The Five Best Low-Carb Hacks

Here at the Diabetes Diet, we’re fully on board with the making life easier message. Living with diabetes is like supporting a part-time job on top of everything else in your life.

And boy, if we were unionised, we’d revolt against the lack of time off and sick pay (ha!), and work conditions that are an uphill struggle all the time… One of the reasons low-carb diets make life easier for the sugar-challenged is that we don’t have to spend ages figuring out how many carbs are in particular dishes and how much insulin we need to cover them. Meat, sauce and salad is a lot easier to work out than meat, veg, roast potatoes and a Yorkshire pudding.

So, with that in mind, here are our favourite hacks:

Make your home carb-proof

bar of chocolate on the diabetes diet
Get thee behind me, Satan…

If it’s not there, you won’t miss it. Temptation comes in many forms, but it’s much easier to ignore the siren call of crisps or chocolate if you don’t keep them in the house*.

Have easy meals

If you can master the omelette, fried fish, steaks, burgers or open a tin of tuna, mix it with mayonnaise and tip it on a bed of crispy salad, you’re laughing. Diabetes makes you tired. Have some go-to super-fast meals you can make quicker in the time it takes to order and wait for a take-away.

Eat two starters when out

Starters tend to be lower in carbs than main courses, so go for two of them. Three, if you are very hungry.

Stock up on low-carb snacks

Cheese, olives, unsalted nuts, hard-boiled eggs… all help satisfy cravings and have plenty of protein for satiety.

Try some of the substitutes

To be honest, I’ve yet to meet the low-carb bread recipe that convinces me, but some of the baking ideas might work for you. Bread, cakes, biscuits and even fudge are out there so why not give some of them a try?

*Reader, all too often I slip on this one. Or do that thing where I buy crisps or chocolate for my other half, kidding myself that they are for him. No, no, not me oh luscious purple-foil wrapped packet…

Should I stockpile insulin ahead of Brexit?

insuline supplies on the Diabetes Diet website

I picked up my repeat prescription this week, and asked the all-important question. By the time I’m ready for the next one, Brexit is supposed to have taken place*. Will the UK’s insulin supplies run out?

As one of life’s optimists, I tend to ignore worst-case scenario planners, which makes me either naive, stupid or just someone who prefers to live in the now, as worrying about the future and events I have little control over seems pointless. It’s likely I’m all three.

Anyway, at the pharmacy I asked the chemist if I should stockpile insulin, seeing as very little of it is manufactured in the UK and insulin seems to get mentioned in the same sentence as food whenever people talk about stockpiling. As it happens, I have lots of one particular insulin, the rapid acting stuff, while my supplies of the long-acting stuff needs regular replacing. If the worst comes to the worst, I can beg an insulin pump from someone and use that…

No-one’s talking about it…

“If they are stock-piling, no-one’s talking about it,” the chemist told me, “And we’ve heard nothing officially.”

She didn’t then add, “If I were you, though, I’d make sure you’ve got four months’ supply at least and contemplate taking your diet as low-carb as possible so you don’t need as much.” I’ve made that advice up, obviously, but she didn’t add any caveats so either someone higher up in the medical supplies chain has decided on a policy of silence or the fears aren’t justified.

Ms Stupid/Naive/Live in the Moment has decided to leave worrying about her insulin supplies for now. There are many other factors which could affect insulin supplies in the future too—climate change, fuel shortages, war or the Zombie apocalypse, coming to a town near you all too soon.

And of course, the biggest factor is the soaring rates of type 2 diabetes. According to a recent report, about 33 million people who need insulin currently do not have access to the drug. That figure is expected to rise to 41 million by 2030. A lot of these shortages apply to people in Africa and Asia where increasing urbanisation, more sedentary lifestyles and changes to diet have led to soaring numbers of type 2 diabetics. In the States, however, insulin shortages also affect the population as prices have risen sharply over the last few years. Three companies dominate the market, and proof once again that free market systems seldom contribute to the greater good.

*And goodness knows what will happen on the 29th.

Making Sundays Special

roast pork on the Diabetes Diet
Roast pork – eat this to make your Sunday special… (recipe Ministry of Food, Jamie Oliver).

New Year’s resolutions? Pah! One, you can makes changes any time you want, and two, most of us see them as miserable—the lose weight, take up punitive exercise regimes kind. In this part of the world, January is a challenging month. The weather’s dreich, the nights are long and the pennies few and far between. Who wants to add starvation and exhaustion to the mix?

One resolution I do intend to stick to is my campaign to Make Sundays Special again. Years ago, my husband and I used to make a point of doing something on Sundays. He works most Saturdays, so the Sundays were the one day a week we could visit castles, go to Edinburgh, take the motorbike out for a spin, bike to Balloch, drink too much and cycle back via the main road while piddled*. Last year, we fell into the habit of doing nothing. He’d be downstairs catching up on Colombo (why, why, why?), and I’d hide away upstairs working or writing. We added doing the supermarket shopping to a Sunday. As I love food, I don’t mind the supermarket shop but does it belong on a precious day off? I think not.

Cut the screen time

In 2019, I’ve vowed to spend less time in front of a screen. I’m there for work and as a hobby, and I dread to think how many hours I spend hunched over my laptop. On the plus side, I use a standing desk so it’s not as sedentary as it could be. On the other hand, it’s still not healthy. Time to reinstate the Sunday activities, such as:

Ben Lomond

I have Ben Lomond in my sights. Hill climbing is one of the best activities you can do in Scotland. The Munro is right on my doorstep, and the shame is I’ve yet to climb it.

Three Lochs Walk

I’d also like to walk from Balloch to Helensburgh with Sandy. I’ve done it a couple of times with my friends, and it’s a fabulous walk because of the views you get of Loch Lomond.

Linlithgow Palace

We’re members of Historic Scotland and we’ve yet to visit Linlithgow Palace so a train trip there and a pub lunch is in order.

Uni tour

The University of Glasgow offers walking tours. As I work there, it will be fascinating to find out more about this iconic Glasgow building. Another tour that has always piqued my interest is the one you can do of Glasgow Central station. If I book now, we might get there in the summer. (It’s terrifically popular.)

Sunday roast

Roast pork, the before version.

Finally, it’s nice to include special meals in your Sunday plans. As a child, I didn’t like the Sunday roast—probably because it meant sitting at the table waiting for adults to finish so we children could be excused, and I have memories of thick slabs of meat and nasty bits of under-cooked fat. These days, I’m a fully paid up member of the Sunday roast forever club. While the meat is nice, the best bits are the accompaniments – home-made gravy with a decent amount of wine thrown in, roasted parsnips and carrots, crackling if you’re making pork (or just make it as a side dish anyway) and one roast potato as a treat.

Bring on the special Sundays!

What’s your idea of a treat on a Sunday? Is cutting back your time online part of your plans for 2019, and if so what do you intend to do instead?

*Don’t do this at home, folks!

BMJ: How to get a better sleep if you work night shifts

From Optimising sleep for night shifts by Helen McKenna and Matt Wilkes 3rd March 2018

Night shift work happens when your body would rather be asleep. Alertness, cognitive function, psychomotor co-ordination and mood all reach their lowest point between 3am and 5am.

After a night shift is over, the worker has to try to sleep when the body would prefer to be awake. This shift away from the circadian phase compounds the fatigue and can lead to chronic  sleep disturbance. There is  more likelihood of occupational accidents, obesity, type 2 diabetes, heart disease and breast, prostate and colorectal cancers. Psychological and physical well being is affected and accidents or near misses when travelling home are much more likely to occur.

Performance on the night shift gets worse as people get older and it takes longer to recover from a night on.

On average most people sleep about 8 hours a night.  Some people cope with sleep deprivation better than others. Performance will be impaired after two hours of sleep deprivation and gets worse as sleep debt accumulates. Therefore before starting a set of night shifts it is wise to sleep in the morning before, avoid caffeine that day,  and if you can take a nap in the afternoon between 2pm and 6pm.  For a nap to be most effective you need 60-90 minutes asleep.

When you start the shift, try to fit in a nap of about 30 minutes if this is the sort of job that allows this, but have a coffee immediately before the nap, and don’t have any more caffeine after the nap.  Sleeping longer than 30 minutes can make you feel groggy as you move into deep sleep and are the roused from it. Caffeine can help performance but you also want to try to sleep the next morning. Avoid it for the 3-6 hours before you plan to go to sleep in the morning. If you are doing critical tasks especially between 3-5am it is wise to build in more checks to your work.

Working in bright light can perk you up on the night shift.

When it comes to eating you are probably best to eat your main meal immediately before the night shift then eat just enough to feel comfortable as the shift goes on.

Jet lag improves at the rate of one day for every hour you are out of phase.  Circadian adaptation is therefore impossible during short term rotating shift work. Therefore you have to do your best to optimise your sleep between the shifts so as to keep the sleep debt minimal.

If you can possibly arrange lifts home or travelling home on public transport after a night shift, do so.

You can try to improve the situation by wearing sunglasses in daylight on the way home, avoiding electronic device screens, using blackout blinds, ear plugs and eye masks or even white noise generators.  A warm bath and then sleeping in a not cold but cool room and wearing woollen nightwear may help. Melatonin taken in the morning after a night shift has been shown to improve sleep duration by up to 24 minutes. Avoid alcohol and caffeine as these won’t help. Drugs such as Zopiclone can improve sleep if taken during the day but it can be addictive and needs a prescription.

After a run of night shift work you may get into the swing of your regular routine by having a 90 or 180 minute sleep, as this is one or two sleep cycles,  or sleeping in to noon and then getting up and getting outside for some exercise in bright light. Do your best to include meals at the usual times and socialise a little.  You will also need to pay attention to paying back your sleep debt by going to bed earlier than usual and sleeping in later than usual for a few days. It is best to avoid day time naps during the recovery from shift phase.

The path to sleep optimisation is an individual thing. Feel free to experiment.

The Quirky Things About Being a Type 1 Diabetic

Because I am hyper-organised (crap), I scheduled time to write a post for World Diabetes Day—spot the deliberate mistake. Said designated day took place on 14 November, unmarked by we at the Diabetes Diet. Hey ho!

Instead, here I am posting about it more than a week later. You could argue that living with diabetes also takes place on the other 363 days (and the extra one every four years) of the year, so why make the 14th special, although awareness-raising exercises are always useful.

Anyway, I thought I’d list some of the quirky things about living with diabetes. We all know the big stuff, but there are some teeny-tiny bits you put up with which aren’t obvious to those who don’t have the condition…

Gnawing anxiety when parted from your bag. I have an industrial-sized handbag so I can carry around everything—blood testing equipment, two pens, spare needles, jelly babies and a full make-up kit*. When I visit people and they try to take my bag from me to put it with coats, I cling to it. I’m never more than a few metres from that bag.

a picture of a blood testing machine on The Diabetes Diet

A trail of litter that follows you everywhere. I do my best to dispose of it at the time, but I wish someone would invent a small bin that magically appears at your side every time you do a blood test or injection so you can throw away your used needles and blood testing sticks there and then. Every few days or so, I have to do a clear out of my bag where old needles, their wrapping and used sticks gather at the bottom. Once, I was in Regent’s Park in London and I spotted a used blood testing stick on the group and it delighted me. I knew it wasn’t mine**, but the thought that there was another type 1 in the vicinity felt comforting.

An aversion to ordering drinks when you are out that are in a glass. How do you know it’s the diet version? I only feel secure when my drink comes in its bottle or can. Otherwise, you might end up drinking the full-sugar one which will hit you like a sledge hammer almost immediately.

Puncture-marked fingers. I’m still on the waiting list for the FreeStyle Libre so in the meantime, my fingers keep that little collection of black dots that marks frequent finger pricking. You are supposed to vary the fingers, but my right hand bears the brunt of tests because I’m left-handed.

Toilets are very important. High blood sugars make you pee a lot and the first thing I work out whenever I go anywhere is—where’s the loo? Also, I’m not fussy. I have friends who won’t use dirty toilets such as the ones you get on trains. I don’t care. It’s a loo and it’s going to take me from bursting discomfort to huge relief in minutes.

It’s a full-time job. Managing diabetes takes up a lot of time and energy. You don’t get holidays and you can’t quit, and you have to do it on top of everything else you do. The boss is often a moody cow too. The skill-sets needed include arithmetic (figuring out insulin doses to match food), organisation (making sure you have everything you need when going out and keeping on top of your prescriptions), an understanding of biology and how your body works, and the ability to forward plan for most aspects of your life.

 

*Strictly speaking, not needed for diabetes

**On second thoughts, it could have been. Those things get everywhere. I’m always finding them in weird places.

The FreeStyle Libre—a two-week report

a sensor and reader on a post on the Diabetes DietYou find me, un-sensored and sad… Yes, I’ve completed two weeks on the FreeStyle Libre sensor and reader system, and now I’m back to finger pricks, at least temporarily.

At my last diabetes clinic appointment, my consultant* agreed that I’m a candidate for flash glucose monitoring (which is different from blood glucose testing, but more on that later) and sent me off with a 14-day sensor while I wait for bureaucracy to kick in.

So, what’s flash glucose monitoring like? For the uninitiated, the system comprises a sensor you wear on the back of your arm and a reader that can be used any time. Type 1 diabetes tends to encourage obsessive compulsive behaviour, and the FreeStyle Libre system facilitates that, though it’s no bad thing.

Where flash glucose monitoring differs from blood testing is that the sensor reads levels from interstitial fluid, so it lags about four and a half minutes behind blood glucose readings. If you drive, the DVLA requires you to do blood tests, rather than scans beforehand to avoid the risk of hypos while driving.

Parents love them because they can check children with type 1 diabetes while they sleep, able to work out if they are risk of a hypo, and they are also routinely prescribed for pregnant women who have diabetes as frequent testing makes it easier to maintain the tight control you need while growing a baby.

The accompanying app can be downloaded by others, who can gain access to your information if you give them permission. Again, something that is useful for parents although such scrutiny would have horrified the teenage diabetic me.

Here’s what I found:

Frequency of testing

After a day or so of overcoming the hesitation—I can’t do another test, I just did one an hour ago… Oh. Yes, I can—I averaged 11 scans a day, and about two blood tests usually at the same time to check accuracy and a few times because I was hypo.

Ease of testing

Easy-peasy-lemon-squeezy! You can use the reader through clothing, it only takes a few seconds. It’s much easier than pulling out a meter, sticks and finger-pricker—especially when you’re out and about.

Accuracy of readings

I had the odd bit of disparity—usually if my blood sugar was low, as the sensor lags behind blood glucose readings. However, most of the blood tests I did at the same time varied only by 0.1 o 0.2 mmol, and I did get hypo readings that registered at the same time.

Sensor adhesion

No issues there. That thing stuck to me for the two weeks. I didn’t do any swimming in that time, so I can’t attest to how well it works in that setting. Nor did I try it out in the sauna/steam room as threatened—though one suggestion a fellow user came up with was using cling film to bind it onto your arm. The reader lasted on the battery charge for the full two weeks too.

Most useful bits

There are lots of things that sell flash glucose monitoring to me—ease and frequency of testing two of them—but there are other super-useful components. One is the pattern tool. You can see where you have the most glucose variability and when you tend to have hypos. In the two-week period, I had (ahem) 17 low glucose events, most of them between 11am and 5pm and that corresponded with the time of day I have most glucose variability.

I’ve never been good at logging my blood tests. It just feels too much like hard work. I know you can download from your meter, but the checks I made on the flash glucose monitor gave me a clear idea of what happens. And, more importantly, some ideas of how to fix it.

The excess hypos may have been because of the half-marathon, which happened not long after I started my 14-day sensor and because I’ve been eating more carbs. As we say in the Diabetes Diet, more carbs mean more insulin. Bigger amounts of insulin mean bigger mistakes. A salutary reminder, then, that it’s back on the low-carb for me.

Thanks too, to Steven Morrison—my blog and book co-author’s son—who emailed me in detail about his own experiences using the FreeStyle Libre. He’s a convert too, and the cling-film tip came from him.

So when does my prescription come in? I’m now on a list for a short course at the hospital and once I’ve taken part in that, the organisers write to my doctor recommending she add sensors to my list of prescribed diabetes medications and gear. Fingers crossed, it doesn’t take too long.

 

* #LovetheNHS

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?