Dottli is the diabetes app that helps monitor Type 1 Diabetes better.

Connecting the dots of Midsummer – things to note as a diabetic

Midsummer or “Juhannus” as we call it here in Finland, is my favourite holiday. For many, the summer really starts from Juhannus. The reason for this is that while it can be cold and rainy, it is the most popular time to start one’s summer holiday.

 

 

Traditionally Juhannus is spent on summer cabins by the lake. The fest often means having a lot of food and spending time with friends and family. Sauna (and beating each other with birch twigs while in sauna) and swimming are common pastimes of Juhannus.

Midsummer festivities and maintaining a steady BG trend

For diabetics, there are a few things to take into consideration while enjoying midsummer’s eve.

  • First, you are eating a lot or there is food to be had. Grilled meat, sausages and vegetables plus early harvest potatoes are among the classics of summer foods. It means that a diabetic has to factor in increased amounts of fat, protein and carbohydrates. It is hard to keep BG levels steady!
  • Second, if you are consuming alcohol (like it is tradition on Juhannus), you must be careful with insulin. Alcohol has a tendency to first raise your BG levels and then in a few hours, bring them crashing down. You do not want to go low in the middle of the night.
  • And third, swimming and sauna can have an effect to your insulin absorbtion.

Lot of greasy food with carbs, alcohol and sauna can make for a great evening, but for a diabetic it will be a challenge to maintain good BG levels. I find it easier to easen up a bit on my BG goals and just go easier for this one magical night.

I like sharing pictures and bg values from my evening on Dottli’s messenger. It’s fun to see that my over-the-top BG levels are not that uncommon among diabetics on midsummer’s eve!

– Miika

The writer has had t1d for 15 years and feels like his health is better because of diabetes and the more strict lifestyle it demands.

midsummer's bonfire

Bonfire is an important part of Finnish midsummer festivities.

 

7 rules of thumb for effective diabetes management

What are the core pillars of diabetes management? Type 1 diabetes is a complex condition, which tends to keep us wondering what are the causes for strange bumps in our BG trends. Sometimes it feels like we have no control over our beloved partner in life. And sometimes the cause for continuous high BG levels can be because we have forgotten to adhere to the very basic rules of thumb of diabetes self care. Here is a list of seven things that should be present in our daily lives.

The diabetic, who takes care of himself…

 

…measures BG-levels regularly

I think we all know that we cannot have optimal BG levels unless we measure BG levels regularly. That’s the one and the only way to know, how our treatment is succeeding.

…exercises regularly

Exercise is good for all of us, but especially for us diabetics. Exercising keeps our metabolism active and often that makes it easier to predict the effect insulin will have on our BG levels. You might need to find the proper insulin dosage for post-exercise days, but it’s totally worth the extra effort!

Regular exercise can help in keeping bg levels near optimal.

…eat healthy, counts carbs

Avoiding extra fat, salt and sugar helps you manage your BG levels. Salt will also increase your blood pressure, which is not a good thing for diabetics. High blood pressure increases the strain to your veins, heart, eyes and kidneys. It’s good to weigh food every now and then just to check if your carbs estimations are right. Carb estimation is rarely as accurate as carb counting.

…checks and adjusts carb to insulin ratio regularly

By making meal pair measurements you can analyse if your insulin dosage is at a proper level for each meal. Meal pair measurement means measuring BG before meal and two hours after the meal. In the morning you might need more (or less!) insulin per 10 grams of carbs than in the evening. The only way to get your treatment right is to do meal pair measurements! Also, you should consider actually counting your carbs when doing the meal pairs.

…enjoys peer support

Self-caring diabetic knows the power of peer support. It’s gives so much energy to meet people who understand your diabetic problems from just a few words.

…analyses treatment results and thinks how to make changes

You have a doctor and a nurse supporting you in your diabetes management, but it’s ultimately you who makes the treatment decisions. You have to get to know your diabetes and body in order to be really successful. What kind of response does your body give to cardio exercise? What about weight training? How does your need for insulin alter during different stages of the day? Where are your cannula sweet spots? Life teaches you these things about diabetes and by analysing your treatment, you really get to know your body and diabetes.

analyse your diabetes management

…has mercy on himself in the end

The meaning of mercy can not be overemphasized. You do your best and that’s enough. We all fail and the bad days come for all of us. Diabetes management not a sprint, it is a lifelong marathon.

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Good Mood Diabetes – the small moments of success

“Aw yea! A full night of sleep with optimal BG levels!”

Diabetes or no diabetes, the days of our lives are filled with small moments that can brighten our mood if we are perceptive enough to notice them. I call those rays of sunshine as something that brings me ”Good Mood Diabetes”. Living life as a type 1 diabetic, the positive rays can be scarce at times, but when you do finally find them, they can be rewarding. Here is what I often find to be my ”Good Mood Diabetes” signs.

Perfect after meal value

This one I get almost every day at at least one meal. My BG value isn’t necessarily top notch, but my estimation was correct and BG value was at least somewhat good!

Carb Estimation success - Good Mood Diabetes|Dottli Diabetes Blog

Carb estimation success! Yeah!

The cannula works like a dream

These occurrences tend to be a lot more rare than I would like. But boy, it is always a good 3 days when the cannula hits “the sweet spot”. Rotating the injection sites at at least 4 different locations seems to help a lot. Finding the sweet spot is actually a bit more than just a little ray of sunshine, it lifts my mood a lot.

Cannula trendline - Good Mood Diabetes|Dottli Diabetes Blog

Look at that straight line, that’s 12 hours!

A1C has improved since last time

Oh this is a really Good Mood Diabetes factor. When it happens, I usually tell all my closest diabetic friends and family. Maybe I even do a little victory dance!

Dottli App for Diabetes - Good Mood Diabetes | Dottli Diabetes Blog

Dottli has helped me and a lot of others improve our A1C.

Exercise without a hypoglycemia

My BG usually rises through the roof after exercise, but during it, the hypo risk is always there. Good preparation and having some carbs really helps avoiding hypos during exercise. When you nail it, it feels good. And if you manage to counter those post-exercise highs, even better!

View post on imgur.com

Next time you experience a moment like those above, try appreciating the moment. It might boost the positive effect of the little ray of sunshine! 🙂

– Miika

peer support for diabetes
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Peer support – 5 + 1 places where to find it

Peer support plays an important role in my life. It reminds me of the positive effects diabetes can have. Meeting people who understand my condition relieves my stress about diabetes and makes it easier to cope with. The feeling of not being alone is a warm one indeed. But where can a freshly diagnosed diabetic find peer support? I made a list of five items to help you search for peers both in the real world and on the net.

  1. Each country has its own diabetes association. Most often the purpose of those associations is to guard the rights of diabetics and organise peer support. You should search for your own country’s diabetes association. The associations often arrange local meetings around the nation and some even offer diabetes support persons for your aid.
  1. Sometimes it can be a bit of a threshold to just go to a peer meeting. It can be easier to go for a run or hike with fellow diabetics. Some countries have online communities dedicated for diabetics with a certain hobby. See Connected in Motion, which is a community for diabetics who like outdoor activities (they have great videos!). Similar communities may be found in your country. Or maybe start one together with your local diabetes association?
  1. Online groups. There are several traditional diabetes forums to be found around the net, like this one. Facebook also has a lot of discussion groups and probably in every language, so be sure to search for them. I like forums because it is easier to search for discussion threads concerning a certain subject. FB groups easily become a never-ending stream of duplicate threads.
  1. Search for blogs and Twitter, Instagram and Pinterest feeds on diabetes. It can also be empowering just to read about others’ views on diabetes. If you just like reading and watching, search with hashtags. We use #t1d, #type1diabetes and #diabeticlife, but there are many others and also country specific hashtags, like #diabetesuk or #diabetesfi.
  1. If you have a diabetes related question in mind and want to ask in anonymously, you can use JDRF’s Get Support function. You just type in some background information and your question and their volunteers will answer you! Of course, they won’t provide any medical assistance, but will answer questions about what it is to live with diabetes.

And one extra tip for peer support!

+1. Grassroots peer support! When you do find some diabetic friends, you can suggest sharing your logged diabetes values in messenger styled chat. Dottli’s app does the sharing automatically and it can really help to motivate you to take better care of yourself. I wrote a blog post about grassroots peer support earlier, you can view it here.

– Miika

 

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What to expect when dating a person with type 1 diabetes

Type 1 diabetes is an illness which is not easy to manage and it influences practically everything in life. When someone starts dating a person with type 1 diabetes, there might be some things that are good to know. Firstly, you should know the basics of type 1 diabetes. The internet has tons of very good information available. Here is a nice fact sheet about type 1 diabetes from Juvenile Diabetes Research Foundation (JDRF).

The symptoms of hypos and hypers differ amongst diabetics

Now that you know the cold facts, you should know that every person with type 1 diabetes is unique. Exercise raises someone’s BG levels, whereas others have to drink sugary drinks to avoid going low.  Different diabetics experience low or high blood glucose levels differently. One might get angry or anxious when approaching a low BG, whereas some just go pale and shaky. It gets worse at the grocery store if one has a hypo standing in line with a chocolate bar in hand. They would just want to pay for the candy bar so they can eat it but the queue just won’t MOVE! That for e.g. is when I feel a bit aggressive but I have learned to just eat the candy bar while standing there and pay for the wrap.

Eventually you’ll probably learn to see when your significant other is acting “like in a hypo”. However, you might want to avoid suggesting a blood glucose measurement. Nothing feels as frustrating when someone invalidates a type 1 diabetic’s negative emotions by suggesting ”It’s only your diabetes doing its tricks”. I would think it is something like telling an angry woman “it’s just your hormones talking”. Tread carefully here.

At high BG levels the most common symptoms are fatigue and frequent need for urination, but there are differences here too. For the first few years since my diagnosis, I would get relaxed, more talkative and kind of upbeat when experiencing high BG levels. Having an actual “sugar high”. Nowadays I just feel tired and sleepy, I guess my body got accustomed to the highs. But back in the day when I was acting goofy, my GF often asked me if I had high BG, also bringing forth some frustration that “am I only goofy when I’m high?”.

The Zombie Hypo Mega-Munchies

Then there are the night time hypoglycemias. At night, the blood glucose levels can drop pretty low before the symptoms wake a diabetic up. When the hypo is more severe, the body signals very strongly, urging to eat as much as possible. This leads to ‘hypo munchies’ as I like to call them. It is not uncommon for one to stagger into the kitchen and look for anything fast to eat. Bread is fine, fruits too. Chocolate cookies and milk – OH YES! The morning after is horrible, the BGs are sky high, eyes feel swollen and the mouth tastes awful. I ate something my SO (Significant Other) had prepared for herself or for guests more than once and  woke up with a super bad feeling and heard “WHO ATE MY SANDWICH?”. Eventually my fear of my wife’s wrath overcame the instinct level “EAT” command issued by my nightly hypo.

So nowadays while I’m on zombie eating mode (not aiming for brains though), I still have enough higher cognitive functions active to avoid eating stuff reserved for specific purposes or guests. But I’ll tell you, nothing tastes as good as chocolate chip cookies and milk when your body thinks its dying and the only cure is food. They say hunger is the best seasoning, but nah, the best seasoning is a massive hypo.

Then there are some, who don’t feel the hypos and just tumble down in the weirdest places. The loss of hypo feels is a dangerous situation and I’m glad it hasn’t happened to me yet. But my SO worries about me. Type 1 diabetes comes with its risks and complications are a reality for many of us. The complications can include changes in eye sight, problems with feeling on your feet, digestion, kidneys and circulatory system. But if you treat your diabetes well and should complications arise, treat them well too, everything should go reasonably well. Our lifespans aren’t that much shorter if living in a developed country and receiving good treatment.

Dottli provides a nice tool for couples with diabetes

The worst thing about type 1 diabetes at the moment for me is force feeding. I am trying to maintain my weight and there is nothing that frustrates me more than having to force feed. The need for force feeding occurs when I have to exercise and my BG levels are waaay too low. I need to bring it up, sometimes by a lot. I have had to eat a half jar of honey (which I strongly dislike) to get my BG levels to a safe level for exercise. Sometimes my body also suddenly reacts much more strongly to insulin and I find myself at almost hypo values with like 5 units of active insulin running through my veins. I have no choice but to eat, even if I just ate 30 minutes earlier.

These things greatly affect how people with type 1 diabetes feel about themselves. Hence it is a good idea for the SO to understand the things that are happening in the diabetics’ life. A great way to get know your diabetic’s illness is to start a joint chat channel on Dottli’s app. That way whenever a diabetic logs BG value, bolus, meal or exercise, the partner gets the information automatically on the chat channel. It’s a great way to learn to know your better half’s other life-long companion.

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How to pick up healthy habits after summer holiday?

Where did my healthy habits go? I had a long summer holiday during which I slept in and didn’t really watch my diet. The whole spring I was able to withstand eating sugary treats, but when my holiday started, I succumbed. The daily routines like having a healthy lunch every day at 11 o’clock vanished. I could have my lunch at 14 o’clock and eat cake and candy in the evening. I suspect my weight has gone up by at least 2 kilograms during the last four weeks. This week is my first week at work and I know already it will be HARD to wean myself off of the daily sugar fix. Last time I fixed my diet in January, it took me several weeks to get past the sugar cravings.

My diabetes has been okay so far though. Even though my diet has gone awry, I have been able to exercise. The lawn needs mowing and that takes over an hour every week. I’ve gone to boxing practice at least once a week and I’ve hunted some Pokemon while walking in my brand new hiking shoes.

During holidays I sleep in late and eat poorly. That’s not too bad, one might even say it sounds like a proper holiday attitude. I have given myself permission to do all that, but I have kept in mind that it’s only temporary. Now that my work routines are coming back, it’s time to take control again. And this is how I’m going to do it:

1.       I’ll go to sleep at 22 o’clock instead of midnight

2.       I’ll start having steady, healthy lunches at work (I can now share pictures of my meals to my friends on Dottli’s chat channels!)

3.       No candy or chocolate

4.       Sweet pastries only on special occasions like birthday parties or other celebrations. It’s important to separate everyday life and times of celebration.

5.       I’ll maintain my healthy exercise habits

I have a big sweet tooth, but salty treats are not a problem, so I’ll allow myself salty pastries in moderation.

fishing is a part of healthy habits

I really enjoyed my summer vacation.

That’s my recipe for healthy normal life and more easily manageable type 1 diabetes. Healthy habits are an important part of type 1 diabetes care, they are not crucial only for type 2 diabetics. But a list with five items in it means that I have five balls I have to juggle with. I am bound to drop at least one of them and I am prepared for it. When I lapse, I’ll just pick up the ball right away. And if the lapse lasts a week, I won’t give up, I’ll just start again.

That’s the biggest rule of maintaining healthy habits: always start again, there is no such thing as game over.

Miika