Ok, so everyone knows that I’m an upbeat, positive person overall, but I’m not going to sugarcoat anything when it comes to this blog post. As type 1 diabetics we all know that we are up against some serious, long term complications when it comes to battling diabetes on a daily basis 24/7/365. Its ruthless, its relentless, and probably worse of all, it never takes a day off.
Even when we feel like breaking down, giving up and throwing out the dreaded F-bomb because we’ve just had enough of the finger sticks, insulin injections, 2am lows, I’m here to show you why that is never a good idea. Why you need to push through and dig deeper even when you feel like giving up. Always remain vigilant and push through even when you don’t feel like doing so, here’s why!
Glaucoma And Diabetes:
When fluid inside the eye does not drain properly from a buildup of pressure inside the eye, it results in another eye problem with diabetes called glaucoma. The pressure damages nerves and the vessels in the eye, causing changes in vision.
Treatment of open-angle glaucoma, the most common form of glaucoma requires lowering the eye’s pressure by increasing the drainage of aqueous humor or decreasing the production of the fluid. Medications can accomplish both of these goals.
With open-angle glaucoma, there may be no symptoms of this eye problem at all until the disease is very advanced and there is significant vision loss. In the less common form of this eye problem, symptoms can include headaches, eye aches or pain, blurred vision, watering eyes, halos around lights, and loss of vision.
Treatment of this eye problem in diabetes can include special eye drops, laser procedures, medicine, or surgery. Surgery and laser treatments are directed at improving the eye’s aqueous drainage. You can prevent serious eye problems in diabetes problems by getting an annual glaucoma screening from your eye doctor.
Increase In Cardiovascular Disease?
Cardiovascular disease includes blood vessel disease, heart attack and stroke. It is the leading cause of death in Australia. The risk is greater for people with diabetes, who often have increased cholesterol and blood pressure levels. Smoking, having a family history of cardiovascular disease and being inactive also increase your risk.
To reduce your risk and pick up any problems early:
- Have your blood pressure checked at least every six months, but more often if you have high blood pressure or are taking medication to lower this.
- Have your cholesterol checked at least yearly, as well as an HbA1c (average blood glucose over the past three months).
- Further pathology tests such as an electrocardiogram (ECG) or exercise stress test may also be recommended by your doctor.
As a type 1 diabetic, the glycemic index use to be near and dear to my heart, well, that’s until I found out the glycemic load. How do the two differ? Last week I posted about the the glycemic load, but what is the glycemic index and how do they differ? Lets take a closer look!
The Glycemic Index (GI) is a numerical scale used to indicate how fast and how high a particular food can raise our blood glucose (blood sugar) level. A food with a low GI will typically prompt a moderate rise in blood glucose, while a food with a high GI may cause our blood glucose level to increase above the optimal level.
An awareness of foods’ Glycemic Index can help you control your blood sugar levels, and by doing so, may help you prevent heart disease, improve cholesterol levels, prevent insulin resistance and type-2 diabetes, prevent certain cancers, and achieve or maintain a healthy weight. A substantial amount of research suggests a low GI diet provides these significant health benefits. So, it’s worth taking a look at the basic principles of a low GI way of eating.
Why The Glycemic Index Is Important?
Your body performs best when your blood sugar is kept relatively constant. If your blood sugar drops too low, you become lethargic and/or experience increased hunger. And if it goes too high, your brain signals your pancreas to secrete more insulin. Insulin brings your blood sugar back down, but primarily by converting the excess sugar to stored fat. Also, the greater the rate of increase in your blood sugar, the more chance that your body will release an excess amount of insulin, and drive your blood sugar back down too low.
Therefore, when you eat foods that cause a large and rapid glycemic response, you may feel an initial elevation in energy and mood as your blood sugar rises, but this is followed by a cycle of increased fat storage, lethargy, and more hunger! Although increased fat storage may sound bad enough, individuals with diabetes (diabetes mellitus, types 1 and 2) have an even worse problem. Their bodies inability to secrete or process insulin causes their blood sugar to rise too high, leading to a host of additional medical problems.
The theory behind the Glycemic Index is simply to minimize insulin-related problems by identifying and avoiding foods that have the greatest effect on your blood sugar.
High Glycemic Index Foods And Health Problems:
What researchers have learned is that high glycemic index foods generally make blood sugar levels higher. In addition, people who eat a lot of high glycemic index foods tend to have greater levels of body fat, as measured by the body mass index (BMI). High BMIs are linked to obesity, heart disease, and diabetes.
High glycemic index foods include many carbohydrates such as:
- White bread
- Low-fiber cereals
- Baked goods
So the other day I fielded a question about celiac disease and if there is a direct correlation between having celiac and type 1 diabetes. A great question as more type 1 diabetics seem to be diagnosed with celiac disease after their type 1 diagnosis. So what’s the deal with celiac disease? What is it exactly and what can be done to help alleviate the symptoms? Lets take a closer look!
What Is Celiac Disease:
Celiac disease is a digestive illness that occurs due to the ingestion of gluten. If you have celiac disease, your intestines cannot tolerate the presence of gliadin, which is a component of gluten. Gluten is present in wheat, barley, and rye. When a person with celiac disease eats foods with gluten, such as bread or cereal, their immune system inappropriately reacts to the ingested gluten and causes inflammation and injury to the small intestine. This results in symptoms such as diarrhea, bloating, and weight loss, as well as an inability to absorb important food nutrients.
Celiac Disease And Type 1 Diabetes:
So what’s the deal when it comes to type 1 diabetes and a celiac disease diagnosis? While there doesn’t appear to be a direct link between type 2 diabetes and celiac that’s not necessarily the case when it comes to type 1.
Per the celiac disease foundation:
“The link between type 1 diabetes mellitus and celiac disease was first established in the 1960s. The estimated prevalence of celiac disease in patients with type 1 diabetes is approximately 8%, and about 1% in the general population. Most patients with both conditions have asymptomatic celiac disease, or symptoms that may be confused for symptoms of their diabetes. For this reason, and the significantly higher prevalence rate of celiac disease in diabetes patients, many doctors recommend getting screened for celiac disease after a diagnosis of type 1 diabetes, as well as celiac patients getting screened for type 1 diabetes.
A recent study in 2013, contributed to by Dr. Peter Green, a member of Celiac Disease Foundation’s Medical Advisory Board found that there were no standard uniform practices for screening type 1 diabetes patients for celiac disease. Of the facilities in the study that did screen for celiac disease, 60% of them only did so if there were symptoms present. The authors of the study suggested that a uniform protocol for screening should be in place, as well as a need for further education on the gluten-free diet in patients with type 1 diabetes for dietitians.”(1)
The unfortunate part of this is that once you are diagnosed with an autoimmune disease, such as type 1 diabetes, you become prone to developing others. As for the signs, symptoms and treatment options, lets take a look.
Symptoms Of Celiac Disease:
Celiac disease symptoms typically involve the intestines and digestive system. They can also affect other parts of the body and children as well as adults tend to have a different set of symptoms. Those symptoms are as follows:
Celiac Disease Symptoms in Children:
Children with celiac disease can feel tired and irritable. They may also be smaller than normal and have delayed puberty. Other common symptoms include:
- weight loss
- abdominal bloating
- abdominal pain
- persistent diarrhea or constipation
- pale, fatty, foul-smelling stools
How To Diagnose Celiac Disease In Adults
Adults with celiac disease may experience digestive symptoms. In most cases, however, symptoms also affect other areas of the body. These symptoms may include:
- iron-deficiency anemia
- joint pain and stiffness
- weak, brittle bones
- skin disorders
- numbness and tingling in the hands and feet
- tooth discoloration or loss of enamel
- pale sores inside the mouth
- irregular menstrual periods
- infertility and miscarriage
Last week I fielded a question on my Facebook page on the pro’s and con’s of artificial sweeteners and a product was brought up that I was not all to familiar with, that product, agave nectar. As a type 1 diabetic and not a fan of any artificial sweetener (hello sucralose), I decided to take a look and see what this “natural” alternative is all about.
Agave nectar is a natural sweetener, valued as a vegan alternative to honey and touted for its low glycemic index. Foods with a higher glycemic index (GI) tend to trigger a greater surge in blood sugar and insulin—the hormone that helps the sugar get into cells—just after eating. (These spikes can be particularly problematic for those with diabetes. High-GI foods also tend to make you hungry again sooner because they’re digested quickly.)
According to a study in the American Journal of Clinical Nutrition, agave’s GI value is about five times lower than table sugar’s. Currently no studies compare how, relative to other sugars, agave may affect blood-sugar control, but based on the buzz agave’s been generating, we’ll likely see research in the near future.
Agave Nectar Glycemic Values By Comparison:
Organic Agave Nectar 27
Fructose (fruit sugar) 32
Lactose (milk sugar) 65
High fructose corn syrup 89
Sucrose (sugar) 92
Glucose tablets 146
Health Benefits Of Agave Nectar:
Agave nectar contains saponins and fructans. According to Dr. Sahelian, saponins, which are found on quinoa and many plant roots, including ginseng, have anti-inflammatory and immune system-boosting properties, including antimicrobial capability. In fact, the Aztecs used agave syrup to treat wounds because of its antibacterial properties. Inulin is a type of fructan or fiber that has many health benefits. Studies suggest that inulin can be effective in weight loss because of its low impact on blood sugar and its ability to increase satiety and decrease appetite. Inulin is also associated with lowering cholesterol, reducing the risk of certain cancers, and increasing the absorption of nutrients, such as isoflavones, calcium and magnesium. Inulin can also be found in some varieties of yogurt.
So check this out, your body has the amazing ability to take the foods you eat and literally turn them into you. Pretty cool don’t you think! Whether you eat an apple, a steak or a kale salad, your body is able to break that food down into its chemical parts and reassemble those parts into your cells and the energy you use all day. This is flat out awesome considering outside the plant and animal kingdom, nothing else that can do that!
Here is the deal though, your body is only as amazing as the material it has to work with, like a fine tuned machine, the quality of the food you put into your amazing body has a huge impact on your overall health. An apple is not just an apple, nor is a steak just a steak. As stated above, your body is able to break those foods down into their chemical parts, like macronutrients and micronutrients. So what makes these nutrients so important, lets take a closer look!
What Are Macronutrients:
Macronutrients are nutrients that provide calories or energy. Derived from the prefix makro (Greek), which means big or large, used because macronutrients are required in large amounts. There are three broad classes of macro-nutrients which make up your primary food sources know as proteins,carbohydrates and fats.
The main function of macronutrients is to provide energy, counted as calories. While each of the macronutrients provides calories, the amount provided by each varies. Carbohydrates provides four calories per gram (I think we are all pretty well versed here),proteins;also four, while fats provides nine calories per gram.
Macronutrients also have specific roles in maintaining the body and contribute to the taste, texture and appearance of foods, which helps to make the diet more varied and enjoyable.
Macronutrients broken down:
- Carbohydrates – are required for energy. As diabetics we all have varying opinions on carbohydrates and the amounts that we like to ingest , but glucose, which is a monosaccharide, is the most essential source of energy in the body. The brain works entirely on glucose alone. When an immediate source of energy is required, glucose is converted into glycogen which is stored in the liver. When energy is needed it is converted into glucose again and used to release energy. Carbohydrates provide 17 kilojoules of energy per gram.
- Fats – have the highest caloric content. This means they provide the largest amount of energy when burnt. When measured by a calorimeter, fats provide about 37 kilojoules per gram, making them twice as energy-rich than protein and carbohydrates. Extra fat is stored in adipose tissue and is burnt when the body has run out of carbohydrates. Fat is also needed to take up fat-soluble vitamins.
- Proteins– are the third and last source of energy. They are the last to be used of all macronutrients. In cases of extreme starvation, the muscles in the body, that are made up of proteins, are used to provide energy. This is called muscle wasting. Proteins also provide 17 kilojoules per gram.
Most of you already know that I love to exercise. My day starts out at 4am, early yes, but its the only time that I get to myself during the day. As a stay at home dad of 4, I consider this a small sacrifice for my sanity as well as to benefit my bottom line as a type 1 diabetic, my health!
What makes exercise so important? Well I think we all know the answer to that question as there are so many benefits including better control of our overall blood sugars. There is a list of exercises you can do, but lets take a closer look at how you can exercise safely for better control!
Diabetes And Exercise:
Whether you have type 1 or type 2 diabetes, diabetes and exercise should go hand in hand, at least when it comes to the management aspect of the disease. Not only can exercise can help you improve your blood sugar control, boost your overall fitness, it can reduce your risk of heart disease and stroke, all risk factors that we face.
While exercise is great for us and the benefits are well documented, as diabetics it also poses some unique challenges. To exercise safely, it’s crucial to track your blood sugar before, during and after physical activity. You’ll learn how your body responds to exercise, which can help you prevent potentially dangerous blood sugar fluctuations.
Exercise And High Blood Sugars?
This was one of the biggest hurdles for me when I was first diagnosed. My numbers would skyrocket after a workout or even during a gym session. The issue is that exercise triggers the body to release stress hormones, like adrenaline. Adrenaline tells the liver to release glucose, or cortisol which makes you more resistant to insulin, and since strenuous activity triggers an increase in these stress hormones, chances are (even temporarily) your blood sugars are often increased.
That being said different exercises affect us differently and we also know that we’re all very unique, and lets face it, type 1 diabetes effects everyone differently and no situations are ever the same. Our blood sugar response to exercise will also depend on our level of physical fitness and personal exertion. Generally speaking, 30-40 minutes of high intensity interval training will bring different results than an hour of running, doing the stair climber or even walking the dog so it will be important to closely monitor your blood sugars during exercise and see how these activity levels effect you.
Let me just say that I absolutely LOVE coconut oil! We use if for baking, cooking and even to moisturize skin. Coconut oil is amazing and here’s why!
Coconut oil, a dietary cooking oil extracted from the coconut, includes antioxidant, anti-fungal, antibacterial and antimicrobial properties that stem from the existence of capric, caprylic and lauric acids found in the coconut oil. The body uses these acids to combat internal and external stress, infections and diseases. Coconut oil is widely used for its benefits by weight loss dieters, athletes, and alternative and conventional medicine practitioners. Coconut oil increases energy, sustains endurance, does not leave fatty deposits in the arteries or heart and has a lower caloric count than many other dietary oils.
Coconut For Weight Loss:
Coconut accelerates the body’s metabolism by relieving stress on the pancreas. Coconut oil contains healthy saturated fats that prevent foods from becoming incompletely digested, which in turn aids enzyme and thyroid function. Naturopathic doctor Bruce Fife states that by substituting coconut oil for other oils in recipes, individuals end up eating less because the beneficial fats in coconut oil naturally make people feel fuller sooner than if they had ingested other dietary oils. The coconut diet is not necessarily a “diet” because instead of limiting or restricting the dieter’s food intake, it replaces the widely used refined fats with coconut oil to incorporate a lifelong weight reduction plan that is based on the healthier coconut oil fat.
Coconut Oil And Lauric Acid:
Coconut oil has many health benefits which are attributed to the presence of lauric acid. When it is present in the body, lauric acid is converted into monolaurin, a compound that is highly toxic to viruses, bacteria, fungus’s and other microorganisms because of its ability to disrupt their lipid membranes and virtually destroy them. Monolaurin is effective for treating candida albicans, fungal infections and athlete’s foot. It also targets bacterial infections and viruses like measles, influenza, hepatitis C and even HIV.
In fact, researchers from the Philippines are studying the effectiveness of lauric acid against HIV/AIDS due to its strong anti-viral properties. Moreover, lauric acid is non-toxic, making it a better alternative to modern drugs that are typically prescribed for viruses as well as fungal and bacterial infections. Without lauric acid, monolaurin cannot be produced by the body. Breast milk is the only other source of lauric acid, which must explain the lesser incidents of infections with breast-fed infants. It has also been observed that regular consumption of boosts immunity and reduces incidences of sickness.
As diabetics, glucagon plays a vital role in part of our overall management and as I experienced a couple weeks ago, it can save your life. As a type 1 diabetic, I’m very well versed on how this works (unfortunately), and why it is so important and how it can keep us out of emergent situations or in my case, help you come out of a diabetic seizure. So for all the newly diagnosed diabetics out there, young and old, what is glucagon? What is it so important that we should have it on us at all time, wherever we go? Lets take a closer look!
What Is Glucagon:
Glucagon is a hormone (like insulin) that is naturally made in the pancreas. The pancreas produces this hormone when the body needs to put more sugar (glucose) in the blood to be used for energy. Glucagon raises the blood sugar by sending a signal to the liver and muscles (where your body naturally stores glucose) to release glucose.
The difference between the two, is that insulin lowers your blood glucose (sugar) by helping your body use the glucose in the blood for energy. Glucagon raises your blood glucose (sugar) by causing the liver and muscles to release stored glucose quickly. Though glucagon helps raise the level of glucose in the blood, it is not considered a sugar.
The Role Of Glucagon In The Body:
Glucagon plays an active role in allowing the body to regulate the utilization of glucose and fats.
Glucagon is released in response to low blood glucose levels and to events whereby the body needs additional glucose, such as in response to vigorous exercise.
When glucagon is released it can perform the following tasks:
- Stimulating the liver to break down glycogen to be released into the blood as glucose
- Activating gluconeogenesis, the conversion of amino acids into glucose
- Breaking down stored fat (triglycerides) into fatty acids for use as fuel by cells
Insulin And Glucagon:
Glucagon is usually given by injection beneath the skin, in the muscle, or in the vein. It comes as a powder and liquid that will need to be mixed just before administering the dose. Instructions for mixing and giving the injection are in the package. Glucagon should be administered as soon as possible after discovering that the patient is unconscious from low blood sugar. After the injection, the patient should be turned onto the side to prevent choking if they vomit. Once the injection has been given, contact your doctor. It is very important that all patients have a household member who knows the symptoms of low blood sugar and how to administer glucagon.
So after have a couple of amazing conversations over on the Facebook page, a lovely young lady asked me if injecting insulin was the reason why she was gaining weight after her type 1 diagnosis. While I’ve heard this several times, is it the insulin that is causing the weight gain, or could it be something else? Perhaps a hormone that as type 1 diabetics we also stop producing since our beta cells have died off.
Have you ever heard of Amylin? Could the lack of this hormone be the reason why she is seeing an increase in her weight? What is amylin anyway, and is it something we should be concerned with if we are no longer producing it?
These are all great questions and honestly this was news to me as well as I’ve never heard of it. So lets take a closer look at what this little hormone does and if it has a direct impact on our overall health as type 1 diabetics!
Function Of Amylin?
So what is amylin or as its also called pramlintide and how can it help us? Amylin is a peptide hormone (insulins partner in crime) which is released by the beta cells in response to ingesting food. This hormone, is also released at the same time as insulin, but in different quantities and its primary function is to help aid in the digestive process by helping to control the rate of digestion.
The complete range of functions of amylin is still not fully known, but its main function has been determined to be to help to slow the speed at which food is digested and glucose is released into the bloodstream after a meal. Essentially, amylin keeps too much glucose from appearing in the blood in the first place.
Amylin accomplishes this in a number of ways. It decreases appetite by promoting a feeling of fullness, hence reducing food intake. It slows gastric emptying and inhibits the secretion of digestive enzymes, all of which slow the appearance of glucose in the blood after a meal and it also slows the secretion of glucagon, which otherwise causes additional glucose release by the liver at mealtimes.
In short, the release of amylin minimizes glucose spikes that often occur after meals. I know, frustrating right! I mean this disease is already hard enough, now this. Fortunately for us, we do have another option to replace this important hormone that has also died off with our beta cells so go ahead and keep on reading.
Can We Replace Amylin?
Well, your in luck! Welcome to the world of symlin, the equivalent to amylin. Symlin minimizes the blood glucose rise that occurs after we eat. We have all dealt with the dreaded post meal spikes which can make us feel as though we are drudging through concrete. Post meal spikes can have a negative impact on our A1C as well as progress the development of complications further down the road, so symlin is a viable option to help prevent this from happening.
To good to be true, right? Well, symlin can also be a valuable weight loss tool. Users of symlin lose an average of 6.6 pounds over the first six months of use, mainly by consuming smaller portions at meals and snacking less often. Given that many people with type 1 diabetes have difficulty controlling their appetite (likely due to lack of the amylin hormone), adding symlin to one’s treatment has obvious lifestyle benefits.
Symlin, like insulin, is taken by injection in a fixed dose typically before meals (I can also be taken post meal). The FDA has approved symlin for use by adults with type 1 or type 2 diabetes who take rapid-acting insulin at meals. The bad news: Symlin has not yet approved for use in children but several studies have shown that symlin is safe and effective when used in a supervised manner by adolescents.
Side Effects Of Symlin:
The most common side effects of Symlin include:
- severe hypoglycemia
- severe ongoing nausea
- vision problems
- fast heart rate
- feeling jittery
More common side effects may include:
- loss of appetite
Its always a good idea to chat with your medical team if you have any side effect that bothers you or that does not go away, particularly if your finding yourself having constant hypoglycemic episodes.
If you feel that you’ve done everything in your power, including revamping your diet and your still finding difficulty controlling your post meal numbers, this is definitely something that you should discuss with your doctor.
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