As a type 1 diabetic I am quite familiar (unfortunately) with the signs and symptoms of diabetic ketoacidosis. Diabetic ketoacidosis (DKA) results from lack of insulin associated with high blood levels and your body starts to produce high levels of blood acids called ketones. Diabetic ketoacidosis is associated with significant disturbances of the body’s chemistry, which resolve with proper therapy.
This usually occurs in people with type 1 diabetes, but DKA can develop in any person with diabetes. Since type 1 diabetes typically starts before the age of 25, diabetic ketoacidosis is most common for this age group, but it may occur at any age with both males and females are equally affected. So is DKA something that we should be worried about? Lets take a closer look!
What Causes Ketoacidosis ?
So what’s the deal when our results come back showing ketones in urine? Circumstances arise for people with type 1 diabetes when the individual does not have enough insulin, a hormone the body uses to break down sugar (glucose) in the blood for energy. When glucose is not available to feed our cells due to high blood sugars, fat is broken down and used as fuel vs glucose and this is particularly not a good thing. As fats are broken down, acids called ketones build up in the blood and urine. In high levels, ketones are extremely poisonous. This condition is known as ketoacidosis.
Blood glucose levels rise (usually higher than 300 mg/dL) because the liver makes glucose to try to combat the problem. However, the cells cannot pull in that glucose without insulin.
DKA is often the first sign of type 1 diabetes in people who do not yet have other symptoms. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin, or surgery can lead to diabetic ketoacidosis in people with type 1 diabetes.
Although not common, people with type 2 diabetes can also develop DKA, but it is rare and typically triggered by a severe illness.
What Are The Warning Signs Of DKA?
DKA usually develops slowly. But when vomiting occurs, this life-threatening condition can develop in a few hours. Early symptoms per the American Diabetes Association include the following:
- Thirst or a very dry mouth
- Frequent urination
- High blood glucose (blood sugar) levels
- High levels of ketones in the urine
Then, other symptoms appear:
- Constantly feeling tired
- Dry or flushed skin
- Nausea, vomiting, or abdominal pain
(Vomiting can be caused by many illnesses, not just ketoacidosis. If vomiting continues for more than 2 hours, contact your health care provider.)
- Difficulty breathing
- Fruity odor on breath
- A hard time paying attention, or confusion
Any of these symptoms should immediately be discussed with your doctor and they will let you know the next course of action, including treatment options or better yet, a trip to the ER may be in order especially if you can flush them from your system. Speaking of treatment options, what can you expect? Lets take a closer look.
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 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 4 calories 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 9 calories 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 4 calories per gram.
Ever wonder why when we are severely dehydrated as diabetics or when we are dealing with an extreme high blood sugar our medical team tells us to make sure we replenish our electrolytes? I mean, what is an electrolyte anyway, what are the symptoms of low electrolytes and how can they help us as diabetics or if your just out mowing the lawn? Diabetic or not, they are extremely important when it comes to our overall health so lets take a closer look!
When dissolved in fluid, salts tend to break apart into their component ions, creating an electrically-conductive solution. For example, table salt (NaCl) dissolved in water dissociates into its component positive ion of sodium (Na+) and negative ion of chloride (Cl-). Any fluid that conducts electricity, such as this new saltwater solution, is known as an electrolyte solution: the salt ions of which it’s composed are then commonly referred to as electrolytes. So that leads us to the next question…
What Are Electrolytes?
There are several common electrolytes found in the body, each serving a specific and important role, but most are in some part responsible for maintaining the balance of fluids between the intracellular (inside the cell) and extracellular (outside the cell) environments. This balance is critically important for things like hydration, nerve impulses, muscle function, and pH levels.
With the correct body water balance, the electrolytes separate into positive and negative ions. When the body loses water or becomes dehydrated an electrolyte imbalance starts to occur. During heavy exercise, sodium and potassium electrolytes in particular are lost through sweating. To ensure constant electrolyte concentrations in the body, fluids must be regularly consumed.
To avoid an electrolyte imbalance which can cause lethargy and muscle twitching, athletes consume electrolyte solution drinks to make sure the electrolyte balance is maintained during and after exercise – this contributes to achieving optimum performance
You should drink frequently during strenuous physical activity. Thirst usually does not kick in until well after you have reached a state of dehydration, so consume plenty of fluid whether you feel like it or not. About 6 to 8 ounces every 15 minutes is sufficient. Help replace electrolytes by consuming a beverage that contains 0.7 milligrams of salt per quart of fluid. Consuming fruit slices, such as bananas, strawberries and oranges can help restore lost potassium, but obviously we still need to be careful here and a small bolus may be needed after exercise due to the sugar content in fruit.
7 Major Electrolytes & Their Function:
Let’s take a look:
- Sodium (Na+)
- Chloride (Cl-)
- Potassium (K+)
- Magnesium (Mg++)
- Calcium (Ca++)
- Phosphate (HPO4–)
- Bicarbonate (HCO3-)
So what do each of these to?
Sodium (NA+) is the major positive ion in fluid outside of cells (extracellular) and when combined with chloride the resulting substance is table salt. Some functions of sodium include the regulation of the total amount of water in the body and the transmission of sodium into and out of individual’s cells, which plays a role in critical body functions. Many processes in the body, especially in the brain, nervous system, and muscles require electrical signals for communication. The movement of sodium is critical in generation of these electrical signals. Too much or too little sodium can cause cells to malfunction and extremes in the blood sodium levels.
Potassium (K+) is the major positive ion found inside of cells. Some of the functions of K+ are the regulation of heartbeat and muscle function. The proper level of potassium is essential for normal cell function. Any seriously abnormal increase or decrease in K+ can profoundly affect the nervous system and increase change of irregular heartbeats.
Calcium (Ca++) is needed to build and maintain bones. It also plays a role in nerve impulse transmission and muscle contraction.
Magnesium (Mg++) is an essential mineral that is involved in more than 300 enzyme reactions in the body. Mg supports heart and nerve function. Mg is essential in the formation of bones and teeth and in converting blood sugar into energy.
Chloride (Cl-) is the major anion (negatively charged ion). CI- is found in the fluid outside of the cells and in the blood. The balance of chloride ion (CI-) is closely regulated by the body. Seawater has almost the same concentration of chloride ion as human body fluids. CI- plays a role in helping the body maintain a normal balance of fluids.
Ok, so I was researching some information the other day when it came to certain foods and I came across a term that was unfamiliar to me. As diabetics we are so use to hearing about the glycemic index (that’s all that was preached to me upon my T1D diagnoses 11 years ago) and why we need to make sure our foods are on the lower end of this scale to make sure our blood sugars remain more stable and do not skyrocket, but as I was researching these particular foods, I came across something I’ve haven’t really heard much about…the glycemic load
What is this glycemic load? Is it the same as the glycemic index? Will it have a direct impact on my blood sugars?All great questions so lets take a closer look!
Difference Between Glycemic Index And Load?
Just to quickly review, the glycemic index is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels. Carbohydrates with a low GI value (55 or less) are more slowly digested, absorbed and metabolized and cause a lower and slower rise in blood glucose and are categorized into 3 categories.
The categories are as follows:
Low = GI value 55 or less
Medium = GI value of 56 – 69 inclusive
High = GI 70 or more
Lower glycemic index foods, unlike high GI, will not cause your blood glucose levels to spike and crash, meaning you get sustained energy from the foods you eat. So now that we’ve reviewed that tid bit of info, how does the glycemic load compare?
How About The Glycemic Load?
The glycemic load of food is a number (just like the glycemic index) that estimates how much the food will raise a person’s blood glucose level after eating it. One unit of the glycemic load approximates the effect of consuming one gram of glucose, but the difference is that the glycemic load accounts for how much carbohydrate is in a particular food and how much each gram of that particular carbohydrate will raise ones blood glucose levels (now you can see my peaked curiosity).
Foods with a low glycemic load keep blood sugar levels much more consistent, meaning that you avoid experiencing those quick spikes and dramatic lows that we can become accustomed to. The reason being is that you are accounting for that particular carbohydrate with it comes to bolusing for your meals.
By watching the glycemic load of the foods you ingest you can dramatically impact your overall health in many ways. A diet focused on foods with a low glycemic load can:
- Make it easier to lose weight and avoid the dreaded diet plateau
- Avoid the roller coaster effect and maintain stable blood sugar levels (yes, please!)
- Help you burn more calories
- Help with insulin resistance
- Lower your risk for heart disease
How Do I Calculate The Glycemic Load?
Ok, so this is probably the most important question. The glycemic load (GL) is a measure of both the quality (the GI value) and quantity (grams per serving) of a carbohydrate in a particular food. A food’s glycemic load is determined by multiplying its glycemic index by the amount of carbohydrate the food contains in each serving, then dividing that by 100. Confused a bit, lets take a look at this example of an apple.
Using a small apple as an example: GI value = 38. Carbohydrate per serving = 15g
GL = 38 (glycemic index) x 15 (grams of carb)
So the glycemic load of a typical apple is 6. Great, now your probably asking yourself, what do you do with this information?
Well, similar to the glycemic index, the glycemic load of a food can be classified as low, medium, or high reflecting on how quickly they will raise your blood sugars:
- Low: 10 or less
- Medium: 11 – 19
- High: 20 or more
For optimal health, it is recommended to keep your daily glycemic load under 100. However, the simplest way to use the GL is to choose foods with the lowest GI within a food group or category and to be mindful of your serving sizes.
Hypoglycemia is the clinical syndrome that results from low blood sugar. The symptoms of hypoglycemia can vary from person to person, as can the severity as I’ve personally dealt with in the past when my severe low was accompanied with a seizure.
This was the first time this as ever happened to me since being diagnosed as a type 1 diabetic over 11 years ago now. While I don’t remember the seizure itself, lets just say we made it a memorable experience for the community as it happened at my sons fall soccer tournament. So what is a hypoglycemic seizure and what are the warning signs of having a seizure? Lets take a closer look!
What Is A Hypoglycemic Seizure:
So what causes a seizure? A hypoglycemic seizure may be triggered by injecting too much insulin, or failing to eat soon enough after using a fast acting insulin (exactly what happened to me); excessive use of alcohol, skipping meals,or exercising vigorously without adjusting insulin dosages or eating properly.
A seizure may also be triggered by oral diabetes medications that cause the pancreas to produce more insulin. Whatever the cause of the seizure, it needs to be treated as a medical emergency. To identify the onset of ahypoglycemic seizure,look for the following warning signs of seizures and symptoms:
- Feeling faint or too sleepy
- Feeling cold or clammy
- Unexplained emotional behaviors
- Uncontrollable crying
- Unaware of surroundings
- Changes in vision
- Loss of ability to speak clearly
- Loss of muscle control
- Muscle weakness
So what does eating paleo mean, what is the definition of paleo? I have several friends that keep throwing out the words paleo diet and swearing by it, especially when it comes to helping stabilize their blood sugars. Honestly I’m not a huge fan of “diets” in general but after doing a little research on paleo, I can certainly understand why they are so giddy over living paleo!
The Paleo diet is certainly not a new idea. Coming to popular attention with the publication of a book on the subject by Walter Voegtlin in 1975, its central concept is to mimic the diet of humans that lived 25 to 50 thousand years ago, during the Paleolithic Age. Voegtlin claimed distinct benefits are associated with what he claims was the high protein and low carbohydrate die of the ancients. His plan is occasionally called the caveman diet, the Stone Age diet and the hunter-gatherer diet. Proponents of the Paleo diet continue to practice it, and it has been somewhat validated by the emergence of other similar low-carb diets.
Health Benefits Of The Paleo Diet:
For most people the fact the Paleo diet delivers the best results is enough. Improved blood lipids, weight loss and reduced pain from autoimmunity is proof enough. Many people however are not satisfied with blindly following any particular form of eating, aka “a diet”. Fortunately, the Paleo diet has stood not only the test of time, but also the rigors of scientific scrutiny.
With a very simple shift the paleo diet not only removes the foods that are at odds with our health (grains, legumes, and dairy) but we also increase our intake of vitamins, minerals, and antioxidants and brings us back to the way our ancestors ate…eating unprocessed foods like meat, vegetables, fruits, nuts as well as seeds.
Paleo Diet For Diabetics:
There are a number of studies investigating the effects of Paleo diets on type 1 and type 2 diabetics and results are impressive. A study published in July 2009 in “Cardiovascular Diabetology” compared the Paleo diet to the Mediterranean diet in subjects with type 2 diabetes over a period of three months. The researchers found that the Paleo diet reduced fasting blood sugar levels, hemoglobin A1C, plasma insulin levels and insulin resistance significantly compared to the Mediterranean diet, indicating potential benefits of the Paleo diet for people with type 2 diabetes. Here are 5 more studies and how they help stabilize blood sugars, feel free to check them out.
Pro’s Of The Diet:
Right off the start you can see how well this diet is going to control blood sugar levels. In a world where many of us experience roller coaster-like blood sugar fluctuations, this aspect alone proves to be an extremely beneficial aspect of the set-up.
As most of us know, the more stabilized our blood sugar levels are, the less likely you’re going to be to experience food cravings, to battle ongoing fatigue, and to be at the potential risk of developing diabetes down the road.
Since the paleo diet is also chalk full of healthy fats from all the seeds and nuts that are being consumed while also being low in saturated fat due to the restriction of dairy and high fat meat sources, this is also going to work to improve your cholesterol profile and help to reduce the risk of heart disease.
When using the paleo diet you shouldn’t find you have any issue getting enough protein in either, which is something that’s critical for both the fat loss and muscle building process as you’ll be including lean meat sources with each meal. By choosing to incorporate a wide spectrum of fruits and vegetables in your menu, you’re also going to help to keep calorie intake on the lower side, so this will be beneficial from a fat loss point of view.
If you are someone who happens to actively looking to build muscle and thus require that higher calorie surplus, you can simply add larger doses of nuts and seeds into the plan to help boost your calorie and healthy fat intake up higher.
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, stroke, provide more stable blood sugar readings, and help lower blood pressure ~ 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.
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
I’ve been fielding a lot of questions lately in regards to the health benefits of chia seeds and more importantly what are chia seeds? Well, if your looking for a great way to boost your energy and add some protein to your diet, or boost your omega 3 intake, look no further.
Chia seeds come from the desert plant Salvia hispanica, a member of the mint family. Salvia hispanica seed is often sold under its common name “chia” as well as several trademarked names.
Its origin is believed to be in Central America where the seed was a staple in the ancient Aztec diet. The seeds of a related plant, Salvia columbariae (golden chia), were used primarily by Native Americans in the southwestern United States. These gems are fantastic in so many ways, what makes chia seeds so powerful? Lets take a closer look!
Skip The Coffee And Boost Energy:
Don’t want to feel like taking an afternoon nap? Your energy levels have a lot to do with what you eat. Chia is one of nature’s highest plant-based sources of complete protein. Usually protein from items like peanut butter and some beans are incomplete, meaning you have to combine them with other foods to get the full benefit. Not Chia though, it’s protein is complete to raise your energy levels. The combination of complete protein, vitamins, minerals and blood-sugar balancing gel all work together to make sure you have steady, never jittery energy.
Chia Seeds And Weight Loss:
Chia seeds contain both soluble and insoluble fiber. The soluble fiber in chia absorbs water and expands to form a gel that fills you up faster, so you consume fewer calories, hence weight loss. Fiber and protein slow the digestive process so hunger isn’t triggered as quickly as with sugars, starches and other simple carbohydrates. The insoluble fiber, which does not digest, aids in preventing constipation and digestive disorders by cleaning the colon.