Diabetes

Eating Some Carbs, and Moderate Protein

3 Comments

A few months ago, I wrote about some of the changes I was making towards my carbohydrate intake, and I think it’s time for a bit of a follow up.

I’m quite a spontaneous eater. For a long time, I’ve struggled with trying to curb my snacking and be diligent inbetween meals. I would have weeks where I would be super diligent, have excellent blood sugars, but was super hungry and fidgety. Those good spells rarely lasted beyond a week or two, and I would eventually end up rebounding with more carbs.

I was also eating a lot of fast acting carbohydrates and empty foods that left me hungry soon after. Some days I would snack mindlessly in the afternoons, and I never felt great or super energetic at the end of the day.

I knew all of this, but never resolved to do anything about it until recently. In my mind, I never set out on this with the intention of going extreme low carb. Life is too short not to eat cake or drink coffee. For me, this was more of a way to try and improve my eating habits, incorporate more sustaining energy sources into my diet, and to feel better overall. Maybe, just maybe, that would be the key to making my glucose levels a little more manageable.

I now try to have at least one protein source with either breakfast or lunch. For breakfast, I’ve thrown eggs on toast into my rotation alongside Oats or Weetbix and Banana. For lunch, I’ve thrown steak sandwiches and tuna sandwiches into my rotation, rather than having toasted ham and cheese every day. Dinner is usually a cooked meal, and would likely include a protein source at least 4 times a week.

Significant protein meals do need a bolus. I’m still experimenting with this, but I’m finding that setting an extended bolus for 50% of the protein over 2 hours is too much. I would like to give this theory a go, where I would bolus for 100% of the protein amount over 20g.

On good days, I try to keep my snacks inbetween meals very low carb. I usually snack on nuts and cheese, and often have a milky coffee with it, which is about 8g of carbs.

There are still plenty of moments where I indulge. But it doesn’t necessarily happen every day like it used to. Treating myself is more of my choice now, not simply because I’m feeling empty and craving something sweet. If I’m guessing for a piece of cake, I do try to look at it and think about the carb count. It really does make all the difference. The Calorie King app on my iPhone is also really handy for finding carb counts on the go.

https://www.instagram.com/p/BMgOvS9DCjw/?taken-by=franksita

I don’t have a strict number of carbs that I hold myself to each day. As a ballpark figure, I would say that I would eat an average of 30g per meal. But it really does depend on the meal. A low day might be 70-80g of carbs. A high day might be 120g. I think I would rarely go near 150g in a day.

What’s surprising me the most is how much I have unconsciously reduced the amount of carbs I have eaten. For instance, there are days where I glance at my pump and realise that I’ve only eaten something like 75g without even noticing. My blood sugars are more manageable, in part because I have reduced my carb intake, but moreso because I don’t have that urge to snack mindlessly anymore. There is definitely more of a variety and satisfaction in my diet, which translates to less of a desire for junk food. I think I have brought my lunch once in the last month, as opposed to every Friday. Unless you count coffee.

I definitely don’t view carbs as the enemy, so long as I go about them sensibly, carb count and pre bolus insulin appropriately. Carbohydrates that I do eat regularly include nutritious lower carb bread, such as Baker’s Delight Cape Seed loaf or Burgen varieties. Greek style vanilla yoghurt, fruit, vegetables, milk and oats. I eat pasta and rice in moderation if they are a part of the evening meal. I also have a block of chocolate handy for a treat if I’m craving something sweet. 

I often receive e-mails and messages asking me if I would consider going on a genuine low carb high fat, or ketogenic diet. For me, what I am doing at the moment is realistic. That 30g per meal is a number that doesn’t send me rebounding on more carbohydrates. Super high fat or greasy meals don’t particularly appeal to me, either. And to be honest, I’m never going to be the kind of person who converts to low carb as a way of life.

As always, diet is a very individual choice, and I have come across a variety of different perspectives in the DOC. There’s no right or wrong approach. In my mind, the right diet is the one that is realistic, that you can sustain, and that will make you happy.

At the moment, I’m confident that this is the approach that I want to continue with going forward, and the one that will send me toward the a1c I am aiming for. 

My Desk Says a Lot About My Diabetes

2 Comments

My blood sugars have decided to go rogue in this past week, and I’ve had a tough time trying to predict what they’re going to do to me next.

You can see it by the mere sight of my desk.


There’s a FreeStyle Libre reader in the white organiser that I have kept within close reach lately. It’s been my saving grace this weekend, while my blood sugar levels have been completely messed up. It provides me with trend arrows the minute my blood sugar levels began skyrocketing, and again as soon as they start plummeting low.

There are test strips strewn across my desk. There have been a few scary moments this weekend where my blood sugar levels were moving quite rapidly. Despite wearing a Libre sensor, during confronting moments like these I need reassurance. There were times where I felt compelled to prick my finger every couple of minutes, just to be sure that my blood sugars were heading in the right direction.

There are blood stains on the beech coloured surface of my desktop that, frankly, don’t look pretty. I’m tempted to clean it, but I know that diabetes won’t allow it to stay clean for very long.

On the left hand side, I’m staring at a notepad that is strewn with numbers. Basal rates, insulin to carb ratios, blood sugar levels, units of insulin taken, carb counts and corresponding times of the day. Notes that I sit and stare at for prolonged moments of time, as I try to make sense of blood sugar levels that aren’t making any sense.

I open my desk drawer and I see a huge party bucket of skittles, that I certainly have no intention of cracking open at any party. Skittles that I carefully divide into portions of 9, and store in empty test strip containers. 9 skittles that add up to 10g of carbs, a perfectly convenient serving that I can easily shove down my throat the moment a hypo strikes.

https://www.instagram.com/p/BMd52LqjFVE/?taken-by=franksita

I scoop up all of the used test strips into the palm of my hand, and walk over to the rubbish bin. I place my foot on the pedal, and the lid lifts to reveal a vial, half filled with insulin. The vial I threw away last night when my blood sugars were skyrocketing, just to be sure that it hadn’t spoiled.

It’s here in this moment, staring inside a rubbish bin, that I see the bigger picture. Suddenly, I don’t feel like the going is so tough anymore. I don’t feel as crappy as I have been for the past few days. I don’t feel the guilt of awful blood sugar levels so much.

When the going gets tough, I still have the best tools available for me to manage. A script for 25 cartridges of insulin costs me a mere $35. A box of 100 test strips costs me $16. Although my wage is less than glamorous, I can make room for FreeStyle Libre sensors when I need them. I have devices that can be uploaded to a PC, where I can analyse the data. I can call my diabetes educator for assistance, completely free of charge thanks to the public health system in Australia.

I have nothing to complain about. For DOC friends in the US, skyrocketing insulin prices are of real concern. A loss of health insurance coverage is of real concern, because it’s tied to diabetes supplies. Meanwhile people with diabetes in developing countries of the world cannot even afford insulin, supplies, education, treatment – and the ability to merely survive.

T1International are a fantastic organisation based in the UK that advocate for equitable access for people with type 1 diabetes worldwide. You might be familiar with their #Insulin4All movement. This year, T1International are urging us to sign the Type 1 Diabetes Access Charter. The Charter will be used to bolster advocacy efforts worldwide, showing that there are many voices united in support of these rights.

Insulin is a right. Managing your blood sugar is a right. Diabetes education is a right. Healthcare is a right. A life free from diabetes discrimination is a right.

It makes me sad that in this day and age, not everyone in the world is able to access the same standard of diabetes care that I do. Signing the Charter only takes a moment of your time, and you can do so by clicking here. 

Make it the one thing that you do this Diabetes Awareness Month.

Throwback Thursday: The Things I Don’t Tell You About My Diabetes

1 Comment

Two years ago I began writing this blog, and opening up about my diabetes. It’s incredible to think that there was a time where I did shy away from my diabetes, considering that I called in sick to work yesterday citing high blood sugar levels!

I look back at old posts and realise how much my attitude towards diabetes has changed over time. I distinctly remember not being able to sleep one night, sitting up in bed, grabbing my laptop and simply letting the words flow. While a lot of things from this post have changed for the better, some things here still hold true.

***

There are so many aspects of my daily life that those around me would have absolutely no idea about. Of course most people around me know that I check my blood sugar levels and inject myself with insulin. But what about all those other invisible things that nobody ever sees, the things I choose to keep to myself.

Thoughts. Its been almost five years since I’ve been able go to bed without being plagued with worrying thoughts. What will my blood sugar level be in an hours time? In two hours? Four hours? Tomorrow morning? Do I still have active insulin in my system from dinner? How much more am I likely to drop? Will I go hypo? Or will my blood sugar rise later on because of the fatty food I had earlier?

Hypos. Being woken up at 2am drenched in sweat and shaking like mad. The frustration of having to open my eyes and get up from my comfy position under the covers. I know I’m hypo, but I’ll still reach for my meter just to be sure. Yep. I’ll reach for the bag of jellybeans sitting beside my bed, begrudgingly shoving them into my mouth. I hate them. The dry, sugary taste that will stick to my tongue for hours and leave my throat dry. I’ll be dying for a drink by the time I wake up. And then I’ll have to fall asleep all over again.

Hypers. Waking up in the morning thinking of one number while my meter is showing something ridiculous like 20. I’m so furious, so frustrated at the thought of my blood sugar being that high for that long. Then cue the scary thoughts of diabetes complications and damage I’ve done to my body. Desperate to being my blood sugars down ASAP, I’ll dial up a big dose of insulin. Only to find a few hours later that I’ve overcorrected and am hypo instead.

And then there’s those public situations. Like Work. Having to refuse that spontaneous treat that my workmate has brought in to share, and then being asked why not. Or accepting it and then racing back to the bathroom for a quick jab of insulin while nobody is around. And then waiting for that private moment to test my blood sugar level away from prying eyes. I’m doing myself a favour. Saving myself from that conversation where I’m asked if I can’t eat sugar and told stories about that friend or relative who has diabetes too.

But I take it all in my stride. I don’t complain to my family. I don’t tell those well meaning conversationalists to shut up. I just deal with it. And most of the time, I dont even stop to actually think about what I’m doing. Its just something I have to do. Its a part of being me.

Pressing a Button

Leave a Comment

“Go on. Take it!” One of my work Mums urged me at a plate of sweets she had brought in.

“Crank it up, Frankie,” my other mate added.

I definitely knew I was going to dive in and have something. But I was hesitating for a moment, while deliberating over a carb count and giving myself time for the insulin bolus to kick in.

Don’t get me wrong, my decisions around my food are my own. Sure, my work mates see me pull out my pump from time to time. They see me scan my FreeStyle Libre frequently while I’m wearing it. They see me drink coffee, eat sweets, laugh and do all the other “normal” things.

But I don’t think they actually appreciate just how complex these seemingly simple actions are.

Like making sure that bolus is delivered prior to eating. Making sure that I think carefully about the carb count I’m estimating. That I give enough insulin not to send me high after eating, but not too much that it will send me plummeting within an hour. Factoring in physical activity, and not being too reactive with insulin corrections.

As we were resting later, I pulled out my pump once again.

“You check it all the time?” She asked me.

For both of our benefit, I gave her a much, much simpler response.

“Yes. Whenever I eat, I pull this out and press the button to get my insulin” I replied.

“It’s better than injections?”

“It’s so much easier than before. If I want to eat, I can just press the button. If my blood sugar is high, I can just press the button, instead of having to stop and give an injection.”

I wish managing diabetes was as easy as pressing a button. But it’s nice to dream.

Working Towards a Lower hba1c

Leave a Comment

I am only two weeks away from finding out what my latest hba1c result will be. And I am dying to know.

In August, I learned that my hba1c had gone up after three months on a pump. I was extremely disappointed at the time, but did take solace in the fact that my BGLs are far less variable than they once were. 

I’ve been working hard at taming my blood sugar levels over the past two or so months. I do genuinely feel like I am making progress and taking steps in the right direction. But there are definitely still some tough spots that are taking time to work through. 

Routine has been key to taming my blood sugar levels. Through the week I generally wake up, go to work, have my meals, come home and go to bed at the same time each day. Having that sort of consistency makes it easier to experiment, compare and make adjustments to insulin doses.

Nights have probably been the most consistent. I still wake myself to check once through the night. Sometimes small correction doses are needed, but I am waking up in range almost every morning.

Mornings are probably the smoothest portion of my day, blood sugar wise. It is still extremely tough to obtain consistent results, because I begin work at 7am with varying levels of physical activity from day to day. While breakfast on Monday left my levels smooth sailing, the exact same breakfast (and an identical waking BGL) yesterday sent me a little higher than I’d like. As much as I try not to beat myself up, this is ever so frustrating!

Afternoons have been somewhat tricky to smooth out. I sit down to lunch for an hour at 1pm after a morning of physical activity, which means I need a higher basal rate in action for this hour alone. I go back out to work at 2pm for another hour of physical activity, before finishing at 3pm where I once again need a higher basal rate of insulin. It’s definitely been a loooong game of trial and error, with many curse words thrown towards the sight of upward trend arrows on my FreeStyle Libre. Urgh.

Speaking of FreeStyle Libre, it is a lifesaver. Having easy and unlimited access to glucose monitoring means I have greater insight into what’s happening with my levels. Adjustments are easier to make, and I can better respond to highs and lows. Like this low, that rebounded high, and ended miraculously in a steady line.

 It’s becoming hard to live without it (first world problem, I know…).

Evenings are probably affected a little by my afternoon levels, and I’m confident that they will be easier to manage once my afternoon basal rate is right. My evening meal is also a cooked one, meaning that my carb counts are more estimated and varied than others. 

I am also being super diligent with my eating. I am putting more effort into preparing my meals and snacks through the day. This has definitely resulted in more variety and enthusiasm towards the food in my lunch box (hello ham and eggs on toasted Sourdough), and less of a desire for junk food and unnecessary carbohydrates. I definitely want to expand on this in another post to come. 


I’m also noticing that my total daily dose of insulin is now both lower and more consistent, which can only be a good sign!

Which brings me to now. I am nervous. I have absolutely no idea whether I have done enough to make a dent in my hba1c. I’m trying not to be too unrealistic about my expectations, but I’d be lying if I said I didn’t have high hopes. If my average glucose readings are anything to go by, I’m expecting that I’ll be sitting around half a point lower to where I was in August.

I’m determined to make these last two weeks count. And not because I’m scrambling, like I did back in my diabetes juvie days. I’m watching my FreeStyle Libre reader like a hawk, and making those last minute improvements that will hopefully make all the difference.

I am absolutely dying to find out where my hba1c is sitting right now. Crossing my fingers and toes for November 9…