Breaking the insulin resistance cycle involves a number of things, including reducing simple carbohydrate-rich foods, like grains, juices, processed foods, etc, in our diet. Below are 5 guidelines that will help slash insulin resistance and improve blood sugar control overall. This is useful advice with people who have diabetes, PCOS, metabolic syndrome and for those who just need assistance to lose weight.
No naked carbs. What? Since carb-rich foods (legumes, fruit, starchy vegetables, grains, and sugar) give us quick energy and have the greatest effect on raising blood sugar levels, it is ideal to have a source of protein or fat with this food to buffer the absorption of sugar going into the bloodstream. For example, an apple (carb) with peanut butter is far more favorable than eating an apple alone.
Reduce snacking and eliminate grazing. Be sure to eat enough at each meal (review plate visual) by cueing into your satiety and hunger levels, so you do not need to eat more than three-four times a day. When we have smaller, more frequent meals, we cause our body to produce more insulin, creating higher circulating levels of insulin. High insulin levels cause insulin resistance. Transition to 3 meals and an optional snack each day.
Hydrate. Drink 20 ounces of water first thing in morning. I play a game by making myself drink my water before I am allowed to enjoy my coffee. Do what motivates you. Overall, aim to drink half of your weight in ounces every day. For example, if I weigh 200 pounds, I need 100 ounces of water or herbal tea per day. Drinking water is one of the simplest ways to improve your hormone (including insulin) functionality, hunger, and fat-loss.
Forecast meals. No need to make a formal meal plan, but spend five minutes a week reviewing which meals you will be eating out or at home. Sketch out at least 3 meals (doubling some of the recipes can save you time) and reflect these meals onto a grocery list. This can help you get in front of your health by making healthy food the obvious choice. It can also help reduce food waste. Win-win.
Eat with the sun. Eating during daylight hours supports our natural body clock, and therefore our hormone functioning. The more in sync we are with our circadian rhythm by eating with the sun, we support hormone balance, improving insulin resistance. Doing this also improves sleep and high-quality sleep is the “secret sauce” for health. Additional motives to eat earlier? Data suggests when we eat past 7 PM we increase our insulin secretion by 50 to 70%. High insulin leads to insulin resistance. If you find yourself eating late, make it a smaller, lighter meal.
I write to you today with a frog in my throat, feeling humble, scared and grateful.
Last week, immediately after my Endo appointment, we headed to FL to have a reunion with 2 other families. I felt like a badass driving down because my A1c returned to a territory I want to stay in, reading at 5.6 (a non-diabetic range). Yet, just when I think I have a routine, a plan, momentum, I realize I am at a loss.
Days into the trip I woke up with a blood sugar of 383 mg/dL. “Wtf?!” I haven’t seen a high like this in years.
Is it bc we ate a late dinner? I always have a high fasting when I eat late; but not this high. Was it the Prosecco I drank last night?? Maybe the alcohol made me low, I didn’t wake up, and glucagon shunted into my bloodstream??
Maybe it’s because I’m not sleeping enough? I was often the first to go to bed because I know less than 6 hours of sleep makes blood sugar control hard, but I’ve had 2 newborn babies and my blood sugar never behaved this bad.
Was it because I was less active than being at home? I was still running and swimming. Was I dehydrated severely? No.
What’s going on? Is the insulin bad? It worked fine yesterday and the day before and since then I haven’t stored it differently. I had it on the bathroom counter; maybe the room got too hot when we had our showers?
I take action – I’m aggressive with my basal/Tresiba for the day, upping my dose from 8 units to 12, then layer on another 2 units, making it 14. I take an intramuscular injection to correct the high.
Is it the heat? I always go really high with high humidity and temps above 80F. But I’ve lived in Australia with 100-degree temps and no a/c and it never got this bad.
Two hours later I’m only at 220 mg/dL, arrow across. Blood sugar goes up 2 points. I take more insulin.
Trying my best to keep my fears and frustrations to myself, I head to the beach with everyone.
I see diagonal down on my CGM. “Yay, the insulin is working.”
I have some dried mango in my beach bag in case the insulin begins working too well.
I’m in the water and run back to our things, aka my phone to read my blood sugar via my continuous glucose monitor (CGM) and grab my daughter her floaty.
Double arrow down reading 45 mg/dL. Where is the mango??? I eat it.
Five/ten minutes pass and my friend comes back to get her son a snack.
I actually start feeling really scared. I started praying. The mango isn’t doing a thing, still 2 arrows down (this means my blood sugar is dropping 4 points per minute).
My friend pulls out a cooler with juice boxes for the kids. Amen! Juice will help.
I chug the juice.
I’m so low my CGM can’t read my blood sugar. CGM reads, “LOW” double arrow down.
My friend has no idea I’m scared for my life at the moment. Am I going to go into a seizure?
I ask my friend to get my husband. I start crying. Am I going to die because of this damn high blood sugar, now firing back?
Thirty minutes in, I level out, head back to our house and over-analyze everything for the next 2 days with 1 more similar low blood sugar scenario. The second time I used maple syrup to bring my sugar up, followed by a juice. I asked my husband to hold me until the carbs kick in.
I threw out my current pen of Fiasp for fresh insulin starting day 2, but I robotically took the same Tresiba day 2, and I was hesitant to take another full dose of a new bottle. So now day 3, it’s confirmed on what the problem was…
Spoiled Tresiba/basal insulin.
Sometimes I think I’ve got this disease, but it can be mean, scary, horrific. Diabetes teaches me day in and day out to make my time count and I’m so grateful for my insulin, my CGM, my juice box, my life.
I had a great trip overall, diabetes won’t taint it, and I’m happy to be home to ground myself and make a difference in this world.
This scary event was a gentle reminder of what it may feel like to be newly diagnosed with type 1 diabetes or going through a confusing time of diabetes management. There is always something to learn, and I should have been more bold with changing out my insulin sooner.
When I help my clients with diabetes understand how to best manage their blood sugars, of course, I mention nutrition and insulin, but there is a large emphasis on a number of other variables, including, but not limited to the following…
Hydration – being well hydrated can help your insulin work most efficiently
Allergies – seasonal, food, medication
Food sensitivities – if the gut is inflamed, the body is, hence poorer insulin sensitivity
Stress – good and bad stress can impact blood sugars.
Movement – move every 30min and exercise every other day
Hormones – male hormones fluctuate as do females
Public speaking (a form of stress)
Outdoor temps – heat makes some type 1s high (me!), but others it runs blood sugars down.
It is with great pride and gratitude to announce that this year’s JDRF Gala on May 18th broke an all-time fundraising record! Your generosity resulted in over $660,000 raised for the mission that ties us all together.
The gala was a result of so many hands and I am so thankful for your support…and we couldn’t have done it without our family, friends and JDRF community.
How many presents does an 8 yo girl get when she is diagnosed with diabetes the day before her birthday? (long pause)
Looking back, on my earliest memories, they all begin in second grade. No matter how hard I try, I can’t recall much before then. It starts with my diagnosis.
But as I drift through that memory on, I remember more of the hard ones than the happy. In those first few years, I had several seizures – a few at school and some in my sleep.
I remember writing a letter in crayon to my mom and putting it in her bathroom drawer – saying “I don’t want to try anymore. It isn’t fair that I am the only kid in the family who has diabetes. I hate it (stomp foot) and I don’t want it.”
When my mom found it, I was waiting for her to yell at me, but she surprised me instead. She pulled me aside, sat down with me and told me to never take life for granted and that I was capable of overcoming this.
I AM capable, but it’s a heavy burden. There are so many layers to Type1 that are invisible. There is no limp or mark to distinguish us. We often look perfectly healthy until you see the tubing from a pump poke out from our waistband, or a little white pod stuck to our arm. Then you wonder – what is that?
Meanwhile, we wonder if we dosed enough insulin. If I should’ve eaten more before walking my kids to school, if that 30 grams of carb is going to kick in at Teagans soccer practice or if I need to tell a stranger I need help. We wonder if this is the high that is going to tip the scales to a complication.
It’s not just about nutrition and insulin, there are dozens of variables that affect our diabetes management. As a dietitian, I help my type 1 clients with what’s on their plate but also looking beyond. We need more options to manage this disease. Thankfully JDRF is racing to find a cure for tomorrow while striving to improve the lives of those with T1D today through advocacy and outreach.
We have studies being funded focusing on beta cell regeneration, research, screening individuals at risk of developing T1, vaccines that might prevent it, and work underway for Open Protocol, taking the closed loop system one step further.
JDRF is also working to improve the odds for expectant mothers with their closed-loop insulin pump research – some of this research is here at OSU. I was on shots nearly the whole time I was pregnant with my daughter (we didn’t do the best family planning!). And pregnancy means fluctuating hormones, fluctuating hormones mean fluctuating insulin needs and there were days I would take 17 shots. Not finger pricks – shots.
Can you fathom what it’s like to fear you are hurting your baby because your insulin isn’t working nor absorbing as you’d predicted?
Type one is scary. But when we come together, we make it a little less lonely, and with perseverance we build hope. We have events like tonight where we can make a tangible difference.
My family and I are grateful for all of you being here and I am going to be bold, as bold as I am with my insulin, and ask each of you to do all you can to help us make a difference. Your generosity and support this evening will 100% go towards JDRF mission of finding a cure, better treatment options and to prevent it in the first place.
Tonight, please help:
build the hope all of us need,
fund research that can resolve some of the hardships and the mental burden this chronic disease carries, and
break a record on the generosity a room in Central Ohio can create.
Do you workout for your mind or your body? Do you do it to lose weight, be stronger, or just have more energy? Yes, I’d love to have a 6-pack, but I personally do it to be a better mom, for my blood sugars and for my mood.
Exercise invigorates our minds and is a form of self-love and stress management. It seems far-fetched to say that your workout will be spiritual, but it can leave you feeling mentally refreshed! Try one of these 5 workouts to see what fits you best, mind and body.
If you’re looking to clear your head, then running or jogging is a great option. Hit 2 birds with one stone and phone a friend to come with you. I do this weekly with my friend Cindy.
Forget the treadmill, and head to a park or beach. Sure, you can do this in the city, but nature is good for your stress hormones. Push yourself to a level of attaining that ‘runner’s high’ that people talk about so often.
#2: Martial arts
Whilst martial arts isn’t perceived as very ‘zen’, there’s something to be said for taking all of your stress out on a punchbag. If you’re having a difficult week, or you just feel like things are building up, try a session like martial arts and come out of the other side on the positive.
Pilates is so good for a stressed HPA-axis (aka stressed adrenals, chronic stress). Not only is it wholly dependent upon good mental and physical control, but many people report that it helps them to feel grounded, too. As those at c2b state, ‘when you’re truly connected, you really are the best you can be.’ If you want to experience this interconnectedness, then pilates should be on your list.
Holler! This girl just signed up for a 13-month contract at a yoga studio less than 2 blocks from my house. Yoga has taken the world by storm recently, and whilst it’s not really the most energetic of workouts, it really is a test of strength, flexibility, and mental prowess. Whether you’re taking part in a hot yoga class, or you’re just trying it out at home, there is no reason not to give this a try if you’re really looking to regain some control over your mind. There are plenty of yoga options out there! PS, stay-tuned as I share the progress I’ve made in my mind, business, relationships, and body after investing months of a solid yoga practice.
Walking is the secret sauce of blood sugar control. A slightly brisk stroll will lower blood sugar in type 1 diabetics by 1-2 mg/dL per minute. Many cultures (Italy) who engage in an after-dinner stroll have a lower BMI and I am sure the bonding over the leisure exercise enhances relationships. However, going for a long walk will help you to burn fat for energy, and it’s great for your fitness levels. On top of this, it allows you to reconnect with nature and it can really give you a chance to clear your head. Go for a walk, and think about all of the things that you appreciate!
Let me know which movement speaks to you the most.
Thanks to the awesome DOC (diabetes online community) I seamlessly hacked my G6 Dexcom and am currently on day 34 of my first sensor. I hope I don’t jinx it!
So this is how I went about it: Make sure you write down or keep the paper off of the sensor that has the code on it. You’ll need it to do a restart.
1) Once the session ends, start new session with NO CODE.
2) Let it warm up for 5 minutes.
3) Go into the settings in the Dexcom app on your phone and stop session (towards the bottom, you will need to scroll).
4) Start a “new sensor” with the code you used when you first put on the sensor. I keep the little paper in a specific spot in my nightstand.
5) 2-hour warm up and done!
I LOVE the G6. I am so excited about it, I got a smaller wristlet that doesn’t have to carry around my meter and supplies 24/7.
This was originally posted on my type 1 friend’s site, Caroline Potter, when she was pregnant and going through the changes in diabetes for each trimester. Enjoy.
Please welcome Kelly Schmidt to the Flourish blog today for an encouraging and informative Q & A about Type 1 Diabetes and pregnancy!
From Caroline: One of the most beautiful parts of my very difficult pregnancy has been connecting with so many of YOU—I can’t tell you how encouraging your comments, prayers and emails have been to me and the saying “it takes a village” has come true to life!
Managing not only a difficult pregnancy but also the effects of Type 1 diabetes has been exhausting and most days far too draining to want to talk online I wanted to bring on my beautiful friend and fellow Type 1 mom, Kelly Schmidt, RD, LDN, to chat all things Type 1 pregnancy. She is a beauty inside and out and such a wealth of knowledge! Kelly has been such an encouragement to me and I know you will love her!
**Please note, this information can also be helpful to those with gestational diabetes or blood sugar issues in pregnancy. This is not medical advice.**
Type 1 Diabetes and Pregnancy Q & A
Pregnancy can be such an emotional time, but then you add the extra emotions of being high risk and managing the ever so changing and complicated task of having Type 1 diabetes. What is your encouragement to expecting moms to manage this time of both joy and anxiety?
I am grinning as I write my response as I so easily remember the moment I found out I was pregnant. I first told my husband and then ran for my phone and called my mom with fear. I was scared to eat, exercise or cause any movement in my blood sugars with a growing fetus inside me. But then I realized there are many babies born to mothers with diabetes and I was going to be okay.
Embrace each moment and know there is a higher plan, and to tap into that inner strength and intuition and do the best you can in taking care of yourself. Round up your medical team and even social media support. I found extreme value in connecting with other women who were in the same stage I was during the initial weeks of pregnancy. While my CDE (Certified Diabetes Educator) was rather awesome, I really benefited from connecting to other type 1s and I even made a Pen Pal from across the country. We had our first baby just weeks apart, but it was very beneficial to exchange notes of what foods were working for stable control and noting when crazy increases happened with our basal/long-acting. To say the least, Type 1 Diabetes allows us to have an automatic connection with one another. Don’t hesitate to seek a tribe. In the least, I’d be happy to connect.
How can meal timing and consistency play an important role in managing blood sugar levels?
I approach a client who is newly diagnosed with diabetes and a woman who is newly pregnant with diabetes in a similar fashion, and with this, consistency is one of the most important things to implement to feel good and to learn what works and doesn’t work for blood sugar control. There is an incredible value to eat at the same times and with consistent portions of fat, protein, and carbohydrates. It was key to have a soft plan of batch-cooked meals for the week, and by no means, did they need to be fancy.
Especially in the second half of pregnancy, insulin need to manage Type 1 diabetes can greatly increase. Some days I feel like I am just pumping myself full of insulin and I don’t love that feeling. What is your encouragement to women who also don’t like that feeling but also know that balanced blood sugar is best for both mom and baby?
Do whatever you need to do to keep blood sugars in range. If you are worried the excess insulin will put on weight, understand your wellbeing and baby’s well-being is most important, and the weight will come off. IT, Will. Come. Off. Cross that bridge when you get there, and put your best health first.
Also know, as the weeks go on the amount of time needed for a pre-bolus goes up as does basal/long-acting needs. For example on pre-bolusing, first trimester you may find 15 minutes is needed before eating, 2nd trimester moves towards 30 minutes, and 3rd trimester it indeed may need to be 45 minutes. By third trimester it’s common to be on 3x as much basal as well. The amount of insulin isn’t the worry, keeping blood sugars in range is.
How can hydration affect your blood sugar in a negative way?
A 2011 study from Diabetes Care, found when adults who drank only half a liter of water (~two glasses) or less each day, they were more likely to develop blood sugar levels in the pre-diabetes range, versus people who drank more water. While we already have diabetes, this study is important, because it highlights how other hormones, such a vasopressin increases with dehydration, telling our kidneys to hold onto water, and this can influence higher blood sugars. As well, water/hydration, helps insulin do its job. And lastly, if wearing a CGM, being properly hydrated can help our it work be more accurate.
Beyond water, those of us with diabetes, are at risk of losing our electrolyte balance as our blood sugars move up and down. Sea salt, mineral water, and a diet abundant in vegetables can help counteract this. Please note, the use of table salt/iodized salt is not recommended. It can stress our thyroid, among other negatives in the body. Pure, unrefined sea salt, pink Himalayan salt, and Celtic salt, are all great options. Last note on salt, if you are eating mainly a whole food diet, low in dairy and grains as well, you will need to salt your food more. If you are craving salt, listen to that as a sign you need to sprinkle a little more on your food, as well as, making sure you are getting enough rest. When our adrenals are working hard, they can also stimulate salt cravings. Proper hydration can take effort, and it’s handy to always have a water bottle on you (preferably glass or stainless steel).
How can hormones, blood sugar and insulin need change postpartum—both immediately after delivery and in the months that follow?
I had a pump on both times I delivered, and I knew coming to the end of my third trimester, I needed to plan new rates. With my CDE we agreed on a total basal for after delivery and it was about 10% lower than my pre-pregnancy insulin needs. Everyone is different, but it’s common for that basal to be even lower than that, and I had to change my insulin immediately, right after holding and bonding with my child.
In the following months, there were some jumps in my insulin needs but insulin needs vary from one mom to the next. I know a few friends with type 1 – and when they nursed they needed to eat something simultaneously to prevent a low. I didn’t have that so much, but my rates were very low for the first 3 months, and went up, as my baby’s milk needs grew less. When I introduced solids (which I did at 10/11 months), my insulin needs dramatically went up.
I feel like we as Type 1 diabetics have been taught that only food influences our blood sugar, but I personally notice that stress—both physical and emotional—greatly influences my blood sugar. What are some great ways to minimize the stress and some calming activities you enjoy?
Walking is magical. A fast-paced walk can lower blood sugar 1-2 mg/dl per minute, and I took advantage of this when I knew I didn’t take my insulin early enough before eating. I still utilize walking even not pregnant. It can help catch a high, pick up the pace of insulin or mobilize a carb immediately. I remember when we lived in Chicago and all I wanted when pregnant was a little gluten-free pizza, and just 1 triangle slice sent my sugars up. So on that Friday night, I just walked up and down my stairs for 10 minutes. Also don’t be scared of highs, just work to correct them quickly. A high BG won’t hurt baby, a constant high is where the risk comes in.
Hydrate, hydrate, deep breaths and then hydrate. Both water and breathing (plus prayer or meditation) make everything better.
Flip the script. I delivered both of my kids in Chicago and especially with Teagan, the care was horrific (sorry for the transparency NorthWestern). I was informed falsely I had ovarian cancer, then I was provided the wrong genetic results, then given results scaled against a non-high risk female, and was tossed around 10 different doctors. I wanted to go bonkers and leave the practice when I was 20/30 weeks but was nervous no one would want my high-risk case. But to say the least, I treaded through the stress and remained as calm as possible because baby feels it all. Every challenge is an opportunity and our response is more important than the circumstance.
How can you balance knowing your own body and trusting your “gut” with also trusting your medical team in a high risk pregnancy?
Be your best advocate in labor. I controlled all my insulin/CGM/Blood sugars during labor, which was not preferred by the doctor or nurse staff, but they honored my interest and my blood sugars were steady through each. Declan was even a 36-hour labor! All of us with diabetes have a different case— the solution to blood sugar control is not the same for one person to the next.
If you want to focus on labor without thinking of blood sugar control, pass the responsibility to your team.
Exercise is a fabulous way to help naturally lower blood sugar. Both in pregnancy and not, I have noticed walking greatly lowers my blood sugar! What are some great pregnancy safe exercises that will help balance blood sugar and not spike it?
As mentioned, I loved walking, but I also incorporated other exercises into my care. I fell in love with water aerobics and got certified as an instructor when I was 27 weeks pregnant, but I also really enjoyed yoga. I always informed the instructor I was pregnant and asked if they were aware of modifications.
Yes, some higher intensity exercise do raise blood sugar—for me barre classes, HIIT training, and heavy lifting all required and still require taking insulin before a workout.
What are your favorite real-food sources of carbohydrates?
Right now I could have fresh raspberries all day long. Overall the foods I am listing are chosen, not 100% on flavor, but on flavor and easy on my blood sugars. I have a gentle gut and some carbs spike me far more than others. For example, sweet potatoes spike me far more than white potatoes. Usually, it’s the opposite for others. My favorites include lentils (love lentil pasta), berries, cooked onions (odd, yes), Brussel sprouts, green beans, and plantains.
Do you have any supplements or vitamins you find helpful for managing Type 1 Diabetes during pregnancy?
Diabetic or not, a good probiotic is so important to take care of our gut while our hormones transition, but also to prevent a positive Strep B test, which is found in 1/3 of pregnant women. If we are positive for this test in the USA, we must put on antibiotics at labor. This isn’t the worse thing, but it’s beneficial to do what you can to avoid it.
Additionally, a high-quality fish oil is great for the baby’s brain, but also supportive of preventing postpartum depression.
Methylated B vitamins—type 1 pregnancy’s have higher folate needs, and methylated folate is far better than folic acid. Folic acid can even be harmful.
Magnesium can help with insulin sensitivity, muscle comfort, bowel movements and more.
*I always make recommendations specific to client needs and please consult your medical professional before taking anything.*
What is your best encouragement to managing Type 1 diabetes and pregnancy?
Test like it’s a part-time job. This is obvious, but the pre/postprandial checks are crucial, and with my second child, I went on a CGM around week 16. It was amazing, and once I did it, it proved to kickoff a good streak of optimal A1Cs. With the CGM I realized my hormones went nutty as I went to bed at night. I remember my line graph on my CGM climbing from 9pm-11pm. I eventually got aggressive with my insulin and prevented this high from happening.
Be bold with insulin. Use your diabetic intuition of when to dose more insulin than what is calculated to bring a number down or cover a food. Once the baby comes, you will have a motherly instinct and I tell my mom diabetic clients to use that instinct with their diabetes too. I understand my diabetes better than ever after having kids.
Calculate insulin needs for protein. The way I do this (and I am sure you have heard of this): add the protein in a meal and divide it in half and finally add in the carbs. That number is what you use for measuring your insulin needs. Example meal: a 3 egg, veg omelet. An egg has 6g of protein, so 6 x 3 = 18. Take that 18/2 and you get 9. So 9g plus whatever carbs are in the veg, so we can pretend it’s 5. So total “carbs” to calculate insulin needs is 14 grams.
Don’t read too far into the “no-no’s” for pregnancy ie. no shellfish, wine, soft cheeses, etc. Every country, as I am sure you know, has different suggestions. Practice using your instincts here. Full transparency, I enjoyed a few glasses of wine with each pregnancy as it was thoroughly enjoyed and gentle on my blood sugars.
I admit I have come a long way since Nov 23, 1991, when I was diagnosed with type 1 diabetes (T1DM) on my birthday. From sneaking mint chocolate chip ice cream into the living room and eating mouth-fulls with a spoon, to now dedicating my career as a dietitian to helping others understand, manage (with diet and lifestyle) and enjoy this disease. Yes, enjoy.
When I talk about T1DM, which is only 5% of the population of people with diabetes, connect with someone with T1DM, who therefore becomes an instant great friend, and do work on this condition, I find myself in a state of flow where time doesn’t matter. It’s magic.
Type 1 diabetes doesn’t just mean 1 devastating diagnosis, it means 4-8x the risk for heart disease, 4x the risk for cancer, 3.5x the risk for kidney disease, 80% of vision impairment, increased risk for cognitive decline and a life cut short by a decade.
But you know what? No one is promised tomorrow.
This disease has pushed me to find all the tricks and trades of health. I eat really clean (maybe sometimes too much), but I am aware of what I am eating, as I have to match insulin to my food every time I take a bite. It also pushes me to be active. In fact, I aim to be active every other day, if not more, to keep my insulin resistance low, and my sensitivity high (makes keeping blood sugars stable easier). I try (repeat try) to get enough sleep. If I sleep less than 6 hours, I have to think about increasing my insulin the next day by 10-30%. If I am stressed; I need to babysit my meter and dose insulin like a hawk. But sometimes, stress will make my blood sugar drop. It’s unpredictable, so I have grown (continue to grow) to be flexible. I find the best supplements to fill the gaps and repair that moving blood sugars cause. I seek out every new study, and old, and fine-tune how to feel my best. Don’t worry, this often includes red wine and it certainly includes a community (shoutout #JDRFCentralOH; proud board member!) of others on the T1DM journey.
Type 1 teaches us to count our blessings. There are many hard days and night, but the good ones are really good. I’ve grown from believing I was all alone with my diabetes to feeling confident. I’ve gone from burnout to being empowered (although nursing burnout is an ongoing thing). I feel scared, but more often brave. I hope to change the percentage of people with type 1 diabetes to have beautiful labs in the non-diabetic ranges and I want to inspire you that it’s possible.
In closing, my main advice for anyone with type 1 diabetes, as a diabetic and dietitian, is to drop the carbs (even if you are still growing, if you are active, if you are pregnant, etc). And drop them low. The fewer the carbs, the less insulin we need, and less variability of having a blood sugar spike high, or drop too low/seizure. With the transition, start with breakfast. Eating a fat and protein dominant meal in the morning (like an omelet with 3 eggs and vegetables) can set you up for successful blood sugars for the day.
I can’t help but mention 1 more thing – no matter what you are dealing with in your health, give yourself grace. Be proud of who are, what you are accomplishing and embrace the chapter you are in. I’ve come a long way, but we can’t compare someone’s chapter 10, to another’s chapter one. Take a few deep breaths every day, drink enough water, and socialize.
On July 19th, Mike Agee, the President of the Columbus JDRF chapter, asked if I would do a brief overview of the latest enhancements in type 1 diabetes research at a corporate breakfast hosted by the JDRF One Walk sponsor CAS. No doubt, I was happy to assist.
I was proud of how well prepared I was to do the task (not to toot my own horn). But I knew, going into the presentation, my professional face and poise would be challenged as type 1 diabetes and JDRF hit so close to home.
After introducing myself and highlighting one of the many reasons I choose to support JDRF is not only bc they have been there for me and my family through my entire diabetes journey (nearly 27 yrs) but their commitment to achieving real results.
While a cure is an ultimate goal, JDRF is committed to doing the greatest good for the largest number of people in the shortest amount of time—this means better therapies, better treatments and better access to these advances until we have a cure for this disease.
In the presentation, I clarified the differences between type 1 and type 2 diabetes, yet both forms of diabetes can cause horrific complications. I struggled to explain this point, as my throat got a lump in it, and tears filled my eyes. I have witnessed people close to me go through all of these complications: kidney disease/failure, eyesight conditions/blindness, cardiovascular conditions/heart attack and nerve disease/neuropathy. I need you help.
I’ve dedicated my career to helping people with diabetes, yet, my advocacy and work aren’t enough. Type 1 diabetes is a small fraction of the total diabetic population, and to be frank, this disease isn’t the biggest money maker for Pharma to invest in. We need to fundraise through organizations like JDRF to get the advancements to save lives.
JDRF is making progress and had some significant wins the last several years. One of those wins was in 2017 when Medtronic released the first ever hybrid closed-loop system to automate the dosing of insulin – known as the 670G. This product has relieved a significant portion of the mental burden of managing T1D.
Without JDRF initial funding, this device would NOT be commercially available for an estimated 5-6 more years from now. Do you know how many lives are saved from this? From someone who has had 5 seizures in my life, from low blood sugar, and a majority of those taking place in my sleep, this is a huge deal. Research and advances like this is why we still need funding and I need your help.
If you are local to Columbus, Ohio, I invite you to walk with me as part of, “Kelly’sDream Team,” on Sunday, September 30th.
JDRF is helping make this disease easier, they are funding research to prevent more type 1 diabetes diagnoses, and JDRF research is the HOPE for all of us with type 1 to find a cure.
As someone with type 1 diabetes, and coaching many with diabetes, we have to consider over 50 things that are non-food related that can affect our blood sugar control, and one of the most common moving variables include the female cycle.
In fact, I have to change my daily basal weekly, if not more, to coincide with my cycle and insulin sensitivity. Along with this tweaking, I have been collecting data and savvy tips in a notebook on this topic and have organized the insights below.
Wellness for a female is different and is achieved differently than for a male. There needs to much a bigger component of emotional health and support, which is why it’s important to understand our moving hormones.
The benefit of being a female (among many!) is we have a period. Wait, how is that a benefit? Well, our cycle is termed as a 5th vital sign per the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion and this vital sign offers insight into our health, each month.
First and foremost, when assessing your period, understand our body will always choose survival over making babies. In fact, the period you have this month reflects your life 2-3 months ago. As well, if you are taking savvy hormone balancing supplements like maca, chaste tree, vitex, evening primrose oil, to name a few, give it 3-4 months to take effect.
Balanced/Balancing Hormones Involves the Combo of:
Daily bowel movements. If you don’t poop every day – you can’t remove the digested estrogen out of your system. Gut health is super important.
Modulating toxins in our life. Most environmental toxins will come from the practices women take within hours of waking up – deodorant, makeup, toiletries.
Sleep. If you are not sleeping 7 hours a night, you are not going to have balanced hormones. Research even shows that the liver can’t detox with sleep deprivation and liver needs to be optimal to metabolize our hormones as well.
Diet. Eat regular and balanced meals, emphasizing the importance to eat healthy fats. Avocado, olive oil, and organic animal fat are great sources, to name a few. The research on broccoli is so strong for detoxing estrogen and this is crucial for hormone balance. If a female is not having a bowel movement daily, the estrogen is sitting in the intestines and can be reabsorbed. We want it to move along as it should daily, and if this is not happening, consider tweaking the diet to include more vegetable fiber, remove grains in the diet and add a magnesium supplement to get things moving. Overall, lots of leafy green vegetables are key to a nourished body and healthy, fertile hormones.
Blood sugar stability. This is one of the most crucial things for hormone balance. Do the best you can to reduce blood sugar swings and variability. If blood sugars are too high they can structurally change the ovaries.
Movement. Most of our hormones won’t work unless we are moving. This is esp true w/ inactive thyroid to active thyroid.
Happiness: Plan a girls night and go have some fun. Or find a good book. Whatever helps you live a little and un(wine)d.
Sex. Yes, sex, intimacy and orgasm can help naturally balance hormones.
While PMS is not normal it is natural to feel a shift in energy throughout the month, and that’s why it’s important to vary the amount and type of exercises you are doing and cycling your food/carbs throughout the month.
Week 1 (on period): MENSTRUAL
Day 1-10 females are most like males. Progesterone and estrogen are the lowest, and the first half of the cycle is called the follicular phase.
Insulin – many women may experience high blood sugars on the first day of their cycle, but it levels out the remainder of the days of bleeding. Personally, (bc I am sure you want to know), I am more insulin resistant on the first and last day of my cycle/bleeding, so therefore I may have a basal of let’s say 10 units on Day 1, drop down to 9 units, and then on the 6th day of bleeding I go back to 10 units.
Diet – Aim to eat higher fat and protein-rich meals, which means to ease up on carbs (fruit, legumes, grains, starchy veg), but do not restrict as much as you did before you started to bleed.
Protein helps to replenish lost iron. If a period is heavy – eat iron-rich foods with a focus on vitamin C. A citrus, spinach salad with some steak? Other good foods to source: seafood or seaweed, and low carb vegetables.
Exercise – slow movement pilates or yoga, stretching, walking or light hiking. A few days after the onset of your period you may feel energized and ready to pick back up your exercise routine. Movement this week can be variable from girl to girl, and from month to month. Listen to your body and what it needs.
Agenda – This is a good week to ground yourself, relax more physically and construct or address personal goals. Pull out a journal and reap the benefits of writing out your thoughts.
Seed cycling: 1T of pumpkin seeds and 1T of flax meal per day.
Week 2: FOLLICULAR
Diet – highest carb week, lowest calorie.
Persist including protein and fat in each meal, but bring down the total fat, and increase carbs. Typically, meals will be smaller than the 2 weeks before your period/bleeding. Females are most insulin sensitive around this time of their cycle and they can tolerate more carbs without blood sugar spikes. Since the onset of your period, your estrogen will gradually rise until ovulation (which starts at the end of this week). Keep in mind estrogen has an inverse relationship to appetite. When estrogen is highest, you may notice less hunger.
Exercise – a great time to do HIIT training, challenging and longer workouts.
Agenda – it’s common to be restless and able to tackle projects and goals, including batch cooking for the week ahead when willpower is less. Right before ovulation, you may notice you feel your best, sexiest and most social. Make the most of it.
Seed cycling: 1T of pumpkin seeds and 1T of flax meal per day.
Week 3: OVULATORY
Insulin – blood sugars can seem less seamless (to put it nicely). For 2-3 days blood sugars will run higher, and I view this as a mini period. What I do to manage my blood sugars and insulin here, I do more aggressively, and for more days, prior to bleeding.
Diet – Wind down the carbs, and begin increasing fat and fiber. You may notice some cravings for chocolate as well. Increase magnesium-rich foods, including cocoa. Five days after ovulation, you might find benefit and emotional/energy relief in eating ~30 grams of carbs at dinner (assuming you are eating a lower carb diet; less than 100 grams). This bolus of carbs (like half of a sweet potato) can support serotonin levels and improve sleep, sense of calm.
It’s not uncommon to have constipation post ovulation. Find use of chia seeds, and high fiber veggies. Focus on hydration aggressively until end of week 4.
Agenda – Ovulation is a great time to enjoy raw foods, raw salads, high-quality protein, and foods high in zinc. During ovulation, you may notice slight cramps. Your body is preparing to release 1 of 500 eggs (which is a fraction of the eggs you were born with). Ovulation is on average 10-16 days before a period. After Ovulation, this is when progesterone and estrogen increase and progesterone release a lot of sodium and holds onto a lot of water. This can lead to bloating. Your body temperature may be a degree higher as well. You want to salt (NOT table salt, sea salt please) your food here. Listen to your body needs.
The second half of a female cycle is called the Luteal phase.
Seed cycling: 1T of sesame seeds and 1T of sunflower seeds per day. I use tahini and sunbutter often during this half of the month.
Week 4:(right before period) LUTEAL
Insulin: the 7-10 days leading up to your period, insulin demands will be the highest and trickiest. This is where I take notes on what basal totals I am taking days leading up to my period and what cravings I had and how I treated them. I personally take these notes in my calendar on my phone – and happen to miss a few months, but I always have some notes to fall back on. It’s also common to see a need to increase basal insulin the most the day before your period (thanks progesterone!). If on an insulin pump, it can be a great idea to have a separate basal pattern to switch to for these days.
Diet – Lowest carb. Eat more cruciferous vegetables, more root vegetables. Limit booze AND caffeine (even though we may be craving them more).
Start increasing fats and lowering carbs or being more strategic with carbs (aka plan out your meals).Roasted foods are really good right now as they bring out the sweetness of vegetables. Note, however, this is a good time to eat more food period. If you limit food to amounts from prior weeks, you will indeed crave more sweets, as your body merely needs more calories. Many females deny themselves of this and end up with larger cravings. Days leading up to a female’s period, serotonin production is less. Eat high tryptophan foods (turkey, bananas, buckwheat, oily fish, flaxseed).
Studies have shown women who have a high intake of oily-fish (omega 3 fatty acids) including sardines, salmon, and mackerel, tend to have milder PMS. EFAs are also hormone regulators.
Leafy greens right before your period is helpful in calming your nervous system (due to calcium, magnesium and potassium). Even consider a green powder here, such as those sold by Organifi.
Overall understand your desires for food when it’s this time of the month. Just understanding what is going on with your body can help resolve overeating or poorer food choices. “This too shall pass.”
Exercise – step back and understand what your body needs. It could be stretching or it could be a long hard workout. This week is often a wild card.
Agenda – This is the best week to have pre-planned meals as your energy and interest in making meals will be low.
Supplements – Magnesium supplementation is important for cravings, energy, mood and blood sugar control, especially 7 days before the period. Additionally, fish oil, B vitamins, and tryptophan are recommended to help with PMS and can be used starting with ovulation (if not all month).
Seed cycling: 1T of sesame seeds and 1T of sunflower seeds per day. I use tahini and sunbutter often during this half of the month.