Tips to stay healthy with Type 1 diabetes

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10 Tips to Stay Healthy with Type 1
A Type 1 psychologist shares 7 guidelines from certified diabetes educators, as well as 3 mental tips of her own.


BeverlyAdler.jpg

Beverly S. Adler | July 28th 2015

Michael J. Fox once said this about living with Parkinson’s disease: “I often say now I don’t have any choice whether or not I have Parkinson’s, but surrounding that non-choice is a million other choices that I can make.”

As someone who lives with Type 1, I argue that you can say the same about living with Type 1. You don’t have a choice whether or not you have Type 1 diabetes, but you can make “a million other choices” of how you will live with it.

My job is to help others with diabetes make the best choices for themselves. As a cognitive behaviour therapist and certified diabetes educator, I specialize in treating the emotional issues of coping with diabetes. I help my patients examine their thoughts and actions toward living with diabetes.

The American Association of Diabetes Educators have developed seven key guidelines to help manage diabetes. Called the AADE7 Self-Care Behaviors, they include:
-Healthy Eating – Having diabetes means learning how to count carbohydrates and how the foods you eat affect your blood sugar. A healthy meal plan also includes complex carbohydrates, protein, fiber (beans, whole grains, fruits and vegetables), lots of green, leafy vegetables, and limited amounts of heart-healthy fats.

-Being Active – Physical activity can help you keep blood sugar levels normal and manage your diabetes. Being active can also improve your mood and reduce your feelings of stress and anxiety.

-Monitoring – Checking your blood sugar levels regularly gives you information about your diabetes management. Monitoring helps you know when your blood sugar levels are within your target range and helps you to make choices in what you eat and what you do.

-Taking Medication – Obviously, it’s important that you take your insulin, but it’s vitally important that you understand how much to take in certain situations. This comes from careful monitoring of your blood sugar levels and getting to know the cause and effect between your insulin therapy and your blood sugar levels.

-Problem Solving – Everyone encounters problems with their diabetes control. If/When you have a problem, you need to know how to troubleshoot your self-care. This can include analyzing and evaluating your situation and thinking about what was different from usual that could have affected your blood sugar. It also means coming up with solutions to try, as well as looking at what worked and what didn’t. Don’t get bitter, get better.

-Reducing Risks – You can take steps now to lower your risks of developing health problems in the future. Recommendations to reduce your risks and avoid other health problems include: not smoking, seeing you doctor regularly (to check A1C), visiting your eye doctor at least once a year, brushing and flossing daily and seeing your dentist, taking care of your feet, and listening to your body.

-Healthy coping – Living with diabetes and its daily demands for self-care can be stressful and may negatively impact your self-management. Not only can stress increase your blood sugar levels, but it can contribute to you making poor choices. The good news is there are many healthy ways to cope with stress.

I think this last point is vitally important, and I want to share three options for managing the stress of living with diabetes:

-Be kind to yourself. Do the best that you can do. It’s important to feel good about your successes. Give yourself credit when you are successful at managing your blood sugar and don’t be overly critical of yourself if you fall short of a goal.

-Seek support from a network of family and friends who you can talk to when you are upset. Seek opportunities to meet other people with diabetes, such as attending support groups or participating in online forums (such as podcasts or tweet chats), so that you won’t feel isolated and alone. Talk to a psychologist or other mental health provider who provides diabetes-focused therapy if you feel depressed or overwhelmed.

-Choose to have a positive attitude, and cultivate it every day, but also accept when you feel down about diabetes. To have occasional negative thoughts is normal; research has shown that acknowledging those thoughts may help people with diabetes keep their blood sugar levels stable. Acknowledge, but don’t dwell; living with a negative mindset will limit your ability to cope. The way you think about events can influence your mood, thoughts and actions.

Type 1 diabetes is a health challenge that you didn’t choose, but doing what you can to stay healthy is a choice you make each day. It’s a lifetime practice to embrace the best you can.


A good read, especially if you are a newbie, need guidance/support, going through negative feelings or having a bad day, take care.
 
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Jeremy_Wood

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Nice one @Robinredbreast - I totally agree with all of this.

Some people might find it hard to start being kind to themselves but if you can get there it can make a world of difference.
 

NoKindOfSusie

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I really, really wish people would stop banging on about physical activity. I would love to. The fact that I can't absolutely kills me. It is not a choice. I have never felt this sick for this long and it is just grinding me down. It's almost starting to just be normal now but every so often I just end up leaning on something going "oh god" and it hits you.
 

mountaintom

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I really, really wish people would stop banging on about physical activity. I would love to. The fact that I can't absolutely kills me. It is not a choice. I have never felt this sick for this long and it is just grinding me down. It's almost starting to just be normal now but every so often I just end up leaning on something going "oh god" and it hits you.

I think you should find out if there’s something else going on. Diabetes shouldn’t be making you feel like that unless you’ve really low BG.
 

mountaintom

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Could it be your insulin that’s making you feel like that? Would it be worth trying a different insulin?
 

LooperCat

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I’d really suggest changing from Lantus at your next DSN appointment. You really shouldn’t be feeling this sick x
 
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NoKindOfSusie

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I don't think anyone knows how sick I should be feeling. I think a lot of people just forget what normal feels like. It's only been seven months, I can still remember what normal feels like.
 

EllieM

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Plenty of new diabetics on these boards, and plenty of diabetics who take strenuous exercise. We/they may well be sick of having diabetes in terms of testing and managing levels, but our insulin doesn't make us feel sick. Have a look at the lantus thread here and see if it helps
https://www.diabetes.co.uk/forum/threads/changing-from-lantus-to-tresiba.140216/
Personally, it sounds to me as though you should be pushing for tresiba at your next clinic...
 
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EllieM

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I don't think anyone knows how sick I should be feeling. I think a lot of people just forget what normal feels like. It's only been seven months, I can still remember what normal feels like.
OOps, forgot to hit reply in the post above, please read it. :)
 

NoKindOfSusie

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Totally agree. Being diabetic should not make you feel as you are describing.

I remember how I felt before diagnosis and feel a million times better now!

Do not understand why you are unable to exercise at all. Either you dosing is incorrect, your mental outlook is preventing you or something else is going on. I'm assuming you've tried to deal with these issues via your GP.
If I try to go running I make it about 500 metres and feel like I need to lie down. Basically I constantly feel like I just ran a 5K. Basically it is exactly what you would expect to feel like if your body was suddenly to become unable to extract energy from food so it is not exactly shock of the century. I would not really expect to be able to do much given what I am able to eat.
 

LooperCat

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If I try to go running I make it about 500 metres and feel like I need to lie down. Basically I constantly feel like I just ran a 5K. Basically it is exactly what you would expect to feel like if your body was suddenly to become unable to extract energy from food so it is not exactly shock of the century. I would not really expect to be able to do much given what I am able to eat.
Do you eat any fat to make up for the calories you’re not getting from carbs?
 

Draco16

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Basically I constantly feel like I just ran a 5K.

I don't get what you mean when you say this, as you seem to be suggesting it is a bad feeling? After 5k you should be feeling alive and alert, it's not exactly tough endurance distance. As you can't run 5K now I presume your memory of feeling awful after 5k is pre diagnosis, why did you feel so bad then?

1. Are you sure haven't got anything else going on? Ask for some wider blood tests. Given your limited diet it could be wider nutritional deficiency. Iron deficiency? The symptoms match...
2. Unfortunately fitness and strength takes months / years to build up... but only days / weeks to lose. If you haven't done much in the last 6 months that is why even after 500 metres now you'll be feeling it. That is true of everyone, T1 or otherwise.

I would not really expect to be able to do much given what I am able to eat.

3. Exactly. It's like someone going on a car forum and posting that they put a litre of petrol in their car and it stopped after 10 miles and wondering why it didn't go 300 miles. And then every day putting the same one litre of petrol in and wondering why they get the same result.

It really is simple maths
5k = 250 calories
40% of calories from carbs = 100
4 calories per gram of carb = 25g carb needed
25g of carb at your carb ratio = x amount of insulin to convert the carbs to energy

You're so depleted in energy you may need to replenish your stores more to begin with, or get more knowledgeable on high fats for energy, but that is not an overnight switch.

I eat 180g of carb per day and I train a bit almost every day. If I'm running a marathon i'd eat maybe 500g carb. Yes 500! But I don't take them all as 5 litres of full fat coke that I down in 5 minutes. I fuel with slow release carbs, again keeping each portion to a manageable carb size.

If i'm driving 10 miles I put a litre of fuel in my car. If i'm driving 300 miles I put 30 litres in.

Notice the pattern...

Or simply accept if you're unwilling to put more than a litre of fuel in your car then you won't be able to drive very far.

Refusing to fuel = refusing to run.
 
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NoKindOfSusie

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I don't get what you mean when you say this, as you seem to be suggesting it is a bad feeling? After 5k you should be feeling alive and alert, it's not exactly tough endurance distance. As you can't run 5K now I presume your memory of feeling awful after 5k is pre diagnosis, why did you feel so bad then?

I didn't. I used to love it, it was great. What I feel like now (or what I felt like at about 11am today) is just completely exhausted like you would if you'd been running, just without all the endorphins and good stuff.

And yes normally I would go running then eat a six inch subway marinara melt and a chocolate cookie and feel awesome, it's weird the things you crave when you can't have them.
 

Circuspony

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I didn't. I used to love it, it was great. What I feel like now (or what I felt like at about 11am today) is just completely exhausted like you would if you'd been running, just without all the endorphins and good stuff.

And yes normally I would go running then eat a six inch subway marinara melt and a chocolate cookie and feel awesome, it's weird the things you crave when you can't have them.
You can have them. Just inject for them!
 

Fairygodmother

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@NoKindOfSusie, in different posts You said you elected to skip the stage when you’re put on a fixed insulin regime so that your ratios and basal can be calculated, which would have enabled you to find out how much to inject for what you chose to eat. You also said you’ve chosen not to go to at least three appointments for diabetes checks.
Maybe it’s time to bite the bullet and attend an appointment? Seek help? Ask for ways you can get control so that you can escape from your current situation? Just saying, with your best interest at heart.
 

becca59

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@NoKindOfSusie. We have direct messaged in the past. I have made suggestions. Lots of other people have made excellent suggestions. There has been much support in most of these posts. We are all LIVING with this disease. I know you don’t want it and have railed against acceptance. However, I repeat, we are ALL LIVING with this disease on this forum. You are not living you are existing. This makes me extremely sad.
The problems you describe are not normal for the vast majority of people. Please, please, please seek out an alternative GP who you feel comfy with and can refer you to a supportive diabetic team. You do not have to accept what you have at the moment. There is something radically wrong with your medication or there is another underlying, as yet undiagnosed condition.
You are young and life is for living. Please do not come back with an excuse, take control of your life now!
 

NoKindOfSusie

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@NoKindOfSusie. We have direct messaged in the past. I have made suggestions. Lots of other people have made excellent suggestions. There has been much support in most of these posts. We are all LIVING with this disease. I know you don’t want it and have railed against acceptance. However, I repeat, we are ALL LIVING with this disease on this forum. You are not living you are existing. This makes me extremely sad.
The problems you describe are not normal for the vast majority of people. Please, please, please seek out an alternative GP who you feel comfy with and can refer you to a supportive diabetic team. You do not have to accept what you have at the moment. There is something radically wrong with your medication or there is another underlying, as yet undiagnosed condition.
You are young and life is for living. Please do not come back with an excuse, take control of your life now!
Okay mum.

(My mum is far away, you guys are as good as I'm getting right now!)

Appointment next week, I am going armed with I Am Serious Lawyer suit, @Mel dCP approved battle handbag, and determination to be cool, calm, professional, and UTTERLY IMPOSSIBLE TO DISLODGE until they let me stop taking this stuff (and presumably try something else.)

Also libre on order.

And no I am not going to start eating chocolate cookies as I value my toes and my eyesight.
 

becca59

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Okay mum.

(My mum is far away, you guys are as good as I'm getting right now!)

Appointment next week, I am going armed with I Am Serious Lawyer suit, @Mel dCP approved battle handbag, and determination to be cool, calm, professional, and UTTERLY IMPOSSIBLE TO DISLODGE until they let me stop taking this stuff (and presumably try something else.)

Also libre on order.

And no I am not going to start eating chocolate cookies as I value my toes and my eyesight.

Wonderful news! Am honoured to be a stand in mum. Go that battle suit and handbag!