#Type1Runs… or Plods

 

my feet in Sketchers

 

The half-marathon training continues… limps on, more like. My body repeatedly tells my brain this was not wise. Sheer stubbornness forces me on.

It heartened me to read of another type 1 saying her training veered between 20-mile runs that went well and three-mile runs that floored her. We juggle not only the effort of running with balancing blood glucose levels.

Too high and running turns into an activity that resembles wading through waist high treacle. Too low, and your calves seize up as your body goes on a glycogen hunt. Either way, both states bring you to a grinding halt.

Magic formula

The magic formula that is running with diabetes is akin to Google’s most complicated search algorithm. Factor in sleep, the previous few days’ average blood glucose levels, where you are in your cycle (if you’re a woman), what you’ve eaten, how much insulin you have on board, how much food you need before running, what foods provide the best fuel sources, how far your blood glucose levels drop and by what time spent running…

If you can work it out, you’re better at this lark than I am.

Exercise affects us not just at the time but for up to 24 hours afterwards. And if you’re exercising for more than an hour at a time, it becomes trickier to work out what you need to do with insulin and food.

Pilates and yoga

Bouts of activity that last half an hour to 45 minutes are relatively easy to manage. If you want to do more exercise than this, you can break your activities up—a walk in the morning and an easy jog in the evening, say. And plenty of Pilates and yoga thrown in for those nice stretch and flexibility benefits.

My vow is post September 30, I’m never doing a run longer than a 10k and my weekly runs won’t add up to more than nine miles, if that. Dear reader, I make myself accountable here.

Meanwhile, September 30 (the half-marathon date) hurtles ever nearer. Yikes!

 

 

My Favourite Health & Fitness Freebies

free sign on the Diabetes DietA continuous glucose monitoring system, the MiniMed 670G self-adjusting insulin pump, a personal trainer AND an unlimited food budget so I can buy organic, ethically sourced food all the time…

And, whoops—you interrupted me there in the middle of a reverie relating to the things I’d have to help me manage my diabetes if money were no object. The top of the range monitoring and pump therapy tech is obvious while the food and exercise one less so—but activity and an excellent low-carb diet can help you manage your blood glucose levels.

Stable blood glucose levels don’t guarantee you riches or the partner of your dreams, but a person who doesn’t ride the blood sugar roller coaster is far more energetic, and free to pursue what they want unhindered by the hell of mood swings.

In the meantime, what can we fiscally challenged diabetics do so we can fix our blood glucose levels to the best of our abilities? Here are suggestions for freebies that can help you manage your condition…

YouTube—otherwise known as the exercise channel in our house. Online, you’ll find tens of thousands of exercise uploads—from yoga to Pilates, barre classes, HIIT workouts and weight-lifting. You could spend several years working your way through them and not do the same workout twice. If you find gyms off-putting or their membership fees too expensive, YouTube’s perfect. Look for workouts that don’t need equipment either.

Start with walking workouts (Lesley Sansome’s Walk at Home channel is great). Fitness Blender’s videos are explained well, and the exercises done at a speed you can keep up with. Jessica Smith TV does a huge variety of workouts that offer different fitness benefits, and Heart and Soul Fitness does the same.

MyFitnessPal—there are studies that claim food tracking helps you maintain your weight. Food logs are useful for we diabetics too as they allow us to work out how much insulin we need for meals we eat regularly. MyFitnessPal has a huge database, but you can also add your own recipes and the site will give you a full nutritional breakdown of each.

MySugr – a free app for logging blood sugar results and additional information such as insulin does, exercise, weight, blood pressure and more. The app is useful, but if you don’t log for a day or so you will struggle to remember all the information you need to input for a complete picture of what is going on.

The internet—thanks to the world-wide web, there’s a wealth of information at our fingertips. As a teenager and twenty-something with diabetes, I only knew one or two others with the condition, and we didn’t meet up regularly to swap notes. Now there are forums, websites, charities, blogs, recipes and more online where we can find out more about the ol’ defunct pancreas problem.

A word to the wise… We all know the internet allows unprecedented freedom of speech, which is mostly for the good. But it’s also a place where information spreads unchecked. Blogs—and I include this one too—offer opinions and personal experience, which do not always equate to fact and recommendations suitable for you. Still, the Diet Doctor, Diabetes.co.uk, radiabetes.com and diabetesdaily.com offer gems. (I  apologise if I missed your great site out—limited room here.)

NHS 70 logo on the Diabetes DietAnd finally…drum roll… the NHS! Here in the UK, we folks with type 1 diabetes get free healthcare and prescriptions. I mump and moan occasionally about wanting the latest tech, but I’ve had diabetes for more than 30 years and in that time, I’ve never paid for medications, appointments or equipment. Our fabulous healthcare system has existed 70 years now. It’s shaky on its feet sometimes, but you can’t argue with the wonderful principles at its core—free healthcare for all, based on clinical need.

What are your favourite diabetes freebies? And what websites or blogs do you like?

The Good Ol’ Days of Diabetes

Ah, the good ol’ days of diabetes – glass syringes, peeing on sticks and rigid eating times.

cover of Artists Town by Emma BairdWe veterans remember them fondly and with the odd head shake in disbelief. Did it really used to be like that? by ‘eck, we have come far… Recently, I wrote a book, Artists Town, which features. a type 1 protagonist. My book is set in the early 1990s and life for we pancreatically-challenged has changed substantially since then.

My own diagnosis came in the 80s. Here’s what used to happen then. See if you remember any of this stuff, and newbies read it and gasp.

  1. Glass syringes. Yup! The environmentally-friendly option too, given the waste your average type 1 inadvertently produces these days.
  2. Urine, not blood testing. It was a lot less painful; a lot less accurate too.
  3. Dextrosol. Standard treatment for hypos were these chalky, horribly-flavoured, expensive sweets. After a while they turned rock hard too. When Lucozade tablets appeared on the market, I was in HEAVEN.
  4. Exchanges. Long ago, doctors and nurses taught us carbohydrate counting. One exchange was roughly 10g of carbohydrates and you were given an amount for every meal and snack. To make it simple, one tbsp. of cooked rice or potatoes equalled an exchange, as did a slice of bread or an apple.
  5. NO SUGAR. It astounds me that at some point post my diagnosis, advice for diabetics included ‘eat anything you want and cover it with insulin’. As a wee girl, doctors said no cakes, no biscuits, no sweet, ice-cream and watch out for sugar in ketchup. Nine-year-old me burst into tears.
  6. Tab – the only no-sugar fizzy drink on the market. It tasted of grapefruit. The no-sugar market exploded in the mid to late 80s.
  7. The all-knowing doctors. In the 80s, doctors were still viewed as all-knowing, authoritative figures and you didn’t question them when they told you why you were having so many highs/lows. They were the experts. Your day to day experience of living with diabetes counted for naught.
  8. Fruit salad. Young me got offered a lot of fruit salad for dessert – the world’s worst pudding when it comes to taste, and not that great for your blood sugar levels anyway. I haven’t eaten the stuff in decades.
  9. Terrible chocolate and carob bars. Boots had a line of chocolate they advertised as suitable for diabetics. It was a) not very nice and b) little better than the real stuff for blood sugar control. And as for carob bars… carob is one of those acquired tastes, and I never got it.
  10. Two (count ’em) injections a day. This is the one that will astound the newbies, what with today’s regimes of multi-daily injections or pump therapy. I took one long-acting and one-medium acting insulin, mixed together twice a day. This meant meal times had to be the same and stuck to every single day. While flexibility is nice, sometimes I think there are advantages to rigidity. “Sorry, I need to go. If I don’t eat now, I’ll collapse” – a great excuse to get out of anything.
  11. Thrift. My mum and I used to cut up my blood testing sticks to make them last longer, possible then because you measured your blood sugar level by comparing the colour the pad on the stick turned to a chart on the tube. We cut them lengthways, a fiddly but effective job.

Artists Town is now available for pre-order on Amazon.com and Amazon.co.uk Please note – this book contains adult content and strong language. 

Sausage, Pepper and Red Lentil Casserole

Plate of sausage casserole on The Diabetes DietProving once again, a low-carb diet can be plant-based*, I bring you the sausage, pepper and red lentil casserole!

My ‘beef’ (see what I did there) with the hi-jacking of the term ‘plant-based’, is that it’s assumed to mean vegan, whereas I’d argue you can eat meat, fish and eggs and still have most of your diet made up of plants.

Sausages and lentils have a long dating history. The French twin them together for cassoulets as lentils soak up meat juices and add cheap bulk to a dish. Bulk’s important to me. Who wants a small bowlful of food when you can have a big one?

The better quality your sausages, the better the finished dish. The casserole is great with buttered cauliflower or broccoli. Or you could add another 250-300ml of vegetable or chicken stock to turn it into soup.

And a cheeky helping of grated cheese on top always adds extra deliciousness.

Sausage, red pepper and lentil casserole

  • Servings: 4
  • Difficulty: easy
  • Print

  • Two peppers, insides removed and chopped
  • 100g celery, sliced finely
  • 100g mushrooms, sliced
  • 75ml red wine
  • Four, good quality pork sausages, each cut into chunks
  • 75g chorizo, sliced
  • 75g red lentils
  • 2 cloves garlic, crushed
  • 400g tinned, chopped tomatoes
  • 1 chilli, chopped (optional)
  • 1tsp smoked paprika
  • Salt and pepper

Put everything into your slow cooker, stir well and put on the high setting for four hours.

The mix makes a soupy casserole because it’s done in the slow cooker. You might want to take the lid off yours for the last 20 minutes to get rid of some of the excess liquid.

To make the recipe on the stove, use a large saucepan. Place the chorizo slices in the pan, then turn on a gentle heat so the oils from the sausage run out. Add the other sausages, celery, peppers, mushrooms and garlic, mix well and cover. Cook over the gentle heat for ten minutes. Add the tomatoes, lentils, red wine, chilli and paprika, stir well and bring to the boil. Turn down to a simmer and cook for a further 30 minutes, mixing from time to time.

In both instances, add salt and pepper to taste.

Each portion has 17g carbs and 4g fibre.

*And also that my food styling and photography skills get no better.

 

#Type1Runs—Race Report

Paisley 10k medal at The Diabetes DietAh, Instagram abounds with diabetics who perform superhuman feats of athleticism while battling their blood sugar levels at the same time.

Not me. I’m here as your bog-standard ordinary gel whose only prize ever will be persistence. Did you note I got a massive disclaimer in there before going on to write about my latest race?! I like to make sure I’ve lowered the audience’s expectations before I start.

Anyhoos, for those of you still reading, here it is. On Sunday, I ran another 10k in preparation for the BIG ONE (the half-marathon) next month. Conditions were much more promising than the last time. Back in June, Scotland experienced an unprecedented spell of warm weather. Plus, that course was hilly. And I woke up that morning with a blood glucose reading of 13.1.

Scottish summer

In theory, the Paisley 10k should have heralded a vast improvement. I’ve been running for longer, the back-to-usual Scottish summer conditions (dreich, grey and cool) were present, and the course is flatter.

Still sensing that disclaimer?

Bah, humbug dear readers. I added three minutes to my previous time. Not only that, the online system was cruel enough to remember I took part in the Paisley 10k ten years ago when I achieved my personal best. There it was, my 2008 time taunting me with its nine minutes faster brilliance.

Sprint finish

For those who want the numbers, I awoke on Sunday morning with a blood sugar of 8.5 (I’d knocked one unit off my basal rate the night before). Half an hour before the race, I was 8.1. I ate half a Hike bar before starting (10-15g carbs) and I finished the race at 11.1, possibly because I put on a sprint finish. Nothing like pretending your race pace is much faster than it really is.

I didn’t take insulin afterwards, ate the second half of the Hike bar and went off for a session in the sauna. An hour later, my blood sugar level was 4.9. A massive portion of battered fish and mushy peas later (I know, NOT low-carb), further low blood sugars and indigestion kicked in*… 3.3 one hour after the meal, 5.8 two and half hours later.

Lessons to take—eat more. Try something other than a Hike bar. Drop the daytime basal injection rate. Keep practising. Keep experimenting. Expect fluctuations and weirdness.

All shapes and sizes

Mass running events are special though. I’d recommend everyone takes part in at least one if they are able to—and these days there are loads of 5ks and even 3ks you can do. You see all shapes, sizes and abilities (and the two former don’t predict the latter), the crowds cheer you like a champ and even a slowcoach like me will overtake enough people to feel gratified**. The runners’ high exists.

Now, time to take off my medal. It is two days later after all.

Low carb diets ‘could shorten your life’

diabetes diet by Emma Baird
Avocado, mushrooms, bacon and salad – plant-based.

And now for something completely different… Last week, headline news suggested low-carb diets were dangerous—more likely to lead to an earlier death.

As it’s a rare week, some nutritional or lifestyle study doesn’t hit the news, I sighed. “Oh, whatever.”

I don’t have the skills or knowledge to interpret the data, but two websites I trust have commented on the studies (and more importantly, the way they were reported). You can read them here:

https://www.dietdoctor.com/all-over-media-low-carb-diets-could-shorten-life

https://www.diabetes.co.uk/news/2018/aug/new-low-carb-link-to-life-expectancy-should-be-interpreted-with-caution-99971624.html

 

*Was worth it.

**One of whom wore a tee shirt saying Vegan Runners. Just sayin’.

Lamb, Hummus—an Ethical Eating Experience?

a picture of chunks of lamb marinating in a dish by The Diabetes DietCan you be an ethical carnivore? I asked the question in a post a few weeks ago as I’ve been reading The Ethical Carnivore – My Year Killing to Eat by Louise Gray.

The one-time vegetarian in me wants to feel that the food choices I make cause minimal suffering and don’t impact the environment as negatively as factory farming does. At the same time, I like following an omnivorous diet and think that is the best possible health choice.

So, what to eat?

Eat less meat

I believe in what small-scale producers do. They deserve our support, but their products are expensive and more of an effort to seek out. As many people have discovered before me, the answer is to eat less meat, which is what most people did in years gone by, and buy the best quality you can sourced from farms that treat their animals with respect and dignity.

Chicken, pork and beef are all problematic unless you buy them from farmers’ markets and small co-operatives because of the ways they are farmed before they are killed. The same applies to dairy. As for fish, most of the stuff in supermarkets comes from fish farms and/or is sourced from far-away countries, making it an environmentally unfriendly choice.

Unlike Louise Gray, I can’t bring myself to directly kill anything, hypocritical as that is. But I’m open to eating a lot less meat, trying out plenty of low-carb vegetarian dishes and including more beans and pulses in my diet.

Lamb – the ethical choice

I’m also happy to continue eating lamb, as the production of lamb doesn’t lend itself easily to factory faming. And there are sound arguments for it here. If you want to eat lamb in this country, it can be a challenge sourcing the UK stuff (an irony that appals me as a farmer’s daughter) because most supermarkets import New Zealand lamb.

Nevertheless, if you do find it, lamb lends itself to many delicious dishes, including this one – lamb with home-made hummus. This amount makes enough for two to three dinners.

a pot of hummus made by The Diabetes DietFor truly velvet-y hummus, you should take the skins off the chickpeas. I’ve done it—once—and it makes quite a difference. But it’s a tedious job. Skins-on chickpeas will still make a fabulous-tasting dish.

Lamb with Hummus

  • Servings: 2-3
  • Difficulty: easy
  • Print

  • 2 lamb leg steaks, chopped into equal sized chunks
  • Juice of a lemon
  • 2 cloves garlic, crushed
  • I green chilli, sliced finely
  • 1 tbsp sumac
  • Rapeseed oil
  • 1 tin chick peas, drained
  • 3tbsp tahini
  • Salt and pepper

Mix the chopped meat in a bowl with a tablespoon of the lemon juice, salt and pepper, the sumac, chilli and one of the cloves of crushed garlic. Set aside to marinate for at least 30 minutes, though a couple of hours will benefit the dish.

Blend the garlic, lemon juice and tahini in a food processor so a minute or so to get it as smooth and combined as possible. Add the drained chickpeas and two tablespoons of rapeseed oil. Mix well. Add a tablespoon of water if you feel the mix is too thick. You can also use a hand blender to make the dish.

Heat a tablespoon of oil in a frying pan and add the meat. Cook over a high heat—the meat will take about five to ten minutes.

Serve with the hummus.

My carb-loving husband made his own flat breads to go with this, but it’s fine just as it is with a salad on the side—perhaps a Greek one to continue the Mediterranean theme.

Allow about 8-10g carbs per serving.

 

 

Brexit and Insulin Shortages

a plstic box c ontaining insulin on The Diabetes DietInsulin shortages and low-carb dishes—no obvious connection, I grant you but bear with me.

The first relates to a news item on Channel 4 last night, which warned of insulin shortages post-Brexit in the UK as the country produces little to no manufactured insulin (apart from a factory which makes the stuff derived from pigs).

Sir Michael Rawlins, the chair of the Medicines and Healthcare products Regulatory Agency, told the Pharmaceutical Journal last Friday that, “We make no insulin in the UK. We import every drop of it. You can’t transport insulin around ordinarily because it must be temperature-controlled. And there are 3.5 million people [with diabetes, some of whom] rely on insulin, not least the Prime Minister.”

412,000 people on insulin

Strictly speaking, that’s no true as the Channel 4 story pointed out. Wockhardt UK produces the animal insulin, but its products are used by some 1,500 to 2,000 patients every year. And that’s less than 0.5 percent of the estimated 421,000 people in the UK who rely on insulin.

Channel 4 News spoke to the major manufacturers, Sanofi, Novo Nordisk and Lilly. All of them make insulin in Europe.

The Healthcare Distribution Association (HDA) UK which represents medical suppliers in the UK wrote to the UK Government post the referendum in 2016 to warn of serious upsets to the supply chain should Brexit negotiations go wrong.

Buffer stocks

HDA UK said the UK medicines supply chain had “inbuilt resilience” and “flexibility”, and that they were aware of proposals by the government and manufacturers to develop plans for a buffer stock of all medicines.

A spokesperson for the Government said they were confident of reaching a deal, there were contingency plans in place to ensure no disruption to supplies.

Channel 4 News’ fact check conclusion is that as the companies and the Government don’t anticipate shortages, we should be okay.

Back to low-carb recipes and my tenuous attempt to link the two. If you follow a low-carb diet and you use insulin, in general you don’t need to take as much insulin. If shortages come, you’ll have more time to use your insulin while the powers-that-be attempt to sort out this almighty mess.

Cue plug for this blog and The Diabetes Diet! Is that distasteful of me?! Probably.