Diabetes and Food

Happy Easter Monday!

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I just wanted to take this opportunity to wish you and your loved ones a very Happy Easter.

I hope that your day was full of chocolate, hot cross buns or anything else that you do to mark this time of the year. Enjoy what’s left of this glorious four day long weekend, and may your blood sugar levels co-operate.

For me, guilt is simply not worth it when it comes to this time of the year. But at the same time, I definitely think that my days of eating until I can no longer move are behind me. I simply don’t enjoy the insomnia, night sweats and rage correcting stubbornly high blood sugar levels long into the night.

The Easter Bunny brought me exactly what I wanted this year. There’s also a bag of Woolworths Cadbury Choc Chip Hot Cross Buns sitting in my freezer. And I may or may not be heading to the shops later to pick up a bit of extra cheap chocolate (medically necessary, of course).

If you haven’t already, be sure to head over to the Dexcom UK & Ireland Facebook page and share your Easter Selfie. For each donation received, they will donate 10 pounds to Spare a Rose which provides insulin and other diabetes supplies to children in need. Have fun!

Feeling Tired With Type 1 Diabetes

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The final stretch of last year was a pretty challenging time for me, physically.

I felt tired. All. The. Damn. Time.

I would often find myself crawling into bed at the end of the day, feeling utterly exhausted. I was no longer waking up to my 1am alarms, and my blood sugars definitely suffered for it. I would wake up after a solid eight hours of sleep feeling bleary eyed, wanting nothing more than to close my eyes and go back to sleep again.

I honestly could not find an explanation for the way that I was feeling. Although the management of my blood sugar levels had slipped a little since achieving a personal best hba1c in July, my ability to manage them was still far better than they had ever been in my pre-pumping era. My bloodwork from July was also really good, and I had seen my endo in August.

I probably should have made an appointment with my GP, but I honestly didn’t feel that he would have been very helpful to me.

I felt more burdened than I had felt in a long time. in fact, I’d go as far as to say I felt equally or more burdened than I did during my start on insulin pump therapy. These feelings affected my work, my attitude around others and my overall quality of life. Part of me was ready to accept that these symptoms were simply a tradeoff of living with a demanding chronic condition like diabetes.

Living with type 1 diabetes creates somewhat of a complex relationship with food. We need food to fuel our bodies, but at the same time food spikes our blood sugar levels – and we want to avoid out of range glucose levels at all costs.

What’s the best nutrition advice for a person with diabetes? From my experience, It depends on what you’re reading and who you’re talking to. While I absolutely love my diabetes community, the overwhelming messages that seep into my brain is to avoid this food group or cut back on that one that and stop the spikes from happening.

I don’t want to single out any particular way of eating, but diabetes has distorted my relationship with food without me even realising.

The average male needs to consume about 8,000 kilojoules of energy per day to fuel his body so that it can function properly and match energy expended through activity. I don’t think I was even coming close to that. Not to mention having an active job where I’m on my feet all day expending even more energy by the minute.

I honestly cannot ever recall being taught to eat to fuel my body and meet my daily energy needs – from healthcare professionals and diabetes websites alike. Or perhaps I wasn’t listening carefully enough.

The past month or so has been a bit of a learning curve for me. Let me just say that it is pretty challenging to eat 8,000 kilojoules of quality food every day, and I have slacked a little at keeping tabs on this at times.

Of course, as with anything you make a major change to in life, diabetes management also demands attention and there have been a few tweaks to basal rates. I’ll share more specifics in time. 

But I’m sitting here in the sunshine typing this today, feeling far better than I have in quite some time.

In Conversation with Leonie and Elly of Diabetes Meals Online

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Today I’m thrilled to introduce Leonie and Elly, a mother and daughter team from Melbourne who created Diabetes Meals Online. I’ve known of them for quite some time thanks to social media, and today they’ve taken some time out to chat with me about their connection to diabetes and the business that came from it.

Frank: So, you’re a mother and daughter team. Can you tell us a little about your connection to diabetes?

Leonie: Elly, my daughter, was diagnosed with type 1 diabetes in 2013 – a complete shock and we both struggled with the diagnosis for the first 6 months. I thought I must have done something wrong during pregnancy and she was in shock – we knew nothing about diabetes back then. She had 4 hospitalisations in ICU in the first 18 months and she is now managing really well and hasn’t been to hospital in a couple of years. I bought her a Dario about a year ago which she loves. She is too old for the funded CGM and pump but we intend to get her one as soon as we can.

Frank: You’ve since established Diabetes Meals Online together. Where did the inspiration for that come from?

Leonie: We both hate cooking and found trying to read the nutrition information panel of every ingredient really tiring. Elly and I, and my dad, who loved cooking, decided to try and make meals with clearly colour coded carbs and sugars to make meal times simpler for people managing diabetes. We bought a dietitian on board to design a strict nutritional criteria and a couple of years later bought an Educator on board just to check that our message was ethical and not offending anyone.

It has been quite a journey but late last year we finally found the right manufacturer for our meals – and can now deliver all over Australia (we had heaps of customers and health professionals begging us to deliver Aust wide from the beginning but we were only doing fresh meals around Melbourne – now I’m excited to be able to go Aust wide!)

Frank: Diet can be a pretty controversial topic in the diabetes community. What sort of dietary inspiration or guidelines have you drawn upon in creating your own product?

Leonie: Yes it sure can and we want to remain ethical and trustworthy thus our dietitian and diabetes educator advise us on all things medical. I follow lots of diabetes groups and am pretty active on social media watching what authorities are posting and staying up to date. We never, ever give medical advice – we always point people back to their own health professional for individual advice. We don’t (and would never) claim our meals help manage diabetes – but simply make meal time choice easier.

Frank: I’ve seen that your meals are pressure cooked, sealed and can be stored in the pantry for up to two years. Could you tell us a bit more about the process involved in producing the meals?

Leonie: Yes, it’s called Retort and is very popular worldwide. We are a bit behind here in Aus but Heinz use the same process for their soups and baby foods. All the fresh ingredients are put into the special pouch which is then sealed. They are then pressure cooked in a huge pressure cooker. This locks in nutrition, flavour and aroma and makes them commercially sterile meaning they have the long shelf life and don’t need refrigeration (until opened).

Frank: What has been the most valuable thing for you both in terms of living with diabetes?

Leonie: Hmm – tough one. I think for Elly, over the past couple of years, she has realised that it is not going to stop her living her life the way she wants – she just has to deal with things that people without diabetes would never even think about. For me it has been offering a meal option for others to help make that meal time easier – there is enough to deal with in diabetes and when I read all the customers ‘thanks for providing such a valuable service’ I’m really touched – and proud!

***

Leonie also sent me some meal samples to try, and I wasn’t really sure what to expect as I have never used a meal service before.

The meals arrive pressure cooked and sealed, and can simply be kept on hand in the pantry until needed. Heating up is as simple as making a small perforation in one of the top corners of the packet to allow for steam to escape, and then placing in the microwave on high for 2-3 minutes.

Carbohydrates, sugar content and calories are at the forefront of the packaging, along with the usual nutrition information panel. The ingredient list was also very easy to read!

The meals are clearly designed to meet the body’s energy needs and nutrition criteria, and include a balance of carbohydrate, fat and protein in each serve. The carbohydrate content ranged from 19 to 30g per meal, which probably won’t be an option for those following low carb diets. The meals are gluten free, however, which is a great option for type 1s with intolerances or coeliac disease.

Chunky Italian Meatballs in Herbed Tomato Sauce.

Chilli Con Carne with Brown Rice

After cautiously inspecting, preparing and smelling this strange new product, I was pleasantly surprised. The flavours were there and it tasted like a freshly prepared meal. The seasonings were a little strong for my liking when I tried the meatballs, however my second meal of Chilli Con Carne was much more enjoyable. I’ve still got the Mild Butter Chicken to try.

You can find Leonie and Elly’s range of meals available at diabetesmealsonline.com.au. They deliver Australia wide.

Disclosure: Leonie sent me three meal samples to try. There was no expectation that I would blog about Diabetes Meals Online, and all thoughts expressed here are my own! 

‘Instant Diabetes’ Jokes

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Am I supposed to get angry and explode with rage every time I hear an incorrect comment about diabetes?

Am I supposed to bring to a hault an incorrect comment about diabetes, and politely correct that comment with fact?

Or should I just stand there and listen to the umpteenth diabetes joke, having done both of the aforementioned more times than I can keep track of, and accept that I’m never going to be able to change other people’s pre-conceived perceptions of diabetes?

The latter is sounding like the more tempting of these options lately.

I’m not really a fan of seeing rage ensue over an inaccurate comment about type 1 diabetes. I don’t think anyone should be crucified for a mistake, unless of course they fail to see any sign of wrongdoing.

I knew absolutely nothing about diabetes in the first seventeen years of my life without it. I get it. When I first heard the words ‘diabetes’ in the Emergency Room, my whole body flooded with guilt as I thought about every bag of chips, plate of ice cream and can of soft drink that I enjoyed as a kid. 

I later learned that I had type 1 diabetes, an autoimmune condition whereby an unknown trigger caused the insulin producing cells in my body to begin attacking themselves. Type 2 diabetes, on the other hand, is a condition whereby the body becomes resistant to insulin over time and often has more definitive causes. These can include age, genetics, ethnicity and sometimes lifestyle choices.

I’ve lost track of how many times I have explained the concept of type 1 diabetes to some of the people around me. And hey, I don’t mind being asked about it. I sure as hell don’t mind explaining it.

But you would think that being around someone who manages type 1 diabetes all the time might help you to at least not make those jokes about ‘instant diabetes.’

Yet, these comments still ensue right in front of me during conversations about that mouth watering, sugar laden dessert that was served at the dinner table last night.

Or, on the other end of the spectrum, this.

This is where I throw my hands up in the air, and accept that life’s too short to let the ‘instant diabetes’ jokes bother me.

The triple chocolate Flake birthday cake I made a few weeks ago that is most definitely not a cause of diabetes!

Review: Fit With Diabetes e-Book by Christel Oerum

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As much as I like to proclaim that I don’t exercise, the reality is simply not true. While I might not partake in dedicated workouts or fitness regimes, there is plenty of physical activity in my day. My job keeps me on my feet all day, and I do enjoy getting outdoors and going for walks through my neighbourhood in the afternoons. Not to mention all of the incidental exercise involved with tasks like housework!

As with every other aspect of my life, my diabetes needs due consideration when I’m active as well.

I’m a big fan of reading offerings that give me practical information I can take away and apply to my own diabetes management at home. It’s one of the reasons why I’m such a big fan of Christel Oerum, a longtime T1D and co-founder of the website Diabetes Strong (diabetesstrong.com). Christel created her website after struggling to find information about exercise and nutrition with diabetes. 

Christel has recently launched an e-book, Fit With Diabetes, and kindly sent me a copy which I had the pleasure of reviewing.

The book kicks off with a chapter on goal setting and finding your motivation, which will likely resonate with most readers. Who doesn’t have something at the back of their mind that they’re aspiring towards? Even if your direct goal isn’t fitness related, I’m willing to bet you would find something in this book that will help you reach that goal. Improved blood sugar levels, better nutrition and healthier lifestyle comes to mind.

I was nodding my head as I read through the chapter on Cardio, the main form of physical activity that I tend to make adjustments for. Given that getting up and going to work every day involves cardio, I’ve had no choice but to endure months and months of practice, patience and frustration to finally reach a place where I can work, eat and navigate my blood sugar levels without so much bumpiness.

Most cardio workouts increase insulin sensitivity during and after a workout, causing blood glucose levels to drop. The book provides practical suggestions for reducing basal rates and insulin doses for meals in advance of a workout, right through to avoiding lows in the hours afterward. Christel’s lived experience really shines through as she provides plenty of real life examples for undertaking cardio with both an insulin pump and Multiple Daily Injections.

Have you ever noticed your blood sugar levels starting to rise after exercise is over? One of the lightbulb moments that I had while reading this chapter was that a reduced pre-workout insulin bolus might need a follow up if food is still digesting once the workout is over. Ding!

The book moves into resistance training, and admittedly this chapter didn’t speak to me so much as I haven’t stepped inside a gym in years! Christel talks through navigating blood sugars during these higher intensity workouts, which can cause blood glucose levels to rise.

This chapter is definitely written in the spirit of motivating the reader to get into the gym and move past any personal reservations or fears. There are several pages of sample resistance workouts and illustrations in the book, with exercises that will suit both the gym go-er and someone with basic equipment at home.

For me, however, the most valuable part of this book was the chapter on nutrition. I say this because the nutrition advice in this book makes the most sense, but in my opinion isn’t reaching enough people with diabetes. I’ll have more to share on this soon…

Christel talks through calculating your daily kilojoule (or energy) needs in order to fuel your body and match the energy you expend each day. It was refreshing to hear her recommending carbohydrates rather than avoiding them altogether. Based on her own experience, she recommends a diet of 30% carbohydrate, 40% protein and 30% fat, however of course you could adjust these percentages to suit your own preferences. 

Another handy tool that Christel suggests to help track your nutrition is the smartphone app, My Fitness Pal. I’ve been using it myself since reading this book and it is amazing.

There are also chapters on meal planning and recipes, losing weight with diabetes and further advice to support a healthy lifestyle.

The Fit With Diabetes e-book very much runs in similar veins as Gary Scheiner’s Think Like a Pancreas. It wasn’t screaming at me to change everything about myself, nor was it holding back on providing practical suggestions because ‘everyone is different.’ The book is simply there to help you get more out of physical activity while managing diabetes.

Even if you’re not a fitness nut like me, I am very confident that you will find something to take away from this book. You can purchase your copy of the eBook here, and you can also follow Christel at diabetesstrong.com.

Disclosure: Christel sent me a copy of the Fit With Diabetes e-book. There was no expectation that I would write about or promote the book, and all opinions expressed here are my own!