Wednesday, 30 May 2012

Great article  on gastrointestinal issues in people with diabetes. 

It is good to know what you are up against.  I struggled with some of these issues before I was diagnosed but since I have been diagnosed as a Type 1 and have started insulin therapy these issues have substantially decreased.  Good knowledge to have anyways.

Tuesday, 29 May 2012

Success! Glucose Under Control

Yesterday I posted about my glucose control being a little out of whack over the past few days.  I rested pretty much all day yesterday and tried to drink plenty of fluids and it seems as though the tickle in the throat is gone.  This morning my blood glucose was at 7.5 (135 for Americans).  This is an ok number for me, anything under 8 I consider ok.

In order to get there I had to increase my Levemir from 40 units per day to 46 units per day over a 4 day period.  I was worried about going low overnight with the increase but that did not happen.  I have had a fear of going low overnight because you hear real horror stories about that.  I am starting to get over that though.  We shall see. 

Perhaps as my journey continues I will start to be a little more aggressive with my basal insulin like I am with my bolus insulin.  Situations like this just go to show that you have to always be watching for patterns to keep under control.  Soon I may have to lower the Levemir down again but perhaps not if I start getting levels around 6 (108) in the mornings.  Any lower than that and I don't think I would be comfortable.

What do you aim for as a level in the morning?  Is it consistent and are you comfortable with it?

Monday, 28 May 2012

Over the past few days I have just not been able to get my blood glucose under control!  Frustrating!  There seems to be no reason why it has suddenly spiked up.  It seems like no matter what I do there is no rhyme or reason to it.  I have started to give myself 1 more unit of Humalog when I do a correction and it still isn't working.  When I wake up my fasting glucose is 10 (180 for my American friends) and that is where it stays for the rest of the day it seems.  Also, I have been increasing my Levemir by a couple of units per night.  Still when I wake up it is at 10 (180) or more.  FRUSTRATING!

Then I found the culprit, this morning I woke up with a tickle in my throat.  No cough or anything. just a plain old sore throat.  It is amazing how these small things can set you off course.  My doctor said that even the weather affects some people's glucose levels.  I believe it! 

This is a hard disease to get your head around sometimes.  Everyday is a learning experience that is for sure. 

Thursday, 24 May 2012

The meal for today is Chicken Souvlaki with Greek Salad and Lemon Potatoes.

I love making this meal because it is so flavourful and relatively easy to make.  Basically, I take two chicken breasts and cut them into cubes.  I cook for two and find 1 chicken breast per person is a good amount of food.  I let them marinade for a few hours in the fridge.  Take them out and skewer them on the small wooden sticks and throw them on the BBQ. 

To make the potatoes, I like them with dill, lemon, salt, pepper and lemon juice.  I use small potatoes that are about 3 gr of carbs each.  What I usually have is 5 potatoes, so about 15 gr of carbs.  I halve them and put them in tin foil along with the dill, lemon juice, salt pepper and used lemons.

15 g of carbs per serving
The salad is a combo of...

Makes about 4 servings

1/2 of a cucumber
1 red and 1 yellow bell pepper (12 gr of carbs total)
1/2 red onion
1 cup of baby tomatoes (6 gr of carbs total)
feta cheese
2 or 3 Tbsp of Olive Oil
1 Tbsp of Balsamic Vinegar
1 Tbsp of Fresh Thyme

4.5 gr per serving

The marinade for 2 Chicken Breasts is as follows...

2 or 3 sprigs of rosemary chopped
1 sprig of thyme chopped
3 cloves of garlic minced
juice of 1 lemon
salt and pepper
lemon rind to taste
2 tbsp of Olive Oil
I also like to have a couple Tbsps of tzatziki with my meal to dip the chicken and potatoes in.  This has 2 grams of carbs in it.

Total Grams of Carbs is 21.5 g of carbs per meal

Wednesday, 23 May 2012

I have found this new product (for me anyways) called Chia Seed.  Apparently, the ancient Aztecs used to harvest it and it was a staple in their diet and even used it as currency in trade.  It is also the same stuff they use to make chia pets.  There are many ways it can be used and it is quite nutritional.  It is full of protein, fibre and as an added bonus has lots of omegas in it.  As far as flavour goes, it is bland.  It takes on whatever flavour you put in it.

One way you can use it is to just sprinkle it only a salad or into your cereal or yogurt.  This is a little crunchy for my liking though.  You can also grind it up and use it to top yogurt or cereal similar to how many people use flax seed.

There is another way to eat it but you must be warned, it is a little strange...  Well, some would consider it very strange.  If you soak it in liquid for about 15 minutes it takes on this weird consistency.  I guess I would describe it as a sort of tapioca texture.  Or perhaps crunchy bubble tea, if you have ever had bubble tea.  I have found if I take two Tbsp and soak it in 2 cups of either almond milk or water it makes me feel quite full.  It would be good in a shake as well.

Now, like I said, this is not for everyone.  Many people might consider it's texture, shall we say, slimy and off putting.  I find it isn't that bad though and I am going to continue to use it.

Sometimes I put two Tbsp in a glass of water and just drink it quickly.  It's relatively tasteless and does the job.

If I am feeling more ambitious I will put two Tbsp in 2 cups of cold almond milk and add a little cinnamon and splenda to it.  It tastes pretty good to me and it gives me a low carb snack with lots of fibre and I am always looking for fibre to help with my overall health. 

I picked up a 900 gram bag of this at Costco for $9.  That is cheap compared to the grocery store where it is $7 for a 300 gram bag.  Here is the nutritional info for 2 Tbsp.  (Sorry for the image quality, I just took a picture of the bag with my phone as I couldn't find one on the internet.)

Tuesday, 22 May 2012

Late at night or throughout the day sometimes I need something extra to eat because I had a light supper or lunch.  I do not usually have snacks as part of my nutritional routine unless I am working.  Sometimes in the morning I will get a little hungry after breakfast and I have an apple or something but it is rare that my breakfast isn't enough to get me through to lunch.  If I am working then I need to have a snack around 2 pm. or I will be low by the time I go home.  I usually try to keep this snack between 15-30 grams of carbs. 

The fact is though, for other times of the day I don't want to inject myself with 1,2,or 3 units of Humalog just to have a quick snack so I am not hungry before bed. 

As far as my insulin routine for nighttime snacks there are 3 situations I could be in.  For each situation my rule basically goes ...

1.) If I have had a normal day then I make no adjustments and try to have a low carb snack.
2.) If I have had a day where my BG has been high I will have a small snack and adjust at a rate of 1 unit of Humalog to 14 grams of carbs. (I don't want to get nighttime lows so this is about half of the normal insulin I would take, usually it is 1 H per 7.5 grams.)
3.) If I have had a day where my BG has been low I will have a regular snack (15-30 grams) and take no insulin.

Of course, with all of these situations I factor in my 10 pm. BG number as well.

This post is about situation #1.

Sunday, 20 May 2012

Who is my hero thus far since I have started my diabetic journey in August of 2011 with a diagnosis of Type 1 Diabetes?

This is an easy one for me.  My wife has been especially supportive through the whole process of getting diagnosed, starting treatment, reminding me of things when I need to be reminded.  She is especially good at not being the "Diabetes Police", no nagging from her because she knows I am doing my best.  She goes with me to lots of my appointments so she is just as informed as I am and for support if the news is not good. 

It isn't easy on spouses of diabetics.  The stress on my wife and I has been immense over the past 8 months.  Spouses have lots to worry about as well.  Are they being supportive?  Are they being too supportive?  Are they supporting their partner in the right way?  On top of that there are the chances of long term complications I know my wife thinks about that a lot.  How could you not?  I feel for all spouses of diabetics as it is an especially hard role to play and I think that as diabetics we need to remember that. 

Friday, 18 May 2012

Rough day.  Getting sick, lots of corrections.

Diabetes is such a complicated and misunderstood illness.  Before I was diagnosed I admit to being quite ignorant.  I knew what it was, I knew there were two types, and I knew some people had to inject insulin everyday. There are a few things I wish everyone knew about diabetes...

1.)  That there is a difference between Type 1 Diabetes and Type 2 Diabetes.  The lady at the Subway yesterday told me her husband was diabetic since he was 4.  I thought "oh, well, that is too bad he's had type 1 for so long."  Then as I am leaving she gives me some unwanted advice to "control it with diet and exercise, that's how my husband does it.  Well, he still takes 5 needles a day". huh?  Thanks for the healthy lifestyle tip.

2.) I don't want your healthy lifestyle tips/miracle cure/have you heard of "insert fad product here" if I just met you.  Really, unless you are my Dr., dietitian, nurse educator, or another trusted friend with diabetes I don't want to hear it.

3.) I look healthy on the outside.  That doesn't mean I am feeling good on the inside, either mentally or physically.

4.) Yes, diabetes is manageable.  Thanks for the reminder.  What people don't understand is the huge amount of work that goes into managing it properly.  Also, sometimes even with our best efforts to manage things and keeping out A1C's low, there still can be complications.  That doesn't mean it is our fault.

5.)  Type 1 Diabetes is not a disease "I gave to myself".  This is not something I "deserve".  I am not a burden on the health care system anymore than someone who has any other chronic illness.

Sorry if this sounds like an angry post but it is.  Over the past 8 or 9 months there have been too many times to count how angry I have been when people with misconceptions about diabetes feel the need to make their uneducated voices heard.  Sometimes it's funny but usually just a little unsettling.

Thursday, 17 May 2012

What magical diabetes thing do I need/want.  A cure.  A real one.  Not a machine.  Transplant success would be fine.  Hopefully this isn't that magical.

Wednesday, 16 May 2012

Be happy that you don't have low testosterone and diabetes.  Check out my low testosterone needle (the one with the beautiful pink ribbon) compared to my Humalog pen needle.  The good news is that I only need to take the low testosterone needle once every two weeks.  The bad news is that it hurts like hell!  Men with diabetes, get your testosterone checked, if you are lucky like me you may also get to experience the joy of getting one of these babies every couple of weeks!  I am being a little sarcastic but low testosterone and diabetes do go together so it is worth getting it checked out.  Sometimes the low T can be confused with depression and other illnesses.  Doctors don't always think of checking for it.  Mention it to them. 

Well, as a newly diagnosed diabetic there are lots of things I can improve on.  If I had to pick one then I would say it boils down to drinking.  I didn't drink a lot before I had diabetes but I did enjoy having drinks with friends on the weekends or after work. 

The guidelines that I was given were 1-2 drinks per day no more than 14 per week.  First question I asked was of course "Can I save them and carry them over like vacation days."  I said it jokingly, but really, why add "no more than 14 per week" to the guidelines if you can't save them up?  The answer was of course no. 

So I have cut back on my drinking, in the end it just isn't worth it to me when I weigh the risks of complications and hypos vs. the rewards of having a few extra drinks.  I still have the odd glass of wine with supper and have a few beers with friends on the weekends but I try not to take it too far.  When I do drink, I eat extra carbs and test myself constantly.  Better safe than sorry.

Tuesday, 15 May 2012

So today's post is about one thing in relation to diabetes that I do well... hmmm.  I haven't given in to an all out week long sugar binge yet... mmm, not good enough.  I do have a recurring fear/fantasy of this though.  Regardless, one thing I know I do well is staying prepared.  It is really no thanks to me but to my wife.  She is a very organised person and she has good ideas when it comes to being organised and a trick so I can never leave home without my diabetes bag.

I have a men's shaving kit that I keep both of my Humalog and Levemir in as well as my testing kit, extra needles, glucose tablets, liquid glucose that people can squirt in your mouth if they find you passed out, hand sanitizer, hard candies, the dreaded glucagon and last but not least my car keys. 

The car keys are the trick.  I have a push button start on my vehicle so if I leave the key in my diabetes bag I can't start my car without it.  That means no leaving the house without my diabetes kit.  My car won't let me lock my keys in the car, so when we park it and go anywhere I have to take the bag with me. 

Monday, 14 May 2012

Since being diagnosed as a type 1 dibetic last summer only recently have I come to discover the great amount of blogs about diabetes out there.  Some have been especially helpful and interesting.  Those include ...

and most recently...

All have great things to say.  They all have interesting ideas and comments, things I can easily relate to and some things I would never think of.  As far as I am concerned with this disease, all the information I can get is great.

Saturday, 12 May 2012

Having diabetes forces you to be organised.  If you aren't organized you are going to get into trouble fast.  For me my organization happens at two main times.  Every night at 10:00 pm and every Tuesday at 10:00 pm. 

I have my Iphone alarm set to go off at 10:00 pm. every night.  At that point in time I stop whatever it is I am doing.  I grab my diabetes bag and take my levemir shot.  I empty out my Humalog case for any used needles/garbage that comes along with taking 3-4 Humalog shots a day.   Then I replace the used needles with new ones.  I also put one extra needle in my Levemir case if needed.  I check the insulin levels in my pens and make sure there is enough for the following day.  At this point I check my blood glucose and make sure I have enough testing strips for the following day.  All of this takes about 5 minutes.  By doing this I eliminate the fear of not having any needles or not enough insulin when I am going through the next day. 

On Tuesdays after I have done that little chore I set up my prescriptions for the week.  I have a pillbox that goes for everyday of the week both AM and PM.  I put everything in there.  From my multivitamin, to my Crestor, to my fish oil.  At the same time I check all of my prescriptions and make sure I have enough of everything to get through the following couple of weeks.  This means checking all of my drugs including insulin, my needles, lancets, sharp containers, etc. 

Following this program helps me take some of the stress out of my life.  As diabetics we have enough to worry about and it can get easy to foget to check to make sure you have enough needles for the day before you leave the house.  Following this program has helped me, hopfully it can help you as well or give you some ideas as to how to make your life a little easier.   

Thursday, 10 May 2012

So with this meal I went with a salad.  I have been eating a few more of them lately but only if they can actually satiate me so I don't go nuts at the fridge later.  This meal definetly has some fat content in it being the sirloin, blue cheese and pecans.  Keep in mind the fat in the pecans is the "good fat" and they have lots of fiber.  Plus, the sirloin and blue cheese give me a good excuse to pour a good Cabernet Sauvignon!

Ingredients in this meal...

2 cups of mixed greens (3 g of carbs)
1/2 a cup of cherry tomatoes (3 g of carbs)
1/2 an anjou or bartlett pear (11 g of carbs)
2 Tbsp of toasted pecans
2 Tbsp of crumbled blue cheese
2 Tbsp of store bought yogurt based blue cheese salad dressing (3 g of carbs)

Total Carbs : 20 g of Carbs 

Wednesday, 9 May 2012

Well today I put some pork tenderloin on the grill. A fairly lean meat. We had some leftover Quinoa from yesterday so we used that up. And of course had our little side salad to go with it. Grilled zucchini is delicious, just put a tiny bit of olive oil on it, some salt and pepper and throw it on the grill. Keep your eye on it though, it can burn quick!

Ingredients for today's meal of Pork, Zucchini and Quinoa

1 cup of Quinoa - (35 g carbs)
1 6 oz piece of pork tenderloin
1 small zucchini cut into 3 lengthwise (2 g carbs)
Mixed Greens with 1 tbsp Italian Dressing (1 g carb)

Rub for Pork Tenderloin

1 clove of garlic minced
1 tsp of extra virgin olive oil
1 tsp of dried Italian Seasoning, (oregano, basil, rosemary)
Salt and pepper to taste

Total Carbs - 38 g Carbs

Tuesday, 8 May 2012

Today's quick and easy supper is tuna steak on the BBQ with grilled bell peppers, quinoa, and a small side salad.

BBQ Tuna Steak (0 carbs)
1 Cup of Quinoa (35 carbs)
1 Bell pepper roasted (6 carbs)
Side salad mixed greens ( 1 carbs from 1 Tbsp Renee's Mediterranean salad dressing )
Lemons for flavour on the tuna

Tuna Marinade for 2 Tuna Steaks

2 Cloves of garlic
1 Tbsp Lemon Zest
2 Tbsp Soy Sauce (1 carb but 900 mg of sodium)
1 Tbsp Rice Wine Vinegar
1 Tbsp Sesame Oil (0 carbs but 9 g of fat)
Pepper to taste

Total Carbs 43 grams of carbs per serving.

First off I have to say that I realise what we eat as type 1 diabetics is not as restrictive as what type 2 diabetics deal with. Most of us use carbohydrate counting and hopefully this will aid with that. Type 1 diabetics generally have more complications so it is still important that we eat a variety of healthy nutritious foods to keep ourselves in good shape.

These are not actually meal plans they are just what my wife and I are making and consider them to be relatively healthy and tasty. I am not a health nut. I am not going to say that all of these meals are super healthy and have no fat, no carbs, crazy amounts of vitamins and minerals, they are just what I see as reasonable meals. I will post the full meal here and then possibly a picture of it. Then I will break it down.

I am going to attempt to list the nutritional info for each meal. This should help us with our carb counting. For those of us that have other health issues to watch related to food it should be a help as well. (At least that is what I am hoping.) For now I am just going to list the carbs per ingredient and for the total meal.  When I say the amount of carbs it is Carbohydrates - Fibre = Total Carbs.

Then I am going to break down the meals into proteins, starches, and vegetables. That way you can substitute whatever you like, mix and match, etc.

Ambitious, yes, extremely I think. But, if it can help simplify my life and your life then why not give it a shot? This way I will have a good record of how many carbs are in many of my favourite meals and snacks. Hopefully others find it useful as well.

Saturday, 5 May 2012

Time to deal with the nutritional aspect of diabetes.  We all know it is important.  I think it is an individual choice and I am not going to give any nutritional preaching here.  I think we all probably get enough of that from our friends/family and best of all strangers.

How important is nutrition really?  My endocrinologist told me in my first meeting with him "no Coca-Cola and no french fries, don't drink a bottle of wine every night with supper".  Obviously he was being facetious.  But it brings up the question of how intense as diabetics do we have to be about our nutrition?  If you let it, it could take over your life. 

We have more to worry about with our nutrition than most people.  We have to watch the salt content, count the carbs, still make sure we are getting enough nutrients, getting our HDL's up through eating, etc.  Again, it is a lot of things to look out for and if you let it, it would be easy to spend hours a day just maintaining nutrition.

So what is the alternative.  Just give up and eat whatever you want?  Eat 200 grams of carbs with every meal and take 30 units of Humalog 4 times a day?  I think not. 

Friday, 4 May 2012

Carbohydrate Counting

When I was first diagnosed with type 1 diabetes my Dr. told me to eat 75 grams of carbs with every meal and to take 8 units of Humalog with every meal.  Breakfast, lunch and supper.  It was exhausting.  It's not easy to eat that many carbs all the time!  You get full.  It was a pretty rough two weeks to be honest.  Is this what I was going to have to do for the rest of my life? 

It reminded me of hearing all of those old stories of rigid diabetes regimens from the past.  Eat at 7:30 am. same thing every day, take 10 units of insulin, eat at 12:00 pm. everyday, take 12 units of insulin, eat at 6:00 pm. everyday, take 15 units of insulin.  Lucky you, today is boiled fish day.  Now go on your walk!  Yikes.

I have been trying to deal with my insurance companies over the past two weeks.  Probably one of the most frustrating times I have ever had.  I just spent 1.5 hours on the phone and I think I am actually worse off than I was when I started!  Unbelievable!!!!!!!!!  I know you all feel my pain.  At least it is almost the weekend!  I hope everyone has a great and healthy one.

Thursday, 3 May 2012

I didn't really want to post about this as it is seen as non-manly to have issues with testosterone but the fact is that many male diabetics suffer from low testosterone and some may not even know it.  So, here we go!

Time to add another complication to the list.  Low testosterone.  It is a strange phenomenon and they do not know why but men with diabetes have a much greater chance of having low testosterone. 

I hit the jackpot again!  Awesome!  I am 31and have low testosterone.  My testosterone level is 8 nmol/L.  The average range is 15 - 30 nmol/L.  Now for an 80 year old a doctor may not be too concerned about a man with low testosterone of 8, but for a 31 year old that is abnormally low. 

For my friends out there who are not on the metric system to convert 1nmol/L of testosterone I believe it would be = 28.843 ng/dL.  So the normal range I think would be about 400 to 900 ng/dl approx.  My level would be about 224.  That is an ugly number.

Enough with the math already!  As if we don't do enough of that everyday!

Wednesday, 2 May 2012

Well folks I have gone to the dentist and got my cavity filled.  The needle was way easier than even an insulin pen needle so that was good.  They also checked the rest of my gums and teeth and everything looks great.

What did come up in the appointment though was that I had to remind the dental assistant (who was awesome) that I had added one medication to my giant list and that I had taken one off. 

It is very important for all of your medical practioners to know what medications you are on at all times.  This would include your family doctor, your endocriniologist, your diabetes educator, your dentist, your chiropractor... everyone that has anything to do with your health in general.  This is crucial as the results of different drugs being combined can be catastrophic. 

We all know this but I am used to the practioners asking me if I have changed any medicines.  It is important for us to remember to update our medical teams even if they forget to ask. 


Another Amazingly Dumb Comment - From a Co-worker

Well, I went to visit my workplace today.  I was explaining to a co-worker that when I was diagnosed I lost a drastic amount of weight in a very short time. About 25 pounds in less than a week.  I was eating all sorts of junk food trying to keep on weight not knowing what was wrong with me.  This particular
co-worker is very understanding and we have a fairly close relationship.

Another co-worker, who I would describe as super vain is walking down the hall,  overhears me talking about this and comes into the office.  "That sounds awesome, I should get diabetes, I already suffer from hypoglycemia.  Why not go all the way?" 

An uncomfortable silence ensued between the three of us until she left the room.  My other co-worker and I just kind of looked at each other incredulously. 

Some people are completely self absorbed.  I had to hold my tongue in this situation.  I felt like asking her if she would also feel like her feet were going to burn off her legs everynight but I kept that one to myself.