Category Archives: Diabetes and Diet

What is the Carnivore Diet and Why am I Doing it?

The carnivore diet generally consists of eating only animal meat. For many, it includes other animal products that don’t raise blood sugar like cream and butter.

There are various reasons why people are doing this diet. Some are doing it because they’ve heard that it boosts physical performance and they want to see if it does that for them.

Some are doing it because it sounds appealingly primal. For these people, this sounds like a temporary fad diet.

Others, connected to Bitcoin, are doing it as a lifestyle statement of sorts protesting centralized banking and healthcare–or something like that. You’ll have to read more about it as I do not have an affiliation with this group.

One of the more common reasons I have found for people taking on such a limited diet is that they have ailments they are suffering from and are desperate to treat in a way that doesn’t include harsh drugs but rather work at the root of the problems. This is the camp I fall into.

I’ve been following this diet for several years out of curiosity as an objective observer. I’ve read claims of an all meat diet healing one’s gut and therefore being useful for those with multiple food allergies, sensitivities, and autoimmune conditions. The goal here is to heal and then reintroduce foods.

This past year I’ve had several months long bouts of fatigue and joint pain flares. These have happened over the last decade but the pain and duration of the flare-ups have been getting progressively worse. I’ve also developed some kind of dermatitis on my face and have psoriasis. Things get real when they happen to your face because you can’t hide it and you’re constantly reminded of it.

My doctor said that he could give me prescription non-steroidal anti-inflammatory drugs like Naproxen but those can damage kidneys over time. He said he could give me steroids but those would raise my blood sugars. Neither option seems like a solution to me. I’m only 35 years old.

My kids have my genes and another motivation for me to figure out what might help autoimmune problems is to know what may work in the case my kids were to develop something.

Desperate Times Call for Desperate Measures

So anyway, I finally became fed up enough recently that I decided to find out if the diet could be tried without serious health consequences.

I did research on the topic of how bowel movements happen in the absence of dietary fiber, the need for vitamin C changing while not consuming carbohydrates, and what the latest science says about cholesterol. If you’re interested, I urge you to research these fascinating topics.

Sufficiently armed with a base level of confidence that I wasn’t going to kill myself by doing this for a few weeks, I plunged into the diet one week ago. I haven’t removed coffee because I don’t want to deal with caffeine withdrawal just yet. I’ve been eating beef, chicken, salmon, sardines, pork, eggs, butter, and cream.

One Week Symptoms

Here’s what I’ve experienced so far:

The first two days I had cravings for everything except meat. I also started sweating a lot, which for me isn’t much, because I am not one to sweat, so just sweating period was a strange occurrence. I would sweat at each meal which wasn’t very appealing. I sweat a lot the first two or three nights, too. My weight, after 3 days, went down 3 pounds which may have been initial water weight loss.

On day 3 I noticed that my stomach has flattened. That’s weird, I thought my belly was just really pudgy. It appears I was bloated or retaining fluid there. My husband was surprised to see a little bit of a four pack of abs. He said, “Wow, your waist is actually really small, isn’t it?” Apparently so.

Another thing I noticed on day 3 was that I sprung out of bed so easily in the morning. For many, many years, since I was a teen, I’ve been trying to wake up while feeling happy and energized. I couldn’t do it. These last 10 years have been brutal. I have needed more than 8 hours of sleep each night and I have had such a hard time in the mornings that I had extended my waking hours into the night (since I feel pretty good then). So two years ago I was going to bed at 12-2 am most nights and getting up late. All this time I’ve been wanting to get my sleep schedule in sync with my husband’s–he gets up at 6 am, sometimes earlier. Well, since day 3 and each day since, I’ve been up at 5:30 or 6 am.

In the past 20 years, I’ve consistently struggled in the morning because when I wake up I feel like I’m dying and feel super depressed and stiff for about 30 minutes. Eventually, I feel better but it makes life hard when you don’t welcome the day. Maybe I’m just excited and these effects will wear off soon. We’ll see.

Another thing I’ve noticed is my coffee has started to taste much sweeter despite me drinking it the same way I have been having it for a long time.

As you can imagine, my blood sugars have been ridiculously stable. On the first three days, I had to treat a  few low blood sugars with a glucose tablet or two but I’ve since lowered my basal and haven’t had any more lows. I am now taking 6 units of Tresiba in the morning and 3 units of Tresiba at night. I take about 6-8 total daily units of regular human insulin with my meals. I may take a unit or two of Humalog as a correction to stay below 100 mg/dl.

Speaking of meals, I’ve needed only two a day because the food is so filling.

My digestion is fine (I was worried I’d get constipated but that hasn’t happened). I take a magnesium supplement every day and Vit D3. I’m thinking of adding a little bit of Vitamin C.

The other thing I’ve noticed is I seem to be much more sensitive to the effects of alcohol this past week. Just the other night I had two shots of liquor (something I do only a few times a year with no problems) but this time I suffered the worst hangover of my life and the first one as a mother, which truly embarrasses me. I endured nearly 8 hours of vomiting–that was just yesterday.

I don’t know how that happened. I threw up bile for the first time since I was in the hospital with severe kidney stone pain 12 years ago and had to keep a hawk eye on my blood sugars while sipping water infused with electrolyte drops. Lesson learned the hard way. Take severe caution with alcohol.

Maybe I’ve hurt my liver in the last week and that’s what happened? Not likely. I’ve been eating mostly meat and veggies for a long time and my liver tests have been great. I do have high bilirubin levels but always have and providers have speculated that it’s a harmless genetic thing (possibly Gilbert’s Syndrome).

I Will Keep You Updated

It’s still early for me so I will strive to be objective as I continue to note whatever positive and negative things pop up. I have no big hopes or expectations. I just want to find out if this helps. If not, I’d be very happy to go back to my beloved vegetables, nuts, and dark chocolate.

The good days of my monthly menstrual cycle are currently happening. The effects of rising estrogen and the oomph of extra testosterone make everything better. I’ll have to really test this out through my monthly week of low hormone hell which nothing–not even rainbows or ice cream can survive.

I do want to point out that I’ve never been a big meat lover. For the past decade, my favorite foods have been mostly vegetables, flavorful sauces, herbs, spices, and sweets. I joke that I like steak only because I get to have steak sauce. Or that I like shrimp because of that tomato-based cocktail dip. Wings dipped in blue cheese–you get the idea.

Eating only animal products has made meals so strangely satisfying. I can’t figure out why that is if I love veggies but am no longer eating them. I’m entirely weirded out. Since I’m feeling fine, I’m going to keep it up for a while to observe my symptoms.

Time will tell me more. If you think this sounds crazy, I’m with you, but I hope I am not judged harshly for trying to stop my widespread pain. It’s bothering me enough now that I’m willing to try anything. I don’t feel like I have anything to lose. I have other ideas to try to help rule out causes to my symptoms. I’m determined to somehow make things better for myself. Right now, it’s the carnivore diet.

For better or worse, I will update you soon.

Calling Things by Their Proper Name and Why High Blood Sugars Always Make You Feel Bad

Dr. Stephen Ponder, an endocrinologist living with type 1 diabetes, has been posting thought-provoking questions on Facebook. One of the latest questions was: “How often do you say “good” or “bad” when talking about blood sugar (or an A1C)? If not, then how do you describe them? Should kids use “good” and “bad” when talking about their sugar levels?”

I thought I’d answer in the form of a blog post since this sparked a whole long train of thought for me.

Confucious supposedly said, “The beginning of wisdom is to call things by their proper name.” If something causes you harm–for example, as high blood sugar does, then I hesitate NOT to call it a “bad” blood sugar because it simply is, whether we acknowledge it or not. I believe it would be bad for my health if I didn’t identify, accept, and name the truth on a regular basis. It’s hard to swallow but my reality needs to be very much imposed on me if I am to act in my best interest.

Houston: We Have a Problem

People email me all the time asking what the secret is to my pretty good diabetes management and how I have the discipline for it. Honestly, any good I derive from my actions begins with calling things by their proper name. That means that I admit that eating what I want and covering it with insulin doesn’t work well enough (for me). I openly say that low carb for type 1 diabetes is the only way I know of, to get close to achieving normal blood sugar levels, a healthy weight, and safety from severe hypoglycemia. And I say that not having normal blood sugar levels is physiologically harmful because we know it is. If it weren’t, no one would be diagnosed with pre-diabetes with a 6% A1c level but, they are every minute of every day. It is on that basis that I call a 6.5% harmful and deem it not good enough for me.

If I don’t acknowledge that something is “bad” or “not good” then I don’t follow with the appropriate response or actions which have to do with changing those blood sugars or anything else. We need to apply judgment in our daily lives. It’s necessary. I have to be able to admit to myself when I’ve mistreated a loved one or I’ll certainly continue to do it. I have to be able to admit when I’m overeating, or I’ll keep gaining weight. And I have to be able to say “no, that’s not good for me” or I will suffer various potentially unlimited consequences. What is it they say to those with an addiction? “You must first admit there is a problem.”

High Blood Sugars Make You Feel Bad Even if You’re Told Not to Feel Bad

I understand parents of children with diabetes don’t want to use “good” and “bad” in relation to blood sugars or diabetes management in part because the child didn’t have anything to do with getting such a brutal condition and we don’t want them to feel bad about themselves due to diabetes. And I do support the effort many parents put into saying things like, “It’s not that you did anything bad, it’s that this isn’t working and we need to figure out what will work better.” There is still an acknowledgment that something isn’t working and the troubleshooting can begin and the child can feel better, physically, mentally, and emotionally.

I’ve recently put quite a bit of thought into why I struggle to do what I needed to as a kid with diabetes. There are several reasons but I think the main one is that doing what my parents and I were told to do didn’t ensure my success, at all, and made me feel sick and anxious anyhow and thus I acted out of hopelessness, by lying about my blood sugars, not always doing my blood sugar testing, and sneaking sugary foods to self-medicate my feelings of despair. I knew what my high blood sugars meant for my future, and in the immediate moment, my self-esteem took a hit. High blood sugars (especially really high blood sugars) make you extremely sluggish, make your saliva thick and foamy, your thinking slow, and make you not look and feel generally healthy (albeit subtly, at first).

Let’s face it, anything that is a detriment to health is a detriment to outwardly attractiveness, if not now, then later. I remember thinking as a teen that I was totally ok with my ears sticking out–there was nothing I could do, and they functioned properly, but I wasn’t ok with the weight gain I was experiencing from the way my diabetes was being managed. I wasn’t ok with becoming less attractive due to diabetes nor slower as I played sports which requires you to compete using your energy and speed. I couldn’t prove to myself or anyone else how just how good I could be as I couldn’t fully apply myself to anything. Within my capabilities, I tried SO hard, though. Not getting results for your efforts because of diabetes makes a person crazy. And successful diabetes management relies on the most effective efforts, not the most industrious ones so I lost out.

For those without diabetes, think of how you feel about yourself when you’ve been injured or come down with a bad cold–you’re knocked down a few pegs, right? Even if people are kind to you and don’t make you feel bad about any of it. Admit it, you feel less attractive, less productive, and you may feel motivated to do whatever it takes to get yourself back to feeling good, even doing things that you were not willing to do before that experience.

I believe many people with diabetes, including children, are in an impossibly precarious situation when their blood sugar management is less than ideal. This is particularly true once they learn what elevated blood sugars can do to them over time or once the negative effects stack up over the years. No, it’s not fair, or whatever, but all I know is my “good” diabetes management began when I admitted to myself that my diabetes management was “bad” and that if I were willing to make some sacrifices in the name of tight blood sugar management, I may have a ticket to health and happiness. It’s been more than worth it, which is why I keep annoyingly banging this tired drum.

Is it Possible to Do Better?

I am partial to diabetes management for adults and children which makes it easier for them to be successful with their diabetes because the alternative leads to misery. No matter how much you tell a person they are “good,” if their blood sugar levels are often high, they are going to be feeling poorly much of the time, and that is going to make them feel “bad,” regardless. It’s very hard for us to separate how we feel, physically, from how we feel, mentally. One follows the other. Feeling unhealthy does not lend itself to feeling good and it never will.

Do some people who don’t feel healthy manage to feel good and happy? Yes, but this is a feat not accomplished by most, and while children amaze us with their resilience alas, they do grow up, and many will suffer the weight of high blood sugars and blood sugar variability and fear of hypoglycemia as evidenced by personal social media accounts and all the studies pointing out rates of anxiety and depression in adults with type 1 diabetes.

This is why I encourage the attempt at a low carb diet for anyone with type 1 diabetes. Thanks to those who do very low carb diets, we’ve learned that it is possible to do better with glycemic control. Did you know that for a long time no one did better than a 4-minute mile and experts said it was impossible and once Sir Roger Bannister did, many others followed suit soon after? That’s because we can only accomplish what we believe is possible. I’m telling you that I’m not special, I don’t have more discipline than you, and that it is possible to achieve very tight and safe, blood sugar control.

The repercussions of this are incredible. In my experience, it leads to better moods, better relationships, improved ability to work, less fear of highs and lows, less anxiety, less depression, better sleep, and on and on. The positive effects are hard to quantify but they are exponential and eventually make going back to another way of managing diabetes something I won’t consider.

You can’t easily feel good about yourself if you don’t feel good physically and you likely can’t feel your best physically if you don’t have blood sugars as close to normal as possible. For more: check out the Sir Roger Bannister of the type 1 diabetes world: Dr. Richard K. Bernstein.

To conclude, I don’t worry about good/bad and any similar terminology when I think to myself, I worry mostly about my outcomes and my actual experience. It’s surprising how happy I can be while honestly telling myself that something is “bad”. That’s because I then put my energy into finding what makes it “good” and focus on that, instead. What you focus on matters and makes all the difference.

(If you manage your blood sugars well without low carb and you’re happy and healthy, I’m not directing this to you, at all.)

5 Ways My Husband Supports Me and My Diabetes

  1. I eat low-carb because coupled with proper use of insulin it’s an undeniable way to get out of the blood sugar roller coaster (aside from those days when I forget I have diabetes–it happens). My husband eats whatever low-carb food I prepare with zero objections because while I try to make great tasting food, the fact is that he understands I do better if I’m not alone in the way I eat at home.
  2. He jumps up to get glucose tablets when I need them. When someone does something for you with a controlled sense of urgency, don’t you feel loved? I mean, I’m not going to die from a 50 mg/dL blood sugar level if he doesn’t swiftly get my glucose for me but I like that he moves quickly to get what I need. Nothing says “I love you” like showing someone you want to shorten their discomfort by a few seconds if you can, by acting quickly.
  3. He lets me have a pity party but he does not participate in it. I really appreciate that on the days I am wallowing over my diabetes, my husband respects that and is a shoulder to cry on. I also appreciate that he doesn’t join me, though. I like that when I see things through considerably foggy lens for a time, he is still seeing clearly. He doesn’t get all sad and pitiful with me because he sees that in objective terms, I’m alright and will continue to be once I have my good cry or time to vent.
  4. He doesn’t lie to me. This is one of the most important ways he helps me with my diabetes–and everything else. If i’m fat, I don’t dare ask my hubby if I’m fat because he’s going to look at me like, “why are you asking me a question you know the answer to?” To his credit he’ll say “you’re beautiful and I love you” (cuz that is what I was fishing for all along!) but to tell me i’m not fat, if I am? Nope, he does not support me having any delusions. He also wouldn’t pretend a 200 mg/dL blood sugar level is fine for me to have all the time and he also wouldn’t let me believe that me having ice cream each evening isn’t a problem involving a lack of self-control when it fundamentally is (speaking for myself here). As a result, I have a partner who wants the best for me and that is something we all deserve.
  5. My husband takes care of himself. In doing so he inspires and leads me to do the same. When someone who respects themselves loves you, you can’t help but want to respect yourself, too. Then when they’re having a weak moment, you can help lift them up as they’ve done for you. I hope I do that for him sometimes.

My Experience With Intermittent Fasting for Type 1 Diabetes

In a nutshell, intermittent fasting means closing the window of time during which you eat.

If you have breakfast at 7am and finish dinner at 7pm, you’d be eating during a 12 hour window and fasting for the other 12. Many of us don’t do that, though.

Nighttime snacking is likely an epidemic and from what I hear/read, it is wise to give your body at least 12 hours of fasting time.

Have you ever skipped a meal and felt lighter, recharged, and not hungry? I have often felt this way. I understand about a third of you will probably be about the opposite but such is my experience.

Intermittent Fasting for Weight Loss

I was interested in intermittent fasting years ago when I read what Tim Ferris had to say about it. He has access to exceptional people, is wildly curious, and respects science to as much as a degree as I can tell so I tend to consider what he has to say.

I started trying it a year and a half ago in the hopes it would help me lose some stubborn weight. If I didn’t have type 1 I might have type 2 diabetes. In other words, I become resistant pretty easily and quickly to insulin. If I eat my disciplined way and exercise my basal insulin is about 11 units every 24 hours. If I eat the standard american diet and don’t exercise it goes up to about 30 units every 24 hours. Big difference.

Anyway, I began by just not eating breakfast and having my first meal of the day at lunch (noon) and then having dinner at about 6pm and finishing up at 7pm for the night. I continued my walking most days, trying to walk at least 3 miles a day.

This was easy for me because I have always regretted breakfast. Seriously, I eat it and feel too full for lunch and if I skip lunch I get hungry so it just complicates things and zaps my precious energy. For so long though, the commonly heard “never skip breakfast” has prevented me from doing what felt right.

I lost 10 pounds in about 8 months. I’ve since lost another 5-6 pounds by having lunch not at noon, but at 3pm each day. I’m never hungry before 3pm each day so it seems I have adjusted to this way of eating, which is cool.

Intermittent Fasting for Better Blood Sugar

The other reason I’ve enjoyed intermittent fasting is because instead of figuring out insulin for three meals or more a day, I’ve cut it down to two, giving me one less variable to mess up my blood sugar levels with.

Skipping breakfast helps with the dawn phenomenon and morning exercise, too I think.

For example, when I get up, I first test. I adjust with insulin if needed, usually giving the tiny bit extra for the dawn phenomenon and then get on the treadmill. Exercising in the morning before food has proven to help burn more calories AND it has been proven to keep exercise happening in the first place. If we put it off for later in a busy day, it may just not happen at all.

During and after my walk on the treadmill I will drink coffee, which is my personal way of incentivizing my walk.

When Will I Stop Losing Weight?

I’m very curious about this question because if eating well, consistently walking, and fasting keeps reducing my weight, what does that mean?

Does it mean that intermittent fasting is helping to boost my metabolism? I swear I eat as much food as I used to, if not more. My last blood tests from 2 months ago show my thyroid working much better than it did 2 years ago when it was at the very lowest end of normal, so that is encouraging.

I’m not done losing weight so I will just continue on the path i’m on. I estimate that for my 5’4 height and very small frame I should weigh less, still. Belly fat is my main concern and as my kids lovingly tell me, my stomach is a “cozy and squishy pillow” to lay on.

I’ll be very interested to see if my blood pressure changes in a positive direction with any additional weight loss (fingers crossed). You’ll be the first to hear about it if it does.

Why I Understand Low-Carb Proponents for Type 1 Diabetes

Some people are very strong supporters of a low-carb diet for people with type 1 diabetes (or any diabetes). Historically, this group of people has not been well-received by many with type 1 diabetes or those who have children with type 1 diabetes because of the way that insulin can be utilized to not deny a person certain foods and the joy they bring.

I can sympathize greatly with the idea that we all deserve a treat from time to time and I can understand why some want to eat what they want and just learn to manage with their insulin timing and dose. I can certainly see why raising a child with type 1 diabetes and having them never eat sugar or many carbs can seem like a daunting and almost cruel route.

I’ve long made the case for reducing carbohydrates on a personalized level. For example, I do believe that some people cannot feel well or thrive on an extremely low carb or ketogenic diet (I can’t) so it makes sense to take symptoms in consideration. I do think that facts indicate how reducing carbs increases the chances for more stable blood sugar levels but, there are different degrees one can take when it comes to carb intake. I’m not extremely low carb but I have a low enough carb intake that my blood sugar management is pretty good, my triglycerides are very low, and I avoid extreme highs and lows on a consistent basis.

The “I can eat that” movement of the past decade has seemingly fizzled out. Or maybe I’m not reading as many diabetes blogs as I used to. Either way, I can’t help but wonder if people have endured experiences like the ones I have which bring me to the conclusion that “yes, I can eat that, but I will likely suffer the consequences of doing so, so in a way, no I can’t eat that”.

Early on, during the first decade or so with type 1 diabetes, these consequences seem acceptable to many of us. The future is far away. As someone who has now lived with type 1 diabetes for over 22 years, I see things differently.

After 20 years with type 1 diabetes, there is a much higher likelihood for a great number of horrible complications. These are ominous when you aren’t experiencing them but when you are…well let’s just say that it is an entirely different story. There is a pain on top of the pain of those complications and it involves the question “What if?” “What if I could have avoided this?” “What if I had just managed to have better blood sugar management during those first 10 years?” “What if I had just ate fewer carbs?” Those questions are brutal. I endure them on a regular basis. I sometimes wish I could relive my childhood and rip all those carbs out of my hands.

So because of those questions and the pain associated with them, I feel that it is a good idea to share with others what I wish I could have done differently so that they may be better armed to avoid the complications I’m getting a taste of now. Everyone should do what they think is right for them, of course but, I didn’t even have a chance growing up because no one said “low carb eating can help you avoid dramatic blood sugar swings” and my healthcare team encouraged eating pasta, oatmeal, and cereals-all the things I avoid like the plague nowadays. (The other negative side effect is I’m now working really hard to learn to trust doctors again.)

I respect any diet a person chooses if it works for them. I totally understand not having the level of willpower required to deny pizza or ice cream on occasion (I haven’t got it). Most people with type 1 have an A1c that is too high, though. I’ve had an A1c between 5- 6% for the last 11 years and stuff is starting to happen. And some of this can’t be alleviated much or fixed with any medication or treatment. I’m only 33 years old. Not everyone is as sensitive as me but we don’t find out until it is too late.

That said, I’m generally doing very well. Life is good and I am healthy enough to do the things I want to do every day. I’m just choosing to recognize that some unfortunate things are starting and I still have many decades to go–and that is terrifying. I’m picky. I want to be AS freaking healthy as a non-diabetic. I don’t deserve less than that…but I know I have to work for it.

Some Dr. Bernstein supporters are kind of known as bullies in the online diabetes community. I hear comments about them where people express annoyance at how passionate they are about pressing others to consider a very low carb diet for type 1 diabetes. While I want people to engage myself and others in a respectful way and most of these low carb supporters have been very respectful to me personally, I have never been able to deny that even when someone is rude, they have a point. An A1c that is at or near normal levels is probably the best defense when it comes to complications.

Yet, at the same time, I acknowledge that I can’t eat as disciplined as I’d like. Well, not that I can’t, but apparently, I won’t, although I do better than I used to which gives me hope about the future. Kudos to those of you who do. You have my bewildered awe and respect and to those of you who struggle like I do, don’t stop trying and please stay open-minded about what you are capable of. Many years ago I saw no way of getting my 9% A1c down until I learned about low carb eating and I slowly began to implement it.

That said, we are all on a different part of our own journey and I support you where you are at. I share what has helped me because I wish I’d known some of these things sooner. Time has a way of flying by and I find it telling that I am not traumatized by a childhood full of insulin shots and finger sticks and being different and having sugar-free jello for my birthday. No…it was those crazy blood sugars.

Saturday 2015 Diabetes Blog Week My Favorite Blog Post

Click for the Favorites and Motivations – Saturday 5/16 Link List.
If you have been blogging for a while, what is your favorite sentence or blog post that you have ever written?  Is it diabetes related or just life related?  If you are a new blogger and don’t have a favorite yet, tell us what motivated you to start sharing your story by writing a blog?  (Thank you Laddie of Test Guess and Go for suggesting this topic.)

 

My favorite blog post: (Because getting this info down took forever and it’s one of the biggest things that helps me…)

Classification of Carbs

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I really believe carb counting alone is insufficient when it comes to my diabetes management.  At least the simple way it’s taught.  It’s just my opinion and I’ll explain why:

I’ve found that for ME, there are adjustments I make for different types of carbs.  These are adjustments beyond just subtracting grams of fiber.  A carb is not a carb.  They vary spectacularly and learning their differences helps me keep my blood sugars in range and helps me decide which carbs to avoid.

I classify my carbs:

-Refined grains

-Sugar/sucrose/plain fructose (no fiber)

-HFCS (High Fructose Corn Syrup)

-Chocolate, ice cream, and other high fat desserts

-Poultry/Meat/Seafood

-Fruits and vegetables

Refined Grains

When I eat anything with processed grains like white rice sushi or pizza or cookies, cake, or crackers, I have to watch out for a post meal blood sugar skyrocket.  It doesn’t happen right away which is why it’s often confusing to dose for these kinds of foods.  For example, last time you had pizza you were high afterwards so this time around you give more insulin, only to get low in the middle-towards the end of your meal.

I find that about 30 minutes after eating anything with refined or processed grains, I have to give another dose of insulin.  An insulin pump option on a dual or square wave bolus works well for a lot of people, but from what I gather, people with and without pumps have a hard time keeping blood sugars in range with processed grains.

Sugar

Eating something like candy made from glucose or sugar or drinking plain 100% juice or sugar sweetened beverage is a bit different.  I find that if I’m going to consume this within a reasonably fast amount time (as opposed to snacking over a period of 30 minutes) then I count carbs and using my 1:15 scale, I give just that amount of insulin.  Then I wait 15 minutes for the insulin to start working (more if I’m not in range).  I find that the insulin cancels out the sugar carbs pretty well and there is no shocking aftermath.

High Fructose Corn Syrup (HFCS)

This one is interesting.  At least for me (remember, this is just what happens in MY body).  I find that candy or beverages made with HFCS works like when I eat refined grains.  But that makes sense to me when I think about corn being a grain!  It’s easy to forget because people serve it to kids and say “eat your veggies”.

High fat desserts

This gets it’s own category because of the large amount of fat (and because they’re my favorite!)  I try to stick with dark chocolate for a low dose of sugar.  I also make sure to buy desserts that do not have HFCS in it as a sweetener.  I try to get the gourmet kind with minimal ingredients and then I count carbs and give insulin in the middle of eating since the fat content really slows down the absorption of most of these foods.  If there is a lot of sugar I give insulin prior to eating as usual.  I’m referring to a dessert like high fat truffles, mostly.

Poultry/Meat/Seafood

I count carbs and then add a tiny extra amount of insulin to my carb count depending on how much I eat.  I don’t have to do this unless I’m really filling up on this protein source.  I love how these foods fill me up and do very little to my blood sugars.

Vegetables and Fruits

I’m a fan of these, especially in terms of carbs.  As you are well aware, the high antioxidant, vitamin, mineral, fiber, and water content of these foods makes them wonderful for our health.  I definitely don’t need as much insulin for these foods.  I count the carbs and then omit for fiber content.  Fruit is something I stick to consuming in it’s natural state and in small quantities.  The sugar in fruit is fructose and too much overloads the liver, causing fatty liver problems.  Oh and it definitely affects blood sugars.  My favorite are cherries, they are very low glycemic.  Have you tried them for a low?  It takes so many!

I know I didn’t talk about legumes or nuts.  I don’t eat legumes anymore.  I think I ate too many as a kid.  I treat legumes like vegetables and I treat nuts like meat.

With any food:  If I eat a lot, I need to give a little extra insulin for the full stomach effect that Dr. Bernstein has talked about in his books.

I adjust for a few other things.  I’ve mentioned them before but here we go again:

BM status.  Eww, I know.  But being backed up might make a person anticipate a need for more insulin.  The opposite of that issue= less insulin.  So watch out for major lows if you get food poisoning!

Stress.  If I’m stressed, I have to give a little bit extra insulin to combat the stress hormones and their affects on my blood sugars.

Exercise.  Different types of exercise require different diabetes management approaches.  Read Ginger Vieira’s book for that info and so much more-even worksheets for getting all these changes right!

PMS.  Days before I start, I need to up my basal insulin.

Sleep.  If I stay up late (past midnight), I have to give some extra insulin (unless I’m active).

Sedentary.  If I’m being sedentary more than two days in a row due to sickness or diabetes burnout or whatever, I definitely have to up my basal insulin substantially (by 30-40%).

Too much artificial sweeteners.  Certain artificial sweeteners in high doses do contain carbs (it’s a small amount per serving so they’re legally allowed to round down to 0) so if you’re binging on diet coke, check your blood sugar and stay alert to a sneaky increase.

That’s all I can think of.  It’s just an example of how you want to be aware of how your body reacts to different types of food and activity.  You can see why I stick with meat/poultry/seafood, vegetables, and fruits.  Much better blood sugar stability and less variability for me.  But when I do splurge, at least being aware of how those foods act differently help me manage them for those occasions.

I write all this out because you can have tighter blood sugar management.  It helps to learn yourself and the foods you’re eating.  Again, get Ginger’s book or ebook and discover how to improve your blood sugars.  I highly recommend it.

Friday 2015 Diabetes Blog Week What I Eat

Click for the Foods on Friday – Friday 5/15 Link List.
Taking a cue from Adam Brown’s recent post, write a post documenting what you eat in a day!  Feel free to add links to recommended recipes/shops/whatever.  Make it an ideal day or a come-as-you-are day – no judgments either way.  (Thank you, Katy of  Bigfoot Child Have Diabetes for this topic.)

 

Here is what I ate one day last week.  It’s pretty typical though I do like to change it up quite a bit:

Breakfast

In a magic bullet blender I put in a handful of frozen berries, a little fresh mint, some kale, chard, spinach, (or other dark leafy greens), some almond butter, chia seeds, and unsweetened coconut flakes.  I drink it up in a wine goblet.

11am I have coffee with a little milk.

Lunch

Kale salad with feta cheese, tomato, red peppers, and olives.  A slice of uncured deli turkey.

3:30pm I have tea time.  Today is a chocolate mint mate with nothing added.

Dinner

Some sauteed mushrooms, potato, squash, in a bed of peas with mint.  A glass of cheap wine.  A hibiscus popsicle.

 

This is a typical feel good day.  There are days when I have pizza with grilled veggies on top and ice cream.

 

Juice Fasting with Type 1 Diabetes

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I’ve written about juicing in the past here.  Last week I decided to try a few days of juice fasting.  I drank about 2 to 3 liters of vegetable and fruit juice each day and the only other thing I consumed was water.  I used a high quality omega brand juicer and drank mostly non starchy vegetables.  I lasted 4 whole days.  Here’s how it went down:

First of all, why did I do this?

Several reasons.  First of all, I just felt like it was the right time for me, motivation-wise.  But, also I was extremely curious to see how someone with type 1 diabetes, like myself, would manage such a drastic reduction in calories and a juice fast.  I also wanted to welcome springtime with tons of fruits and vegetables without their pulp for an infusion of vitamins and minerals.  And I wanted to reset my way of eating.  I hate Winter and so every year when it’s cold and dark, I tend to comfort myself too much with sugary and fatty foods.  It doesn’t matter how healthy walnuts and almonds are, eating too many will make you fat.  It seems easier for me to do something extreme like a juice fast in order to remind myself how much better it feels on a really healthy diet.  Last summer I did a raw food detox for a few days and felt so great, lowered my need for insulin, and felt ready to eat healthier again so I figured this would be similar.

Day 1

I started on a Saturday.  I felt fine until mid afternoon when I developed a headache.  I was outside much of the day and running after the kids.  It was probably good I stayed a little active.  I don’t know if the fast caused my headache because I have allergies and during this time of year I get the type of headache I had that day so maybe, maybe not, I don’t know.  Either way, the headache got worse and worse (it was like a migraine).  By 10pm I was in agony and threw up 5 times and shivered violently for a good hour.  My blood sugar dropped and I had to get orange juice in me.  My husband was my nurse and checked my blood sugar every hour until 1am while I slept it off.  This wasn’t uncommon for me.  I am very sensitive to nausea and migraines often make me throw up several times a year so again, I don’t know if this was something I can attribute to the fast but it certainly was a miserable start and I worried if I was going to last another day.  That night I injected half of my long acting basal insulin and it ended up working perfectly.

Day 2

The next morning I woke up feeling perfectly fine.  No headache, no weakness, no morning stiffness in my joints.  I jumped out of bed in a majorly uncharacteristic way and got straight to juicing breakfast.  The entire day went amazing.  I felt great though I did take a nap (something I never, ever do) in the afternoon.

Day 3

I woke up wonderfully again and this time felt like I was floating on air.  This was so strange.  I told Alex, “I feel…euphoria!”  And then I googled “symptoms of a fast” and found that people often feel “euphoria”.  Wow.  Ok, so it’s not just me making this up.  I felt extremely peaceful and calm and happy.  I napped again this day.

Day 4

I felt fine again but started getting loose stools and that progressed for the worse during the day, leaving me feeling a bit dehydrated and uncomfortable.  And my peace was decidedly disturbed.  I chose to end the fast that night because during the next 2 days I was to drive a total of 12 hours to presentations about diabetes and didn’t want to be stuck in a car on the interstate while needing a restroom.  Not to mention diabetes and dehydration is a bad combination.  It only takes one high blood sugar for things to possibly swing out of control.  I made a pact with myself before I started the fast to above all, be safe.  I would have liked to continue but I think for my first juice fast 4 whole days was probably ideal.

Random things about this experience:

-I am an A blood type which is associated with eating more of a vegetarian type diet.  I looked into my metabolic typing a while back and found out I’m what they call a “carb type” which happened to correlate with my blood type.  Ignoring all this information, I have to admit I’ve always felt best on fruits, vegetables, and light protein sources like chicken, white fish, and legumes.  A juice fast is really great for my “type” (whatever that really is) and perhaps that’s why I didn’t have a lot of the negative symptoms others report during these fasts.  Just a thought.

-I’ve heard of people doing a juice fast by blending fruits and vegetables in a blender and then straining the pulp.  I wouldn’t recommend this as the best option because the fast motion of the blender is harsh on the valuable nutrients in the foods.  An Omega single masticating juicer is gentle and while it completely separates the pulp from the juice, it leaves all your vitamins and minerals intact.  The downside is these juicers are expensive and take up a lot of space.  I love mine (and am grateful I bought it before the kids were born-you know back when I had more money).

-I also know some people do a juice fast with store bought juices.  This is not a “juice fast”.  Store bought juices are miserably deficient in the valuable nutrients the foods once contained because they’ve been pasturized and stored for far too long.  Making your own juice means you know how fresh your fruits and veggies and herbs are, you ensure their cleanliness, and if you drink them right away, you get loads of nutrition in a glass that many people rarely get in a full week.

-It’s probably not correct to call this a “detox” because from what I understand, and I could be wrong, to detox you need fiber which will act like a sweeper of your colon.  Maybe what I’ll do next is just use the same foods but put them in a blender for green smoothies.  A green smoothie detox!

-Juicing omits all the fiber so nutrients are more easily digested and absorbed by the body.

-I juiced the following foods:  kale, collard greens, spinach, celery, beets, carrots, ginger, mint, cilantro, bok choy, arugula, cabbage, watermelon, blueberries, apple, lemon, oranges, and grapefruit.  You’d be surprised how good mint and ginger makes these juices taste :)

-I lost 4 pounds on the fast, my skin looked great, I felt more in tune with my body, and very satisfied with life.  All in all I can’t wait to do it again, if only for a weekend.  It’s been a week since my fast and I’m still using lowered insulin requirements so this seems to help me with my insulin resistance problems.  Now I just have to continue to eat right.  But if I slide out of place I know this may be just the encouraging boost I need to get me back on track.

Disclaimer:  I’m not a doctor nor any kind of medical professional.  So don’t take my word for any of this, it’s just my experience and I’m drawing from my personal knowledge base. Some people do not eliminate on fasts (which is important) and endure irreversible damage to their vital organs such as their kidneys and liver.  A fast is something very serious if you have a health condition and you want to really research the topic, perhaps talk to your medical team, and definitely listen to your body through the entire process.  Beginners should do very short fasts at first as should people who eat an unhealthy diet.  Drink plenty of liquids, rest as needed, and stick to light exercise.  A fast should not feel awful and if it does, stop.

Emotional Eating with Diabetes Book Review

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Emotional Eating with Diabetes is Ginger Vieira’s 2nd book.  It tackles a subject all too familiar to people with diabetes and perhaps, not acknowledged enough by everybody else.

I’ve blogged about my struggles with food but not in great detail.  So I want to share my emotional eating story.

I’m a really emotional person and someone who has lived with type 1 for over 18 years (and through childhood and teenage years) so put that together and add in some 1st world body issues and you have someone who can review this book from a very personal place of experience.

And while I think I’ve got a good grip on my emotional eating issues (they don’t resurface often), I’m like an alcoholic in the sense that I need consistent reminders to stay on the right path and out of the dark side.  I really benefited from reading this book.  And I think I’ll read it every single year from now on for support.

It started when I was 12 and had only been living with type 1 for a year.  I would beg my mom for gum at the grocery store and then sell each piece at school for 10 cents, which I’d then pool together to buy an alternate lunch at school each day-a Little Debbie oatmeal cookie or fudge round.  I hated diabetes and the rules that came from my doctors so much that I was going to spite them any way I could.  So I ate what I wasn’t supposed to for lunch.

Then I started sneaking in candy bars and granola bars when no one was looking just to eat what diabetes wouldn’t let me eat.  (Do remember, this was before fast acting and 20-some hour insulin so back then we did have to abide by some rules that we don’t have any longer.)

I would binge and then feel like the worst person in the world.  And I developed a cycle of rebellion mixed with self-hate and a neglect for self-respect (ironically something I was all for in other manifestations).  People didn’t know I had a problem because I hid it.  And that was probably the first sign of a problem for me.

My health suffered, my weight went up, I had a hard time keeping up with such a destructive way of living.

Eventually (after years of hard work), I began to enjoy eating healthy and learned how to treat myself in a respectful way when it came to food.  And because food matters so much in diabetes, my health improved dramatically-no, my life improved dramatically.

If this sounds at all like you or you want to stop feeling obsessive about food, get this book.  It’s written in a straight forward but friendly way that will acknowledge all your fears and anxieties and help you through them.  This book will give you a guided path to where you want to be and show you how to be kind to yourself along the way.

I agree that the “can’t eat that” mentality is harmful. Ginger stresses that we make our own decisions and instead of telling ourselves we can’t have something, we either choose to or choose not to. And that’s how I do now with bread, rice, and pasta and other heavy carbs. I choose not to have them but I know that if I want them, I can have them. There is a difference between enjoying chicken and veggies  and eating that same dish while staring longingly at the rice side that is “forbidden”. Our minds are very susceptible to this kind of pressure and they are bound to crack.

Every now and then I eat my favorite food-ice cream, and I eat it really slowly, savoring every bite.  And I remember how I used to eat it so fast my tongue would burn and I would ask myself “What are you doing, you’re not even enjoying this?!”  That’s when I realize I’ve come a long way.  And yes, it took baby steps, the way Ginger describes in her book, but eventually we can get where we’re meant to be.  And the journey is so worthwhile.  This book is succinct, kind, and best of all I believe it’s effective.

I strongly recommend it.

Buy it here Smile

Interview with Type 1 Living Abroad, Ariana Mullins

 

Remember earlier this year when I interviewed Nathan ShackelfordHis blog is still one of my faves.  Well, he said I might like to check out his sister’s blog.  Ariana Mullins has type 1 diabetes like her brother, but doesn’t blog about it.  Instead she blogs about her family’s adventures living in Europe.  She is a fantastic writer (she just wrote my favorite blog post ever) and takes some amazing pictures.  Do check out her blog, it’s a beautiful reminder of what living a healthy, fabulous, and grateful life is all about.

I asked her some questions about how she manages her diabetes and what it was like having diabetes and living in Europe (and other places):

How long have you had type 1 diabetes?

I was diagnosed 21 years ago, at age 12.  By the way, I was diagnosed by my dad and his glucometer, and never even saw a doctor  about my diabetes until I was 14.  My dad and older bother are both type 1 diabetics, and we were living in a rural area in the Philippines. My dad helped me work out my insulin dosages, taught me to estimate carb counts, etc.  My brother sent me my first insulin wallet, (which I used for the next 15 years!)  I decided right away that I wanted to be healthier than any non-diabetic, and took everything related to self-care pretty seriously.  Six months after diagnosis, I left for boarding school, on another island– so I was really on my own!  When I did finally see an endocrinologist, he was amazed that I had an A1c of 5.6!

What’s your motto in life?

“Never make decisions based on fear.”  I think I have lived this philosophy pretty well with my diabetes.  I haven’t let my diagnosis keep me from doing anything I really wanted to do, with the exception of snorkeling and scuba diving.  I used to snorkel all the time as a kid, but once I became diabetic, the idea of being in the middle of the ocean with low blood sugar was just too hard to justify!  Other than that, I have not let my diagnosis keep me from living as fully as possible, trying as many new experiences as I can.

Ariana and her brother, Nathan:IMG_1246

What is your diet like and why do you eat that way?

I eat low carb, and follow more of a paleo-type of approach.  I love food, and love to cook.  We originally started eating a grain-free diet because of food allergies that my daughter and husband have, but I quickly realized that it was great for all of us, and simplified my life a lot, since I was already not eating much starch anyway.  We eat plenty of meat and eggs, lots of vegetables, coconut products, and plenty of fat.  If we’ve been to France recently, then there’s plenty of great cheese on the table, as well!
I don’t crave a lot of sweets, but I do make room in my day for dark chocolate (usually 80%) and am happy to try out grain-free dessert recipes for my family, although I don’t usually eatmuch of those treats.  We always eat very well, though, with an emphasis on great quality items.  Who wouldn’t be happy to have a nice steak with herbed butter, grilled asparagus, olives, and a fresh, herbal salad for dinner?  Add a glass of red wine and some chocolate for dessert, and I feel like one lucky lady!  I never feel deprived, and absolutely love eating all of the great food at our table.

I think that one of the most positive, proactive things a person (regardless of health concerns) can do is to look at their food supply– what are we really eating, and where did it come from?  How was it produced?  Taking an interest in our sustenance is extremely rewarding, and eating well does not have to be expensive or difficult.  It’s true that eating quality food is a real priority for me, both in terms of budget and effort, but I don’t spend more than the average person (in fact, probably less!) and we feel incredibly wealthy when we sit down to eat together.

(Sysy speaking-she isn’t kidding.  Below is her cooking.  It’s what I want for dinner.)

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What in your opinion, is the toughest thing about living with type 1 diabetes?

I think the hardest part is just that it’s always there, on my mind, and impacting the smallest decisions in my day.  What I eat, when I eat.  The type of exercise I do, when, how long, etc.  Although diabetes doesn’t limit me much, it impacts everything.  When I leave the house, I have to think about whether I have something on hand in case of hypoglycemia, and whether it’s enough, or where I could get more, if needed.   And I am always counting…  The insulin I took, what I ate, when, what I will eat, what my last number was, what happened yesterday or the day before, trying to anticipate what my blood sugar might do.  There are so many variables– how much sleep I got, the amount of stress I am under, how old my insulin is, which ratio of insulin in my system is basal, how long a bolus dose will be working… The list of factors is endless, and it can be overwhelming at times, when there is a problematic dynamic happening that I need to figure out.  I can do everything “right” and still not get the numbers I am shooting for.  Diabetes takes a ton of mental energy and patience, and when other things in my life are a little wild, it can feel like too much!

Do you ever fear your daughter will develop it?

Yes, I do fear that she might.  Genetically, the chances are not too bad, but there is always that possibility.  Honestly, this is another reason that we eat the way we do– I want to give her the best health foundation that I can.  I do my best without being obsessive, and the rest is really not up to me.  It’s not something I think about every day, though, and it really wouldn’t be the end of the world if she did develop diabetes.

With her adorable daughter, Amelia:IMG_5617

Is it challenging living abroad with type 1 diabetes? What places have been the most challenging/least challenging?

I don’t find living abroad with this diagnosis to be much more challenging than living in the US.  In Germany, I did have to do more work to find a doctor that spoke English.  My diabetes is the same here as it would be anywhere else in the world.  I think it would be more challenging living in a really hot country, where I had to think all of the time about keeping my insulin cold.  Or a place that I couldn’t find supplies so easily.  But so far, it’s not hard at all.  We travel quite a bit, and that of course presents some challenges, but usually nothing too serious.  And of course,  the travel is so worth it!

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If you can’t find glucose tablets, what do you use for lows?

Fruit– I often carry an apple in my purse.  I can’t find Smarties candy here, which is my #1 choice.  Fruit leathers are pretty good, though, and if I am out and about, then getting a little bit of fruit juice is fast and effective.

How many times a day do you check your blood sugars?

This actually varies.  Since I have some limitations of test strip supply, I use a “save and splurge” sort of strategy.  I might use tons of strips for a few days, while I am figuring out a dynamic or blood sugar problem.  Once I have logged all of that information and have something to work with, I will make changes, and then check less obsessively, to see how things are going.  On average, though, I’d say I check 5-7 times per day.

Why did you decide to move abroad? Were you worried about how you would manage with your diabetes?

We decided to move overseas because we wanted to live in Europe.  It’s really that simple!  When we found out that my husband could get a good job working for the US government overseas, we jumped at the opportunity.  We lived in Germany for a while, and now we have been in England for over a year.
To be honest, my diabetes was not even a factor I considered when making the decision to move.  I think this makes sense, if you take into account my first years as a diabetic– completely self-managing in a foreign country.  I had not gotten exceptional care from doctors in the US, and the cost of insurance, co-pays and things like that never made me feel like I was particularly lucky to be a diabetic in my home country.  Once, I went to see a really great endo in Portland, and they booked my appointment and said they would accept my insurance.  But it turned out that they wouldn’t– I found this out after the doctor had run a whole bunch of labs (which just revealed that I was super healthy!) and we ran up a bill of $1,000 for that one visit, during a time of financial strain!  I could not even afford a follow up, which would have been the more valuable visit.  See what I mean?  There are great resources for diabetics, but not necessarily available to the people who need them.

So, here in England, the way they manage diabetes is not that great, either.  But they do cover prescriptions and supplies 100%!  Honestly, it is the patient that manages their diabetes, not the doctor.  So I would rather be empowered by having the supplies and medications I need, than lots of face time with doctors and nurses.  That said, there is a diabetes clinic nearby, and I can call one of the nurses, send them my logs, etc., whenever I want, for help.  The technology is a bit behind, though.  Not many diabetics use pumps here, since the funding is limited, and CGM supplies are not covered.  I am currently on a waiting list for a pump class, and then subsequently getting set up with a pump.  I don’t know how long it will be, and it’s not something I am expecting next week, I’m just waiting to see how it plays out.  Interestingly, you have to sort of prove your worthiness to get a pump– a reasonable A1c, and adeptness at carb counting and adjusting insulin.  I know these are kind of basic in the US, but I think it’s more rare to find PWDs who are very engaged in their own management.  This observation is simply based on the way things are handled– I haven’t met another PWD here yet!

What advice do you have for someone with type 1 who is considering moving to England (where you live now)?

I would recommend that they work to get their diabetes well-managed, through whatever resources they have available to them at home first.  It may vary depending on where in England they land, but I don’t think the management resources here are great.  They would need to be pretty competent with trouble-shooting and investigating issues on their own.  Sure, there are doctors and nurses here to help, but it could take a while to get an appointment at a diabetes clinic, or to find the exact type of help they need.  For example, if I had been working with a great endo before I moved here, I would have tried to set up a way to stay in contact with them, and pay for consults over the phone or via email.  On the other hand, if they qualify for NHS coverage, then they are going to love getting all their supplies for free!

The thing that most positively impacts your diabetes management?

A curiosity about the human body, and health in general.  Being diagnosed at a young age definitely sparked my life-long interest in health and nutrition.  Our bodies are really amazing.  They are always working hard to do their best, and deserve our best in return– the best nutrition we can find, plenty of rest, play, etc.  It makes me sad when I see people feeling angry with their bodies, or fighting them– the body is always working really hard, and never tries to sabotage us! The discomforts or troubling symptoms I may have are just forms of communication.  If I pay attention and respond, I can take great care of myself!  Don’t let the challenges of living with diabetes overshadow all of the really wonderful things that we are capable of through such exquisitely designed structures!

Where in the world would Carmen Sandiego be if she had type 1 diabetes?

Probably in Germany!  The best diabetes technology always seems to be coming from there, and they also have a great healthcare system that allows diabetics to get the care that they need, with minimal personal expense.

Any last words?

I don’t usually write about diabetes, so this was a positive exercise for me, in terms of articulating my experience with this condition.  Diabetes is actually not a big part of my identity.  I learned from an early age that I didn’t like being thought of as “that diabetic girl.”  People either felt sorry for me, or felt like they needed to get involved, or (worse yet!) tell me their best diabetes-related horror story.  No thanks!  Life is so interesting, and there is so much out there to experience, so I do my best to strike the balance between taking good care of myself, and just living and enjoying everything else around me.

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With her husband, Jeff.

Thank you for letting me share a bit about my experiences, Sysy!

Anytime!  Thanks for being so candid and helping prove that people with diabetes can do anything.

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