Burnout

As I sit (let’s be honest, I am standing) here at my desk, I am having a serious brain bash because my mouth is numb from the dentist and my mind is telling me to run and go drink a tub of honey. How does this make sense? Well, when my blood sugar is super low my tongue and the side of my mouth always tingle. If you have diabetes, I am sure you can empathize. To say the least, while I am working, my eyes are glued to my continuous glucose monitor (CGM).

In a nutshell, this situation I am experiencing right now is how I have felt about my diabetes in the last month. It’s been a knee-jerk and while my blood sugars have been decent, they have been way too much freaking work to be where they are. And never in my (adult) life have I cared about what people think, or where their eyes go when I meet or greet them, but I am feeling sensitive about the fact many people directly look at my Dexcom arm, which usually has a bright purple sticker on it and my upper back where I have been recently hosting my insulin pod. Indeed I ripped my CGM off my arm last night partly because I am over this! I needed a break, and although my CGM break was short, I found myself seeking a new spot (my butt) to put my Dexcom to deal with this emotion.

What’s going on with me? I usually jump at the opportunity to educate people about what is on my arm and back…Ahhh, I am totally burned out.

My lifestyle and diabetes are not dancing very well together, and I realize I need to take a big deep breath (or 10) and figure out how to get the 2 at least on the same radio station. The best way to do this, I am finding is slowing down, breathing more and talking about it.

I have dozens of clients with diabetes and while I am providing sound recommendations I am being transparent with my current struggle and human feelings. Simply writing this post is allowing me to have a weight lifted off my shoulders and I would love for viewers to add any feedback or mentions on how they can relate in the below comment section.

I may be the @diabeticdietitian, but I am not superhuman. I want to eat or be able to not eat whenever I want, sleep however I want (often I roll onto my CGM or pod and it hurts), and not think about the carb, protein, fat breakdown of food. I can loosen my expectations for my control, but I know that will make me a cranky person, so what goes?

Instead, I am making small tweaks, setting boundaries (like turn phone to airplane mode come 9pm or really work at being present when I am with people) and reaching for broader goals. As shared, instead of chucking off my CGM for days or months (which is totally fine to do, and I have done that), I am finding more conservative spots to stick my CGM and my pod (lower back) until I want to forwardly talk about them in public. Instead of obsessing about tight control, I mapped out a plan to eat super nutritious, and more importantly, desired foods. I know what I like, I know how to bolus for some of my favorite foods, I just need to slow down, lighten my to-do list and ground myself.

Diabetes can knock us down sometimes, but it brings us opportunities and connections we would never have otherwise. As my Insta-friend @type1dchick put it best, “God gave his toughest battles to his strongest soldiers” and I will add that the diabetes community is a strong one and a great place to be.

Chin up.

As If We Are Scientiest

Ever since I was diagnosed with type 1 diabetes at the age of 8 years old in 1992 I began to learn and understand that my activity, food choices, and mental health all had an impact on my diabetes, or what we check multiple times a day, my blood sugar. Can it get frustrating? Yes; I’m preaching to the choir. But it’s interesting. This situation (as in no one day is the same) allows me to understand my body in a way that others aren’t able to do (is this the silver lining??). I can truly assess how certain foods make me feel (energy, mood, mental clarity, blood sugar response, etc) and affect my insulin sensitivity.

Overall, I feel like a scientist when learning how to manage my diabetes and through the last 21 years I have most importantly learned, “There is no such thing as failure. It’s simply feedback. Assess, roll with the punches and carry-on.”

Sure it is easy to get down on myself when I slip up on diet, dismiss exercise and have a sub-optimal blood sugar reading to show for it, but what is that going to do for me? Nothing, and certainly nothing good. The right thing to do is to understand why a blood sugar is high or low (which sometimes can’t be pin-pointed) and think of a way how in the future, I can prevent the situation.

Having type 1 diabetes for 21 years and counseling others with type 1, type 2 and gestational diabetes I have learned:

  • what macronutrient ratio (number of carbohydrates, verse fat verse protein) work best to have at each meal. For example, I do far better on a low carb diet where the margin of error is less when matching my insulin to my meal/carbohydrate content. Thanks to Dr. Bernstein’s book, Diabetes Solution, I truly grew to appreciate this concept. 
  • Firstly realizing this with myself, I do not thrive on gluten containing grains. Indeed, when I would eat whole grain bread my blood sugars were tougher to control (I did not fully realize this until 2009 when I did a 4 week gluten free diet; and I have been tested twice for celiac with negative results). Furthermore, looking at the data I am not the only person with diabetes finding this relationship. Research suggests that 10% of those with type 1 diabetes has celiac disease and this does not even encompass those with gluten sensitivity. Adding to this foreseen correlation a recent study just came out last year showing that a gluten free diet put a newly diagnosed 5 year old boy’s type 1 diabetes into remission. 
  • Supplements can have a place for people with diabetes. Especially real food supplements (I do not advocate synthetic supplements). I think the topline most important supplements are those that help strengthen our gut integrity and immunity. This can include fermented cod liver oil, vitamin D and a probiotic. Additional supplements can be of use, including chromium picolinate, gymnema sylvestre and magnesium.  
  • Sleep is crucial. If you have diabetes have you ever noticed an increase in insulin resistance with little sleep? When my sleep is rough, I can easily see an increase of 30 mg/dl+ in my readings. This starts in the morning and throughout the day I will notice an increase in cravings as well. talk about a lose-lose situation. 
  • Stress can act like a spoonful of sugar sometimes too. Can you relate with what I am saying? Even good stress can make my blood sugar go up. For example, I do a lot of public speaking and with this event, I am excited to present but have some nervous nerves and if I don’t give a small bolus I end-up with hyperglycemia. Managing stress is just as important in making smart choices of what to put on our plates. 
  • Exercise is so important (as if you already didn’t know). But this month, along with numerous other studies, a study published in Diabetes Care found that people with type 2 diabetes had better blood glucose control and an improvement in body composition. Besides this current study exercise (including walking, swimming, playing, tennis, you name it) can help your release stress, sleep better, have a more positive outlook on life and more. 
The underlying message here is that diabetes does bear a challenge, but it also gives us insight on what works for us. My diabetes is a daily reminder to not only count my blessings, but to push myself to be the healthiest I can be. We have to take the good with the bad and when our diabetes act up, we need to remind ourselves to take our emotions out of the equation and absorb the information as feedback. It’s as if we are our own scientist working on a daily experiment of optimal health.
Cheers to you and good health,
Kelly (Registered Dietitian Nutritionist)

If This Is Out Of Order Then Everything Else Falls Apart

Can you guess what I am going to say? If you are thinking sleep, you are close! And nearly correct, but I am putting my finger on the root of the problem, which also disrupts sleep: Stress.

Stress is defined as a constraining force or influence. That is it. Just a force. But now, how can this force call for so many problems? When we are stressed our capillaries constrict, our thought processes are interrupted, focus is lost, we either reach for sugar and can’t touch food, sleep goes out the window, perhaps cholesterol levels go up, along with blood sugar and blood pressure, and geesh! We forget to breath. Yet, I know I am not addressing anything new, but the reminder this post serves to cope successfully with stress is needed; especially around the holiday season.

What are your go-to mechanisms for coping with stress? Do you call your mom? Does that do you worse? Do you go on a walk? Drink tea or water? Watch a comedy? Run? Walk? If you said yes, to any of the above, you are on a great path. But what other simple things can help you de-stress and reach your best health? How about some of these ideas?

  • While in Australia I had the pleasure of meeting with an inspiring lady who was a psychologist. We had a chat about the mad increase in anxiety currently being experienced by the common person. What is the cause? Well, there are probably a hundred things including technology, which makes us all feel like we need to know everything about everything. But the important thing to spend time on, is learn how to manage anxiety. This lady suggested for people to listen to their breathing, yet, quite often this can cause more stress. As a second recommendation, or perhaps first, she tells her patients to take 3 deep breaths every day. Or maybe twice a day. No matter what, whenever someone thinks of it, take 3 deep breaths, and soon one will find out their anxiety is less overall.
  • Gratitude. Start every morning by writing down something you are grateful for. This will assist you to practice mindfulness which is much stronger than stress.
  • Pay it forward. I think we all understand what it means to “pay it forward,” and in doing this everyone once in a while, allows us to stop and smell the roses and realize whatever race is running through our minds does not have to the tone of our day.
  • Use online free resources to help consumers manage stress, steps, food diary, labs and more.
  • Journal. Very much like the suggestion to write down one thing you are thankful for, it is also good to journal your thoughts. This is especially handy before bed. With a calm mind, comes a solid sleep.
  • Meditate. Using free resources again, iTunes has some free meditation downloads. Take advantage and decide which podcasts works best for you.
  • Exercise. Most recently I have been participating in FitGirl’s candlelit yoga sessions and they are just wonderful. I perform yoga poses in ambiance and leave with a clear mind.

Between holiday shopping, cooking and entertainment, take care of yourself with a mind, body approach.

Cheers to you and good health, Kel