Education on Diabetes

The Menstrual Cycle and diabetes

The menstrual cycle can make sugar levels harder to control. Keep reading to find out why, and my tips for diabetes control.

How does the menstrual cycle impact blood sugars

The majority of girls living with type 1 diabetes will notice that their blood sugars rise around 7-5 days before their period starts.

This is due to a rise in the hormone progesterone. Progesterone builds the lining of the uterus before it shed during the menses.

Progesterone increases blood glucose because it reduces insulin signalling (causing some insulin resistance), as well as increasing glucose release from the liver.

Blood sugars usually return back to normal within the first couple days of bleeding, due to the rise in oestrogen.

This is what happens to the majority of women, but some may find that their blood sugars are lower, or not impacted at all (this is quite rare).

How to support blood sugar balance during this phase

tracking menstrual cycle

There are quite a few ways to support blood sugar balance during this time. We want to focus on promoting insulin sensitivity.

The first thing I recommend is to track your menstrual cycle. Take note of your cycle length (bleeding around every 28 days). Write a reminder in your diary a week to five days before so you expect to see your levels rise.

Now you will know why your blood sugars are being more difficult to control and you can implement some changes.

1.Adjust your insulin dose. – Look at your doses and slowly increase them if necessary. You’ll need to trial and error how much insulin you need, and whether increasing your basal or bolus works better for you.

*For example, a week before I’m expecting my period, I’ll increase all of my rapid doses by around 1-2 units. I have tried increasing my basal over a few days, but I find it sends me into a hypo. You have to juggle doses around, and stick to what works for you!

2. Watch your carbohydrate intake – Make sure you are paying extra attention to what type of carbs and how many carbs you are eating. Carb counting can come in very handy!

*For example, I notice if I eat more than 40-50g of carbs in one go, my sugars can get very stubborn. I also try to stick to complex carbs to avoid rapid blood sugar spikes.

relax - menstrual cycle

3. Try to reduce stress levels – If we are stressed, the body will secret more cortisol, which can also cause blood glucose to rise. So prioritise time to rest and relax!

4. Walk! – Gentle forms of cardio will really help to promote insulin sensitivity. Go for a walk after your main meal in the evening. Walking outdoors also helps us to unwind and relax after a busy day.

Irregular periods

If you have irregular periods it can be much harder to keep track of your sugar levels.

My best advice is to note down every time you have a period, and contact your doctor so they can help and advise you.

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If you liked this post, be sure to check out Top tips on alcohol consumption and diabetes control! and Metabolic syndrome 101!

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Diet, Education on Diabetes

The Keto Diet and Type 2 diabetes

The keto diet can help the management of type 2 diabetes. Make sure you have read The Keto Diet 101 before reading the rest of this post!

How eating keto can impact blood glucose

Quite a lot of people living with type 2 are overweight, so eating a high fat diet might seem confusing and unhelpful.

red meat - keto diet

The reason the keto diet can be useful in type 2 is because it causes our body to use our fat stores for energy, rather than glucose.

Eating high fat and reducing carbohydrate intake can help to promote weight loss and regulate blood sugar levels. It is important to distinguish between the types of fat you should be consuming if following the keto diet. Avoid having a diet high in red meat and processed/packaged foods. These foods contain high levels of saturated fat, which we do not want too much of.

Instead, prioritise eating extra virgin olive oil, avocado, nut butters, nuts and seeds and hummus for example.

Things to consider

Eating keto also promotes gluconeogenesis (when the body makes glucose from other sources), and can cause an increase in cortisol in some people. In other words, gluconeogenesis and high cortisol can also cause blood sugar levels to spike.

For this reason, eating keto can make little difference to sugar levels and can leave some people feeling fatigued. While the keto diet can be helpful for some, it is not a ‘cure all’ (no diet is!).

nutritionist - keto diet

There are other diets that can help to drastically lower blood glucose in type 2 diabetes. This can include increasing high quality fats and proteins, and swapping to lower GI carbohydrates. (I.e. reducing carb intake, but not as drastically as when eating keto).

Trial and error is the best way to figure out what dietary model suits you best. Some people living with type 2 love the keto diet and reap the benefits. So giving it a go may be worth it.

If you have been diagnosed with pre-diabetes or type 2 diabetes, changing your diet is vital for your health and the management of your blood glucose levels. So chat to your doctor and see a nutritionist if you can. This is the best way to figure out which diet is best for you, and it is a decision you need to make.

Thank you so much for reading The Keto Diet and Type 2 diabetes! I hope you found this useful and it answered some of your questions! Be sure to subscribe and follow me on Instagram!

If you liked this post, be sure to check out Gluten – what is the big deal? and How to remove gluten from your diet

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Education on Diabetes, Top Tips

The Morning Phenomenon

Some people living with diabetes struggle with the morning phenomenon (AKA – high blood sugars in the morning). This can be confusing as we don’t expect our sugars to rise when we are sleeping and not eating.

There are a couple of different causes of the morning phenomenon, so here is everything you need to know, as well as how you can help to prevent it!

Hormones

morning phenomenon

In the morning the body secretes cortisol and growth hormone. Both hormones cause blood sugar levels to rise to give us enough energy to wake up. Of course people living with diabetes either cannot make insulin, or have insulin resistance. Therefore too much sugar remains in the blood.

Morning spikes can cause fatigue as it interrupts energy delivery, so it is something we really want to prevent.

The best way to combat this is to look at your basal insulin. Take a look at your dose with your doctor and they can help to recommend a different dose, or perhaps a better time to take your basal insulin.

Waning insulin

Another cause of the morning phenomenon is not having enough insulin in your blood to last the whole night. Of course this will result with higher sugar levels.

Again, taking a look at your basal insulin is the best place to start. If you take your basal in the morning it may not last until the following morning. You and your team may decide to increase your basal dose, or even consider basal splitting. This is when you take the basal in divided doses so you have enough background insulin 24/7.

The Somogyi effect

hypo snack - morning phenomenon

The Somogyi effect is when a low blood sugar in the night causes a rebound high blood sugar. The body is overcompensating for the low blood sugar, and releases too much sugar into the blood.

The best way to prevent the Somogyi effect is to prevent the hypo in the first place. So make sure you eat enough carbs with your evening meal and try to limit exercise late at night. Always check your sugars before going to sleep, and I advise having a snack if you are below 5.0mmol/L.

My final tip is to have a portioned hypo snack by your bedside. This will prevent you over-treating a hypo during the night.

Thank you for reading the Morning Phenomenon, I hope this was useful! Be sure to subscribe and follow me on Instagram!

If you liked this post, be sure to check out Exam stress and sugar levels and Summer travelling tips


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Fitness, Top Tips

How to handle a hyper mid-workout

When our sugar levels spike during a workout it can be super confusing and we are left not knowing what to do. Here are my tips on preventing sugar spikes and how to correct it!

Why do hyper’s hit mid-workout?

why hyper's can hit mid-workout

One of the main reasons a hyper hits mid-workout is due to adrenaline.

Your body secretes adrenaline to increase your heart rate and increase oxygen delivery to working muscles. Adrenaline also increases glucose release into the blood so you have plenty of energy to workout.

Normally, small amounts of insulin would be secreted from the pancreas to ensure glucose can be used as energy. Of course people living with type 1 diabetes cannot do this, so we must adjust our prep.

The aim of the game is to find trends during exercise, e.g. when you spike, when you drop and what helps you to stay in range.

Don’t panic if you get it wrong, sometimes we have to make mistakes to learn. I used to get it wrong all the time and it would result in me having to stop my workout.

Prepping to workout

There are so many factors to consider when prepping to workout, some to consider are:

sleep - hypers during workout
  • The type of exercise
  • Nutrition
  • Insulin doses
  • How much you slept on the previous night
  • Recent alcohol consumption
  • Stage of menstrual cycle

In order to get your prep right, you have to record and learn how certain factors impact your sugar levels. For example, if I sleep less than 7 hours the night before weight training, I can expect my sugar levels to spike. I have noticed this time and time again, therefore I know my workout prep requires more insulin.

The menstrual cycle is a big factor for women to consider. Sugar levels tend to spike at certain stages, so it is a really good idea for women to track their sugar levels over a few months and apply what is noticed.

In summary, take a few weeks/months (as long as you need) to track how your sugar levels react to situations. You can then adjust your nutrition, training method and insulin dose to accommodate and keep your levels in range!

Correcting a hyper mid-workout

cardio - hyper's during workout

We need to be careful not to over correct here, the last thing we want is to drop into a hypo!

The type of workout I’m doing decides how I treat high sugars.

If I’m weight lifting I will inject a bigger correction dose (usually 1-2 units) and swap to cardio based exercise until my sugars come back down.

If I’m doing cardio and spike (this is pretty rare for me), I will inject a smaller dose (1/2- 1 unit) and continue with cardio.

When sugar levels spike above 13mmol/L I would recommend stopping your workout and continuing once your levels return to normal. This rarely happens to me, but if it does, I will calculate a correction dose and go for a slow walk. This is how I treat hyper’s normally.

If your sugar levels consistently spike while working out, you need to bring this up when you see your consultant. They will help you make a plan and can give you tips on how to calculate your insulin doses based on your sugar level data.

wood love summer writing

Thank you for reading how to handle a hyper mid-workout! I hope you found this useful, be sure to subscribe and follow me on Instagram!

If you liked this post, be sure to check out How to handle a hypo mid-workout! and my Simple guide to fitness with diabetes!

Education on Diabetes, Top Tips

5 ways to handle high carb meals

Sometimes all we fancy is a nice burger and chips, but the anxiety of our sugar levels spiking stops us.

Here are my top 5 ways to handle high carb meals, so you can eat that cheat meal and stay in range!

1. Nail your insulin to carb ratio

Finding your insulin to carb ratio should be part of your consultation with your endocrinologist.

Insulin to cab ratio is essentially how many units of insulin you need per 10 grams of carbs. If you know this number, it makes it 10x easier to figure out how much insulin you need for each meal.

If you are unsure of your ratio, be sure to ask your consultant at your next appointment!

2. Pair it with protein and good fats

Having a balanced meal with carbs, protein and fat is essential. The presence of fat and protein slows down the digestion of carbs, slowing down the absorption of sugar. This really helps to keep sugar levels balanced post mealtime.

So ensure you are having a portion of protein – a palm sized portion of meat/fish/tofu, or 2-3 eggs for example.

Also ensure you are consuming good fats with your meals – by good fats I mean unsaturated fats. E.g. extra virgin olive oil, avocado, hummus, nuts, seeds etc.

3. Staying active is your bestie

walking - high carb meals

Another trick I like to use when eating higher carb is to walk post meal.

I like to go for a leisurely walk with my family/friends for around 30 minutes, or until my glucose comes back down into range. I will usually begin walking when my glucose goes above 9mmol/L with sharp rise (arrow pointing up on my FGM).

This not only keeps sugars balanced, but it is also a lovely routine to get into for socialising and for mental health!

4. Go for brown carbs

 brown rice- high carb meals

If you can, opt for brown or wholegrain carb sources. I know this is harder when eating out, so don’t sweat it if you can’t – it is fine to eat white carbs every now and then!

The reason I recommend brown carbs is because they contain higher amounts of fibre, protein, essential fatty acids and micronutrients than white carbs.

Therefore, opting for brown for the most part of your diet is adding essential nutrients!

5. Give your insulin enough time to kick in

Another tip I have is to give your insulin enough time to kick in. This amount of time varies between individuals, but it is a tip that has helped me so much!

Before higher carb meals (for me that is 60g of carbs or more) I will inject about 20 minutes before eating. – This works wonders for me, if you want to try out this tip I recommend starting slowly to avoid hypo’s.

So start with injecting 10 minutes before eating, then increase or decrease this time if you spike afterwards. Set a timer straight after you administer the insulin so you know exactly when to eat!

Experiment and adjust this time until you find what suits you! – Using an FGM or CGM is especially helpful for this!

timer - high carb meal tips

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If you liked this post, be sure to check 5 ways to improve digestion! and 5 Easy ways to lower your HbA1c!