Can Snacking Help You Manage Diabetes?

There are many reasons we snack, both good and bad. Some snacks are healthy and helpful, but sometimes we snack out of boredom, stress, or anxiety.

Can snacking actually help your diabetes management? Yes! Some foods and habits can help keep your blood glucose in your desired range. We met with registered dietician and strength and conditioning coach, Ben Tzeel, to discuss snacking!

Best Overall Snacks

Snacks that include protein tend to keep you satiated, and promote stable blood sugars over time. A snack with a large amount of fast-acting carbohydrates may spike your blood glucose quickly and lead to a low afterward, while a snack high in fat may contribute to elevated blood glucose hours later.

For folks following a ketogenic or ultra low-carb diet, a mini charcuterie snack with cheese, meat, and pickles might work well. And for those looking for something quick and easy, staying under 15 net grams of carbs (like the ones found in this list) works well to get you to your next meal. One of Ben’s favorite brands is the NRG bites from NRG Foods, with ~110 calories per bar and 4 to 6 grams of fat, 8 to 10 grams of protein, and 8 to 12 grams of net carbs (depending on flavor).

Snacks and Dawn Phenomenon

While there isn’t a magical snack that stops dawn phenomenon, there are some foods that don’t contribute to higher blood glucose levels overnight. Dawn phenomenon, or dawn effect, is when blood sugar rises in the early morning from about 2 am until 8 am. In order to wake up, hormones such as cortisol and glucagon are released. These trigger the liver to increase glucose production. Normally, the pancreas would then produce insulin to adjust. However, the impaired (or complete lack of) insulin response characteristic of diabetes causes blood sugar to rise. Small snacks with protein and fat work better after dinner than snacks containing carbohydrates. Leftover protein from dinner or a small serving of nuts, such as low-carb trail mix, works well!

Best Snacks Prior to Exercise

While this may seem counterintuitive if you’re counting calories for weight loss, our bodies need fuel to stay active for longer periods of time. In certain situations, having a snack before exercising can help keep blood sugar stable. Please note, we don’t recommend having a snack and giving an insulin bolus to cover for the snack. For pumps using automated insulin delivery (AID) you’ll need to pay attention to timing. Eat it too soon and an AID pump will see a rise in BG and begin to adjust, giving you more insulin. Definitely not what you want right before exercising!

Ben recommends having your snack 30 to 45 minutes before exercise, giving your stomach enough time to start digesting the food and to stabilize your blood glucose. Try avoiding anything too high in fat or dairy products to prevent gastrointestinal upset. Staying below 20 grams of carbohydrate, mixed with some protein and fat, will help slow the absorption and blood glucose rise, and avoiding a large spike before exercising.

If you’re taking long-acting insulin or a medication that lowers your blood glucose, you may find having a small snack beneficial in preventing a low (hypoglycemia) during exercise. If you’re using an insulin pump and adjusting your basal rates or using an exercise profile, you may not need or want a snack prior to a short-duration exercise. If you’re using an insulin pump, you may find it useful to reduce your basal rates 30-90 minutes prior to exercise, or to use the exercise/activity function rather than snacking for short duration activity. Exercising for longer than an hour? You may want to include food as a way to manage your blood glucose levels and/or fuel your body for exercise. For more information about longer-duration exercise and type 1 diabetes, read more from Dr. Mike Riddell and his colleagues in the Exercise Management in type 1 diabetes: a consensus statement.

 

No matter the way of eating you follow, you can adjust snacks to fit your lifestyle and help keep your blood sugar in your desired range!

Our thanks to Ben Tzeel from Your Diabetes Insider for joining our online session and for providing his expertise and insights. To learn more about or contact Ben, you can find him on his website or Instagram page.

References

Riddell, Michael & Gallen, Ian & Smart, Carmel & Taplin, Craig & Adolfsson, Peter & Lumb, Alistair, et al. (2017). Exercise management in type 1 diabetes: A consensus statement. The Lancet Diabetes & Endocrinology. 5. 10.1016/S2213-8587(17)30014-1.

Source: diabetesdaily.com

Why You May Be Experiencing High Blood Sugar

High blood sugar is part of a life with diabetes, whether it’s type 1type 2LADA, gestational diabetes, even the more rare forms of the disease. But sometimes, hyperglycemia can seem unexplainable, persistent, and stubborn.

This article will outline the reasons why you may be experiencing high blood sugar, and what you can do about it.

What Exactly Happens When Blood Sugar Is High?

High blood sugar, by definition, is when there’s too much glucose in the blood and not enough insulin to help the cells digest it. That extra glucose floating around in the bloodstream is what brings about symptoms of frequent urination, fatigue, brain fog, headache, body ache. In severe cases, it can lead to diabetic ketoacidosis (DKA).

People with diabetes manage their blood sugars by taking either oral medications or insulin, and monitoring both their food intake and exercise on a daily basis.

But even when you’ve done everything “right,” like counting carbohydrates and taking your medications, your blood sugar may rise and stay annoyingly (or dangerously) high. These are the top reasons why you may be experiencing unexplainable hyperglycemia.

You’re Stressed

Ever wonder why when you’re stressed about work or school your blood stays high? That’s because the release of natural hormones in your body, like adrenaline and cortisol, spike when you’re stressed, leading to insulin resistance, and in people with existing diabetes, high blood sugars. Whether you’re prepping for a big test, selling your home, hustling for that promotion at work, or fighting with your spouse, stress can send your blood sugars skyrocketing.

Dawn Phenomenon

Dawn Phenomenon describes the high blood sugars and insulin resistance people experience in the morning, usually between 2 a.m. and 8 a.m. 

The phenomenon is natural: late overnight, the body releases a surge of hormones in preparation for the new day. These hormones can trigger the liver to dump glucose into the bloodstream. In people with diabetes, the body cannot produce a healthy insulin response, and therefore blood glucose levels spike up.

Many people with diabetes require more insulin during those hours, maybe even twice as much, to counteract this age-old hormonal effect.

A different, less common (but more dangerous) phenomenon may also explain morning blood sugar highs: Somogyi effect.

You’re Sick

When people with diabetes are under the weather (or fighting off an infection), their blood sugars tend to be much higher than normal, and they become much more insulin-resistant.

This can sometimes result in needing 75% (or more!) of your average daily insulin requirements. Make sure you’re staying hydrated, monitoring for ketones, and taking as much insulin as you need to keep your blood sugars in range.

If you cannot control your blood sugars during illness – especially if you’re having trouble eating or drinking – it’s very important to get in touch with your doctor.

You’re Eating Too Many Carbs

Let’s face it: carbohydrates spike blood sugar. It’s something that people with diabetes need to think about nearly every time they eat.

Test your blood sugar frequently to see how your own body responds to different foods. Some people may find that they can comfortably eat fresh fruit, but not added sugars or white rice. Some may find something completely different.

And if you use insulin before meals, you probably already know that carbohydrate counting can be an inexact science. The more carbs you eat, the more insulin you need to take, and the more difficult it is to deliver that perfectly dosed and perfectly timed pre-bolus.

Even a little carbohydrate restriction is likely to help reduce the frequency and intensity of blood sugar highs.

You’re Eating Hidden Carbs

Ever order a salad at a restaurant, thinking it will be a nice, low-carbohydrate option, only to experience debilitating high blood sugars for hours on end afterward? There are many deceiving foods that we think are low-carb, but are anything but.

Sugar and starches hide in many foods where you wouldn’t expect to find them, especially at restaurants and among the processed foods in the grocery store. Some examples of foods that seem “healthy” but can cause a blood sugar nightmare include:

  • Salads with sweet dressings and croutons or other toppings (or salad in a bread bowl)
  • Soups
  • Smoothies (especially fruit smoothies)
  • Fruit juice
  • Foods labeled “gluten-free”
  • Granola
  • Flavored yogurts
  • Fat-free ice cream
  • Restaurant foods (especially due to extreme portion sizes)

“Healthy” does not necessarily mean “diabetes-friendly.” Fat-free products are often fortified with sugars and starches. And many gluten-free products have even more carbohydrates than their standard gluten counterparts.

If you’ve chosen a restaurant that can provide nutritional information, ask for it, so you’ll know exactly how many carbohydrates you’ll be consuming. Consider asking for salad dressings and sauces on the side. 

Your Insulin Pump May Be Kinked

If you’re insulin-dependent, the first thing you should do at the sign of stubborn high blood sugar is to check to see if you have a kink in your insulin pump cannula. This can block the delivery of insulin, leading to a very frustrating day.

If you’re unsure, change your pump site! Make sure to call your insulin pump manufacturer to let them know of the issue, and they will usually mail you a replacement for free.

You’ve Injected Into Scar Tissue

If there’s no kink in the cannula, or if you’re using syringes to deliver multiple daily injections (MDI), you may have also just picked a “bad” site. When insulin is injected (either manually or with an insulin pump infusion set) into scar tissue, absorption suffers, resulting in unpredictable and high blood sugars.

Make sure to always rotate your sites as much as possible to avoid developing scar tissue and the inevitable high blood sugars they bring.

Your Medications Need Adjusting

Our bodies are constantly changing. It would be silly to expect the same insulin to carbohydrate ratio or insulin sensitivity factors or even the same number of milligrams of our oral diabetes medications for our entire lives.

Make sure you’re seeing your endocrinologist or diabetes doctor regularly; they can help refine your medication regimen.

You may be especially likely to require adjustments if you’ve recently lost or gained weight, have increased or decreased your activity levels, are going through a stressful life change, are pregnant, or planning on becoming pregnant, or haven’t been to the doctor for a while.

Your Medications Are Expired

Always check to make sure your medications aren’t expired! At room temperature, insulin will lose potency

Oral medications can last much longer, but you still need to be cognizant of expiration dates and make sure you’re refilling your prescriptions regularly to avoid taking an expired (and potentially useless) dose.

What to Do When Your Blood Sugar Is High

High blood sugars can range from not-a-big-deal to a life-or-death emergency. Make sure to check your blood sugar often and monitor for any signs of diabetic ketoacidosis (DKA). If you have blood sugars that are over 250 md/dL for more than a few hours and you have moderate to high ketones, you will need to seek emergency medical care immediately. If you don’t have ketones, but want to feel better as soon as possible, try some of these tactics:

  • Exercise – cardio (a walk, jog or even jumping jacks) can bring blood sugar down quickly
  • Take a correction bolus of insulin
  • Change your pump site
  • Chug water
  • Take a hot shower or bath 
  • Manage stress with a quick yoga sequence or meditation
  • Test for ketones (if you have moderate or high ketones and your blood sugar has been high for several hours, call your doctor or go to the emergency room right away)

Understanding why you’re experiencing high blood sugars is one more way to improve your life with diabetes! Always work with your doctor before changing your oral medication and/or insulin therapy.

Have you ever experienced a mystery, stubborn high blood sugar? What helped you to get it down quickly? Share this post and comment below; we love hearing from our readers!

Source: diabetesdaily.com

High Blood Sugar at Night: What to Do

This content originally appeared on diaTribe. Republished with permission.

By Eliza Skoler

Why do your blood sugar levels increase at night, and what you can do to prevent this? Learn strategies for managing high blood sugar levels overnight and in the morning, including healthy bedtime snacks.

For National Sleep Awareness week, we are focusing on how to regulate overnight blood glucose (sugar) levels. With the many factors that can affect your glucose levels, nighttime can be a challenge. Some people with diabetes experience high overnight levels while others fear or experience a glucose drop during sleep. Trying to keep glucose levels stable overnight will help you get more sleep and feel better – and a good night’s sleep will aid your diabetes management the next day. While this article focuses on overnight highs, you can learn more about preparing for and preventing hypoglycemia (low blood sugar) here.

Here are some tips and strategies for how people living with diabetes can get better sleep at night and avoid high blood sugar levels.

Click to jump down:
Symptoms of High Blood Sugar at Night
Is It Safe to Sleep with High Blood Sugar?
Why Does Blood Sugar Go Up at Night? 
What is the Dawn Phenomenon?
How to Stabilize Your Blood Sugar Overnight
Great Bedtime Snacks for People Living with Diabetes
What Should Your Blood Sugar be When You Wake Up?
How to Lower Morning Blood Sugar

Symptoms of High Blood Sugar at Night

If your blood sugar is high at night you may experience symptoms of hyperglycemia. Hyperglycemia, or “high glucose,” is not defined by one specific glucose level. While many people with diabetes aim to keep blood sugar levels below 180 mg/dl during the day, some people aim for the lower range of 120 or 140 mg/dl at night, when they are not eating.

At night, symptoms of hyperglycemia include:

  • Poor sleep
  • Waking up often to urinate or to drink water
  • Headache
  • Dry mouth
  • Nausea

Other symptoms of hyperglycemia that you may experience during the day or night include:

  • Frequent and excessive urination
  • Extreme thirst
  • Blurry vision
  • Confusion
  • Weakness
  • Shortness of breath

Is It Safe to Sleep with High Blood Sugar?

Glucose levels that are occasionally a little high at night generally don’t pose serious, immediate health concerns. Most people with diabetes cannot avoid some high glucose levels. However, frequent or long-term highs – particularly extremely high levels (above 250 mg/dl) – can be dangerous. It is important for people with diabetes to reduce high blood sugar as much as possible for two key reasons:

  1. Frequent hyperglycemia can lead to major health complications caused by damage to blood vessels and nerves, which can affect your eyes, heart, kidneys, and other organs. This occurs when glucose levels are too high over a long period of time.
  2. Very high glucose levels can be a sign of diabetic ketoacidosis (DKA, or high levels of ketones in your blood indicating that there is not enough insulin in your body). This occurs mainly in people with type 1 diabetes and can be life-threatening. For more information on DKA, read “Ketosis vs. Ketoacidosis: What’s the Difference.”

Why Does Blood Sugar Go Up at Night?

There are many factors that can cause your blood sugar to increase at night. For example: what food you ate during the day, how much and when you exercised, whether you ate snacks before bed, the timing of your insulin doses, and your stress level. You can experience different patterns of high blood sugar at night. You may start with high glucose when you go to bed, start the night in range but go high several hours later, or spend most of the night in range until the hours just before you wake up. By identifying your body’s patterns, you can figure out what is causing your high blood sugar and how to address it.

Common causes of a glucose increase at night include:

  • Eating too close to bedtime: whether you’re snacking or eating a late dinner, a post-meal glucose spike can lead to high glucose levels overnight. In particular, high-fat, high-carb meals (like pizza or pasta with creamy sauces) might delay glucose absorption causing an extended period of high blood sugar levels.
  • If you have type 2 diabetes, a treatment plan that doesn’t adequately address your nighttime insulin resistance or missed doses of your glucose lowering medication can cause high glucose levels at night (and often also during the day).
  • Over-correcting a low glucose level before bed. If you need to bring your glucose level back into range before you sleep, take just enough glucose to stabilize your blood sugar. Quantity-limited treatments (like glucose tablets or small candies) that will raise your glucose levels by a specific amount can be very helpful – learn more here.
  • If you take insulin, your insulin levels may be inadequate during the night. Depending on your dose and timing of basal insulin, the insulin may not last in your body until the morning. Learn about different types of insulininsulin pumps, and automated insulin delivery (AID) systems, all of which can be helpful for staying in your target glucose range overnight.
  • Taking less insulin before bedtime due to fear of low blood sugar overnight.

What is the Dawn Phenomenon?

Another reason for high nighttime blood sugar levels is the “dawn phenomenon.” The dawn phenomenon occurs early in the morning when the body naturally signals your liver to produce glucose, giving your body the energy it needs to wake up.

The hormonal changes associated with the dawn phenomenon happen to people with or without diabetes, though those without diabetes do not experience hyperglycemia. If you take insulin, you may need to try a new basal insulin or adjust the timing and amount of your basal dose (with injected insulin) or your nighttime basal rates (with an insulin pump) to cover an early morning rise.

How to Stabilize Your Blood Sugar Overnight

The most important thing you can do to stabilize your blood sugar is monitor your glucose levels at bedtime, during the night, and when you wake up to look for patterns. This will help you determine what’s going on in your body and how you can fix it. While there are many strategies people use to stabilize blood sugar at night, every person is different – you’ll have to look for trends in your body, experiment with ways to lower glucose levels over a period of time, and learn what works best for your body.

  • Check your blood sugar (or CGM) before bed. If it’s already high, your blood sugar levels may remain high throughout the night. To address this, you’ll want to start by adjusting when you eat your evening meal and what it consists of, and how much mealtime insulin you take to cover it.
    • Avoid eating lots of food close to bedtime. For diaTribe writer Adam Brown, the key to staying in range overnight is low-carb, early dinners, with no snacking after dinner.
    • Consider eating less food at night and taking more basal insulin to cover your evening meal.
  • Check your blood sugar (or CGM) during the night, between midnight and 3am. If you were in range before bed but have high glucose levels between midnight and 3am, you may need to adjust your basal insulin dosage and timing. If you are low during that time, you may experience a rebound high blood sugar later on – this is usually associated with overcorrecting the low.
    • Talk with your healthcare team about the optimal nighttime insulin regimen for you. You may need to adjust your insulin to avoid both early low blood sugar and later high blood sugar.
    • If you take basal insulin, see if you’re able to get an insulin pump or an automated insulin delivery (AID) system. AID systems will automatically adjust your basal insulin doses throughout the night to help keep your glucose levels stable.
    • For some people, a small snack before bed (with a small dose of insulin, if appropriate) can help stabilize glucose levels throughout the night and avoid an early morning high. Keep reading for a list of healthy bedtime snacks.
  • Check your blood sugar (or CGM) when you wake up. If you were in range before bed and between midnight and 3am, but have high blood sugar in the morning, you may be experiencing the dawn phenomenon or running out of insulin (or other medication).
    • If you take insulin, you may need to delay the timing of your basal dose to as close to bedtime as possible. Or, you may increase your basal rates with an insulin pump from around 3am on.
    • If you have type 2 diabetes, talk with your healthcare professional about your glucose-lowering medications to make sure that your treatment plan addresses overnight hyperglycemia.

It’s possible to experience a combination of these events – you may have high blood sugar levels at various points throughout the night. If you have a continuous glucose monitor (CGM, you’ll be able to better track your glucose levels throughout the night. You can use your CGM data to relate your behaviors to patterns in your nighttime glucose levels. Does the timing of physical activity affect your glucose levels overnight? What about food choices throughout the day, in terms of type, quantity, or timing of food? If you don’t have a CGM, the more frequently you can take a blood sugar readings the better. Learn how to get the most of your fingerstick blood sugar data here. It’s important to share your nighttime glucose observations with your healthcare team so that you can find the best ways to stabilize your blood sugar over the entire night.

For more advice on stabilizing nighttime glucose levels, read Adam Brown’s “The Overnight Blood Sugar Conundrum.”

Great Bedtime Snacks for People Living with Diabetes

For some people, a healthy bedtime snack helps to prevent glucose swings during the night. By eating a small snack that is full of protein and healthy fats (and low in carbohydrates), your body may be better able to avoid an overnight high – but if you take insulin, be sure to cover the carbohydrates in your snack even if it only requires a small dose of insulin.

Here are some snack ideas:

  • Plain nuts or seeds – try eating a small handful
  • Raw vegetables, such as carrots, celery, cucumbers, or tomatoes, with a small amount of hummus or peanut butter
  • Plain yogurt, and you can add berries or cinnamon (read about choosing a healthy yogurt here)
  • Chia seed pudding

Remember, a bedtime snack is only helpful for some people. To see if it works for you, you’ll have to carefully monitor your glucose before bed, during the night, and when you wake up.

What Should Your Blood Sugar Be When You Wake Up?

The goal of diabetes management is to keep your blood sugar levels as stable as possible. This means that when you wake up, you want your glucose to be in range and to stay in range throughout the day.

For many people with diabetes, the overall target glucose range is between 70 mg/dL to 180 mg/dL (3.9 to 10.0 mmol/L). To start the day strong, the American Diabetes Association recommends that you aim to wake up with glucose levels between 80 to 130 mg/dL. Talk with your healthcare team about your glucose targets.

How to Lower Morning Blood Sugar

Whether a morning high is caused by the dawn phenomenon or something else, here are a few things you can try to lower your blood sugar levels:

  • Physical activity when you wake up can help bring your glucose level down. Even going for a walk can be helpful.
    • To learn about exercise guidelines and glucose management strategies, click here.
    • Read Adam Brown’s take on walking – the most underrated diabetes exercise strategy.
  • Eating a light breakfast can help keep a morning high from increasing even more. Taking your mealtime insulin will help lower your blood sugar.
    • Adam Brown suggests eating a breakfast that is low in carbs, and notes that sometimes mealtime insulin has to be adjusted in the morning. One of his favorite breakfasts is chia pudding, since it has little impact on glucose levels; see what else he eats for breakfast here.
    • Catherine Newman has six popular, low-carb, delicious recipes in “The Morning Meal.”
  • Intermittent fasting and time-restricted feeding approaches to meal timing can also help people keep morning blood sugar levels in range. Read Justine Szafran’s “Intermittent Fasting: Stabilizing My Morning Blood Sugars” to learn more.
  • For additional ways to navigate mornings, read seven strategies from Adam Brown in “A Home Run Breakfast with Diabetes.”

Source: diabetesdaily.com

10 Ways to Avoid Overnight High Blood Sugar

My biggest challenge when it comes to managing my blood sugars is the overnight hours. I know it is largely in part to the fact that I am a nighttime eater, consuming most of my calories after 7 pm. But I have also done some investigating and noticed my blood sugars naturally rise around 9-10 pm, so I am fighting an uphill battle. I started looking for some tips and tactics to try in order to improve my nighttime blood sugar levels.

Here are 10 tips on how to lower your overnight numbers, which will give you a better night’s rest too.

1. Basal Testing

This should come first no matter what issues you are having when it comes to your blood sugars. Without knowing the proper dose of “background” insulin your body needs, it becomes much more difficult to figure out how to dose for meals, creating a rollercoaster of events. In Gary Scheiner’s book “Think like a Pancreas” he explains basal testing in an easy-to-understand and methodical way.

2. Don’t Eat Too Close to Bedtime

Many people confuse this statement to mean that you can gain more weight by eating late at night. This simply not true. It comes down to a science and so long as you are in a caloric deficit, it doesn’t much matter when you take in your food. However, if you eat too close to the time you shut your eyes, it becomes more challenging to stay on top of your blood sugars. Eating about two hours prior to when you shut the lights will give you more time to assess how your blood sugar is trending, and (if needed) get your blood sugars back in range so you can get some sleep.

3. Take Advantage of Technology

If you are fortunate enough to own a continuous glucose monitor (CGM) , you should make the most of its features. Keep the alarms set to a high and low blood sugar number that you are comfortable with to help wake you if damage control is needed. You can also share Dexcom with a loved one who could alert you of dangerous numbers if you are unable to wake from the alarm on your own. Pumps like Tandem Basal Control have become extremely popular, as they can release insulin if your blood sugars get too high allowing you to focus solely on dreaming of a cure!

4. Try to Relax

It is known that stress can lead to higher blood sugar numbers and can also contribute to insulin resistance. When stress hormones like cortisol kick in, it can raise blood sugar levels, which is often what you see in the morning with dawn phenomenon. Additionally, stress hormones are known to increase insulin resistance. “Hyperglycemia is particularly exaggerated by elevations of cortisol and epinephrine in diabetes as a consequence of an altered response of the liver to these hormones,” scientists summarize. Put down your phone, drink some hot tea or read a good book in order to relax and put yourself in the right mindset for both in-range blood sugars and restful sleep.

5. Carb Count and Dose Accordingly

If you are taking insulin, this is something you likely do on a regular basis. Since I am so picky and stick to the same foods, I really don’t count carbs at all. I use the “WAG” strategy (wild a** guess), but this could wind up costing you a good night’s sleep. Make sure to count your carbs, know your carb-to-insulin ratio, time your dose correctly and keep your fingers crossed. Pumps have calculators built in to help make this easier for you and if you are on shots, you should check out the InPen, which has been a lifesaver for me in regards to getting my doses right and keeping my blood sugars in range.

6. Set Alarms and Stick to a Routine

Setting alarms will not only help remind you to take any oral medications and/or insulin but setting an alarm in the middle of the night can allow you to do a quick correction or chug some water if you are experiencing high blood sugars. Many times, if you take your medication or basal insulin an hour too soon or too late, it could impact your blood sugar levels.

7. Adjust Doses If Necessary

We are often so busy that we forget that many different things can affect both our medication and insulin doses. If you recently lost weight, started exercising, are taking steroids, changed your diet, or have become pregnant, to name a few, you should check in with yourself and your health care team to make sure you are taking the proper amount of medication. Ensuring that you are will no doubt give you better results at all times including the hours of rest.

8. Don’t Exercise Too Close to Bedtime

Many of us have busy schedules that only allow for nighttime workouts. If this is the case, try to fill up on protein-rich foods prior so that you don’t wind up with too much insulin in your system a few hours later when you are trying to fall asleep. Also, weight training can spike our blood sugar meaning you may wind up having to correct it. Being awake and alert for a few hours after a workout can only help your blood sugar management.

9. Be Wary of Delayed Blood Sugar Spikes Due to Protein

There are many times when two hours after dinner I am pleasantly surprised by my blood sugar number. But, I notice it starts to slowly creep up shortly after. Unlike carbs that quickly break down to glucose, protein can trigger a blood glucose rise that takes place over several hours. If your dinner is protein-heavy make sure to check your blood sugars a few hours after to troubleshoot any blood sugar spikes.

10. Stay Hydrated

Water plays a key role in keeping blood sugars in range. If we are adequately hydrated, the glucose levels in our blood can’t become too concentrated resulting in hyperglycemia. Water has the ability to reduce blood sugar by diluting the amount of sugar in the blood. Staying hydrated can also help you in your weight loss efforts. My advice is to make sure you get your water in throughout the day so you’re not paying for it with trips to the bathroom all night!

It isn’t easy to schedule in “troubleshoot my overnight numbers” to our already busy schedule, but taking the time to heed some of the above advice is sure to help your numbers improve, allowing for a more peaceful night.

Do you have trouble with your overnight blood sugars? Do you have any advice that worked for you? Share and comment below!

Source: diabetesdaily.com

Coffee and Blood Sugars: What’s the Connection?

If you’re a coffee drinker and live with diabetes, you may be familiar with the difficulty that drinking a regular morning cup of joe can be. Coffee is one of the most popular drinks on the planet, with the average U.S. adult drinking two 8 oz cups of coffee per day.

Whether you spike or crash, drinking and enjoying coffee is made infinitely harder when living with diabetes. So, what’s the deal? What exactly does coffee do to your blood sugars, and how can you help mitigate the damage?

This article will outline the effects that coffee has on blood sugar levels and ways you can prepare and guard against any negative side effects from your morning routine.

What Is It About Coffee That Affects Blood Sugar?

The majority of people with diabetes see a spike in their blood sugar when drinking coffee, and it’s not a mystery that a lot of the cause can be attributed to the caffeine content in your morning cup.

According to the Mayo Clinic, for people with diabetes, about 200 milligrams of caffeine (about one to two 8 oz cups of plain, brewed coffee) can cause a spike. Caffeine causes insulin resistance and can negatively affect postprandial blood sugar levels, essentially requiring you to take more insulin for foods eaten when you drink caffeinated beverages. Some people even need to bolus for drinking plain, unsweetened, black coffee that has no carbohydrates.

Ironically, long-term coffee consumption is associated with higher insulin sensitivity and lower rates of type 2 diabetes, but in the short term, the caffeine content causes a spike in blood sugars and lower insulin sensitivity. Caffeine is also an appetite suppressant, so its overall effect is sometimes balanced out.

The best option for people with diabetes who are struggling with blood sugar spikes post cup, however, may be to opt for decaf: drinking decaffeinated coffee seems to curb blood sugar spikes in individuals.

Why Does Caffeine Cause Blood Sugar Spikes?

Caffeine spikes blood sugars in a number of ways, including:

  • Naturally raising levels of certain stress hormones, epinephrine, and adrenaline, making you more insulin resistant when you drink it
  • Blocking the protein adenosine, tamping down the amount of insulin your body produces (if you’re type 2), making it more difficult for the body to process carbohydrates as quickly, spiking your blood sugar levels.
  • Inhibiting sleep, when consumed later on in the day. Lack of sleep for even a few days has proven to lower insulin sensitivity and increase insulin resistance, keeping blood sugars stubbornly high

And it isn’t only the caffeine found in coffee affecting blood sugars. A 2004 study showed that taking a caffeine pill before eating resulted in higher post-meal blood sugars and insulin resistance for people with type 2 diabetes. The same can be inferred for caffeinated sodas, chocolate, tea, energy drinks, and even protein bars.

Other Factors That Contribute to Higher Blood Sugars

The caffeine content in coffee is not the only thing to blame for higher blood sugar levels, however. Many people prefer coffee first thing in the morning, right when they’re often already experiencing the higher blood sugars associated with the dawn phenomenon, and combining the two can make it harder to get levels back under control.

Frappucino: sugar-loaded coffee

Photo credit: iStock

Additionally, beware of added sugars, syrups, and sweetened-dairy products that can quickly add empty calories (and carbohydrates!) to your morning brew. The difference in carbohydrate counts between one cup of black coffee (1 gram) and a Grande Frappuccino from Starbucks (50 grams) is stark and can make all the difference between a “good” blood sugar day and a difficult one. Having coffee beverages that are high in saturated fat and sugar on a regular basis can contribute to both insulin resistance and the development of type 2 diabetes.

Even an innocuous latte can still have anywhere between 12-25 grams of carbohydrates, simply from the sugars found in milk.

Ways to Combat the ‘Coffee Spike’

There are many ways to help combat the blood sugar spike from coffee, including:

  • Try not drinking coffee first thing; go for a 20-minute walk to combat the dawn phenomenon before you imbibe
  • Switch to decaf, or even half-caf
  • Cut down on your overall consumption (one to two 8oz cups of brewed coffee per day is plenty)
  • Do not drink coffee late in the day (try to drink it before noon), so it does not negatively affect your sleep, and thus insulin resistance
  • Drink only black coffee, cold brew coffee, or coffee with a touch of (unsweetened) dairy or non-dairy milk, cream, or half-and-half
  • Do not add syrups or sugar to your coffee; opt for stevia instead
  • Add vanilla extract, cinnamon, or sugar-free syrups to your coffee for extra taste
  • If you regularly spike, even from black coffee, aim to pre-bolus before a cup, taking a dose for your coffee 10-15 minutes before drinking
  • Get some morning exercise in immediately after drinking a cup to help curb the spike
  • Talk with your doctor about additional strategies to incorporate coffee into a healthy diet

The routine of a morning cup of coffee is essential to millions of people around the world, but a blood sugar spike is never enjoyable. Incorporating some of these strategies can help you mitigate the negative effects on blood sugar, while still allowing you to enjoy what you love! A little planning and preparation can make all the difference. And that’s definitely something to celebrate. Cheers!

Source: diabetesdaily.com

The Benefits of Working from Home with Diabetes

COVID-19 has officially changed the way the world runs. More than ever, people are staying home (whether by choice or mandate), spending more time with their families, avoiding public events, and yes, working from home. Essential employees, such as frontline healthcare workers, grocery store clerks, sanitation crews and workers rendering city services, are still having to report in person, but COVID-19 has made a third of Americans (over 100 million people) switch to home work.

This can be extremely beneficial if you live with a disability or chronic disease, and can be helpful if you live with diabetes. And while Americans still work more than anyone else in the industrialized world, working from home can help balance the stress of diabetes management. Here are some of the benefits of working from home if you live with diabetes.

No Commute

Let’s face it, commuting is not fun. The average American working full-time (8 hours a day, 5 days a week) commutes an average of 4.35 hours a week and over 200 hours (nearly nine days) per year. That is a lot of wasted time. With rising costs of living and stagnant wages, more people live farther and farther from their jobs, and have longer commutes than ever, which can cut into both one’s sleep and time for exercise. “Commuting” from your bedroom to your home-office leaves more time for quality sleep, morning exercise, and a healthy breakfast, which can set your blood sugars up for an excellent day, which can increase work productivity as well.

Not commuting will also save lots of money that would normally be spent on parking, car maintenance, tolls, and gasoline. Even if you normally take public transit to work, metro and bus tickets add up quickly! Working from home is also much better for the environment; transportation accounts for one-third of all greenhouse gases produced in the United States. Staying at home for cleaner air is an easy and simple way to help the planet.

Healthier Meals

Takeaway Chinese food or pizza at lunchtime can be a blood sugar nightmare. Working from home affords people the ability to cook easy, healthy meals in their kitchens, which is not only a healthier option, but saves money, too. It’s easy to cook lentils or beans in a slow cooker, or wash and chop up fruits and veggies for a quick grab and go snack if you get the afternoon munchies. Additionally, check out these easy, low-carb recipes that you can quickly make from the comfort of your own home!

Fewer Sick Days

People who work from home both take fewer sick days and get sick less often (no sharing germs in a communal setting or on the train en route to work!). Also, going into an office with a mild cold or flu can be miserable, but doing some work from home is almost always accessible. Plus, diabetes can mean dawn phenomenon, a kinked pump site midday, or a bad low that would previously require coming in late or leaving early- none of which would be necessary with a work from home schedule. It’s healthier for everyone!

No Judgement

Ever take a correction dose during a meeting, and get the side-eye from a nosey coworker? Ever have someone compare your diabetes to their distant relative who died of horrible complications from diabetes (when you never asked for the story?). Are people always questioning what you’re eating (or not eating), or how much you exercise (or how much you don’t)? Working from home prevents judgement and prodding questions, and you can go about your day and take the best care of yourself without intervention from others.

A Flexible Schedule

This can depend on your organization or company, but many offering work from home will grant their employees some flexibility in their schedules. If you have an endocrinologist appointment in the morning, shifting your work schedule back an hour or two can prevent the need to take personal leave for the entire day. Likewise, a flexible schedule can allow for a lunchtime run, which can counteract high blood sugars in the afternoon. Need to change your pump site or CGM midday? Working from home can let you do all that while still getting you work done. Flexibility is key to excellent diabetes management, and working from home makes it much easier.

Have you been working from home since the COVID-19 pandemic hit? How has it benefited you and your diabetes management? Is there anything that you particularly like or dislike about working from home? Share your story in the comments below; we love hearing from our readers!

Source: diabetesdaily.com

Control-IQ: The Good, the Challenges, and Tips

This content originally appeared on diaTribe. Republished with permission.

After a month of her daughter using Control-IQ, Katie Bacon reviews the pros and cons of the algorithm and shares her family’s tips and takeaways

When the email came through in early April that our daughter, Bisi, could now download the software to run Control-IQ on her t:slim insulin pump, the timing seemed perfect. After all, our family was staying at home due to COVID-19, so we had plenty of time together to do the training and figure out the new system and how it worked for Bisi and her blood glucose levels. Plus, from everything I’d read about COVID, keeping blood sugars as stable as possible was more important than ever, and it seemed like Control-IQ could help us with that. (The Control-IQ algorithm uses data from Dexcom’s CGM to lower insulin delivery when a low is predicted and to increase insulin when a high is predicted – learn more about Control-IQ here.)

Bisi has now been on the new system for about a month, and while it hasn’t been a magic bullet and we’re still learning, Control-IQ has improved Bisi’s time in range by about 5% (and we’re hopeful that her time in range will continue to improve). Also, even more importantly, it’s improved her quality of life – and ours, as the parents who watch out for her. When I sat down with Bisi recently to ask her about the change, I got her perspective on the burden she feels diabetes has placed on her ­– and the power of Control-IQ to lighten that load. She told me that before using Control-IQ, at any given time 30-40% of her focus was on diabetes. I was taken aback by this percentage, since Mark (my husband) and I have always tried to take some of the weight for her. As she told me, “It feels demanding, like a lot of pressure, as if someone’s poking my head.” But with Control-IQ, she says, she doesn’t need to worry about much except bolusing insulin at mealtime. She has fewer highs, fewer lows, and she says she feels better physically than she did before. “For as long as I can remember, diabetes has been a main focus of my life, but it really shouldn’t be that way. So it’s been nice not to focus on it as much,” she said.

In terms of what Bisi has experienced over the past few weeks since switching to Control-IQ, I’ve divided my thoughts into the pros and cons of the system as we’ve experienced it; I’ve also included tips drawn from what we’ve learned from Bisi’s endocrinologist and DCES.

Pros of Control-IQ:

  • Graph

    Image source: diaTribe

    We’ve found that Control-IQ works particularly well at night, when Bisi isn’t eating anything or bolusing. While our nights had already improved with Basal-IQ (which did a good job minimizing Bisi’s lows), Control-IQ brings down any highs as well (see the graph on the right). I’d say that when Bisi’s pump only dealt with the lows, we still had to wake up maybe six to eight nights a month, on average – and sometimes multiple times in one night. But in the month since Bisi started on Control-IQ, we’ve only had to wake up three times. This is a big change in our quality of sleep (and quality of life).

  • Control-IQ helps keep blood sugars down during the day. As before, Bisi’s blood sugars are less stable during the day, when her activity is variable and when she’s eating meals and snacks. But now, Control-IQ raises her basal rate when she’s headed high and gives modified boluses (60% of what’s called for) if the highs are sustained. We’ve found that her blood sugar does not rise as steeply, according to her CGM, and also that it often tops out at a lower number than it used to.

Cons of Control-IQ:

  • There were a few instances where Bisi had sustained lows that were more difficult than usual to counteract with carbohydrates. These instances have all been when she’s started exercising with a lot of active insulin on board, due to Control-IQ turning up her basal rate in response to a high. Before using Control-IQ, if Bisi’s blood sugar was high, she (maybe with a reminder from me) would have to make a decision to either turn up her basal or give a correction. If she knew that she was going to get exercise in the near future, she wouldn’t do either of those things. But now they happen automatically, so she’s sometimes stuck with too much active insulin on board. It requires a different kind of thinking and a different kind of planning than before.
  • Both Bisi and I wish there were a little more flexibility in Control-IQ so she could set her own target. Bisi used to set her target at 100 day and night, and would often run at 80 or 90 while she was sleeping. With Control-IQ’s built in Sleep Mode target of 110, Bisi runs a little higher than she is used to, especially at night.

Thoughts and Tips for using Control-IQ:

  • We have found that being consistent about pre-meal bolusing is even more important with Control-IQ than it was before. If Bisi waits too long to bolus, her blood sugar goes too high, she gets more basal and an extra 60% bolus from Control-IQ, and then her blood sugar goes too low later on.
  • While it might seem like Control-IQ could enable people to be a little freer in what they eat, so far it has emphasized the benefits of eating low carb as the best way to avoid food-related spikes and insulin-related dips. No matter how good an algorithm is, it’s always going to be reactive rather than proactive, and we’ve found that the smaller the inputs in terms of number of carbs eaten, the more smoothly Control-IQ works. (I think this is partly why it tends to work better for Bisi at night, when she’s not eating anything, than during the day.)
  • Bisi’s endocrinologist validated our sense that exercise-related lows can be steeper with Control-IQ, since you tend to have more active insulin on board. Because you can’t do a temporary basal rate with Control-IQ, she suggested that we set up an alternate program with basal rates cut by 50%. If Bisi knows she’s going to exercise, she can turn on this alternate program 90 minutes to 2 hours before. Or, if she’s eating beforehand, she can put in fewer carbs/give less insulin. Either way, the trick is remembering.
  • During Bisi’s most recent appointment, her endocrinologist pointed us to a feature of Bisi’s Tandem reports that’s helpful to look at as a way to adjust settings. She told us to focus on the difference in the Logbook section between the Basal Total Delivered and the Basal Profile Setting, as a way to tell whether her basal rate at any given time should be raised or lowered; the closer the settings are to the amount of insulin that’s being delivered, the more smoothly the Control-IQ algorithm will work. She also suggested that we “Marie Kondo” (streamline and declutter) Bisi’s basal rates, which had proliferated over time, to help us see more easily where adjustments need to be made.
  • We realized that if Bisi has a random high blood sugar, particularly at night, we should assume that something has gone wrong with her pump site. Before Control-IQ, pump site failure was only one of several reasons – including the dawn phenomenon and the meal she’d eaten the night before – that her blood sugar might have gone high. This realization has helped us reduce that middle of the night detective work, when your brain is at its foggiest. If Bisi has a persistent high, the problem is most likely the pump site, not the algorithm.
  • One adjustment that Bisi has struggled with is remembering to turn off her insulin when she takes off her pump to shower or play sports. (The Control-IQ algorithm is thrown off when the system doesn’t have an accurate sense of how much insulin you have on board.) This is a work in progress for us.

Even though we still feel like we have more work to do in terms of getting the best out of the new algorithm, Control-IQ has improved Bisi’s life in important ways. As Bisi’s endocrinologist told us, “It’s not perfect, and you need to think more about active insulin than you did before. But the goal with this is to have diabetes interrupt your life less than it did before.” For Bisi, the important aim of staying in range now requires less mental effort. As she said recently when looking at her CGM graph after 24 hours of Control-IQ: “This is pure gold.”

This article is part of a series on time in range made possible by support from the Time in Range Coalition. The diaTribe Foundation retains strict editorial independence for all content.

About Katie

Katie Bacon is a writer and editor based in Boston. Her daughter, Bisi, was diagnosed with type 1 diabetes in August, 2012, when she was six. Katie’s writing about diabetes has appeared on TheAtlantic.com and ASweetLife. Katie has also written for The New York Times, The Boston Globe, and other publications. 

Source: diabetesdaily.com

How to Navigate Blood Sugars During a Pandemic

Diabetes management is challenging enough as it is. It takes a daily and consistent effort, around the clock, to check your blood sugar levels, pay close attention to your diet and a multitude of other variables, all while making medication adjustments to stay in your target range. The constant management tasks already take a substantial amount of effort and headspace. It’s no wonder that when a particularly high-stress situation arises, it can make diabetes management especially tricky.

Right now, we are all living through a very stressful time, globally. As the COVID-19 pandemic continues, we are all doing our part in trying to slow the spread of the infection. Between school and university closings, bars and restaurants and stores being shut down, and the constant effort of social distancing, the changes to our daily routines are paramount. Not being able to go to the gym, socialize as we are used to, and the added stresses of childcare, not to mention unemployment concerns, are skyrocketing our stress levels.

We know that stress levels can cause higher than normal blood glucose levels. As a result, many of us may be struggling with our diabetes management more than usual.

Jennifer Smith RD, LD, CDCES, Director of Lifestyle and Nutrition and Registered Dietitian, Certified Diabetes Care and Education Specialist at Integrated Diabetes Services explains:

“Stress comes in all forms and can effect each person a bit differently. Stress at work, from a presentation, a big project for school, studying, a terrifying experience like a car accident, a big game against the top opposing team, a performance in gymnastics, or even a scary movie – these can stimulate the “fight or flight” response in the body. The main hormones that are released in a time of stress are adrenaline and cortisol. The release of these hormones encourages the liver to dump glucose into the blood stream in order to provide a quick supply of energy to “get out of the situation”…our body still responds to stress as if we were running away from a Saber tooth tiger ages ago. This extra glucose can and will raise blood glucose levels. It won’t be the same for each person and different types of stress will cause a different rise in blood glucose, but this is the main reason for the typical rise from stress.”

In these unprecedented times, it is perhaps more than ever important to continue to care for our physical and mental health, and in particular, our diabetes. Optimizing our blood glucose levels can help promote optimal immune system function, which helps us fight off all kinds of infections more effectively. Also, keeping blood glucose levels in range as much as possible can go a long way in helping us to feel our best on a day to day basis, physically and mentally.

Here are some tips for optimizing our diabetes self-care during these high-stress times.

Check Your Basal Insulin Dose

For the many of us who are on a basal/bolus insulin regimen, whether using a pump or multiple daily injections, basal insulin doses (or rates) are the cornerstone of blood glucose management. If the basal insulin dose is too high, we might find ourselves with unexpectedly low blood sugar levels throughout the day or night, while if the dose is too low, we may be constantly chasing higher than desired blood sugar levels.

Jennifer Smith RD, LD, CDCES, explains:

“This the foundation of your diabetes management. Think of it like the foundation of a house – if you build it sturdy and strong then everything placed on top of it will hold stable. If you have a foundation that has holes in it, or it put together with shoddy materials, you are like to have to patch and fix it along with everything you build on top of it or it will all fall apart. Basal insulin is what we use to manage blood glucose without food in the picture. In a body without diabetes there is a fine coordination between insulin released by the pancreas in the fasting state and the livers release of glucose into the blood stream to maintain normal glucose levels. This happens whether or not there is food eaten. Getting the basal rates tested is the baseline of management to ensure that if you skip a meal, or for overnight when you aren’t eating, glucose levels stay stable without falling or rising more than 30mg/dl (1.6mmol). Having this set well will ensure that the bolus insulin you take to cover food or to correct blood glucose when it is too high is working optimally. It may need to be adjusted as you move through life, as hormones for growth, menstruation, stress and illness can change insulin needs. But, if you have your base basal set well, then adjusting for these variables is a bit easier to navigate.”

For most people, stress tends to increase insulin resistance, resulting in higher blood glucose levels. This means that many need more insulin during times of stress to stay in range. However, your response to stress may vary, so it is important to carry out basal testing to determine if your dose is appropriately set.

Photo by iStock

Below, you can find a previously published description of how to determine if your basal insulin doses or rates are working well for you. Once that cornerstone of insulin therapy is properly set, it will be much easier to troubleshoot other areas, like bolus and exercise adjustments. (*Note: always consult with your healthcare provider prior to making any changes to your medication doses).

To determine if the basal insulin dose is set correctly, one can fast for a specific number of hours without bolus (fast-acting) insulin onboard and monitor blood glucose levels to see if they remain steady. Importantly, the test should be performed in the absence of other complicating variables, like exercise, stress, or illness. The test should not be performed if your blood glucose level is low or high.

Many people prefer to perform basal testing in 8-12-hour spurts, so as not to fast for an entire 24 hours. For example, it can be quite easy to check the overnight basal dose by not eating after 6 pm and assessing the blood glucose trend from 10 pm to 6 am (in the absence of food or bolus insulin). To determine the basal dose efficacy for morning or evening hours, one would skip a meal and monitor blood glucose levels to determine whether the basal dose is well-set.

The basal insulin requirement may be very similar throughout the day, or it may vary. In particular, many individuals experience “dawn phenomenon,” whereby hormones stimulate glucose release by the liver in the early morning hours. When using an insulin pump, it is quite easy to adjust the basal insulin rate of delivery to accommodate any variations. For those on insulin injection therapy, it may be worthwhile to split the basal insulin injections into several doses throughout the day, to best match the requirements. These individuals may also benefit from taking a small amount of short-acting insulin upon waking to account for dawn phenomenon.

Accurate basal insulin dosing is the first step to achieve the best blood glucose control possible. Once the optimal doses or rates are determined, one should not need to worry about hyper- or hypoglycemia in the absence of food or other variables (like exercise). This will make it a lot easier to systematically start addressing other variables that affect blood glucose levels.

Reduce Stress

It may be easier said than done, but there are several, proven ways that we can reduce our stress levels. Whether it’s taking ten minutes to meditate every morning, making sure you get your exercise in, or connecting with loved ones through phone or video chats, taking time to care for our physical and emotional health can in itself help us to de-stress. In turn, our blood sugar levels will (hopefully) become more predictable and easier to manage. Check out some of these articles to help you get started:

Mindfulness and Meditation Apps

Staying Active at Home

Taking Care of Your Mental Health

And, as the weather finally improves for many of us, don’t forget about the benefits of time spent in nature. Between the vitamin D exposure and the exercise, you can gain a boost for your immune system and mental state by making it a priority to get outdoors as much as possible.

Create (and Stick to) a Routine

Maintaining some degree of normalcy by having a regular schedule can help us feel more in control and help keep us on track when it comes to our meal planning and exercise goals, which in turn, can have a tremendously positive effect on our diabetes management. A routine can be especially helpful when we find ourselves in a rut or experiencing burnout.

For example, if you’re struggling to check your blood sugar level on a regular basis, you can make a concrete plan of when exactly you will check each day. Next, keep yourself accountable by setting an alarm to do so. Moreover, consider trying out a diabetes management app, to help you stay on track.

If you find that your diet has suffered, try to plan your meals ahead for the week. Focus on nutrient-dense foods and get your family involved. Try out a new vegetable recipe or even a low-carb desert! Similarly, with exercise consider engaging all together at a set time, at least a few times per week.

Make Use of Technology

We are so fortunate to have the advanced technology we have today, diabetes-related and not. If you have found yourself in a rut, not wearing your continuous glucose monitor (CGM), or not utilizing the features on your insulin pump to their fullest extent, this is a great time to lean into the technology that can help us thrive during these difficult times.

Moreover, we can data share with our healthcare providers, providing them with detailed information about what’s working and what’s not. Ask your healthcare providers about telehealth appointments, if you haven’t yet!

Photo credit: geralt (Pixabay)

On another note, just using video conferencing to keep up with family and friends, or even just chatting about diabetes in a forum, is a gift that did not exist even 50 years ago! Making use of the internet to strengthen existing connections and make new ones is critical to our emotional health during these times, and can even help with diabetes management and emotional support.

Lean On Others

If you need help, reach out. If you are having a bad day, reach out to a friend for support. If you’re struggling with your diabetes management, reach out to the online community, as well as your diabetes provider. Don’t underestimate the power of social support, as well as having another pair of eyes to review your data to help you identify where you can make some changes to get back on track.

We may be socially distancing, but we are not alone! Lean into your community and make use of your provider’s expertise, remotely.

Also, be aware of the following mental health hotlines and be sure to share them with anyone who may benefit:

  • National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
  • Crisis Counselor Hotline: Text HOME to 741741 to connect with a counselor

Also, you can visit this website for hotlines that are tailored to more specific mental health issues.

***

How has your diabetes management been affected by the COVID-19 pandemic? What are you doing to stay healthy? Please share your experiences with us in the comments below.

Source: diabetesdaily.com

Diabetes Isn’t “One Size Fits All”

I love the diabetes online community for everything that it offers: advice in times of need, hope in times of despair, helpful anecdotes and inspiring stories, and friendships formed across time zones and many miles.

One of the things that the diabetes online community sometimes does, though, is to try and prescribe how everyone with diabetes should live. One day, it’s the Dr. Bernstein diet, the next, it’s high-carb, low-fat. The Mastering Diabetes (mostly) fruit diet is so popular now that their book has even made the NYTimes Bestsellers list. People are jumping on diet and exercise bandwagons before they figure out what they truly need (and want!) in terms of their diabetes management, and what it should look like, day-to-day.

Parents are often left feeling guilty if they can’t “hack” their child’s insulin pump, and individuals with diabetes feel bad when they don’t (or can’t?) do CrossFit or maintain a super low-carb lifestyle. A once seemingly supportive community now raises an eyebrow if they spot you eyeing over a cookie during a meet-up group, or (god forbid) a sugar-sweetened beverage. But I’m here to say one thing: diabetes isn’t a “one size fits all” disease.

You are not a “bad diabetic” if you don’t have a DIY looping system, or if you don’t want to sit down and try to figure it out. You’re fine just the way you are if MDI or insulin pens work better for you, if you dislike skin adhesives, or feel claustrophobic always having something attached to you.

It’s okay if you spike every morning, without fail, due to dawn phenomenon, and if you don’t ever post your CGM graphs to social media. It’s okay if you don’t have a CGM (really, it’s fine). Or if you don’t take an SGLT2-inhibitor off-label. Or even want to try. There’s no perfect low snack. There’s no perfect meal.

Figure out what your body needs, and honor that. It’s okay if you don’t want to eat low-carb, high-carb, or in-between. Or if you’ve lived with type 1 for 15 years, enjoy your weekly ice cream treat, and don’t want to give it up. Figure out what you need and want, and do that. 

It’s okay if you don’t own a Myabetic bag, or can’t afford one, or think they’re ugly. It’s alright if you’ve never been to diabetes camp or don’t want to go. It’s alright if you don’t want to jump all into advocacy and chant, and rally, and cheer. It’s okay if self-care for you is sitting in a quiet room, and coming to a place of acceptance.

It’s okay if you don’t join any Facebook diabetes support groups, or seek out diabuddies in real life. It’s okay if diabetes is only a very small part of your life. It’s okay if it’s your whole life.

It’s okay if you don’t like going to the endocrinologist, or have to force yourself to see your eye doctor. It’s okay if you don’t like talking about your diabetes with others. Diabetes is not one size fits all.

It’s okay if sometimes you’re feeling overwhelmed, over-stimulated, and need to turn inwards, for yourself and rest sometimes.

There is no perfect way to (micro)manage, eat, exercise, handle stress, socialize (or not!), dose, count, or bolus. There is only the way that will work for you and your body. Find what works for you, and embrace that. 

Have you ever been pressured to manage your diabetes a certain way? Eat a certain diet? Exercise in a specific way? How did you deal with the pressure? Share this post and comment below; we would love to hear your stories!

Source: diabetesdaily.com

Diabetes is Not Unpredictable: A Troubleshooting Guide

I have been living with type 1 diabetes for over a decade and have experienced my fair share of learning experiences in diabetes management. One tenet that I often come across in the diabetes online community is, “diabetes is just so unpredictable!” In my early years of diabetes management, I somewhat sympathized with the sentiment. […]
Source: diabetesdaily.com

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