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Editor’s note: This article is about Ginger Vieira’s personal experience managing type 1 diabetes. What works for her may not work for everyone. Please remember, Ginger is not a doctor, and she is definitely not your doctor! Please talk to your healthcare team before making any changes you make to your diabetes management regimen.
We can’t help the fact that we don’t produce insulin. We can’t help the fact that there are dozens of variables that impact our blood sugar — many of which are hard to predict or prevent.
One of the few things we can take charge of is our habits. While I’ve lived with type 1 diabetes (T1D) for about 25 years, it wasn’t until 10 years into the game that I started to truly appreciate the impact of my daily routine and choices. Those little decisions, little actions, and little habits that we make every day can truly make T1D a little bit easier and help me feel great, too.
Here are five habits that help me thrive with T1D — maybe a couple might be helpful for you.
1. I have only one food rule: choose mostly real food.
I don’t follow any extreme/restrictive diets anymore — but I’ve certainly experimented with them in the past and learned helpful things from each. Like Bruce Lee said, “Take what is useful, and leave the rest.”
Over the years, I’ve experimented with the benefits/impact of different diets that ask you to dramatically limit certain macronutrients. Sure, they all have their instantaneous results but you’re still asking your body to feel at peace with some form of dramatic restriction or deprivation.
(My A1c is lower now than it was on a strict low-carb diet. That’s not the diet’s fault! It simply means I’ve learned how to fine-tune my insulin doses properly regardless of what I’m eating!)
Instead, I focus on one daily goal: eat mostly real food and save a little room for something yummy.
At the end of the day, I need an approach to food that feels good and is sustainable. If you tell me to cut all the carbs from my diet, I know I’m just going to think about carbs all day long. Logically, I don’t think a diet that banishes fresh fruit makes any sense. When you remove that entire food group and expect absolute perfection, you’re bound to end up wanting so much of it. The same goes for the extremely low-fat vegan diet — whoa, my body needs dietary fat! Just because dietary fat increases our need for insulin doesn’t mean it’s evil.
I feel strongly that my body needs a reasonable amount of all three macronutrients: protein, fat, and carbohydrates. Is my diet still relatively low-carb compared to the average American’s? You bet, ranging from 100 to 200 grams per day. I choose my carbs thoughtfully.
I give myself permission to eat a reasonable serving of dessert once a day, then I don’t even think about dessert at all! It takes all the drama out of enjoying those homemade gluten-free brownies. I enjoy some brownies…and then I go on with my life. No drama.
Throughout the rest of the day, I simply try to choose mostly real food. For example:
- Big ol’ simple salad with veggies, feta cheese, olives, dressing, etc.
- Apple with peanut butter
- Carrots and hummus
- Yogurt and peanuts
- Cauliflower wrap (processed) with turkey/lettuce/cheese/mustard
- Chicken with sauteed broccoli/onions
- Venison with bean sprouts/onions/bell peppers
Sure, the wrap/yogurt/mustard/dressing are processed items, but it’s not the end of the world! They are small parts of whole-food meals and snacks. It’s okay — my goal is not 100% perfection.
No drama. No extremes. Just realistic goals that offer flexibility for real life.
2. I get dressed in workout clothes as soon as I wake up.
This habit is a keeper for life. Within minutes of waking up in the morning, I’m ready to rock ‘n roll because I jump right from my pajamas into my workout clothes. Even if I have to wait an hour (getting kids to school, etc.) before I can walk the dog and jump rope, I’m ready.
This early-morning habit means there’s no challenge of having to go back upstairs and change into my workout clothes. I’ll never catch myself saying, “Ugh, I don’t feel like changing my clothes right now. Maybe I’ll exercise later.”
I can just start as soon as the opportunity presents itself.
I believe firmly that my body needs a minimum of a 2-mile walk every single day — unless, of course, I’m sick. We need exercise. Even a little mild exercise like walking is a must. Without it, my mood/work/energy will all suffer. There’s no reason my body wants or needs to simply sit all day at a desk and then all night on the couch. No matter how intense the workday might be, I take time to walk.
Making exercise a standard part of my day means it’s nearly impossible to fall off track, too. When I’m sick, and it’s best that I rest, my body is so grateful when I’m well enough to walk again.
If your first reaction is “well, I’m just too tired to walk” then I urge you to walk even more. Your body isn’t craving more sitting. It feels tired because it’s desperate for some exercise! Let the exercise be your source of energy instead of waiting to have energy before choosing to exercise.
I know my body feels most energized when I get two daily dog walks + 30 minutes of higher-intensity cardio every day — my body craves it! Some days, I add in 30 minutes of light weights, a light jog later in the day, or a karate class.
Exercise charges my battery! The more you do it, the more your body will crave it.
3. I track my exercise on a big marker board.
This one costs a little bit of money — but I’m glad I finally splurged on that big marker board.
By writing down the basic gist of my exercise accomplishments, I feel rewarded for what I’ve done and encouraged to do it again. I don’t get into the nitty gritty details; I keep it really simple — like “jump rope 30 mins” or “30 mins weights” or “run 1.7 miles” or “karate”.
For me, it’s the big picture that helps.
As someone with fibromyalgia (who must limit my weightlifting activity), it’s also helpful to see that it’s been two days since I lifted weights. This tells me it’s definitely safe to do it again! When I was still rebuilding my tolerance for weights — and I was actually a little afraid of weightlifting because it was a big trigger for fibro-exhaustion — seeing how many days it had been gives me encouragement to get it done. “Oh, geez! It’s been a week since I lifted weights!” It helped me reach my frequency goals.
Sometimes, the marker board is a good reminder that I’m due for a rest day! I write a big “REST DAY!” on the board and know I’ve earned it.
At the end of the month, I wipe the board clean and start over. Filling in each day all month long helps me hold myself accountable, encourages me to ensure it is thoroughly filled in and reminds me how hard I’ve worked to be consistent.
4. I forgive myself quickly for imperfect blood sugars.
We’re playing a very long “game” of T1D here. And while I certainly hope we all get an awesome cure someday, I want to show up for that cure feeling empowered and full of joy.
I don’t want to spend my days/weeks/months/years until that cure beating myself up for every imperfect number.
If we have a constant message of “Wow, you suck! Your blood sugar is high! You screwed up again!” in our heads, this 24/7 life of T1D is going to be a lot harder.
Our bodies don’t produce a very critical hormone. (And actually, we don’t produce several other hormones properly either! But nobody ever freakin’ talks about those! Arg! Don’t get me started.)
As I was saying, our bodies don’t produce several critical hormones properly. And we’re supposed to manage this ourselves with manufactured replacements of those hormones? Perfectly? Yeah, right.
The way we talk to ourselves during every high or low blood sugar is a habit — and we can change that habit. We should be giving ourselves mental high-fives every morning for simply showing up for another day of T1D management.
When my numbers aren’t perfect, I choose to say, “Oh, damn it, that didn’t work out the way I hoped! Noted! Ugh. I’ll try something different next time.”
And then I move on.
5. I exercise in a fasted state!
Well, this is hard to explain in just a couple of paragraphs but here’s the gist: when you exercise before you eat, it means you have significantly less active insulin on board. The less rapid-acting insulin you have active in your bloodstream, the less likely you’re going to go low during aerobic/cardio exercise.
This means I can start my workout in my target range and stay there during intense cardio because there isn’t excess insulin on board to cause lows. (Anaerobic/strength training can also be done in a fasted state but keep in mind that intense anaerobic exercise can cause blood sugars to rise.)
If I jump rope for 30 minutes before eating breakfast, then the only insulin in my system is my long-acting injection of Lantus from the night before. My body isn’t going to burn up tons of sugar because I don’t have a bolus of rapid-acting insulin present from a meal.
(Please hear me loud and clear: We all need basal/background insulin present — and if you’re on a pump, you may have to reduce that during the hour prior to fasted exercise — but we do need some background insulin present at all times.)
If I want to exercise later in the day, I know I need to time that exercise for when my last meal bolus of rapid-acting insulin is mostly out of my system.
Injected rapid-acting insulin would need at least 3-4 hours since injection (or 4-5 hours for larger doses).
Inhaled insulin would need 1-2 hours (or up to 3 hours for larger doses).
Another example: When my kids were little, I’d jump rope at 7 p.m. after they went to bed. I knew I should time my afternoon snack for 3 p.m. so the insulin for that snack was mostly out of my system by 7 p.m.
Fasted exercise is not a magic bullet. It still requires careful thought and planning — and I’m still always prepared for lows, just in case. But it’s a game-changer, for sure. It hugely reduces my risk of going low during cardio exercise.
Well, this is just what helps me juggle and thrive with T1D. Like Bruce Lee said, “Take what is useful and leave the rest.”