The Great "Sugar" Confusion

I thought I knew a lot about food and in particular carbohydrates and sugar. However, I attended a diabetes support group recently that sent my head spinning in confusion.  You see, I always thought that the word "carbohydrate" referred to the group of foods that have the most influence on blood sugars and that "sugary" foods would be part of that group. So when a gentleman remarked that white bread was full of sugar my head slowly exploded.

Inside my head I was asking so many questions; - do you mean sugar as in table sugar and that it's an ingredient of bread? - or do you mean in comparison to wheat/brown bread? - are you talking about carbohydrate and not sugar? - are people confusing those two words? - when dietitians talk about sugar; are they talking about sugary foods, table sugar or a subgroup of carbohydrates?

I started second guessing my knowledge and I couldn't respond to the comment which was then followed with other remarks about other foods, such as bananas that are also full of "sugar". Help! But of course none of us had the knowledge to sort all of this confusion out.

So off I went to Google university to try and figure out my confusion and find out once and for all what the word "sugar" actually means. I'm still not very wise but my opinion is that the word is being used in all sorts of contexts and that most of the other general public are confused too.

There's sugar as in table sugar, complex sugar or carb which is a type of carb (obviously) and the other one which is simple sugar/carb, sugars as in my blood sugars.

We have invited a dietitian to our next support group meeting and I think it's going to make for a very interesting evening and hopefully be enlightening.

Diabetics can't have sugar!

How many of us have been on the receiving end of this response? How often have you been offered a nice little treat only to have it whipped away from you because they just realised you're diabetic and OMG "can't have sugary foods"? I must have seemed deranged when I lunged forward across the table and grabbed the little chocolate bar from that lady :-)

I usually don't get too upset with people when they try to "protect" or "safe" me from myself but when my husband told me about his experience with this remark I was a little more peeved. Here's what happened....

He attended a cooking course recently which was attended by approx. 30 people where the course facilitator remarked more than once during the day about diabetics not being allowed sugar. My annoyance came about for two reasons.

The first is that it's just not true. Believe me - google it. Diabetics are allowed to have sugar, just not too much of it. But that is the guideline for EVERYONE, diabetes or not! Too much sugar is just as unhealthy for people without diabetes as it is for people with diabetes.

The second reason hurt me more because person is considered an expert in their professional field of food and has the ears of a lot of people, and is therefore feeding this myth. At my husband's course 29 people went out into the world reaffirmed that diabetics can't have sugar and ready to impart their new knowledge to any diabetic within radius.

I felt that no matter how much effort we put into diabetes awareness and educating the general public about the facts of diabetes it just take one person who has the attention of many to strike out all that good work. It's frustrating.

My hubby is outstanding though! He decided to write to the two organisations involved; Diabetes Ireland and the cooking school to suggest that they work together to raise some diabetes awareness and to put the course facilitator straight in the nice, polite way that he does things.

Hopefully this person will see that discouraging people with diabetes from enjoying her delicious cakes, puddings and scones doesn't make sense and start delivering facts instead of myths. I'm always the optimist.

Why exercise is "tricky" for T1Diabetes, episode 4

A quick recap;
In Episode 1 I talked about one of the reasons that exercise was "tricky"for people with type 1 diabetes is that it can cause low blood sugars (bs) and therefore you may end up eating to replace the calories you used and therefore rendering exercise as a form of weight management as a bit of a lost cause.

In episode 2 I rediscovered that some hypos prevent rational thinking and even though you have taken all the precautions you can you still might end up in a "pickle". I had a low towards the end of my walk and despite having my meter and glucose in my pocket I still thought I had to get home to treat my low.

In Episode 3; I talked about different things I was trying to eliminate such a high blood sugar (bs) reading before my walk and such a low reading after. 

Today, episode 4, and 3 & a half weeks into my new walking regime I think I have found the safe zone.

All this week my bs readings have been in the target range before breakfast, below 10mmols one hour later and just before my walk and in the target range after my walk. I returned to my oatmeal from breakfast because I found that my branflakes would make my before walk bs very high. And my basal strategy is to suspend my insulin pump from delivery insulin for the duration of my walk. 

I'm going to still monitor my bs before my walk but I am hoping to eliminate that one bs check in another week; once I'm sure my sugars have stabilized I won't need that check.

So I'm happy to report that I have (hopefully) overcome the challenge of exercising with T1 Diabetes and eliminated the "trickiness". 

P.S. Bonus, I've been able to give up the digestives (having none in the cupboard helped) :-)

Why exercise is "tricky" for T1Diabetes, episode 3

Just a quick recap;
Episode 1 answer was that exercise is "tricky"for people with type 1 diabetes because it can cause low blood sugars (bs) and therefore you may end up eating to replace the calories you used and therefore rendering exercise as a form of weight management as a bit of a lost cause.

The answer from episode 2 is that some hypos prevent rational thinking and even though you have taken all the precautions you can you still might end up in a "pickle". I had a low towards the end of my walk and despite having my meter and glucose in my pocket I still thought I had to get home to treat my low.

Now on to episode 3.

On day 3 of my walking/get in shape experiment, I decided to reduce my basal insulin programme for one hour before my walk, which coincides with actual breakfast time. 

The result being that my bs were a little high at walk time at 11.4mmols. My walk was uneventful and when I got home my bs was 3.6mmols which is hypo but lets face it, it's not 2.9! So I treated and added the digestive biscuit just because these hypos are getting old:-( Anyway, the packet of digestives are gone now so I think my hips are somewhat safe or maybe they're really never safe:-)

The next day, what did I do? Well I switched my healthy breakfast to a healthier one. I seem to have this desire to make my life as difficult as possible. So lets skip ahead to the first day where everything works out perfectly.

Day 5 of my new regime. My new tactic is going to be suspend my pump and so cutting off delivery of insulin completely for the duration of the walk. My before walk bs was 6.0. Could not be better! The number of my dreams! After my walk my bs was 4.0 - I see the light at the end of the tunnel. 

Day 6; I decided to reduce my breakfast insulin by just 0.25 of a unit just to see if that would keep my in the safe bs number zone. Eureka! I did forget to test before my walk which might mean that I'm getting ahead of myself but my after walk bs was 5.8. 

Tomorrow is another day and hopefully all this extra bs testing is not for nothing and that I can scale it back soon.

Why exercise is tricky for T1Diabetes episode 2

Answer no. 1 from my last post was that exercise is "tricky"for people with type 1 diabetes because it can cause low blood sugars and therefore you may end up eating to replace the calories you used and therefore rendering exercise as a form of weight management as a bit of a lost cause.

Answer no 2 is that some hypos prevent rational thinking. Here's what happened on day two of getting back in shape. Let's try the walk again shall we.

What did I do different this time? Well, I reduced my basal insulin by 30% for 2 hours at 8:30am which was a half an hour after I ate breakfast and a half an hour before my walk. And I remembered to test my blood sugars (bs) before I left the house for my walk. It was a decent 7.8.

Happy out and a pleasant walk in a grey overcast day. That is until about 5-10 minutes from the house when I started to feel a bit jelly-legged and my head was a bit fuzzy. My bs's were low and I could feel it. So I tried to breathe deeply and stay focused on getting home to test my bs for confirmation and to bring them back up again. I remembered that I could suspend my pump and stop all delivery of insulin until my bs's started to come back up.

I did make it home. The glucose meter revealed that I was indeed having a hypo, (2.9 for those of you who want to be alarmed). I grabbed the nasty glucose sweets which I keep in the testing kit. And while waiting for them to work I also grabbed a cup of coffee (why not!). Another problem with hypos is the waiting for your bs's to come back up while you still feel the symptoms and your brain insists that YOU NEED MORE SUGAR!!!! Yes, I gave in, but only to a digestive biscuit:-)

Once the symptoms had abated, I started to go about my day again. Always a housewife before a diabetic, I realised that the washing machine had finished and that by the time I would have the clothes out drying I could test my bs's again just to confirm that they were coming back into a good range, 7.8, perfect and resumed my basal rate on my pump.

Then, like a bolt out of the blue, I realised that I carry my testing kit, glucose and phone with me on my walk every day for the exact situation that I had just come through and why the hell didn't I use it? Oh yes, because the brain is the first part of the body to feel the effects of low blood glucose and so rational thinking can't be difficult or in fact lacking. What are we like!

Stay tuned for episode 3-I think I've cracked it but I don't want to speak too soon!

Episode 3 here

Why exercise is tricky for T1Diabetes episode 1

So it's the first morning of back to school for me, a stay at home mother with type 1 diabetes. The lazy days of summer are over and it's time to get back in shape and tone up those flabby muscles that returned almost overnight when the summer holidays began.

I was actually looking forward to it.

I thought I did all the right things. My blood sugars before brekkie were spot on at 5.2, for a change. I had my healthy breakfast as usual, that didn't change over the summer. I took my bolus. My blood sugars (bs) had been running high after my breakfast during the summer so I didn't reduce my bolus dose. And because of the high bs's I didn't reduce my basal insulin either.

So I got into the usual routine, got children ready for school, dropped them off, chatted a little to some of the other mothers I hadn't seen for 8 weeks, got home.

I moved my testing kit, glucose supply and phone into my pockets so I could carry them and off I went. It was a pleasant morning; it was dry and not too grey. I felt good.

This is all going well except when I tested my bs after my walk which coincides with my 2 hour after meal check I was 3.9. I felt quite shaky so I figured my bs were still dropping. I decided to have a cup of coffee accompanied by a mini Crunchie and mini Fudge instead of the nasty glucose sweets that I usually treat hypos with. Cos, really, the fact that I had to replace the calories I'd just used was enough to drive me to a very large chocolate eclair but I used a little restraint.

Once recovered from the disappointment I brainstormed to find things I could do to lessen the low bs after the walks. I told myself "it's day 1" and "I shouldn't be too hard on myself". It's going to take a couple of mornings to get this right.

Never give up, never surrender:-s

Episode 2 - here