just put the stress down to high blood sugar and go in a circle from there.

This makes it difficult to eliminate the cause of stress.

So, when I see unexpected high BG on my meter I always ask myself if I am stressed about anything. If the answer is yes I will take the following steps to not only reduce stress, but to also decrease the blood sugar.

Walk

The other day, my blood sugar spiked to 10mmols due to stress so I decided to stretch my legs and walk it off. Walking at a fast pace for 30 minutes, with a rucksack on my back and 1 unit of insulin on board, decreased my bg by 7.5mmols. Proving that walking is a great way to reduce bg. As for my emotional stress, I listened to some music on my headphones whilst I was walking and it helped a lot.

An alternative method to this would be to do any exercise you love. Sometimes I just dance. Like literally, I will drop what I’m doing and dance. Yes, I look as crazy as it sounds but dancing is as natural as walking to me. Try it.

Make a Change

When I notice that stress is recurring because of the same thing I try to make a change. For instance, for a few months I would not give myself a day off from doing some sort of work. I am the type of person that will not stop until something is completed, even if it means getting stressed out. However, when I saw what this was doing to my levels I had to make a change.

I started to take a day of rest each week in order to replenish my mind and reenergize my body. I still find this very difficult because rest makes me feel guilty, but I’m sure I will adjust at some point because my blood sugar definitely appreciates it.

I understand that immediate change might not be possible for some;– if your work is stressing you out it might not be a good idea to quit right away (unless you have another to walk into) but you could put a plan in place to reduce the level of stress you are feeling right now. A plan will help you see that there is a way out of your current situation which will, in turn, help prevent the high blood sugars caused by stress at work.

Meditate

I’m sure you’ve heard this before but mediation does actually help. Especially if you have a tendency to overanalyse things or if you sweat all of the unnecessary small stuff.  At first it can be very difficult to stay calm in the face of something we see as an intense situation; an argument with a family member or a friend, the loss of something or someone, or a big change. We can get wrapped up in what is important and what is not.

This is where mediation comes in.

Meditation brings clarity and focus, making space for you to breathe and relax.

A great way to meditate is to sit in a comfortable position or lie down, close your eyes and focus on the rhythm of your breath. Count how many seconds it takes you to breathe in and how many seconds it takes to breathe out.

Hopefully this will help a little bit if you are experiencing any sort of stress.

In a way, although I really hate the feeling of being stressed and hyperglycaemic, it makes me grateful for diabetes because I have another way of listening to what my body is telling me. I have a clearer understanding of what it worth stressing about and what isn’t. The majority of the time its just not even worth it.

Stay healthy.

Rowena x

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There is an overwhelming amount of information on fitness, especially when it comes to diabetes, which is my motivation for writing this post. The truth is, it makes no difference if you’re diabetic or not. You’re just as capable as someone who doesn’t have diabetes. I have been on my fitness journey for a long time, both without and with diabetes and I can assure you that I have met a few road blocks along the way. If I’m being really honest, the workout is not the hardest part, it’s everything that revolves around it that is; accepting no excuses, avoiding procrastination and losing motivation. Whether you are new to fitness or are well into your journey like me, the tips below will help you stay on track.

Find Out What Motivates You…

… and Keep a Reminder close By. Progressing in fitness is hard and if anyone tells you otherwise, they are either trying to sell you something or they have no idea what it’s like to seriously progress in a physical activity. Creating positive change either mentally or physically is not an easy process and it takes time and commitment. There will come a time when you feel like giving up; at this point you need to remember your why. Why did you get started and what motivated you to do so? This is different for everyone. Maybe diabetes is your motivation? If it is, make sure you celebrate the positive effect it is having on your management.

Find Something You Enjoy

I have said this time and time again and I will keep saying it because it is absolutely vital. You shouldn’t dread your workouts. If you hate the gym, don’t go the gym. If you dread running, don’t go running. Think about what you enjoyed doing as a child. Skating, dancing, basketball? Whatever it was, give it a go and see if you get the same enjoyment as an adult. If you can’t remember what you really enjoyed or don’t enjoy that specific activity anymore, think about what you would enjoy now. Lots of people enjoy Pole Dancing for fitness, men included. Try it. Be sure to think without limits. Diabetes is not an excuses.

Avoid procrastination

How much you spend procrastinating will greatly affect your workouts. Nike have the famous slogan “Just do it” and that is exactly what you should do. Don’t wait until you get new running shoes, don’t wait until your personal trainer can fit you in – just do it. You need nothing to start apart from a keen attitude.

Although you probably connected with me through social media, you have to realise how much time you might waste on it. When you are due to exercises, switch your flight mode on. No distraction. No procrastinating by reading text messages, checking email or answering calls. Just you and your goal.

Above all else, don’t let diabetes be your procrastination barrier. At first, yes, it might take a bit more time because you are considering insulin doses, but the more you do said workout routine, the more you will come to grips with how to manage your diabetes around it.

Control what you can for the time being. For instance, don’t leave your pump site change to the same morning as you said you were going to go for a run because if something happens with that you are bound to(and should) prioritise fixing the diabetes related issues over engaging in your fitness commitment.

Hydration

Did you know that even if you are mildly dehydrated it can affect the way you perform physically? Water is central for the overall functioning of the body and plays a massive part in how you look and feel. The minimum amount of water you should drink on any given day, in addition to coffees, teas or juices, is determined by your size and activity level. The International Sports Medicine Institute recommends 1/2 ounce per pound of body weight if you’re not active (that’s ten glasses if you weigh 160 pounds), and 2/3 ounce per pound if you’re athletic (13 to 14 glasses a day, at the same weight).

Think about it, if you are not feeding your body with adequate amounts of water, how do you think it is going to repay you? By consuming the correct amount of water for your body it will help you lose body fat and your body will eventually stop holding onto water because it knows that it is consistently getting enough of it. A good way to gauge your hydration level is by judging the color of your urine. The clearer it is, the more hydrated you are.

I hope this was helpful to you. Always remember to drink enough water to hydrate and prepare your body for the physical activity, seek motivation, avoid procrastination and do something you enjoy.

Rowena x

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About 6 weeks ago I was given a trial of a continuous glucose monitor (CGM) and because I was aware that I would only receive 4 sensors that would last around 2 months, I planned to conduct a few experiments to get a finer understanding of diabetes. Experiments revolve around basal, bolus, exercise and takeaway food (got to have some fun, right?). I have used two sensors so far and don’t plan on using another until September when I go travelling for two weeks and then start my MA in dance and choreography. Anyway, I’ve had quite a few surprises over the past 4 weeks and feel that I have much better control now that I have seen so much data from the blood sugar graphs that were produced every 5 minutes from the Dexcom transmitter.

The first day I wore my sensor I couldn’t believe how many times my blood sugar spiked after food. Even if it wasn’t particularly carby, it was up and down the whole day. However, with a bit of bolus manipulation and play with timing I was able to eliminate any major spikes. Most days I eat around 200 carbs, sometimes spreading them throughout the day, sometimes eating the majority of them in one go. It depends. Anyway, I found that if I took my bolus 20 minutes before eating I could get away with eating 100 carbs with no spike. Carbs could be from pasta, potato, cereal, oats, fruit etc. The only time I found this difficult is if I was eating out because I didn’t know how long food would take to be served. I figured that I could look around and see how quickly other people were being served and gauge it from there and I suppose if I were served quicker than I thought, I could save the carby part of the meal until last. Hmm, that would be testing.

Basal

My basal has almost doubled and as a result of this I haven’t woken up with a blood sugar above 7mmols in a few weeks. I have 7 different basal settings throughout the day and night. (see pic).

Bolus

As a result of finding the correct basal, my bolus doses have dropped significantly. Especially in the morning because I am not chasing my blood sugar with correction doses. Also, I changed my evening insulin / carb ratio from 1/11 to 1/13. And instead of adjusting to 1/20 if exercising for an hour plus I now use 1/25 which seems to have worked so far.

Exercise

Exercises is pretty much how I thought it would be because I test very regularly around my workouts anyway. However, because my basal is now at the correct rate I don’t have to increase my basal if I do morning cardio. I have to decrease it like any other time of the day. Currently reducing basal by 70% for cardio, dance, yoga, shopping, gardening and reducing by 30% for weight lifting (I have very little rest between sets) which is interesting because I also used to increase for this type of activity.

The 6 hour takeaway delay

Pizza and chips are foods I love, but rarely eat. Whenever I have eaten them in the past I would always see a spike at some point and I couldn’t quite catch when it was so I decided I would utilise the CGM to find out more.

When I was on holiday in Belgium I ate a large portion of fried chips in the afternoon and I saw the rise about 6 hours later whilst I was at a concert. I marked 6 hours down and decided to try again the next day by eating a very similar portion of chips, only this time I took a split bolus and released 50% of it 6 hours later. Guess what, no spike.

I tried this on another occasion with pizza which I estimated 100 carbs for and it did the trick. It seems obvious but estimating the correct amount of carbs for the pizza is paramount. I have underestimated in the past because of the reality of how many carbs there actually are in pizza (depending on the base). Don’t do this. Chances are, it’s more than you estimate anyway so be honest with your pump.

It did the trick for me but I think everyone will have a different digestion rate depending on what they have already eaten that day and how much pizza they actually eat. Bear in mind, this is really greasy, fatty pizza. Low fat pizzas digest at a normal rate. Even if I ate a full 10 inch one of 100 carbs.

Disclaimer – if I was eating oven chips of pizza that I cook at home I would not take a 6 hour split bolus because in comparison to a takeaway shop, there is nowhere near as much fat in an oven pizza like Ristorante.

Overall, I am grateful for what the CGM has taught me and I am looking forward to what my future HBA1C is after making a few of the tweaks mentioned above. If you can get your hands on 1 sensor for two weeks and are willing to put the work in and write the results down – I can assure you it will be worth it. I mean, I suppose you could conduct these experiments with a regular blood glucose meter, but it’s a little bit more painful and time consuming.

Rowena x

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Recently I have been thinking a lot about diabetes management and what was holding me back from fixing my stint of night time hypos / hypers. I came to the conclusion that I was overwhelmed with information which lead to multiple possible scenarios as to why my blood sugar might be out of range. This made things complicated when it really was as simple as adjusting a basal rate that was either too high or too low. Next, I realised that I was fearful of nighttime lows which prevented me from taking extra insulin when I needed it. In addition to the vast amount of information and the fear of lows, I also believe that personal belief systems play a significant role in the way diabetes is managed. It all interlinks. I’m definitely not perfect, but I am now in a place of better control since fixing my night time basal and have recognized where I went wrong.

Too Much Information

Diabetes management is very similar to the way weight loss / dieting is looked at. There is an abundance of misinformation out there and it costs a ridiculous amount of time to keep up with it. It might be suggested “hey, if you cut out your carbs you won’t have to take insulin” or “If you eat carbs, but only before 7pm you will be fine” – things like that. I know I am guilty of sharing my dieting habits on this blog, but my aim is to educate rather than to push you to go in the same direction.

The fact of the matter is, even if you did try each and every suggestion, are you allowing enough time for the change to take place? Do you psychologically enjoy this change? If not, then sooner or later you will be back to square one. Take inspiration from what other people suggest, but remember that their body is different to yours so you have to look at and analyze your own results and make adjustments and tweaks from there.

Fear

Is fear holding you back? Are you scared to experiment because of lows or highs? It’s understandable. Sometimes fears become so strong that they become imbedded in your brain and prevent you from doing things like exercise or other physical activities. To break this fear you must begin to feed your brain with things / people that show how that fear is irrelevant.

There was a brief time where I began my workouts with a blood sugar of at least 10mmols because I was fearing lows – I felt weak when I was low. However, an out of range number at the other end of the scale does not allow me to perform at an optimal level either which is why I fixed it fairly quickly. I recognized that I was scared and focused on working out the right level of insulin and timing instead. I also looked at all the workouts I had managed to achieve without lows and this helped me get back on track.

Belief Systems

You must believe that you have the ability to take control of this disease. If you tell yourself “it’s too hard, I can’t do it”, guess what, you won’t be able to do it. Know that there are some factors that you can control which will definitively contribute to the management of this disease. You have full control over your mind.

For instance, I posted a video on YouTube a while back about something diabetes and exercises related and someone (another diabetic) commented, point blank, and told me it was impossible to exercises with diabetes. That was his belief. However, I prove this statement wrong on a daily basis, sometimes multiple times a day. Like I have said before, I don’t believe diabetes is a limitation on my body and I will always make sure I work harder than anyone in the room to prove this point.

Don’t believe anyone if they tell you that you can’t do something, including yourself.

At the end of the day, this is your body and you know it best. One doctor might recommend a high fat low carb diet, another might recommend something else. The truth is you have to think about adherence and something you can see yourself doing a year down the line. Change takes time so if you are struggling with one of the above, be patient, be honest, and don’t copy anyone else, only use them for inspiration and be yourself.

Rowena x

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