I can’t eat that because…

I never considered myself a foodie until I changed my diet.  Now, thoughts about vegan pizza don’t seem so far-fetched. Nor does any kind of pasta or polenta adventure. Every day I incorporate more foods into my diet and every day I get a handle on how my body responds.

My biggest insight so far is that what I eat isn’t the problem, it is my relationship to food that I need to unpack.

My whole life ‘food’ has been a bumpy ride.

I’ve shared before that I was my own food police as a dancer. Watching my weight was critical to how I performed. I can remember being adamant that 2 lettuce leaves were plenty for lunch. I was never anorexic or bulimic, but I definitely had a pattern of starving myself followed by enjoying butter and sugar sandwiches. Luckily this pattern of behaviour didn’t last and by the time I was in my 20’s I had visited a sensible naturopath who explained to me the importance of eating a well-balanced diet.

Yoga, meditation, breathwork and a simple vegetarian diet were my mainstay for many years. I didn’t have the best digestion, but I certainly enjoyed a wide variety of foods and I cherished growing and eating home grown vegetables and trying out new recipes.

Then things got worse.

When I was diagnosed with diabetes there wasn’t much information about the connection between type 1 diabetes and the microbiome. My endo insisted I start eating meat, my GP suggested a keto diet. When I complained that my tummy was burning, or that I was constantly moving between diarrhoea and constipation, I was told it was parasites, leaky gut, candida overgrowth, IBS, gluten intolerance and so many more ailments.

Many alternative health practitioners later, I had narrowed the corridor of foods so much that I was literally starving myself.

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My mind was like a fortress. If anyone contested what I was doing. I.e. restricting my diet, I would defend myself by saying, “I can’t eat that because I’ll have to take too much insulin. I have bad digestion because of diabetes. I don’t want to go low! I have perfect control so what’s the problem?”

Now, after radically changing my diet (I’m doing a whole food plant-based vegan diet with up to 250 carbs a day) and learning how diet, exercise and insulin really work, I can see that I was in denial about my disordered eating. The package may have been different, but it was just as detrimental as those 2 lettuce leaf dancing days.

Coming out of a pattern of disordered eating is not easy. It’s easier to stress about food. Worrying about what I eat was giving me some semblance of control. Releasing the reigns has meant I’ve had to face how scary it is to try new foods, bigger doses of insulin and to trust my body.

My Diabetes Coach and I have been meeting about once a month to try and fine tune how my body responds to different types of carbs. In one of our most recent sessions he encouraged me to be more intuitive with how I dosed. If I feel like having more of a starchy meal, like with sourdough or sweet potato, or oats. Why not pre-bolus, split the dose or take 20% more insulin? I could even take less insulin on more physical days and switch up my dose of long acting insulin.

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At first his suggestions felt scary. If I could just eat the same meals every day I could get the same results, right? Trying different combinations feels way scarier. Like flying a plane solo.

This is what letting go is all about, letting go of should’s, expectations, assumptions, feelings of inadequacy and doubt. All things that led to my disordered eating in the first place. ‘I should be able to control my diabetes. I won’t be able to unless I do such and such. Even if I try I’ll fail.’

I am finally understanding that knowledge is power. When we know how to resolve a problem and have the right tools, anything is possible.

I wish my endo and health team had told me that diabetes is a subject that requires in depth study.  Instead I’ve gone through years of ups and downs to discover that:

  1. Managing overall health is tied to individual constitution; the way I learn and my emotional mental behaviours and patterns.
  2. Seventy percent of the immune system is in the gut. What I eat, when I eat, how I eat and my relationship with food affects EVERYTHING.
  3. Stress reducing activities like yoga, meditation and breath work increase my sensitivity to insulin, improve my mood and mindset.

Screen Shot 2020-08-31 at 1.36.07 PMObviously, nothing is perfect, and living with diabetes is never going to be a walk in the park, but if I knew then what I know now. O. M. G. I could have saved myself so much headache, heartache, denial and self-harm.

Recently friends with diabetes have been contacting me and asking me how I made the transition from a low carb restrictive diet to a high carb low fat diet. We’ve had some big heart to hearts in our chats.  I know first-hand how hard it is to wrap your head around eating 250 carbs a day when you’ve spent years thinking low carb was the only way to get decent management.

The main thing I share is how scared I was, how I definitely needed hand holding and how I haven’t looked back. Having the opportunity to share my experience around food has been a source of healing too. It hasn’t just healed how I approach living with diabetes its transformed how I relate to myself.

If you’d like to learn more about how to transition to a whole food plant based vegan diet with support, check out my diabetes coach,  Drew Harrisberg and the books Mastering Diabetes and Fiber Fueled.

with great respect….

rachel

This post may contain affiliate links to products I trust. Please read Disclaimer for more info

The missing piece

This post may contain affiliate links to products I trust. Please read Disclaimer for more info

When I started writing my book, Yoga for Diabetes in 2015 I knew I wanted it to be something that would be a game changer when it came to diabetes management. If I couldn’t cure my diabetes at least I could use my lifelong passion and knowledge of yoga to manage it and share those life skills with others.

I was diagnosed in 2008 but didn’t start writing the book until starting insulin therapy in 2014. I wrote the book without having fully experimented on myself. Up to that point I didn’t need insulin, in fact I was in denial about my diabetes. However, I did have a deep understanding of yoga and Ayurveda and how potent this combination is in managing any health challenge. Especially in mitigating stress, balancing the nervous system, working with mental and emotional health and overall immune resilience.

How to put insulin into the mix was my personal nemesis, and even though I offered a chapter on insulin and exercise in my book. I was an “insulavirgin.”

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It was after launching my book and connecting with other Type 1’s that I popped my cherry. I decided that injecting once a day and having okay levels (my HbA1c at the time was around 7) wasn’t good enough. Why not at least try having some insulin with meals? Maybe it would make a difference?

Living with LADA ( Latent Autoimmune Diabetes in Adults) means diabetes has been a slow progression for me. I still produce some insulin. I had a lot of anxiety around increasing my insulin use and dosage and at the same time I kept questioning myself, “why stay stuck with what I felt was an “okay” HbA1c?” Surely, I could do better.

I took the plunge with some help from Gary Scheiner, author of “Think like a Pancreas”. Gary suggested I start small and take insulin after each meal. We worked out that I’d need about one unit of insulin to cover thirty carbs and that I should start with half units. I was already on a low carb diet sticking to around thirty carbs a day, so I wouldn’t need much insulin at all. Less insulin, less risk of lows.  My diet at the time consisted of eggs, green vegetables, pumpkin, carrot and avocado. I was so embarrassed to tell anyone that I only ate seven foods. I am not exaggerating S E V E N!

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Being on a full insulin regime even on such a restricted diet was amazing. I was able in a year to reach my goal of having an HbA1c of 5.5. I felt like a champion. There were other days though that I felt a sense of hopelessness. Was this my diet for the rest of my life? Living on seven foods because of gastric distress and food sensitivity? Being afraid to eat for fear of low or high blood sugars? Feeling a literal fear of food?

I’m nervous to share how defeated I felt around this aspect of my diabetes management. I had authored a book all about how to bring yoga into daily life, how to find the perfect practice, how to manage stress, how to live well with diabetes and here I was stopping myself in the one area that’s the foundation for everything.

Nutrition.

When people would ask me what sort of diet I was on I’d change the subject or suggest eating for their Ayurvedic constitution, but to be honest because I couldn’t or rather wouldn’t follow my own recommendations keeping quiet was the better option.

Everybody is different, every body is unique. We eat according to taste, conditioning, circumstance, and what we feel works best for us. Whether you are low carb, keto, paleo, AIP, high carb, standard American, or Australian Diet etc. there is no one size fits all. Or so I thought.

My breaking point happened on an innocent outing to our local farm stall for some Haloumi cheese. Something I indulged in every now and then because it was low carb/high fat and isn’t Haloumi the best taste ever?

I was in my car, cheese on the passenger seat, when I saw a newborn calf still covered in afterbirth being transported in a pickup truck. The mother cow was running after the truck trying to get close to her calf. She was obviously very distressed, her body still raw from giving birth. The farm handlers seemed completely unperturbed by what they were doing. It was just a normal part of farm life. The babies were separated, fed and then sold for veal, while the mother was kept for milking. I felt my heart ripping out of my chest. It was one thing to read about animal cruelty or factory farming, it was another to witness it with my own eyes. As I drove home, I made myself a promise, even if I am afraid of going low, afraid of getting sick from foods, afraid of trying something new, I couldn’t live this double life any longer.

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My will to align my lifestyle with my heart had to be my priority. It was time to step up and drop all animal products and embrace a whole food plant-based diet.

They say it takes seven different influences to make a change for the better. I think of that moment at the farm stall as number seven. I had already heard about going high carb/low fat/plant based from a fellow T1D yoga teacher, I’d seen a fellow T1D fitness and nutrition coach document his journey transitioning from keto to vegan, I’d watched several different webinars and documentaries with the founders of the Mastering Diabetes Program and I had started to struggle with my levels after almost every meal, needing more and more insulin to cover the same thirty carbs a day.

I think of the day I changed my diet as a crucial turning point in my life. Like the day I decided to move to Australia, or the decision to travel to India to meet my now beloved husband. There was a feeling in each of those moments. Something indescribable and deeply exciting.

Starting a plant-based diet hasn’t been a walk in the park, I’ve been lucky to have an expert diabetes and nutrition coach to walk me through some sinkholes and to cheer me on. I started by letting him know I was basically sensitive to every food imaginable and he started by saying “start with what you think you can tolerate.” Then when I had awful symptoms he’d commiserate and suggest they might go away as my body made the switch out of ketosis. “I believe in your metabolism, that it can kick back in and do its job. The more foods you can tolerate, the more diverse your diet, the more your body will thank you.”

Never were these words truer.

I don’t think I fully understood what he meant until I read Fiber Fueled by Dr. Will Bulsiewicz. This book is the bible for anyone wanting to go plant based. In just a few short chapters Dr. B makes the case for a diverse plant-based diet. Did you know that that out of the 400,000 plants on the planet, 300 of them are edible? And that we just eat a small percentage in our standard American diet? Or that there are 40 trillion microbes in our gut micro biome? We are more microbes than human. Did you know that these microbes feed on fiber? The more fiber we have the healthier our gut, our immune and nervous system. When we get into mono foods, or food restriction we deprive our microbes and that’s why we get gut dysbiosis. I.e. gut issues like leaky gut. He even explains how autoimmune disease and gut health are intrinsically linked.

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Since going 100% plant based I’ve noticed huge changes. My thyroid levels have normalised, I’m extremely sensitive to insulin, I’m eating up to 45 different plants in a day. My tolerance of foods has improved, my digestion has improved. My little arthritic aches and pains have disappeared. Besides all the physical changes, it’s my relationship to food that has excited me most.

I am finally loving cooking and creating meals again. Exploring recipes, trying new foods, incorporating miso, seaweed, legumes and grains. Nothing in excess with no restrictions. Managing my diabetes in the mix of eating this way takes dedication. I track my food in an app, I keep tweaking my insulin to carb ratios and checking in with my coach when things start to go awry. As I learn to feel my body in this new way I’m surprised at how easy it is to have steady levels and maintain a healthy Hba1c.

It took a long time, nearly 20 years for me find the answers I so desperately needed to get well. Now that I’m here it’s like the last few moments of finishing a puzzle.  There’s a sense of excitement and expectation and WOW that’s it, I finally found the missing piece!

If you’d like to find out more about Dr. B and his book you can go to his website or order the book here

With great respect…

rachel

15 minutes I can do

I’ve been setting the timer on my phone to 15 minutes a lot lately. 15 minutes to pre-bolus, 15 minutes to wait out a hypo, 15 minutes of yoga and meditation practices no matter what.

Before I was diagnosed I absolutely hated time. I never wore a watch or even looked at my phone. Even as a kid I never wanted to learn to tell the time. Why be constrained by a limitation like that?

Everything had more validity to me when time wasn’t involved. Why does anything ever have to end? Like a yummy meal, or time with a beloved or friend, a day at the beach. Maybe my abhorrence of time has to do with losing my mother at a young age. Having to face endings for me was complicated and traumatic. Being forced to rush through something felt unnerving. As a dancer I was bound by time and timing, but it never bothered me, because the timing of the music, or the timing of the movements to the music uplifted me, reminding me that all creative endeavours are happening in the presence of timelessness. Not that I could put that into words when I was dancing. It was something that touched me and made me cry with inexplicable joy.

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By the time I was nine my grandfather insisted I learn to tell the time. He bought me a Timex with a red strap. We went painstakingly through the details of the big hand and the little hand, what all the numbers meant and what each part of the day represented. My mum bought me a digital clock which rolled over numbers like cards. And then I got a clock radio, even cooler because I could wake up to music.

After I met and started traveling with my husband we would wander through international airports looking at expensive watches. He’d point out all the brands. I knew nothing about Panerai and Patek Philipe. I didn’t even know the difference between a Swatch and a Tissot. When I would badger my husband to tell me what time it was he would say, “you need a watch darling” and I’d reply, “my smartphone is good thanks.”

Then one day when I was stuck in an airport on my own, I decided to splurge. If I was going to buy a watch it would have to be the purchase of a lifetime. I decided on a gold Tissot with Roman numerals and a simple link band. I’ve only taken it off a handful of times since then. When I point at my watch to tell my husband, “it’s dinner time, lunch time, time to go, time to clean, time to ‘whatever’” he likes to chide and say, “I wish I’d never mentioned you needed a watch”.

Watches aside, time has changed my life.

Recently I’ve been navigating some soul crushing lows. Waiting for my blood sugar to come up sends me into a wild panic. What if it doesn’t come up? What if I run out of low snacks? What if…

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Initially I set the timer on my phone to 15 minutes so that I would know when to check again. But when the lows are scarier, in the low 3’s (below 70 mg/dl) watching the minutes tick down is a lifeline. If I can stay focussed for just 15 minutes, I’ll be okay. If it levels out at the end of those 15 minutes I can relax. If it still goes down after those 15 minutes, I can take more glucose, dates etc and start again. As long as I can watch the clock I know eventually I’ll be back to compos mentis.

Knowing I have a tool to support me during a low blood sugar has absolutely changed everything. I have a deep-seated fear of lows. It’s why I insisted on sticking to a regimented low carb diet for 7 years. It’s why I timed every single part of my day to avoid any deviation, and I why I would restrict my social activities.

My goal for 2020 was all about opening up to life, food and freedom. It’s been interesting to be stuck in one place while I navigate this new perspective. Asking myself…what do I want to eat?  What do I want to do today?

If I want to eat heaven in a bowl (a fruit smoothie bowl with crushed seeds and dates) I can. If I want to garden, go for a walk, do a strong yoga practice, I can. If I flub the ratios, don’t reduce my insulin enough or take too much, I’ll be okay.

15 minutes is easy. 15 minutes I can do.

with great respect…

rachel

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I’m back…

This post may contain affiliate links to products I trust. Please read Disclaimer for more info

My blood sugar hit 11.7 mmol today. It’s been a while. I mean a long while. Since starting Insulin in 2014 and simultaneously going low carb I’ve had excellent control. A high for me was about 9 mmol. In the last two years, even that was pretty rare.

The control I’ve had over my numbers has been directly related to a huge amount of food restriction. A.K.A living on eggs, non-starchy vegetables and avocados and olive oil for the last 6 years. When my husband would ask, “How is your dinner?” my standard reply was, “the same.” I could make breakfast, lunch or dinner in 15 minutes tops. Eating to live, and fine with that. Worth the sacrifice if it meant staying healthy.

Don’t get me wrong low carb works. It totally works. The question is… is it healthy and sustainable? I have been low carb for 6 years so it’s doable but healthy?anna-pelzer-IGfIGP5ONV0-unsplashHealthy is having a rainbow in your diet. Healthy is as much emotional satisfaction as physical satiation. Healthy is enjoying food, being social, being able to go out and pick something off the menu without guilt or fear. Healthy is putting the meal together and then trusting that what you inject will do the job. I’m not talking eat whatever you want and cover, rather eat whole foods that please the eye and the pallet. Know you are taking in life sustaining nutrients and that your body can take it in, digest it and distribute the energy accordingly.

This is the basis of a yoga practice, absorbing prana from food, the atmosphere, anything you consume. If our own energy is scattered, stuck or overly dogmatic, we can’t absorb prana which in turn builds Ojas, the basis of our immune system.

In Ayurveda diet should be mitahari, which means balanced. Eating whole grains, legumes, fruits, vegetables etc. Everything according to your type incorporating the six tastes of sour, salty, sweet, bitter, pungent and astringent.JMFO1826Before my diagnosis I was able to follow an Ayurvedic vegetarian diet ad infinitum. After diagnosis I found myself narrowing my diet according to what I felt sensitive to or what I thought wouldn’t cause a high blood sugar. Eventually I was so afraid of going low I stopped trying. I told myself I couldn’t have mung beans or quinoa because it was too confusing to dose for. I couldn’t have fruit because I would spike. My list of excuses was long. My openness and availability to try something new was zero.

In the last few years I’ve started each year with a diabetes goal. In 2018 it was braving meal time insulin (up until then I managed on a split dose of basal with severe carb restriction). In 2019 I worked on healing my gut. My 2020 goal came out of months of feeling helpless around the situation we are facing on the planet and watching two documentaries Cowspiracy and The Game Changers. Discovering that animal agriculture is one of the main contributing factors to climate change and seeing how athletes were able to maintain a vegan diet and increase their performance, made me question what I was eating and why.

To be honest wanting to go vegan was a total heart longing. I’ve never liked the feeling of eating animals (as a kid, I used to pretend to eat my pork chop and when no one was looking I’d push it into a napkin and then excuse myself and flush it down the toilet) so it made sense to stop.pexels-photo-3669638The big question for me was how. How could I make the transition from keto to vegan smoothly? Was it even possible? While I was mulling over the what and how, a T1D friend sent me a PM about a new program she was on which was high carb, low fat and and how successful it had been. She suggested I try it.

I balked at the idea. Then another T1D I follow on Instagram shared his story of going from keto to vegan.  His story was inspiring and confronting. I had to ask myself, what was my excuse really? Was I going to be terrified of carbs and insulin for the rest of my life? What was holding me back?

Doing some deep soul searching around these fundamental questions forced me to take stock of the times in my life where I’d faced a seemingly insurmountable hurdle. I reflected on giving birth. That was terrifying, yet I did it. I thought about how I managed during 9/11. How when I thought I couldn’t handle the shock I actually rose above it and made it through. Even after my diagnosis I was able to eventually find a way to acceptance. I also thought about the beach. Here in South Africa the water is beyond cold. Going in takes a certain kind of bravado.IMG_0674That’s how I decided to approach this new and exciting chapter in my diabetes management. If I didn’t jump in, I might regret it. If I did, hopefully I’d feel refreshed and invigorated.

Five weeks on from transitioning to a plant-based diet. I’ve introduced a huge range of foods, with hardly a hitch in my digestion. The big challenge has been to experiment with insulin to carb ratios to find what works best when. I’ve also had way more highs and lows then before. I’ve had to be courageous while watching that straight down arrow on my freestyle libre. Patient when I see a spike.

My insulin needs have completely changed. I need less basal; more bolus and I am becoming more and more sensitive to insulin. I’ve also had to slowly build my daily carb intake working my way up to about 250 carbs per day. That’s been hard, but I’m getting there. I’ve also rekindled my passion for creating recipes. I’ve made hummus, nori rolls, veggie burgers. I’ve been eating heaven in a bowl for breakfast. Smoothie bowls with dates and figs, bananas and papaya. I now look forward to eating and cooking. I’m excited to try things like beets, leeks, peppers again. I feel like every meal is a party. One I get to have for myself.

The best side effect of my new diet is increased energy and decreased aches and pains. When I step on my mat I feel open, balanced and clean from the inside out. It feels like I’m back.IMG_1095If you’d like to find out more about a plant based whole food diet check out this brilliant new book, Mastering Diabetes

If you’d like to have more one on one support to make the transition I highly recommend Drew Harrisberg from www.drewsdailydose.com

The day I forgot my insulin

Forgetting things is normal. Like forgetting my wallet when I go to the store, or my phone or car keys. It’s usually a hassle and requires some unexpected backtracking, but in the scheme of things forgetting stuff is no biggie. But insulin? OMG! Who knew?

Suffice it to say I have never ever forgotten to bring my insulin with me on a trip. No matter how big or small if my outing includes a meal, I put it in my purse and that’s that. Until the other day. For some ridiculous reason, I forgot it.

And  I didn’t realise I’d forgotten it until we were already miles and miles away.  The morning had run as usual, yoga practice, followed by cooking my lunch, packing it and loading up the car. We were heading to Knysna, a picturesque town on the Garden Route here in South Africa. I’m not sure whether it was distraction, the fact that diabetes wasn’t number one on the list that morning or what. Once I realised what had happened there was absolutely no way I could forget. I was freaked out and mildly hysterical. Even though my husband encouraged me not to be.

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Our purpose driven trip turned into a race against the clock. If I don’t eat my lunch around 1.00 pm my blood sugar tanks. I am not sure exactly why, it’s either the long acting insulin peaking or my own insulin kicking in. Regardless I eat lunch to stop the drop.

As my blood sugar started to tank my husband suggested I eat my lunch. Nope…can’t do that. If I do I’ll go high with no way to bring it down for another 2 hours. The only solution was to fast and eat when I could dose. In the meantime I downed a few glucose tabs amidst a grumbling hungry tummy. I also downed my feelings; frustration, anger and fear.

Fasting wasn’t a problem, but heading to the local bakery to buy Christmas cake was. As I stood in line looking at all the bakery delights I felt defeated. This has been me now for over 11 years. I don’t eat gluten, sugar or dairy because it messes with my levels and my delicate digestion. I don’t usually get upset standing in the bakery line, in fact I don’t care, but today with a perfectly good lunch sitting in the car, fasting and skirting an endless low I was livid. Why can’t I just this once enjoy apple strudel! F…k

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As soon as we got home I ate my lunch. It was 3 pm. I calculated that we could still eat dinner at the normal time so that my schedule wouldn’t be too interrupted. Just because I craved normalcy after this hiccup didn’t mean it happened. The most annoying thing about a mishap in routine is that I have no idea how it’s going to influence anything. It’s a total experiment. It’s not just the physical stuff that goes topsy turvy, it’s my emotional responses.

Despite my efforts to use my go to practices for mental and emotional stability, i.e yoga, breathing, meditation and the teachings of yoga (Atma Vidya), I reacted. After lunch I had a tantrum. It made no sense, it was ugly and probably a result of pent up anxiety.

Reaction sucks. There is absolutely no point in blaming others for enjoying life and doing what they normally do. I could have gone to the chemist and gotten some insulin, I didn’t have to fast for the day, I could have stayed in the car rather than gone to the bakery. I could have relaxed and accepted that this sort of stuff happens, people forget stuff, even big stuff. I didn’t. It’s my style to do things the hard way.

It’s been a few days now since my major stuff up and it’s been interesting to reflect. I’ve learned some really valuable lessons.

  1. When travelling always bring insulin. Put it in purse.
  2. Fasting works, but it does have after affects. I ended up struggling with lows for a few days afterwards because it increased my insulin sensitivity
  3.  Stay balanced during a crisis. Don’t succumb to hysteria. Put things in perspective
  4. Be kind! Be kind to one’s self and others. No one no matter how close knows how it feels to live with diabetes.
  5. Take stock and be grateful! Just 4 hours without access to insulin is nothing compared to someone who can’t afford insulin or lives in a  country where access is limited or non existent.
  6. Never ever forget insulin again!

With great respect…

rachel

My best diabetes hack

One thing I love to do is scour the Diabetes Online Community for diabetes hacks. The best way to deal with all the little and big things that happen when you live with diabetes.  Best place to inject, how to dose for pizza, top CGM insertion points, ideal hypo snacks and that’s just a small glimpse into the vast ocean of support that can be gleaned from others who’ve been riding the tiger. At first, a newbie on the scene, I didn’t have any tips or tricks to share. Eleven years on there are definitely some hacks I swear by. If I had to distill my diabetes management into the ‘best diabetes hack ever’ it would be ‘routine’.

Having a consistent routine in place from the moment I wake up means I can relax. I know that I’m going to have my morning long acting insulin at 6 am, my breakfast at 7 am, I’ll be practicing yoga around 8 am, lunch at 1 pm , walk at 4 pm, long acting shot at 6 pm and dinner at 7.30 pm. I think of this set routine as a framework. Anything that happens in between these times is spontaneous, creative and fluid. Having a non negotiable routine creates stability in my blood sugars, a sense of trust that things are taken care of.

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Living with diabetes can feel out of control. Having a routine puts me back in the drivers seat. I may not be able to tame the factors that affect blood sugar  but I can manage my time impeccably. Routine may be boring for some, for me it’s a balm.

Routine is not just about the timing of shots it’s about consistency of meals, same kinds of foods at each meal. Exercise, a twice daily yoga practice and afternoon walk. Rest, heading to bed before 10 pm and waking at sunrise. These routines are part of in Ayurveda what’s called Dinacharya and are the staples that each Ayurvedic constitution relies on to stay balanced.

As we head into the holiday season it can be daunting to maintain our routines. For me a routine takes the stress out. I’d rather spend my time enjoying special times with family and friends, than try to fit in. It’s taken me a while to get to this. I still need to explain to family and friends why I’ve eaten before the 3 pm Thanksgiving meal, or 11 am Christmas brunch.  Knowing that I’m going to stay in range keeps me sane. After over a decade with diabetes it can be so frustrating to have days and days of insulin resistance after eating and dosing at a time that doesn’t suit. Call me boring, fixed…whatever I don’t mind!

Routine is also what’s enabled me to write everyday here for Diabetes Awareness Month. At first it was quite a task and I wasn’t sure I could keep it up. Consistency has been the key. Sitting down everyday to share my inner world with diabetes has been both healing and cathartic.  Thank you to everyone who has stayed the course with me. Tomorrow is the last day so make sure to check out the final wrap up for what’s been an amazing month of connection, sharing, awareness and community.

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

Take to the Skies

As I am just 24 hrs out from travelling again I thought I would share another post I wrote for Beyond Type 1. I am a well seasoned traveller, but geez travelling with all my gear sends me bananas. This time we will be away for 6 months, which means I am carrying 6 months worth of needles, CGM’s, insulin and test strips. So much stuff that my husband has to carry some in his suitcase and carryon as well. If you are curious to know my top travel hacks for travelling with diabetes keep reading.

“Stuff your eyes with wonder, live as if you’d drop dead in ten seconds. See the world. It’s more fantastic than any dream made or paid for in factories.” – Ray Bradbury

I live between three or more continents in one year, teach yoga internationally and I’m a Type 1 diabetic. This means I have to travel regardless of my health condition. Is it easy? No. Do I enjoy it anyway? Yes. Recently, I participated in a twitter chat to share people’s experiences around flying with diabetes. It gave me a chance to share some of my personal insights — how I use yoga to stay balanced and to inspire others to feel more confident about taking to the skies.

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I carry on me …

  • long and short-acting insulin in Frio wallets
  • two glucometers
  • needles
  • test strips
  • a letter from my doctor
  • ALL MY FOOD!

I also check ahead to make sure that the country I am flying to has access to the type of insulin I need and that I can get a hold of test strips. I google for everything. It’s probably obsessive, but I want to minimize my stress as much as possible.

Before I was diagnosed, I felt free to go just about anywhere and since my diagnosis, I haven’t let diabetes stop me — I’ve just adapted. Being diagnosed as a LADA Type 1 eight years ago, my onset was slow. For the first six years, traveling meant making sure I had all my own food with me and only staying in places where I could cook for myself. When I did go out to eat I always called ahead. I was managing my levels by staying as low carb as possible and had quite a few food sensitivities, so sometimes eating out was a tough call. I always thought that when I went on insulin things would get tougher. I was wrong. Insulin has actually made traveling so much easier.

Instead of trying to use food and exercise to stay in range — nearly impossible when you’re stuck on a plane for 16 hours with airline food — I can cruise through the trip with my once-a-day shot of long acting insulin. I’m not on fast acting yet, so I can’t comment on what it’s like to fly and bolus. But I’m convinced that traveling with your own snacks, not only for hypos, but for your own sanity, absolutely helps you to feel better when you land.

Read the rest at Beyond Type 1...

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

The Good News

I’m not one to write about the latest news on diabetes. It’s not because there aren’t amazing new technologies, cures and treatment protocols on the horizon. It’s just that I’d rather focus on what’s tangible and practical in my personal day to day management. When someone sends me a message with the latest ‘cinnamon’ cure I find myself ranting about the differences between type 1 and type 2 diabetes and how there is no cure for type 1. There are only useful management protocols that may or may not consistently work. A lot of my friends who were diagnosed years ago were told not to worry because a cure was coming in five years.  More than five years have come and gone and we are all still waiting.

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One of the biggest and scariest moments for me was realising that I had a life threatening, incurable disease. I was on the yoga mat in a pose when it dawned on me. I cannot adequately describe that moment. It was a mixture of shock, disbelief, denial and confusion. Coming to terms with that feeling and finding acceptance has been the core of my practice since.  I guess anyone when faced with any kind of diagnosis, or crisis goes through this. That’s why community and support are so needed.

What I am excited about in the diabetes space is how we can thrive with diabetes. There are some really cool organisations out there to tap into. As a regular contributor to Beyond Type 1 I am inspired by how they raised awareness through brilliant community building campaigns. It isn’t just about finding a cure, it’s about networking, inspiration and collaboration. Another powerful resource is Diabetes Daily. Daily updates and articles on all types of diabetes, recipes and research and a thriving community, I feel blessed to have so much information and support on tap.

In fact, today I received an email from the team at Diabetes Daily about a large study that identifies the habits of successful diabetes management. Compiled by the thrivable insights research panel the study looked at what habits those with optimal glycemic have in common? They surveyed 1,938 people and I’m pretty sure I was one of them.

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The survey analysis data demonstrated that those with type 1 and type 2 diabetes who have optimal glycemic control are significantly more likely to:

  • utilize low-carbohydrate diets
  • use insulin pumps
  • exercise regularly

Moreover, patients with type 1 diabetes were significantly more likely to:

  • use a continuous glucose monitor (CGM)
  • eat consistent meals daily
  • incorporate the protein content of their meal in calculating their insulin doses

The comprehensive data report was published on October 16, 2019 and can be found here: Habits of a Great A1c Survey Data Report. The lead researcher, Maria Muccioli, Ph.D, is also available for interviews about the findings. 

To me the best way to control my diabetes is a no brainer. I have heard many people in the diabetes space talk about diabetes as carb intolerance. It’s not that we shouldn’t include carbs its just how much. I find that about 100 carbs per day is my maximum. In my last blog on diet I talked about eating at the same time and roughly the same thing every day. I have also emphasised how important it is to have some way of seeing blood glucose data in real time. The more I know what foods do what, the easier it is to manage my levels . And you know how much I love exercise. Yoga for diabetes is the bomb!

That’s why I get all nerdy about these kind of studies. The more evidence we have of what enables us to live well with this condition, the more health care providers will come onboard. Believe it or not up until a year or two ago my doctor was still giving me a hard time for my dietary choices. Luckily education around this is shifting.

When I personally reflect on how I feel about diabetes management and the resources we have available I feel lucky. When my great grandfather had diabetes, there was no insulin and no education around diabetes. He died of diabetes complications. Ironically my birthday falls on the month and day of his passing. A powerful reminder of how grateful I am to have the education, choices and support to live a long, healthy and happy life with diabetes. Thats the good news!

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

Staying in range

I’m feeling motivated to get my levels back to where I want them. Not that their not in a good range, its just I know I can do better. At the beginning of the year I worked with the Diabetic Health Journal. It’s a great way to stay accountable, set goals and track patterns. When I was using it my Hba1c went from over 6% to 5.5%. For anyone living with diabetes that’s a perfect number, but really hard to maintain. As much as I know that time in range (keeping my levels between 4-8 mmol) is ideal, there have been a few too many peaks and troughs for my liking. So when I opened the journal and set my goal for the week, I thought I’d try some intermittent fasting.

Intermittent fasting is different to a regular fast. I’m still eating, just spacing out when I eat. The last two days I had my last meal at 7.30 pm and broke the fast with lunch at 1.00 pm. That’s 18 hours between meals. The idea with IF is that it increases insulin sensitivity. It means I assimilate the insulin I am injecting better and blood sugar levels are lower. When I’m really sensitive to insulin I can even reduce the amount of insulin I’m taking which means less low blood sugars events. It’s a win win.

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The only issue for me is I am a huge fan of my avocado and egg breakfast. Day 1 was easy because I distracted myself by going to yoga. Day 2 (today) was harder. I was pretty hungry from about 10.00 am onwards.  I also haven’t seen any concrete results yet. I.e lower levels and increased sensitivity. Patience Rachel Patience…

After I started taking insulin in 2014, I came across a book by Ginger Vieira called Your Diabetes Science Experiment. I read it from cover to cover and learned a lot about the variables that affect diabetes. I learned that even though there are  guidelines and formulas for managing diabetes, it’s not one size fits all. Flexibility and a willingness to experiment are key assets. I’ve been using my yoga practice for years as my personal laboratory to see what my body is capable of. Having diabetes has made things tricky. Sometimes I’m not sure what’s affecting what. Is the sequence or practice supporting what I am doing or is a day of higher or lower levels affecting my practice?

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I feel like I am drawing a giant question mark on a blackboard.

Not having all the answers is something I’ve grown accustomed to.  I was the child that had to be ‘right’ or else. I thrived on competition. That’s why having diabetes has been a bonus in my life. It’s taught me to stop comparing, be kinder to myself and take a gentle approach.  So even though I’ve set a goal for myself to get back to the numbers I feel healthiest at I’m also open to the possibility that where I’m at now is absolutely fine.

See you tomorrow #NDAM #DiabetesAwarenessMonth

with great respect…

rachel

What can you eat?

Nine days in to 30 days of writing for Diabetes Awareness Month and today’s topic is diet.  I can’t keep count of the number of times I’ve been asked, ” What can you eat?” It’s actually a loaded question because the answer from a person with diabetes would be, “what can’t I eat?” As long as we know how many carbs we are ingesting (everything from veggies to fat to protein breaks down into a carbohydrate in the system) we can eat whatever we like based on our insulin to carb ratio. I.e how much insulin is needed per carbohydrate. Do the math and presto every food is available.

But that doesn’t mean I choose to eat whatever I want.

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Since I was little I’ve been a fussy eater. I didn’t like green vegetables, any kind of meat,  or corn on the cob. I can remember being at the dinner table and slowly scooting portions of pork chop into a napkin when no one was looking and then excusing myself to hastily flush it down the toilet.

In my late teens I was put on a strict candida diet which meant no dairy, sugar, fruit or fermented foods. Not being a huge fan of animal foods I became a vegan.  My strict diet was hard to maintain during pregnancy so I reluctantly ate fish, chicken and eggs, but as soon as I could I went back to my vegetarian ways.

When I was diagnosed with diabetes in 2008 I had already started eating foods that resonated with my constitution. Being a fire type, pitta in ayurveda, I avoided nightshades and spicy food and instead focussed on cooling foods with sweet, bitter and sour tones, pulses, avocados, whole grains, roasted veggie salads and gut healing protein smoothies. As my initial diagnosis wasn’t clear (they weren’t sure if it was type 2, type 1 or even diabetes) the only change I made to my diet was to eat low glycemic foods and to add fish, chicken and eggs back in.

At that stage I was eating linseed/soy bread, enjoying oats, quinoa, low carb fruits like blueberries and strawberries and lots of different kinds of veggies, soft cheeses like paneer and ricotta. I still dabbled in eating pasta and pizza as long as there was a good quantity of protein in the mix. I never ate packaged or processed food even if it was a ‘healthy’ packaged food. I’ve never been able to deal with fillers and preservatives.

Once my levels became unmanageable my doctor suggested I look at the ketogenic diet. That was in 2013. Keto was just getting popular and having tried everything else bar insulin, I enjoyed the strict discipline of dropping all carbs. At that stage my diet was mainly eggs, some fish and green veggies like chard, zucchini, broccoli, asparagus, fennel, cauliflower, avocado, ghee and the same soft cheeses. My doctor expressed concern that it was too narrow a corridor of foods. So did I, it seemed that blood sugar wasn’t my only issue with what I ate, I also had a lot of trouble digesting foods. Later I found out that the pancreas also helps with digestion and that sometimes it doesn’t work as well as it should in people living with diabetes. Eating the same foods over and over was actually making me sensitive to the only foods I could tolerate. A never ending cycle.

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Thank goodness I went on Insulin after a proper diagnosis in 2014. It has opened up my diet to include more foods again, even though I’ve stuck to a low carb vegetarian diet. It’s so much easier to cook the same meals at the same time each day, to take the same amount of insulin and know exactly how my body will respond. My friends wonder why I don’t get bored, or ask me if I feel like I’m missing out and my answer is always the same. Eating in a way that keeps me calm and balanced is more important and desirable than the headache of eating something that will later cause blood sugar issues or hinder my digestion.

Whether you live with diabetes or not diet is a very personal thing. The body needs nutritious food. It knows what works, how to process it and what to eliminate. All the intricacies of digestion and assimilation of food are out of our hands. It’s up to us to feed the body with nutrient dense foods.

Something I’ve learned to say to anyone who questions why I eat the way I do is this; “I eat to feel well so I can best serve others to feel well too.” 

And that’s that…

See you tomorrow

with great respect…

rachel