For more educational posts and diabetic recipes, visit me at arielwarren.com.
May 22, 2018
Ariel Warren, RD, CD
Hi my T1D friends,
I’ve been reflecting a lot lately, figuring out why fighting for diabetics is so important to me.
To keep it simple, I love diabetics. I love all people, but I have an extremely special place in my heart for my diabetic friends. This love stems from a lot of reasons, but number one is that I greatly understand diabetes and what diabetics go through on a daily basis.
Thinking back, it all started when I was first diagnosed as a young girl at the age four.
The picture above, me (blonde on the left) with my sister on the Easter right before I was diagnosed.
Very early on, I remember never really feeling understood by my endocrinologists or dietitians. Sure, they were informative and kind, but they just didn't get how if felt to be scary low, frustratingly high, or how belittled I felt when I was chastened about a A1c not quite in range (especially during the teenage years).
I know how frustrating stubborn highs can be. Some days, you simply feel that insulin just stopped working for you. Even when you try changing out the insulin or your pump site, or both, give a correction bolus/shot, and even add a heavy temp rate. Nothing, you're still high. Then, as if your body just magically decides it's time to be receptive to insulin, your blood sugar comes crashing down. These days you feel like, "Man, I try to be so good, then I have a day like this. Why do I even try? Is all that insulin just adding to my fat storages? Awesome. I should just eat donuts, my efforts don't matter anyways."
I know how irritating it is when... you correct a low based on your CGM reading with fast-acting carbs, just to find out, you weren’t actually low. You didn’t even want the sugar, and now the it's going to make you sky-rocket and discredit some of that hard gym time you put in.
I know how if feels when... you are watching the screen of the A1c computer during your Diabetes Appointment. The countdown to find out your A1c seems to go so slow. At the same time, you don't want it to be revealed because that dumb little number will either make you happy or disappointed in yourself.
As you wait and impatiently watch you may think, "Dang it, why am I checking my A1c now?? It's been so crazy lately, I know my A1c is going to be up. I've just been so stressed and tired, and kind of sick, I don't want to see it."
If you have a good Endo, they realize that this is just a small glimpse into life and that if it is off. At this point, it is a great opportunity for change or to figure out the root cause of the elevated number. Not all of us are lucky to have such an empathetic Endo, most of us feel our Endo means well, but just doesn't understand what's really going on or simply doesn't have the time to care. During hard times that come with life, we feel particularly judged and insecure with that A1c number.
I know how it feels... to try every diabetic diet, because surely this one will magically be fantastic for your weight loss and blood sugar goals, and just "fit" with you and therefore be easy to stick with, forever. You know, simple to stick to longer than just a couple months, weeks, sometimes just a couple days. Low carb, plant-based, no sugar, no preservatives, 100% vegan, no chemicals, no diet soda, no gluten, no artificial colors, no high fructose corn syrup, no more using plastic containers, no inflammatory fats, no nightshades, no legumes, etc, etc, etc. OMGOSH does the list continue on forever. As a dietitian, I have seen the craziest diet ideas (or schemes is a more appropriate word). Don't get me wrong, lower carb, plant-based, higher protein, there are definitely elements that can be extremely effective for diabetics, BUT the key is not to be extremely restrictive. Doing so tends to backfire in your face and cause feelings of extreme deprivation (keep reading for my resolution to this).
Lastly, I know how scary...those extreme lows can be. Honestly, you can't truly explain to a non-diabetic how terrifying it feels when you are so low, you feel paralyzed in your own body. You feel sweaty, confused, cold, anxious, often irrational and intensely irritated, but the scariest part to me is when you finally snap out of the low. At that moment, you realize how close of a call that low really was. That's when the tears come streaming down your face as you look at your little baby, your child, your spouse, your sister, your brother, and you think how much their life would have been affected if you didn't come back up. Today, such lows are greatly avoided, especially with the use of a CGM, nutrition, and appropriate exercise, but such moments will forever be burned in my memory.
I get Diabetes because I've been there.
It's taken many years of learning from mistakes, being formally educated from college and internships, working at Endorincology clinics, and years of coaching diabetic clients. I know where you are coming from, and I know how to work with you to help you achieve better control with your blood sugar, your workouts, and your weight loss/fitness goals. I know because I've been there. I get it.
As always, my goal is to uplifting and informative with my posts, so I want to end with 5 Tips I've learned as a Diabetic Health Professional.
5 Tips for Better Blood Sugar Management.
#1 MODERATION IS KEY.
If you were to tell me that I can never have a brownie again, I would be quite depressed. I may eat a lot of veggies, but I enjoy a bite of brownie here and there, and I don't feel guilty about it. Practicing moderation is a healthy approach that will make you feel much more satisfied and in control of your life. In order to stay sane, and have a healthy relationship with food, we need moderation.
Moderation. Meaning, eat a majority of healthful foods such as vegetables, fruits, whole grains, nuts/seeds, beans, and lean protein, and having a bite here and there of treat foods (AKA a bite of brownie or a cookie). Just make sure to really ENJOY the treat when you do have your little indulgence. You can also make healthy versions of treats by swapping ingredients (I've developed lots of tricks over the years).
Below a Keto Donut that used coconut flour & cacao frosting.
DISCLAIMER: If a lower carb diet works best, you can sub for lower carb fruits such as avocados, lemons, limes, berries and greatly limit whole grains (or just eat extra veggies instead). If you are vegan, you can get your protein from nuts/seeds, beans, TVP, whole soybeans, vegetables. ETC, I have lots of methods to work with nearly every diabetic management style.
I understand that every diabetic is different, but moderation can still be beneficial no matter what diabetes management style you use. You just have to be smart about your moderation choices.
#2 VEGETABLES ARE YOUR FRIEND.
Vegetables. Oh how I love vegetables. They are such a wonderful and powerful source of vitamins, minerals, and antioxidants. They have been found to be helpful in reducing risks of many cancers, and for reducing inflammation related diseases. Since Diabetes is known as a low-grade chronic inflammation disease, you can bet that I recommend vegetables as much as possible in my clients' diets.
Vegetables are also packed with fiber and high in water content. Fiber is extremely filling, which decreases total calories eaten throughout the day which helps with weight loss. Fiber is great for digestive and colon health, and fiber is great to reduce postprandial spikes (similar to the effects of protein). Since vegetables have a high water-content, they fill you up with much less calories, which is another great way to help you feel full and for better weight loss.
Other beneficial foods to add to your diet are 1/2 cup of nuts/seeds per day along with 3-4 servings of fruit.
#3 GO NUTS FOR DIABETES.
Sorry, terrible pun. Anyway, I am a HUGE believer in nuts/seeds. My go-to snack on the road is 1/4 cup containing pumpkin seeds (with the shell) + almonds. You better not just eat the seeds within the pumpkin shell, there is so much beautiful filling and delicious fiber from eating the WHOLE pumpkin shell. Try Roasted Whole Pumpkin Seeds. So good and filling!! I buy these in bulk.
Nuts and seeds, although higher in calories than other foods, they are found to be very filing and satiating. Many studies have shown that eating high calorie nuts (about 1/4 cup per day) can add 2 years to your life (on average), AND actually help you loose weight because the nuts and seeds are so satisfying.
#4 FRUIT IS FANTASTIC.
Berries & fruit. Not all fruit is created equal when it comes to blood sugar. Tropical fruit such as bananas, mangos, pineapple, papaya, etc are more carb-heavy. Watermelon and grapes are also fruits that tend to shoot up the blood sugar quickly, which could be due to the lower amount of fiber per serving compared to their other fruits.
Did you know that 1 cup of blackberries has almost 8 grams of fiber?? That's amazing. If you are trying to add fruits, but are sticking to low carb, even keto, you can still get fruits in, you just need to be a little more tricky. Try saving your carbs for high fiber berries, or indulge in very lows carb fruits such as lemons, limes, and avocadoes.
#5 THE POWER OF EXERCISE IS REAL.
I am a firm believer in the power of exercise for diabetics to improve overall blood sugar, to reduce insulin resistance, and to help with weight loss goals.
To give an Exercise Low-Down.
CARDIO for Diabetes.
Think steady state run, brisk walk, light jog. This type of exercise tends to lower your blood sugar after about 15 min, especially if you have insulin in your system beforehand (AKA you ate breakfast or did cardio later in the day). Think of cardio as a way of your body making existing insulin more effective. Which is why I often do fasted-cardio. I'll talk about that more in detail for another post.
HIIT, Weight-Lifting, Sprints for Diabetics.
Such exercises tend to spike the blood sugar. To help avoid this spike, you can give insulin beforehand. If your blood sugar spikes and stays high, consider giving insulin before a workout and then a temp basal during your workout. How long and how heavy this temp basal greatly depends on your specific needs. Another tip is to add about 15 min of cardio at the end of your workout to help lower your blood sugar.
Exercise is often tricky for many diabetics. Being a diabetic and dietitian who has an emphasis in Fitness, this specific area is a very common topic I talk in detail with clients. If you are having a particularly hard time with your blood sugar during your workouts, you can email me anytime (ariel@hapibody). I'm here to help.
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When we talk, I will look in detail at what, when, and the amount you are eating, along with what you are doing for exercise (or not doing, we'll be honest with each other). Together we will analyze your blood sugar (use your Dexcom Clarity reports if you have a Dexcom) and together we will decipher why you are getting your frustrating highs and lows. After a single session, you will have answers and a much better clarity of why your blood sugars react they way they do to your food, exercise, and lifestyle.
After talking, we will stay in touch, and you will have direct access to me for any questions. I deeply care about each and everyone of my clients.
If you just have a general question, send me an email and I will get back to you ASAP.
Your friend & Dietitian,
Ariel Warren, RD, CD, T1D
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Lastly, if you want to join a T1D FB Group who is supportive and full of great workouts and blood sugar challenges, join "Getting Fit with T1D". Right now we are having a 1 month HbA1c challenge.