Friday 31 May 2013

A day on the plate of a low-carber

Everyone knows that I had a complete blast at the AnimasSports Day weekend.  I mean, a bunch of other people with diabetes (PWDs), talking, playing sports, eating food and drinking wine; what's not to love? What I was keen to know when the weekend subsided and real life kicked back in, was just how much use the talks were to those who attended.  Mine in particular, as it was a bit of a first.

On the whole the feedback from the weekend was excellent but we were offered some specific feedback that the talks we gave on weight loss would have benefited from some specific information on what exactly I ate, or what the professionals recommended to eat, to aid weight loss.

Don’t get me wrong, I don't exactly recoil at the sight of a potato, quite the opposite in fact; I love a big ol’ bucket of carbs as much as the next person.  But I have learnt a lot in the last year – particularly since getting my Dexcom G4 Continuous Glucose Monitor (CGM) - about what carbs do to me; even the low GI ones people rave about.

So armed with the knowledge that people want to know more, I thought I would share a little more about what I’ve been eating and how I make normal meals into lower carb versions.  Don't worry, you don’t need to go out finding any weird and wonderful carb-free yam noodles just yet (FYI, the most disgusting food to have been invented, ever).

So here they are, some of the typical foods I eat.  Excuse the stock photography - by the time I'd taken all the pictures myself we would've all retired and would now be living somewhere we wouldn't need to cook for ourselves any more.


Omelette, with cheese and tomato.  I am horrible at making omelettes, so invested in one of these little bad boys.  It makes an omelette in 3-4 minutes and tastes amazeballs every time.  This meal keeps me from getting hungry for about 4-5 hours. 

Greek yogurt with berries.  The best ones I have found are the ‘Total’ Greek yogurts.  Not the low-fat version which has a lot more carbohydrate (when you remove the fat, you have to add taste somehow, so low-fat yogurts are usually packed with sugar – even the unflavoured ones).  People seem to have freaked out about fat in the last 30-40 years, but we forget that we still need it; it is vital to our cells and key to avoiding things like depression.  So don’t freak out about the little bit of fat in a Greek yogurt.  For the berries, I find blueberries the best as they are low-GI and don’t cause too much of a spike.

Cooked breakfast.  Rather than fried, I have a cooked English breakfast with grilled tomato, bacon and sausage, and will have scrambled eggs rather than fried.  I do have mushrooms in a tiny bit of butter (not marge; marge isn’t a real food to me) but that's the extent of naughtiness in this one.

Smoked Salmon and scrambled egg.  I can't even write this one without going to make myself some.  Back in five...


Tuna mayo salad.  A handful of salad leaves (stick with dark leafy greens like Spinach, Rocket and Watercress as they are much higher in iron. I once heard iceberg lettuce described as ‘nutritionally useless’, which left a lasting impression).  I then have cherry tomatoes, spring onion, red pepper and any other veggies I have to hand that make a good accompaniment.  I then have tuna and a tablespoon of mayo.

Bacon and Avocado salad.  Same as above but minus the tuna and mayo, and plus grilled bacon and avocado.  Literally the best thing ever.  Anything with bacon is, this is a fact.

 Ham salad. Same as above but minus….Can you see where I’m going with this?

Couscous salad.  I have limited success with couscous, but in order to not get bored and to jazz things up a bit, I occasionally have a couscous salad with coleslaw, beetroot, onions etc to liven the diet up a little.  This will need more insulin but gives a bit more of a ‘bulky’ salad if you fancy a change. 


Stir Fry.  The only danger with low carb is that you could end up eating more red meat.  It is always worth remembering that too much red meat isn’t recommended, so we throw in a stir fry a couple of times a week with tofu.  I suppose I’m lucky that I absolutely love tofu, so it’s not hard to incorporate.  If you don’t, you could use chicken, turkey or quorn type replacements, if you don’t mind that kinda thing.  I shove in beansprouts, sliced carrots, broccoli, green beans, spring onion and buckets of fresh ginger, chilli and garlic.  In order to avoid any sweet sauces, I use Amoy’s rich soy sauce and red wine mixed to give it an oriental kick.

Spaghetti Bolognese.  Unlikely seeming I know, but make your usual Bolognese sauce and swap out the spaghetti for a pile of green beans.  Get in touch if you get hungry.  I never have, and I’m also now never bloated or tired a couple of hours later.

Chilli.  Same as above, switching the rice for green beans.

Salmon with Beetroot and Horse Radish crème fraiche. If you are low carbing and want to watch the meat content, fish is a really good way to go.  I’m not a lover of fish per se, but this recipe is to die for.  Packed with goodness and barely touching the BGs. Get in touch if you want the recipe, it was a touch long for this already monster post.

Piri piri roast chicken.  This one is a total favourite.  It is a chicken breast covered with crushed garlic and Schwartz Piri Piri shake.  Not a carb or sauce in sight.  Roast this with a whole beef tomato, butternut squash, a couple of mushrooms, carrots and parsnips.  It is incredibly delicious, easy and a total of about 30g carbs from really nutrient-dense sources.

Cottage/Shepherds Pie. Make your usual meat part of the meal and swap out the mashed potato for mashed swede and carrot.  You will thank me.  Even when we aren’t strictly low-carbing we now eat this as it is such a welcome change and doesn’t leave you weighed down with potato and insulin on board.

Sausage casseroleThis one is credited to the Hairy Bikers who between them lost about 4 stone (56 pounds) by removing carbs.  Check it out.

Bean casserole.  As above but remove the sausages and add in borlotti, butter and any other kind of bean you like.  It’s awesome, trust me.  Even though beans have a reasonably high carb content, they also have a really high fibre content, and as fibre carbohydrate isn’t digested, it doesn’t affect BGs.  So load up on these little bad boys.

Jamie Oliver’s stew for Jools.  This one is again, simply adapted.  Remove any potato ingredients and pack it more with other veg.  It halves the carbs but none of the flavour.  Jamie has even worked out the carb content for us.

Pasta’ and Passata.  This one sounds a bit misleading.  We used to have a passatta sauces with veggies and pasta but since low carbing just swapped out the pasta for green beans.  Again this one is to have some veggie recipes on the go and lower the amount of red meat we eat.

Although this isn’t exhaustive, it will hopefully give an idea of how we adapt our foods to remove some of the carbs and pack in bag-fulls of veg, quality meats and flavour.  Dr Kelly’s talk touched on how to increase protein by 10% and lower carbs, making the switch to a way of eating more likely to result in healthy and long-term weight loss.

I don’t do the extremes of low-carbing that many do, and often our passata will feature one or two pieces of garlic bread, or a tiny desert of some kind.   But at least the 'treat' at those meals brings the meal to 60g carbs, rather than 120g, because I saved the wasted carbs from sources I don't miss, and used them on the ones I want.  

The meals I've included are now my fail-safe recipes for a good BG and as such, a more likely trip to the gym and general better feeling about all things D.  I tend to stick to no more than 30g per meal as this keeps me within decent upper and lower limits, even when things go a little awry.

If you have any of your own recipes you want to share please, get in touch. I'd love to know how you also tame the diabetes beast.

Tuesday 28 May 2013

Unleashing the stoopid...

It never fails to amaze me that despite having overall normal diabetes control I still have days when all my diabetes know-how goes out of the window and I make decisions which would realistically be out-smarted by a sock with 3 brain cells.  By 'normal' I of course mean a fair amount of steady days, with the odd bat-crap crazy one the next.

Overall, I maintain an HbA1c of around 7% and don't know any of the staff at Accident and Emergency by name, so I consider myself to be negotiating this sometimes wonky path with reasonable success.  It is usually (and reliably) the times when I am under a touch of stress that I lose my ability to function as a reasonably sensible PWD with the ability to make choices.  Clever ones, anyway.

Today was my driving test at work.  Not the first ever one; I passed that 11 years ago.  This one was compulsory with the new job I have been looking forward to starting so very much.  All I needed was a good blood glucose (BG) to work on so that I didn't either a) have a hypo before the test and not be able to take it (hypos mean no driving for 45 minutes under DVLA rules) or b) having a hypo during the test, which would be embarrassing and again, mean no driving for another 45 minutes.  That's all I needed to do.

I was running between 6.5 and 7 mmol all morning from 7am when I woke until 12.30 when I arrived at the test center.  For me, that's a pretty sexy day and exactly the kind of BGs I needed to make this test a go-go, rather than a no-go.  As I arrived, I felt the pangs of hunger creeping in.  Mistaking these for pangs of a familiar slow-moving low BG, and panicking that a hypo could ruin this chance to take the test - an important landmark in my new career - I glugged down half a bottle of juice, 20g of pure fruit sugar.

I was 13.4 and feeling less than jolly by the time my test came around.  Had I been watching in from the outside I could have told you it would happen; I would have giving myself a gentle kick in the leg to stop myself drinking anymore.  A sip, maybe, to ward off any stealthy hypo.  But half a bottle?

Seriously.  Dumb.

What would almost undoubtedly have remained a 5-6mmol (if anything, going up slightly with the adrenaline), was battered for a BG more than double by the time I had finished unleashing the 'stoopid' on myself.

But hey, I passed the test and lived to tell the tale.  Maybe now and then it's OK to unleash the stoopid, if you can spot it when you do it.

Do you do this kinda stuff, too?  You know, the stoopid kind?

Monday 20 May 2013

Not a minute too soon...

When I talk about my transition to life on an insulin pump I always tell people that I never knew how much I disliked injections until I didn't have to do them anymore; then, it became obvious. 

I never minded jabs at all.  I have this vivid memory of back when my family lived in Germany and it was celebrated when, at just four years old, I jabbed myself for the very first time.  I still remember sitting on my parents bed, my skinny little legs dangling over the side.  Due to being little more than a baby and the whole world seeming bigger, my feet were clear of the ground by two, maybe three feet.  My parents and younger brother were there, sat around me.  As I gave myself an injection with one of those old, plastic orange-capped hypodermic syringes, the needle for which seemed metres long, they all cheered and spoiled me with celebrations.  If I close my eyes, I can still see the beige colours of the bed sheets and the 70s patterned carpet.

Last night, as my G4 sensor clung onto my arm after 22 days, still giving me numbers as close as 0.1-0.2 mmol out, but with the adhesive having crapped out on me completely, I decided enough was enough.  I'd given myself a really nasty looking rash (not with the Dexcom adhesive as some people have, but with the plasters I was using in a desperate attempt to secure the sensor for a few more previous days), so decided the time had come to pull it.

(Sorry about the photo grossness, but you know, for the purpose of education...)

I have a rule about sensor use: as my husband and I don't grow a money tree in the garden for me to afford it we have agreed two sensors a month.  This amounts to around £90-100 in any one calendar month which, although still disgustingly expensive (considering I now see this as a fundamental part of my self-management and something I simply couldn't do with out), we are lucky enough to be in a position to be able to fund even that much.  Sometimes, if a sensor doesn't go the full 2 weeks we need (rare), I have to miss a couple of days in between in order to allow coverage for a whole month. Last night,  due to the rash and lack of options to stick the adhesive back on, I had my first sensor-free night in around 73 days.

It sucked.

As I crunched my way through 6 dusty Dextrose tabs to try and bump up my blood sugars after an unwelcome 2.6mmol (46 mg/dl) smacked me in the gut at 2am, I would have given anything to plug back in.  I was having a full-on freak-out about, "What the hell do we do when we have kids and can't afford this anymore", and "Maybe we need to start saving now" kind of dramas that my husband could no doubt do without at 2am.  It was right about then I realised just how much I love my G4: I love it as much as I love not having to give myself jabs.  Perhaps more.   

One day I hope all PWDs (People with Diabetes) will be able to sit around and discuss their CGM readings and talk how much easier it makes all their lives.  While we're at it, I would really like a cure, but that's another post.

As I departed for work today with my new sensor on board and in the two-hour warm-up period, I was happy that no more low blood sugars would creep in today.

Do you have a CGMs, and has it made a difference to your way of life?

Thursday 16 May 2013

Animas SportsDay 2013: I need to find a word more awesome than 'awesome'.....

There is no power for change greater than a community discovering what it cares about.” - Margaret J. Wheatley

When Animas first brainstormed the idea of bringing together a group of people with diabetes with a common interest in Sports and exercise, they most likely had no idea that only a handful of years down the line a spot on that weekend would become such a sought-after commodity in the realm of diabetes events.

In only its fledgling years, it is fast becoming an event in the diabetes calendar not to be missed, offering the chance to learn from the UK's leading specialists about the physiological impact of sport and exercise.  It teaches us how to manage wily blood sugars when you are half way through your desert marathon run (I'm not even kidding - meet Roddy).  

Learning how to manage those challenges and practice the teachings with a host of medical professionals on hand are just two of the gifts the weekend can offer.  Attendees have the chance to hear motivational talks from people who have achieved the most inspirational goals and last but most certainly not least, participants are offered the chance to come together with others from across the continent to form a community of people affected by awesomeness.  That's right: awesomeness.

So how do you sum up that kind of weekend in a post that isn't the size of an average Dissertation?  It's hard, but here goes:

The talks

The weekend kicked off with a welcome and talk from Dr Ian Gallen, the man heading up the education on the weekend who boasts references such as being consultant to Sir Steven Redgrave during the Olympics (we simply file that under 'legendary').  He explained the impact of different types of exercise on the diabetic body and gave information on how to negotiate those changes with a pump or multiple daily injections.  He told us about the effects of hormones on blood glucose levels and how to fuel effectively during exercise.  His talk, the culmination of decades of work, left everyone keen to get going on the 'trying it out' part of the agenda.  

Saturday offered advice from Alistair Lumb about the benefits of incorporating pumps and - to a lesser extent - CGMs in exercise management.   Later, Dr Chris Kelly gave his talk on comparisons between different diets and maintaining weight loss longer term and to accompany him, your very own Ms Independent (Kelly Clarkson?) gave a talk on my own weight challenge over the last year.  

The awesome Claire Duncan took to the floor to share her story of competing in not one but two half Ironmans (Ironmen?) and a full one (140.4 miles of swimming, biking and a whole marathon to boot!), as well as swimming the channel AND being a regular triathlete.  She told us of the pull she has to sport, and offered words of advice to those who want to get started.  And did I mention she's awesome?

Finally, everyone's favourite Mr Motivator and social media powerhouse Paul Buchannon took the floor to talk about the Great Britain Diabetes Online Community (GBDoc) and how his simple idea of getting people talking to one another and find friendship in the furthest corners of the world led to him founding DOCs in over 12 countries.  What a difference one person with an idea and a bunch of enthusiasm can make...

 The exercise

Armed with the tools now firmly stored in our diabetes arsenal, the participants headed off after their more than ample breakfasts to experiment with the advice given and the sports on offer. 

The activities of the weekend included circuit-style fitness, boot camp and spinning, while the afternoon brought Badminton and Volleyball.  On Sunday we had the chance to play a game of rounders, which was evidently more about enthusiasm than skill, although I did manage to hit a ball for the first time since school.  This impresses you, I can tell. 

Other lessons from the weekend included that I ‘volleyball’ in the same manner I ‘Salsa’ and that I am significantly better at smack-talking the other team than I am contributing to the success of my own.

What I really learned about exercise however – including how and when to adjust basals, what recovery snacks are best and how to exercise safely - will undoubtedly assist me in the challenges I hope to embark on in the next few months. More on that, later.

A post with specific lessons will follow because as you can see, there is just too much going on in such a short time to confine it to just one post!

The people

As with most of these events, it is the people who make it what it truly is.  The event saw people of all shapes, sizes, nationalities, exercising experience and sporting prowess come together.  United by diabetes, this year saw a much bigger attendance by our European family members including those from Germany,  Sweden, Switzerland, Finland and the mildly bonkers Danes (who even brought along and demonstrated their own dance?!).
It is the kind of event that starts with people politely asking 'where are you from', and closes with ‘let’s climb a mountain together’.  It is a safe space where everyone there has something in common with you.  It is the only gift I believe diabetes gives us; a universal family.  It allows us kinship with those we’ve never met, and allows us to be friends with people in an instant, simply because they get ‘it’. It brings us community.

As the closing comments were made and with a lump in my throat I felt compelled to speak out.  In the previous day's reflection sessions, Dr Gallen divulged how when he first tried understanding the physiology of the diabetic body during exercise all those years ago, he was told he was ‘mad’ and that it was ‘pointless’. Are we, by extension, then also pointless? Are our goals, no matter how challenging and admirable, also pointless? The people with diabetes who want to climb a mountain?  Those who wish to swim the channel?  Those who aim to lose weight because they deserve a better, happier life?  Those who go on to inspire others?

No, our goals are not pointless; we, are not pointless.  Thankfully, Dr Gallen ignored those comments and years on he and Animas have helped create a community of high-aimers and won’t-settlers, who are achieving their goals because someone understood the value of helping us get there.

To them, I say 'Thank you'.