I wrapped up carb counting yesterday, and I would be lying if I said I wasn’t relieved that I don’t have to poke my fingers anymore. I’m glad I did it – I got some good ideas for tips on how to make it hurt less (the side of the finger is the spot!). I did miss my insulin one day – I was on an overnight girls’ trip and thought I brought everything (got my meter, lancets, blood sugar log, and vitamin) but I somehow managed to leave my syringe behind. Phooey. There goes my perfect record.

As far as carb counting goes, it’s not awful. It gets tiresome and Halloween was definitely tough, but it wasn’t the hardest part. Getting the 30 minutes of activity 5 days per week was a challenge, but not the end of the world. Now, getting the 3 minutes of activity per every 30 of sitting – that was the sticker. Fortunately, the apps I discussed in this post made it easier. I’ll be writing a post reviewing the two apps soon! Even with the apps, it was downright impossible to do that every single thirty minutes. You know, I have 60-minute appointments and on girls’ day I drove for two hours there and two hours back. No exercise there. But I did the best I could and honestly, it really felt good to get up and get the blood flowing and joints moving on a regular basis.

As a special treat, my husband and I completed the #DiabetesDanceDare for Diabetes Awareness. Enjoy!

Managing diabetes is a struggle. It can be overwhelming and exhausting to try to keep your blood sugar under control. Here are 7 reasons I think people find it challenging to do the things they know would be good for them:

1. They are confusing. Nobody can agree. You get one recommendation from your doctor, one from an article you read online, one from a library book, and three others from your friends with diabetes. So who’s right? Sometimes no one, sometimes all of them. Diabetes recommendations (and bodies!) are so, so individual. Just because something is recommended for your friend or even the general public, doesn’t necessarily mean it’s right for you. Discuss your questions with your doctor and your dietitian. They should be able to help you weed out what’s right for you.
2. They are overwhelming. So much to do, so little time: checking blood sugars (sometimes 4-6 times a day!), taking medications, dosing insulin, watching your diet, and staying active. I get it – I’m living it temporarily and I’m already starting to wonder how people do this all the time. Managing diabetes is no joke. Sometimes I feel that as health professionals, we throw too many tasks at patients at one time. Be sure to communicate what’s realistic for you and tell your care team if you need to prioritize changes into smaller steps.
3. Presentation is key. Along the same lines, nutrition information for diabetes is often presented in a tsunami of recommendations to idealize someone’s diet and prevent every chronic condition under the sun. I have sat in on and (I hate to say it) helped teach classes that covered carbohydrates, proteins, portion control, fiber, saturated fat, unsaturated fat, heart healthy recommendations, exercise, and mental and sexual health in one mind-numbing three hour stint. How likely is it that those poor people are going to retain anything useful? In fact, I meet with patients on a weekly basis who have attended those types of classes and flat out told me, “I didn’t learn anything. There was way too much information.” My plea to my profession: BREAK IT UP, PRIORITIZE, and EMPATHIZE.

   
   
   

4. Portion does not mean portion. This is a big one. Diabetes educators and dietitians have adopted a term called “diabetes portion” or “carbohydrate portion.” This amount of a food has about 15 grams of carbohydrate and is intended to make carb counting easier. After learning the portions, someone can simply choose 3-4 per meal, 5-7 per meal, or however many their dietitian recommends, rather than track and count grams of carbohydrate. The unfortunate reality is that the word “portion” sends the message that that amount of carbohydrate is all they can have at once. I can’t tell you how many people I’ve worked with who say dejectedly, “So-and-so told me I could only ever have 1/3 cup rice at a time and that’s just never going to happen.” This misconception is suuuuuuper defeating for people who want to manage their diabetes, because they think they have to starve to do it. My solution? Change “carbohydrate portions” to “carbohydrate choices” or something less confusing so people know they can still eat!
5. It’s not black and white. Eating for diabetes is not a list of “good foods” and “bad foods,” which can be confusing. Carbs are not bad and they give us energy, but people with diabetes simply can’t process too many carbs at one time. It’s not total avoidance, it’s moderation. Sometimes that’s hard to grasp.
6. The media. Ohhhhhh the media…so useful in some ways, so full of garbage information in others.
7. It’s a moving target. Recommendations for managing blood sugar are based on a conglomeration of research in the field. You know what that means? New research = new recommendations. Every few years, the recommendations change a bit based on new information. That’s why it’s important, even if you’ve had nutrition education before, to meet with your doctor regularly and a dietitian at least once a year to keep up on what’s new.

For me, snacks are key to carb counting survival. In general, I feel satisfied after eating a carb-controlled meal but I’m finding myself hungry 2-3 hours after the meal. Snack time!

Ideally, a carb-controlled snack for my plan would have 15-20 grams carbohydrate and some protein (even better if it adds in fiber too!). The carbohydrates keep my energy up while protein helps keep the carbohydrates from raising blood sugar too quickly. My struggle is I’m finding the protein portion tough for some reason.

Some of my favorite example snacks include:

• 6-8 whole grain crackers with cheese
• ¼ cup unsalted nuts with 2 Tablespoons dried fruit
• 1 small apple with 2 Tbsp peanut or almond butter
• 3 cups popcorn with a drizzle of olive oil, dash of salt, and garlic powder, rosemary, and thyme (it’s delicious – and even though this one doesn’t have much protein, it’s a whole grain, it’s high in fiber, and the portion is no joke)

My challenge is that often snack time ends up being on my breaks at work, and proteins are either tough to pack or they need preparation and/or refrigeration. I did a stint with mozzarella cheese sticks and they worked out really well but I got a little bored with them. I haven’t been able to make it to Winco to get the bulk mixed nuts at a decent price (I refuse to pay the prices at most grocery stores), and I’ll be honest, I’ve been too lazy to get a little container to put peanut or almond butter in. I could hard boil a bunch of eggs to have ready and take with me, but here again – too lazy, too busy. Gah.

Many times this last week, my snack has ended up being 15-20 grams carb only, without the protein. That’s less than ideal because besides regulating blood sugar, protein helps a snack be more satisfying for longer.

As I gradually add in diabetes recommendations to follow, I have to say that there is a LOT to it. I hear that from my patients all the time, and they aren’t kidding. Remembering to pack a lunch is pretty much habit, but the snacks are often a last-minute afterthought and making sure there’s protein with them seems like a nice idea that only happens when the planets align just right.

Anyway, this is all good experience for me as an RD and it backs up what I hope I communicate to my patients: do the best you can, take one step at a time, and be prepared that life is going to push you back. Life happens. Life gets crazy. Motivation comes and goes. Just be steady and do your best. After all, your life is worth fighting for!

I gotta tell ya folks, sticking to the diabetes recommendations is exhausting, especially when life gets busy. With Halloween festivities and a rapidly filling schedule I’ve found it tougher to stick with the recommendations this week.

I did overdo my official dinner carb budget on Halloween, but I did it in a planned and intentional way. I spread my carbs out throughout the evening and only exceeded my carb budget by 15 grams. And that’s okay. It’s another case against the “diet mindset”: the recommendations are not hard and fast rules and it’s ultimately your life – you get to decide when to push on the guardrails, how often, and how far. The results are yours to own.

It’s going to be particularly tough this upcoming week, as I’m adding in goals to move for 3 minutes for every 30 minutes of sitting, check blood sugars daily, give myself a syringe poke daily (to simulate an insulin injection), and take a daily vitamin (to simulate taking oral medication for diabetes). It is definitely feeling a bit daunting, and I am only committed to this for another week!

The mental and emotional burden of managing diabetes is very, very real and goes far beyond what I’m facing here. When I don’t meet the recommendations, my body compensates and I chalk it up as a “Whoopsie, I’ll do better next time.” While that mindset applies for someone who has diabetes, they have the additional awareness that ongoing “whoopsies” can really do them harm.

For all those with diabetes, I salute you. Your road is not an easy one to walk. The obstacles and struggles on your journey can lead to diabetes burnout , which happens to everyone with diabetes from time to time.

 If you do feel lost, overwhelmed, or depressed (people with diabetes are more likely to be depressed, and depression worsens control of diabetes), please seek out some support and resources. A great care team, support group, dietitian, or even resources at www.diabetes.org can really help bolster your spirit and help you navigate all those tough barriers. You are not alone!

Hey everyone! The American Diabetes Association just released new recommendations for physical activity for managing blood sugar and I figured I’d share them since I’m carb counting at the moment!

In addition to getting 30 minutes of activity most days of the week, they also recommend spending 3 minutes doing gentle movement for every 30 minutes you spend sitting. This helps send sugar from the blood into the cell and also improves circulation, which can be poor in people with diabetes.

Not sitting too long is a fantastic idea, but for me the biggest challenge is remembering to do it! I have heard about some apps that are designed to help you get up and move more often, so I think I’ll give those a shot this week to try it out. I’ll be testing out Move – Daily Activity to Stay Healthy that gives you specific little activities to do at regular intervals, and Stand Up! The Work Break Timer, which lets you select time intervals anywhere between 5 minutes and 2 hours while at work to remind you to get up and move.

Update: You can find my reviews of these two apps here.

I love pumpkin in the fall. Love it. Stereotypes be darned, I do not care. This scrumptious squash finds its way into curries, soups, muffins, cookies, pancakes, and steamers around my house as soon as the leaves start to turn.

Pumpkin takes a front seat in this seasonal smoothie that is filling, nutritious, and delectable. I started with the Pumpkin Pie Smoothie recipe here and modified it to boost the protein, control the carbs, and add some greens, because if you’re making a shake, why not add greens? You can’t taste them and it’s an easy-as-pie (…see what I did there?) way to get an extra serving of veggies.

Try it for a tasty breakfast that is (bonus!) carb-controlled, heart healthy, and contains servings from 4 different food groups.

Ingredients:

1 cup unsweetened vanilla almond milk (you can definitely use dairy milk but carb-counters be aware it will add about 12 grams of carbohydrate)

1 handful spinach or kale

½ cup pureed pumpkin

¼ cup light vanilla Greek yogurt

1/8 cup plain whey protein (I love the bulk whey protein from Winco!)

½ medium banana

½ tsp pumpkin pie spice

1 tsp honey (or your sweetener of choice)

Instructions:

1. Add almond milk and greens to blender. Blend for 30-60 seconds or until leaves have been completely blended and the mixture looks like green, frothy milk.
2. Add remaining ingredients. Blend until smooth. Enjoy!

Makes 1 16-oz serving. Contains 303 calories, 35.1  g carbohydrate, 14.6 g protein, 2.9  g fat, 0.1 g saturated fat, and 251 mg sodium. Includes 1 serving dairy, 1 serving fruit, 1 serving vegetables, and 1.5 oz protein.