6 easy peasy nutrition tips type 1 diabetics should add to their diet to boost gut health

---

6 easy peasy nutrition tips type 1 diabetics should add to their diet to boost gut health

---

The buzz around gut health continues, especially in light of its role in autoimmune conditions like type 1 diabetes. It’s a rapidly growing area of research and what we know is changing all the time. Perhaps you’d like to focus on gut health but don’t know where to start. Or maybe you’re wondering if it’s really worth the hype. Or questioning, what does the evidence base actually say, or most importantly, is it relevant to me?

In short - yes, it’s important and worth investigating. Yes, there’s a lot of noise out there. Don’t worry, we’ll go through it together.

Read on for some digestible (pun klaxon, can’t help myself!) tid bits around type 1 diabetes and gut health, with some actionable next steps you can take.

Spoiler alert: sorry to break it to you, but that Yakult shot you take every fortnight isn’t going to cut it. Don’t come for me (hides behind computer desk).

Let’s nail the basics

The gut microbiome refers to the trillion bacteria living in the gut. Its main role is to digest and absorb the nutrients from what you eat and drink. Approximately 70%-80% of your immune system is in the gut and the microbiome produces several chemicals vital for a healthy immune system. 90% of serotonin (the happy hormone) is made here. Serotonin in the gut plays a key role in gut motility and peristalsis i.e. moving things through your digestive system.

Sadly, the gut is not Las Vegas (what happens in the gut doesn’t stay there - hence the link between gut and brain).

Key thought leaders in this space suggest that everyone’s microbiome is as unique as a fingerprint and diversity in microbes is key to health.

The more species of bacteria we have, the likelier it is for better health outcomes. Conversely, having a limited species means we’re more at risk of illness.

What’s the link to type 1 diabetes?

Research implicates dysbiosis (an imbalance of ‘good’ vs ‘bad’ bacteria in the gut) in the development of type 1 diabetes. It makes sense considering type 1 diabetes is an autoimmune condition and most of our immunity is found in the gut. It’s possible that disturbances to the microbiome (the bacteria in the gut) persist in those living with type 1 diabetes. It’s tricky nailing down causality i.e. what came first - what is gut dysbiosis then diabetes, or diabetes then gut dysbiosis. Further research is needed, but what’s important to bear in mind is that everyone living with type 1 would benefit from supporting their gut health. And why it’s a key cornerstone of the work I do with all clients. More of that here.

So how can you increase microbial diversity?

Think of increasing microbial diversity as the aim of the game here! It might sound complicated but it doesn’t need to be. Small, achievable goals are more than enough.

1. Increase plant-based fibre

Out of all the microbiomes in our body (vaginal, oral etc.) the gut microbiome is one that typically thrives most with a high level of microbial diversity. Basically, the more species of bacteria the better. How can we achieve more diversity of gut bugs? Well we used to think taking probiotic supplements was the way to go, but now we realise that it’s good ol’ fibre that seems to be most helpful at feeding species and encouraging a wider diversity. So hold off splashing out on probiotic supplements, and first think about increasing different types and amounts of fibre in your diet.

Talking numbers, we’re aiming for 30g for women, and 40g for men, and focusing on 30 different plant foods each week.

Think about a rainbow of colour, challenging yourself to buying a new plant each week, not shying away from fruit, leaning on nuts and seeds, exploring herbs and spices, and keeping the skin on fruits and veg - many of my clients are probably still traumatised by me recommending skin-on kiwi (honestly, not too fuzzy at all).

2. Aim for 1 portion of prebiotics daily

Drilling down into fibre more specifically now, the gut loves all fibre sources, but especially a type of plant-based fibre called prebiotics. These ferment in the large intestine where they feed the good bacteria. They’re very stable and can reach the lower intestine intact - without getting affected by stomach acid etc.

Types of prebiotics include:

• onions, garlic, asparagus, artichoke, leeks, avocado

• oats, barley, chicory root

• bananas, apples

• flaxseed, cocoa

See arty shot of me below, lovingly fondling an artichoke!

3. Include 1 portion of probiotic-rich food daily

As mentioned above, we used to think probiotics and probiotic-rich foods were the best ways to increase diversity, because we thought they repopulated the gut and 'topped up' the microbiome. We now know this isn't true. Once ingested, probiotic-rich foods travel through the digestive tract and come out the other end, rather than staying resident in our gut. That being said, as they travel through our digestive tract, they do exert beneficial effects - they interact with our immune cells, gut cells, dietary fibre and our host microbes that already live in our gut.

So focus on 1 portion daily, which would include:

• Sauerkraut, kimchi

• Live yogurt

• Dairy or water kefir, kombucha, apple cider vinegar

• Sourdough

• Aged cheeses i.e. Parmesan, cheddar

• Miso, natto, tempeh

4. Savour sleep (if you can)

Sleep, glorious sleep! Kinda obsessed with sleep over here. Life with a sleep-avoidant 3-year-old has got me good.

Latest evidence suggests a link between our gut microbiome and sleep. There is a positive association between quality and restful sleep, and improvements in gut diversity and a reduction in inflammation in the gut. Conversely, there’s a link between poor gut health and interrupted sleep, specifically that people with reduced microbial diversity tend to wake more frequently in the night.  

I know, I know, I’m another health care professional banging on about sleep, but I work within a frame of pragmatic nutrition and lifestyle. So do whatever you can to improve sleep, if this is necessary for you. A 1% shift is still an improvement. Focus on your wind-down routine, try turning your phone onto airplane mode, enjoy an Epsom salt bath, or try a calmative herbal tea. I’m a big fan of Hampstead Tea’s lavender and valerian root infusion before bed.  

5. Movement and exercise

Some interesting new research is shaping our knowledge around how exercise, independent of diet, is impacting out gut microbiomes. We’ve seen that moderate and intense exercise can positively impact our gut health, and there are a few theories behind this. Firstly, we know that the gut is home to 70% of the body’s immune system. Exercise can alter how pro- and anti-inflammatory compounds and immune cells function in the gut, for example downregulating pro-inflammatory cytokines and upregulating antioxidant enzymes. These immune cells live next to gut microbes and product antimicrobial factors needed for maintaining host-microbial homeostasis. Secondly, exercise might positively change the gut mucosal layer, a layer that works hard to protect our gut from pathogenic microbes sticking and causing problems.

Remember that mindful movement doesn’t need to be lycra and sweat, and what I believe is most important is finding something you enjoy so you’ll do it consistently.

6. Spend more time in nature

Finally, my last piece of advice is prioritising time in nature. Being outdoors and connecting with nature has a multitude of benefits across the board, but it’s also implicated in positive gut health outcomes. Studies have compared the gut diversity of those living in rural vs urban areas and those in rural settings have a higher amount of microbial diversity. It’s likely that microbes found in nature are able to transfer into your body - very cool.

A few recent studies have suggested that rubbing or dipping hands in soil and plant-based materials increases microbial diversity in the gut, and some smaller studies looking at children populations have shown that by introducing ‘time in nature’ interventions, or adding soil to the areas where children play at nurseries/daycare, has increased the diversity of beneficial bacteria on children’s skin and in their guts.

To reap benefits of nature from a gut health perspective, focus on getting outside often and breathing in lots of fresh air. If you live in urban spaces, spend plenty of time in your local park, or green areas. If you have a garden, maybe get a trowel out and start grubbing around in the soil. Your microbiome will thank you for it!

And there ya go

The Beth Edwards Nutrition take on ways to increase microbial diversity and therefore improve the health and ecology of your gut.

It’s clear that lots of lifestyle and nutrition recommendations support gut health, so feel free to pick the options that most resonate with you (& your gut).

Don’t forget to tell me how you’re getting on! Leave me a comment with the recommendation you’re most likely going to adopt.

Periods and T1D - 4 things you need to know

Periods and T1D - 4 things you need to know

Periods? Not always fun. From cramps to cravings, irritability to insomnia, periods often throw up health challenges. If you live with type 1 diabetes, this can feel even more complicated to navigate. Maybe you’ve noticed differing insulin sensitivity across the month - maybe you go high before you bleed. Maybe you go low. Perhaps you have long-ish cycles. Maybe you don’t notice any issues at all. Maybe you skip cycles.

If you’re reading this, chances are you’re looking for some expert advice around managing diabetes and your menstrual cycle. I get it. I’ve been there. If you’re new around here, I’m Beth and I’ve been living with type 1 diabetes since I was 9. I run an online clinic helping people with diabetes and their families make life with this tricky health condition a bit easier to manage. Back to periods…

Read on for 4 key things I’d love all t1ds to know!

1. Periods and t1d both involve lots of hormones

Periods and type 1 diabetes both involve lots of hormones, so it's no surprise our menstrual cycles affect and are affected by our t1d. You might find your blood glucose levels trickier to manage. Lots of clients I work with find that a few days, or a week before their bleed, they’re more resistant and struggling with sticky highs that are hard to shift. Then, once day 1 of their period kicks in (first day of bleeding) they’re more sensitive and struggling with hypos. What the dickens in going on here? I hear you cry.

This is to do with two of our female sex hormones, oestrogen and progesterone, and their relationship to our insulin signalling pathway:

• PROGESTERONE rises in the second half of the menstrual cycle (also called the luteal phase). Progesterone can make us more resistant to insulin, cue those sticky highs a few days before your period is due. On day 1 of your bleed, progesterone drops and oestrogen starts to build.

• OESTROGEN rises during the first half of the cycle (follicular phase) and typically makes us more sensitive to insulin, cue those hypos during your bleed.

Researchers have described what happens with progesterone and increased insulin resistance as ‘menstrual cycle phenomenon’ (Gamarra & Trimboli, 2023), which is similar to how we’d describe and think about the ‘dawn phenomenon’ (you can read more about that here). The challenge, however, is that there’s such limited research - studies around the menstrual cycle (MC) phenomenon have been underpowered in clinical practice, and the methods to define both menstrual cycles phases and their duration vary from study to study, so it’s hard to gain consensus.

That being said, even if the evidence base requires further robust research, we see a clinical need for lifestyle support, nutrition focus, and insulin dosage adjustment during different phases of the menstrual cycle.

As a reminder, some people find their glucose levels and sensitivity don’t vary across their cycles - that’s OK too.

2. Glucose levels are associated with period variability

Studies show that if glucose levels sit in the target range (usually 4-10 mmol/l) for 70% or more, you may have a more regular menstrual pattern. Spending time outside of the target range is associated with period variability, which might include heavier or longer cycles, or missed periods, or lighter bleeding.

This is because glucose variability impacts how our hormones work - think of the endocrine system as one big orchestra. Every instrument has their place, and they all need to tune up together to make the best sound.

3. Is there a link between T1D and PCOS?

Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in reproductive-aged women. One of the key features of PCOS is irregular cycles or no periods at all, but you might also experience: excess facial or body hair (which is to do with excess androgens), weight gain, oily skin, difficulty getting pregnant, thinning hair from your head.

The cause(s) of PCOS is/are unknown but it’s thought to be linked to abnormal hormone levels, and insulin resistance.

Latest research indicates that the prevalence of PCOS in those with type 1 diabetes is 26%, which means that 1 in 4 people with t1d may also be experiencing PCOS symptoms (Bayona et al., 2022).

If you have a PCOS diagnosis, or feel you’re living with PCOS symptoms and would like some support, get in touch to find out about 1:1 person-centred programmes.

4. Nutrition and lifestyle factors can help

So what can you do to support yourself?

• Firstly, tracking periods can be a great starting point. I would suggest using an app on your phone i.e. Flo and make use of the notes section so you can record info about your glucose levels alongside. Or get into the habit of reviewing your CGM data at specific points in your cycle. Check to see if there are any robust patterns there, for example, are you finding more highs during your luteal phase? If so, speak to your medical team about tweaking basal rates at different points across cycle.

• When you find yourself in a sticky resistance patch, think about your toolkit that can promote insulin sensitivity - this would include gentle nutrition (read my blog here on my fave sensitising foods), mindful movement, stress management and optimal sleep.

• We know that foods with low glycaemic loads and polyunsatured fats can support the insulin signalling pathways, and promote insulin sensitivity.

• Resistance training, like lifting weights or circuit training, can also promote insulin sensitivity.

• Managing stress levels and ensuring optimal sleep can also help to dial down the insulin resistance, especially in the luteal phase

5. BONUS tip

If this all sounds good but you’re looking for a bit more help, check out my self-led e-book all to do with boosting insulin sensitivity, or apply to become one of my 1:1 clients - find out more here!

---

How do you find acceptance of your diabetes?

---

On finding acceptance and peace with my type 1 diabetes

---

But how do we find acceptance?

When it comes to psychological models of chronic health (that's right, yes hello, we've dived straight in), the one that speaks most to me is something called ACT, which stands for Acceptance and Commitment Therapy. In a nutshell, it helps people make sense of their world, and helps people navigate their thoughts, feelings and behaviours, and the specific challenges they face.

It's what we call a third wave cognitive behavioural therapy (CBT), which basically means it's adapted and built on previous CBT models and interventions. Now you've most likely heard of CBT. It's pretty prevalent and is often seen as the gold standard model for 'treating' mental health issues. It helps people to reframe their thoughts and feelings in an effort to change behaviours. 

I'm not a fan of CBT within a type 1 diabetes context. Caveat: if you've found it effective and supportive, then I'd never knock that, of course, but for me personally the method doesn't quite sit right. (More of this in another blog post).

I prefer ACT as it builds on CBT by adding nuance to an individual's situation. It prioritises the concept of acceptance which is super important in any health condition, but especially type 1 diabetes. 

My clinical work is peppered with interventions and relational support that help my clients move towards their place of t1d acceptance, whatever that looks like for them. 

---

These are some of the ways I find acceptance (& peace) with my diabetes each week:

• Celebrating the wins, not just focusing on the challenges.

• Remembering that life throws so much at us, I can’t focus on type 1 all of the time.

• Repeating the mantra: I’m not aiming for 100%. 

• Moving my body for my insulin sensitivity AND my mind.

• Dialling down the vigilance (where possible).

• Resisting the temptation to ‘just work harder’.

• Not equating my self worth to my blood sugar levels. 

---

And if you’re looking for nutrition and lifestyle support to help you navigate life with type 1 diabetes, I’m your online nutritionist - I’d love to help you. Let me show you how…

---

---

Enjoyed this article? Sharing on socials would be a big thank you!

What I'd do differently if I were lucky enough to have another T1D pregnancy

---

What I’d do differently if I were lucky enough to have another t1d pregnancy

---

Hands down, one of the biggest concerns I've faced in my t1d tenure was how I'd be able to manage pregnancy. I was worried about:

• Achieving much tighter control

• 'Morning' sickness and food aversion leading to hypos

• Increasing insulin requirements

• Health complications for my growing baby as a result of t1d

You guys probably share similar worries. I remember working with the Mum of a recently diagnosed t1d girl. Among other things, the Mum was concerned about whether her little daughter would ever be able to have her own family (the daughter could, btw, but her Mum was understandably preoccupied). 

Any pregnancy will carry risks, even if it is deemed ‘low risk’, but throw t1d into the mix and it automatically becomes 'high risk' (still have issues with this terminology - see point 2 about a grass-roots language and pregnancy project you might want to get involved in!) 

It's fair to say I found pregnancy with diabetes like unlocking another t1d level. Type 1 diabetes plus, if you will. It was completely manageable and I gave birth to a healthy little boy, but I won't sugar-coat it. It was damn hard work. I learned lots from the experience. And if I were lucky to do it again (hopefully one day!) there are some things I’d do differently.

Read on to find out 5 things I’d mix up for another t1d pregnancy.

---

1. I'd let go of the dream of a low intervention pregnancy

T1D pregnancies are classified as 'high risk' and require tighter control than usual t1d life. On safety grounds, the pregnancy becomes fairly medicalised, with frequent appointments, blood tests, and scans. This made me feel anxious. Coupled with the physical challenges of pregnancy, I struggled to enjoy this time (erm, where was my pregnancy glow?). If I experienced this again, I wouldn't beat myself up about it, or long for a less medically-intensive process.  

---

2. I'd feel more able to challenge any unhelpful language

There's a lot of stigma and assumptions that fly around pregnancy with any type of diabetes. Due to the mechanics of t1d, there's potential for a foetus to grow bigger than average (a term called 'macrosomia'). During my last growth scan at 38 weeks, the sonographer repeatedly referred to my 'really big baby'. Super not what you want to hear when you're preparing for birth, and also ridiculous given my son weighed 8lbs. Not small, but not really big. 

---

---

3. I'd optimise specific nutrients in the pre-pregnancy, fertility window 

These include vitamin D, iron, calcium, choline, omega 3s. I'd prioritise a food first approach where possible, and get in many different foods before any possible morning sickness or nausea kicked in. I'd consider: 2 portions of oily fish weekly and 2 handfuls of hemp seeds daily for omega 3, regular egg consumption for choline, a daily portion of dark green leafy veg and daily portion of Greek yogurt for calcium, 2 portions of grass fed red meat weekly for iron, and a vitamin D supplement.

---

4. I'd reach out to more families who were going through a t1d pregnancy at the same time 

When I had Stanley, a family friend was also pregnant and t1d - hello Emily! - and it was beyond affirming and reassuring to have her to share things with, ramble on long blood glucose-lowering walks with, and vent with. For a possible next time, I dream of a community or group of us, navigating the trying times of a t1d pregnancy together. 

---

5. I'd remind myself that, at certain points, blood glucose levels will go out of range

And I'd try to remember that I'm not robotic, and things will go skew-whiff. I wouldn't let the highs, or the lows for that matter, dictate my self worth or ability as a mother, pregnant woman, or person with t1d.

---

And if you’re looking for nutrition and lifestyle support to help you navigate a t1d pregnancy, or prep for one, I’m your gal - I’d love to help you. Let me show you how…

Enjoyed this article? Sharing on socials would be a big thank you!

{Interview} Alex Durussel-Baker, Creator of Diabetes by Design

---

T1D Inspiring Interview Series: Alex

---

Meet Alex Durussel-Baker, 36-year-old creator and designer living in Edinburgh with her husband Jerome, 2-year-old son Rowan, and fluffy dog Bacchus (banging name). She runs a design studio called Korero Studio and is the founder of Diabetes By Design, a diabetes education and awareness platform that provides mental and emotional support for people living with and alongside type 1 diabetes.

The questions

Tell us your type 1 journey - what age were you at diagnosis, and what was the experience like?

I was diagnosed at the age of 30 while on a flight to New York City. It was pretty dramatic, especially as my doctor phoned while we were taxiing down the runway and when I hung up I was then faced with 9 hours of no internet access to read about what the hell type 1 diabetes was. Upon landing in New York I was hospitalised for 3 days. It remains the most surreal experience of my life.

In hindsight, is there anything you wish you'd known at diagnosis that you weren't aware of that would've been helpful to know?
I knew so little about type 1 diabetes that I had to do a lot of unlearning. I thought diabetes was something you got when you were old or for eating too much sugar. I had no idea. As one of the most prevalent illnesses in the world, I wish we were better educated as to what diabetes is and its different types.

In your experience, what is/are the best thing(s) about T1D?
Meeting other people with the condition. Building awareness and empathy for the millions of people living with a visible or invisible disability and as a result being a better human. Being able to judge carb content at a distance.

In your experience, what are the main challenges of living with type 1?
I think the biggest struggle is the lack of awareness about the condition and the isolation that creates for us and our loved ones (or sometimes with our loved ones!). Being an invisible illness, no one sees the millions of decisions we have to take just to go about our day. All that brain power could be spent elsewhere! I struggle with brain fog when I am high which really zaps my creative energy.

What, if anything, do you find helps in dealing with these challenges?
Staying curious about my condition, educating myself about it and being gentle with myself when it goes pear-shaped. The last bit is the hardest because it’s so easy to blame ourselves when actually mimicking a pancreas is ridiculously hard and we don’t get a break.

Where do you find support/how do you access support?
In speaking with others who have the condition, unloading, sharing tips and tricks and laughing about this crazy condition and the situations it puts us in.

Can you recommend any great resources (podcasts, books, accounts or blogs)?
@DiabetesByDesign 😛 I’m a big fan of Jen Grieves’s Type 1 on 1 podcast, the book Blind Spots and Landmines was helpful early on in diagnosis to get back into an active lifestyle and later Pregnancy with Type 1 Diabetes was an education in truly understanding the magic of pre-bolusing, that book alone brought my HbA1c down by 2 points. Recently I have been attending some of the #dedoc° online events which are a great way to find out what is happening in this space!

How do you think type 1 has affected your relationship with your body?
It’s changed it for sure, I had to learn to trust it again as I felt it had let me down. Beyond that, simple things like “am I really hungry or am I just going low?”. We have to learn to live with this disconnect because ultimately we are keeping ourselves alive artificially.

How do you think type 1 has changed your approach to life and living?
In my first year of diagnosis, I remember being on a client call and my CGM alarm going off because I was feeling stressed by the call. This was a defining moment when I understood that stress was literally killing us and that I now had the power to decide what was worth stressing about. Thanks to T1D, I value my time more and am careful where I spend my finite energy.

Type 1 is classified as a physical condition, but we all know there is an emotional burden too. Could you describe your experiences?
This question is the mantra of Diabetes By Design. 1 in 4 adults in the UK experience what is known as diabetes burnout, where they become so overwhelmed by the burden and unrelentlessness of managing their diabetes that they stop. This is what leads to the drastic complications of the condition. Some people say that tech will solve this but my answer to this is that if someone is so burnt out that they can’t get out of bed it’s likely they won’t be wearing a pump or CGM. Right, I’ll get off my soapbox.

Personally, I was diagnosed with clinical depression 18 months after my diagnosis and was lucky to access clinical support, many people are still waiting. “Fun fact”, people with diabetes are twice as likely to develop depression than the general population.

How and when did you create your diabetes-inspired design studio Diabetes by Design?
Diabetes By Design was my response to a depressive episode I had in my second year after diagnosis. Frustrated at myself and at the world's misinformation, I set myself the task to create a print and mini essay a day about one aspect of type 1 diabetes. My goals was to make the invisible tangible and to trick people into learning (or unlearning) what they knew about diabetes. This helped me in so many ways but not least in connecting with loved one and strangers through seeing type 1 diabetes differently.

Since starting sharing the prints and essays on Instagram back in 2019, I’ve had three exhibitions, sold prints throughout the world and am currently developing a toolkit to help cut through the overwhelm of learning about Type 1 Diabetes, called the Companion Cards. You can read more about these on my website.

Which print/piece of art/design are you most proud of?
A community favourite is the Rage Bolus print but my two favourites are the Mondrian “Balance” one because it represents what I strive for daily and I am also proud of my newest piece “Interdependent” which is the world map shaped into a blood drop. It’s a more political piece about how we are all interconnected and dependent on each other to survive.

You recently held your widely acclaimed Diabetes by Design festival in Edinburgh, well done! Are there any plans for future exhibitions or events?
Thank you, it was a really fun week! The next big milestone is the Companion Cards as I am presenting them at DiabetesMine in San Diego in November. But I love bringing the diabetes community together so watch this space!

---

Thanks Alex, for your insights, wisdom, and the work you do in the type 1 community space. Right, that’s me off to go and buy EVERY single print Alex has ever created…don’t wait up.

Enjoyed this article? Sharing on socials would be a big thank you!

5 hybrid closed-loop systems that type 1 diabetics should ask their consultant about

---

5 hybrid closed-loop systems that anyone with a dodgy pancreas should know about

---

In my 26 years of living with type 1 diabetes, hybrid closed-loop (HCL) technology is the best medical advancement I’ve been fortunate to receive. HCL is the latest wave in diabetes management, and it makes living with the condition a whole lot easier.

Essentially, the system requires a continuous glucose monitor (CGM), an insulin pump, and a specific algorithm that tells the pump to either suspend the insulin or give a bit more, depending on the CGM readings.

Sounds pretty cool, right? Read on for more explanation…

The pros

• These systems take some of the burden of managing t1d away and research shows an improvement in quality of life.

• These systems tend to work really well overnight, meaning that a good chunk of someone’s time-in-range can be optimised (sleep accounts for about 1/3 of our TIR!).

• Fewer finger pricks (due to the CGM) and no injections (due to the pump) - in theory.

• Increasing flexibility around meals and exercise.

The cons

• Like any other technology, these systems are not immune to failures or errors, which can be disheartening and troubling for those relying on the system to, ya know, like. Live.

• You’ll need to be attached to devices 24/7 which can be a big transition for those currently on multiple dose injections.

• There’s a learning curve for anyone moving to HCL tech and this can take time and patience.

• You’ll still need to input carbohydrate amount, pre-bolus, and tell the pump to bolus insulin.

A note on linguistics - this is not an ‘artificial pancreas’

You may have seen the press, or other outlets, referring to this technology as an ‘artificial pancreas’. Whilst that name is arguably more catchy than ‘hybrid closed-loop’, it’s an inaccurate description of what HCL systems are. Artificial pancreas implies the person with diabetes doesn’t need to do anything, but HCLs do require a large amount of human input.

This new-wave treatment option does reduce the burden on the person living with type 1, but it doesn’t extinguish completely.

See the last point on the ‘cons’ list above.

Can I get a HCL system on the NHS?

After a successful NHS England pilot in November 2023, the National Institute for Health and Care Excellence (NICE) recommended that HCL technology should be rolled out to thousands of people with type 1 diabetes over the next 5 years.

This is great news, though in reality the access to this life-changing tech is still patchy. According to NICE, hybrid closed-loop technology is an option for people with type 1 diabetes who: 

• Have an HbA1c of 58 mmol/mol (7.5%) or more, or have disabling hypoglycaemia, despite best possible management with a pump, and/or real time CGM, and/or flash. 

• Are aged up to 18 years. 

• Are pregnant or planning a pregnancy.

If you think you might be eligible or you’d like to find out what’s possible in your geographical area, have a chat to your diabetes teams. There are 5 main licensed HCL systems available. Read on for a mini bio of each!

1. Control IQ

Pump: Tandem t:slim insulin pump

CGM: Dexcom G6 or G7

Licensed from: 4 years +

The pump is user-friendly with a chic touchscreen, and is pretty compact so can easily attach to clothes or go in pockets.

The system sets the target blood glucose level at 6.1mmols (110 mg/dL for my US friends!) Sadly this can’t be changed, which means the pump isn’t recommended during pregnancy as the target is technically too high for pregnancy, and can’t be manually adjusted to go lower.

People with type 1 can use different ‘Activity’ and ‘Sleep’ modes to fine-tune specific activities or times of the day, though if you’re going to use Activity mode for exercise, it’s wise to activate it 30 mins - 1 hr before the activity, to give the algorithm chance to work.

As a Tandem user myself, one of my bugbears is the amount of waste generated by site changes. The insulin reservoir isn’t brilliant, either, and my rep advised using a coin to flip out the old reservoir, which never feels that brilliant for such expensive and advanced tech.

Feedback from clients and myself is that this system works really well overnight, gently correcting any highs and preventing any lows. I’ve also found that when I’m hot on my carb counting and 15-min pre-bolus, the system can really shine.

2. CamAPS FX

Pump: DANA or Ypsomed

CGM: Dexcom G6 or Libre 3

Licensed from: 1 year +

Currently, this is the only system in the UK licensed for pregnancy. So shout-out to all my fertility crew, this one’s for you!

The default blood glucose target is 5.8mmols (104 mg/dL), but you can custom it between 4.4-11mmols (79-198 mg/dL). There are ‘Boost’ and ‘Ease off’ modes and a ‘Slowly absorbed meals’ function too, to help with fine-tuning. Overall, clients using this system tell me that their TIR is up and their A1c are lower, so it certainly works.

The system runs completely off an app on your smartphone, which will appeal to some as it means you can discretely bolus and not have to interact with the pump directly. No more fishing in your bra for your insulin pump (but also no shame if you do that. I do it all the time!).

Another key feature is that once you’ve entered your 5 day average total daily dose and weight, you won’t be using basals anymore so no more tweaking or tuning - which has its pros and cons.

This system only works off Android, so something to bear in mind.

3. Omnipod 5

Pump: Omnipod

CGM: Dexcom G6 or Libre 2+

Licensed from: 2 years +

The only tubeless pump to use HCL technology (an obvious advantage if wires aren’t your bag!). It means that in my opinion the pod changes are quicker - see point above about waste too, but it’s tricky to see if there are any air pockets in the pod - technically this shouldn’t be a problem if all air is removed during the pod filling process, but I am notoriously bad at getting those bubbly blighters out.

There are ‘Manual’, ‘Automated’ and ‘Activity’ modes to switch between. Feedback from the type 1 diabetes community is that the algorithm starts off fairly conservatively, but then gets more aggressive by pod 3-4. It learns steeply. Just hang in there as you get going.

Like the CamAPS FX you control everything from an app on your phone. The pod on your body is just a white box full of insulin, so once it’s put on, that’s it, no engagement with it necessary or possible. The algorithm is programmed in each pod you put on. The CGM data is sent directly to the pod to calculate how much insulin to give, so you don’t even need the controller near by for the algorithm to work.

But one downside is that you can’t see any history of insulin delivery, which some find frustrating.

P.S if you’re currently using this system and are looking for some top-notch tips for getting the most out of it, I’d really recommend this podcast series from Juicebox.

4. Medtronic 670G

Pump: Medtronic

CGM: Guardian 3 sensors

Licensed from: 7 years +

This was the first HCL pump introduced to the market back in 2016. It’s another great tubed pump option that uses Guardian sensors for the CGM part (so no integration with Dexcom or Libre). It’s also completely waterproof so can be used in the shower or the pool.

It has two modes: 1) ‘Smartguard auto’ mode, which automatically adjusts your basal (background) insulin every five minutes based on your CGM readings, and 2) ‘Suspend before low’, which stops insulin up to 30 minutes before reaching your preset low limits.

Users like the Medtronic pumps for their colourful, visual displays that are easy to work with.

Some downsides - user feedback is that the algorithm can take a long-ish time to learn from your body - up to 2 weeks to prevent post-meal spikes. And the CGM sensors require finger pricks for calibration. Boo.

5. Medtronic 780G

Pump: Medtronic

CGM: Guardian 4 sensors

Licensed from: 7 years +

This updated model requires far fewer finger prick calibrations (hoorah, I hear you cry!) and, like it’s older brother, uses SmartGuard technology (auto mode) and manual mode.

From work with my clients, I hear that the SmartGuard tech struggles to keep up with specific situations, like periods. And once you’re in SmartGuard, you can’t manually alter the basals, so you may have to switch between auto and manual modes a fair bit.

But the biggest issue for most t1ds seems to be around the sensors. The application process is a bit fiddly, and the accuracy can be poor, with users having to change the sensors more frequently than the 6-day wear period.

This system can integrate with Apple smart watches which is a useful perk if that’s your jam.

You’re able to set a temporary sensor glucose target of 8.3 mmols (150 mg/dl) for times where you’d need less insulin i.e. exercise.

Another plus for the two Medtronic systems is that t1ds really rate their customer service - it’s global and the company ship replacements worldwide efficiently without hassle. Especially comforting as we’re pretty familiar with the pump law of sod, which states that if anything should to go wrong, it will most likely happen when one is away from home.

And there ya go

The Beth Edwards Nutrition take on 5 HCL systems that are currently availability to some t1ds on the NHS.

It’s clear that all the algorithms improve numbers, and improve quality of life, but there are some niggles and downsides to each system which are useful consider if you’ve been offered a choice of system.

Do you use HCL? Any points you’d add? Let me know in the comments.

Enjoyed this article? Sharing on socials would be a big thank you!

6 top foods to boost insulin sensitivity

---

6 nutritionally-banging foods to boost insulin sensitivity

I’m a biiiigg fan of insulin sensitivity. It’s a brilliant tool for managing your blood glucose levels and reducing some of those sticky highs - ya know the types I mean, where you’re correcting and you’re still high and it feels like your insulin is water? Yep, those. If you’ve taken a glimpse on my social accounts you’ll see that I talk about insulin sensitivity on approximately every other post [OBSESSED]. If insulin sensitivity were a love language, it’d be mine.

Wait. What is insulin sensitivity?

Put simply, it’s about sensitising your body to insulin. The more insulin sensitive you are, the easier it is to keep your blood glucose in range, and expand the foods you can eat without running the risk of Toblerone-esque peaks. It’s the reverse of insulin resistance, which you might think is exclusively an issue for those with type 2 diabetes. Well, it’s possible that insulin resistance is also a problem for us T1Ds too.

When I work with clients, we implement changes that allow us to zoom out, look at the bigger picture and work on increasing insulin sensitivity in the background i.e. across the whole day, week, month. This then allows them to enjoy a meal out (with unknown carb quantities) or tuck into a slice of birthday cake (uh, yes please) without entering the blood sugar rollercoaster *too* much. A slice of birthday cake might push you up and out of range, but what’s important is that we minimise how high blood sugars go and that we encourage them to come back down quickly. Working on your insulin sensitivity allows for this. Winning!  

Let’s look at my top 6 foods for promoting insulin sensitivity. Time to start salivating…

---

1. Lentils (& other pulses)

OK so I’ve cheated already and listed more than one food. What can I say, I struggle with decisions. So lentils (& other pulses like chickpeas, red kidney beans & butterbeans) are some of my top cupboard staples and all-round insulin sensitising superheroes. They’re a great source of complex carbs and protein, which means they can offer a steady source of energy without spiking blood sugars (the dream). They also contain B vitamins and magnesium, both of which are both co-factors - science-y word meaning ‘helpers’ - in the insulin signalling pathway aka the route to increasing insulin sensitivity. Lentils and the whole pulse family contain soluble fibre which feeds the tiny little gut bugs in your digestive system. When these good bacteria are fed and happy, this seems to coincide with increased insulin sensitivity, so it’s good to get the gut bugs on board! What type of lentils are best, I hear you cry! They’re all ace. Tinned, jarred, or Merchant Gourmet pouch - it doesn’t matter, just go for the most convenient option for you.

2. Fennel and fenugreek

Shucks, I’ve done it again. Two for the price of one, but I couldn’t separate these guys. Both fenugreek and fennel seem effective in increasing insulin sensitivity. How? Well both contain specific phytochemicals which support the insulin signalling pathway that we mentioned earlier. Basically, they lend a hand to the biochemical reactions that occur when insulin is present at the cell, and allow the impact of insulin to be more effective. This means you get more bang for your buck, so to speak, from each bolus or injection. Fennel also has the added bonus of delaying gastric emptying, which means food stays in the stomach for longer and therefore the breakdown of carbs into glucose in your bloodstream is slowed down = less of a spike.

I love to add fennel and fenugreek seeds to salads or salad dressings, or making them into a marinade for fish and meats, or using dried fenugreek leaves for soul-replenishing dahls and curries.

[Special mentions need to go to other herbs and spices - ginger, garlic, turmeric & cinnamon as they have a similar, but less pronounced effect].

3. Wild salmon

Salmon is part of the oily fish family, along with mackerel, anchovy, herring and sardines (the acronym SMASH can be a great way to remember which fish is oily) and is a great source of healthy fats, also know as omega 3s. When it comes to insulin sensitivity, it’s important to not only monitor dietary carbs, but fat intake too. Specifically, the type of fat. This is because cell membranes in the body are made up of fats. In order for the insulin and glucose receptors to work effectively in allowing sugar into the cell and out of the blood, this fatty cell membrane must be lovely and fluid. Omega 3s found in salmon promote fluidity at the cellular membrane level, and allow the insulin signalling pathway (it’s a big deal, this one) to work as effectively as possible. Omega 3 fatty acids are also know for their powerful anti-inflammatory effects. Reducing chronic inflammation is important for anybody’s body, but specifically important in cases of type 1 diabetes, as type 1 has a correlation with inflammatory processes. Finally, opting for wild salmon is important here as it provides more nutrition and is of better quality than farmed counterparts. Tinned is just as good as fresh and is a lot more cost-effective.

[Want some more info on anti-inflammatory eating? Check out my article What’s the deal with anti-inflammation?]

4. Maqui berry

This bright purple berry is native to South America, and is loved by nutritionists far and wide for its potent antioxidant effects and rich polyphenol concentration - two important things if you’re looking to mop up free radicals and keep your cells healthy, you can read more about antioxidants here! In addition to these two powerhouse properties, maqui berry can decrease post-meal changes in blood glucose levels by slowing the rate that sugar enters the blood stream, allowing for a smaller, more gradual rise in blood glucose levels i.e. FEWER SPIKES! So adding maqui berry to your diet across the week is a super smart insulin sensitivity move. Opt for powders as these are easy to add to your meals - my favourite brands are Indigo Nutrition and Healthy Supplies (the latter is a great online shop for buying healthy foods in bulk. This works out much cheaper than going to Holland and Barrett or somewhere else on the high street). And a little goes a long way. A serve is just 1-2 teaspoons.

My favourite ways to add maqui to meals include: stirred into warming porridge, mixed into smoothies, getting fancy with a home-made a maqui bowl (take inspiration from the trendy acai berry bowls…).

5. Bell peppers (specifically yellow)

Bell peppers are packed to the rafters with vitamin C (a banging nutrient needed for T1D health - more in a mo). All bell peppers are high in vit C, but the content increases as they mature, hence why yellow ones are the yellow gold standard. Back to the science - vitamin C is an essential nutrient, we can’t make it ourselves endogenously, meaning we need to ensure daily consumption from foods. Some research studies suggest a causal link between low levels of vitamin C and development of diabetes (both type 1 & 2), suggestive of its role in insulin, or the insulin signalling pathway, or blood glucose dysregulation.

We also know that vitamin C can increase insulin sensitivity indirectly. How insulin works is partly regulated by nitric oxide (a very important substance for blood vessel health). Nitric oxide levels are increased by vitamin C - studies show that injections of vitamin C into the arteries of people with diabetes demonstrates a boost in blood vessel response to nitric oxide these people, making the insulin signalling pathway (here she goes again) work better.

The humble orange is probably the most well-known source of vitamin C, but many other fruits and vegetables actually contain higher levels - as well as bell peppers get munching on kiwi, strawberries, spinach, tomatoes and broccoli. Nom Nom.

And there ya go

6 top foods to boost your insulin sensitivity, and hopefully make life with type 1 diabetes a little less ‘Blackpool Big Dipper’ and a little more ‘Libra zodiac in balance’.

---

Enjoyed this article? Sharing on socials would be a big thank you!

Getting under the skin of my type 1 diabetes nutrition work

How can the Beth Edwards Nutrition method help you and your diabetes emotionally as well as physically?

---

What’s been on my mind recently is the power and potency of the relational. I pretty much work exclusively 1:1 with people with diabetes, meaning we're in a dyad together that allows us time and space to be really seen and heard and listened to. This is what 'relational' means to me in the context of my psycho-nutritional work and clinic. How, even if we have conflicting viewpoints, or we disagree, we can bear witness to each other, and this seemingly has such important benefits not just to physical and t1d health, but to our complete sense of belonging, identity, and sense of self. Connection and space, that's where it's at. 

Being honest, when I first started opened the Beth Edwards Nutrition clinic doors, I felt a great need and urgency to tell you that: 
1. I know it
2. that I should tell you I know it, and
3. that you can use that knowledge to go and do it
 
In a really humbling way, what I've realised through working relationally, is that there's such power in opening yourself up to not knowing. Once you accept you don't know or there could be a different way or that you can change your mind, a space can open up for something other. This could be something creative, more left-field, unique, or scarier, or darker. But in this other, space can be created and you can give yourself permission to think differently.

Through a type 1 diabetes lens, this could be exploring your relationship with your body, or unrealising some of the beliefs you hold about what t1ds should do, or even addressing some of the shame you may feel living with this condition.

This other space gives us other options

The freedom to try. And succeed. And fail. And re-think.  

And the thing about nutrition and psychology is that what we believe to be 'true' can change with further research and investigation. It's an evolving evidence base. We must hold it with seriousness, but also hold it loosely. So we can accept it might change, and we must re-examine what we know to be true. 

Another aspect of this work, is that we both come to the sessions on an equal footing. Locking arms and joining forces. I really value what you're bringing to the table. This is your type 1 diabetes and experience. I have my own experience that I can add and often do. Fundamentally, this is about partnership. This often shifts expectations around the power dynamic you may expect or have experienced in a different healthcare setting. 

I will always offer up nutrition and lifestyle recommendations and gentle guidance, and you will be rooted in the heart centre of these. They are delicately crafted for your unique self. I don't use a fixed protocol that all my clients undergo. And hey, if something isn't working for you, we change it. 

You may have an expectation of what working with me looks like in terms of success or achievement. That might be a lowered hba1c, or an improved food relationship, or another tangible goal. I'd love to guarantee that for you. Sadly there are no givens on that front.

But what I can 100% guarantee you'll get working from me is connection, space, and a prioritisation of the relational. A space to look into the other. And to do this in collaboration with me. 

And most times, if we prioritise the relational (a given), the other achievements can come later. 

Does this philosophy resonate with you? Find out more about my work here.

Should I do intermittent fasting if I have T1D?

What's the deal with type 1 diabetes and intermittent fasting?

---

Hold up. What even is intermittent fasting. Well, it’s defined as a timeframe of not eating. The 5:2 (‘normal’ eating for 5 days + restricting calories for 2 days out of every week) or only eating within a timeframe (i.e. midday + 6pm - also called time-restricted feeding).

Some people adopt intermittent fasting to lose weight and this is where most research is centred. Weight loss occurs due to the restricted eating window meaning you eat less overall RATHER than intermittent fasting being some sort of miracle wonder-cure. So this is about calorie deficit, whether you're fasting or not.

Some T1Ds use fasting to boost insulin sensitivity and manage blood glucose levels. Most research has been done with type 2 diabetes populations so must be treated with caution, though the mechanism of insulin resistance/sensitivity is similar in both types of diabetes.

I'm noticing a few intermittent fasting beliefs circling around that I want to address:
1) Firstly, intermittent fasting doesn't need to be as extreme as the 5:2. Having your last meal at 8pm and breakfast at 8am the next morning gives your body a 12-hour fast without really even trying AND the benefits seem to be the same - bingo!

2) Just because someone tells you how they do it, doesn't mean it's right for you. We're all bioindividuals and it's important to speak to a health care professional before you start.

3) Eating 3 square meals a day and no snacking in between can be beneficial. The 2-3 hour gap gives your digestive system time to carry out essential maintenance + repair. You don't need to do a water fast to see these benefits.

⛔️ IF is not advisable for people experiencing chronic fatigue or adrenal challenges (intermittent fasting is too much of a stressor on the body), nor for anyone prone to disordered eating, a history of disordered eating or with an active eating disorder.

---

---

Enjoyed this article? Sharing on socials would be a big thank you!

Can I eat fruit if I live with type 1 diabetes?

What’s the diabetes deal with fruit?

Since starting back in clinic after maternity leave there's been one topic that's come up with every client: a hesitancy around eating fruit. Maybe this is sounds familiar to you? 

I get it. I've had my own fair share of love-hate feels towards fruit. I didn't eat bananas for a whole year, and not because I didn't like them. Because I was afraid.

Somewhere along the road, it feels that we as the type 1 diabetes community has learned that fruit's too tricky to manage and should be avoided. It's true that it can spike blood glucose levels, particularly after a period of eating low-carb. So I'm not here to sugar coat it (still can't get enough of those T1D puns) - managing fruit isn't a walk in the park but it can be done. And fruit is so marvellous at providing nutrition, fibre, hydration and the micronutrients our bodies need.

You can eat fruit. I promise. Read on for my top tips on how to eat fruit with freedom!

---

Fruity Top Tips

a) think about timing

It's a good idea to enjoy some fruit at the end of a meal, when your digestive system is busy working on other foods. This reduces the likelihood of blood glucose spikes, as absorption of glucose from the fruit is slowed down.

b) pre-bolusing is your pal

You all know how much I prioritise the pre-bolus (where possible). A pre-bolus just refers to bolusing/injecting your quick-acting insulin ahead of time (roughly 15 mins) to allow it to get working on the carbs in a meal/snack and prevent post-prandial spikes. This can be particularly powerful if you're going to be snacking on fruit.

c) start with low GL fruits

As you begin to get more acquainted with fruits, it's a good idea to prioritise the quick wins. These can help build your confidence and create momentum. I suggest to all my clients that low glycaemic load fruits are great places to start, as these have the least impact on blood glucose levels. We're talking strawberries, plums, apricots, oranges, pears, apples, blueberries, nectarines.

d) pair with protein + fat

If you eat a piece of fruit in isolation, you'll be consuming fibre, water and carbohydrates. Despite the fibre and water, the fructose in fruit can still be readily broken down into glucose and then enter the blood stream. If you pair fruit with protein and fat sources, the fructose is broken down more slowly as the protein and fat buffer the impact of the glucose from the fruit.

I'm a big fan of apple slices with nut butters, or a handful of berries with a handful of almonds.

---

How are you feeling about fruit? Have you been on a journey with eating it? Comment below!

What's the deal with anti-inflammation?

Why focus on reducing inflammation if you live with type 1 diabetes?

Let's talk about anti-inflammation. Why? Because it's super important when it comes to T1D management.

It's one of the key cornerstones of my approach and the Beth Edwards Nutrition clinic -- and I'm sharing it with you today! (You lucky devils).

What is inflammation?

• Part and parcel of a healthy immune system.

• It's one of our first lines of defence. Say you cut your finger whilst chopping vegetables, inflammation is one of the first stages of protection against infection.

• Ideally, it's acute: once the immune system has done it's job, inflammation should be 'switched off'. This happens when a resolution is found i.e. the immune system can say ‘this is all good, we can move on’.

• Often, this resolution either isn’t found or it’s interrupted. Something gets in the way, keeping the immune system engaged and working in that specific area.

• This can lead to a low-grade inflammatory picture.

• Insulin resistance and the inevitable blood sugar highs and lows of life with T1D can promote inflammation across the body and/or get in the way of the immune system establishing resolution.

• Hence why anti-inflammatory foods + anti-inflammatory ways of eating are your friends. And we all like friends, right?

---

Eating like an anti-inflammatory pro (but also keeping it practical)

1. Mediterranean eating: The Med approach to eating is all about fresh fruits and vegetables, high quality protein, extra virgin olive oil, nuts and seeds and complex carbs (super duper important for blood sugar balance). It’s packed with anti-inflammatory foods and antioxidants and celebrates the ritual of eating, which is important for promoting a healthy relationship with food.

2. Green tea: it’s packed with l-theanine (an amino acid that helps promote GABA production, our calming neurotransmitter) and has the highest concentration of the polyphenol ECGC which is a potent antioxidant known to reduce inflammation. 1-2 cups a day, but treat like coffee i.e. don’t burn with boiling water and don’t consumer beyond 2pm (it’s got caffeine in).

3. Oily fish: packed with omega 3 fatty acids known to reduce inflammation by inhibiting the release of inflammatory factors. Aim for 2-3 portions across the week and focus on the acronym SMASH - Sardines, Mackerel, Anchovy, Salmon, Herring. Wild and sustainably farmed is best and don’t forget about tins!

---

Do you fancy some anti-inflammatory eating? Which tip will you try this week? Let me know below!

What is my pragmatic approach to life with type 1 diabetes?

Why do I choose pragmatism above all else when it comes to managing T1D?

I'm in the business of pragmatic approaches to life with T1D.

What does this mean?

Well, there is zero point me giving you advice or guidance that's unattainable, stress-inducing or makes you want to cry. Do you agree?

I'm not in the business of chasing 100% TIR (it's not necessary & it's too all-encompassing). What I'm keen to help you find is balance *most of the time* and a healthy acknowledgement that we can't always 'get it right' with T1D.

If I can help you establish where is best to place your energy and focus, and let go of the rest, I think we're on to a winner.

Life with T1D is already complicated enough. I don't want to add food and lifestyle stress to your overflowing plate. Of course I'll push you if you need that, but I'll never ask you to do something that feels faddy or unsustainable. I create recommendations that are person-centred and 100% bespoke to you, your diabetes and whatever is going on with your life. It's the gentle approach from me.

And if something isn't working, we change it. See? Pragmatic.

What is your approach to your T1D? Pragmatic, or would you pick another word? Let me know below!

Easy ways to boost your insulin sensitivity that you can implement today

Nutritionist-approved ways to boost your insulin sensitivity if you live with T1D

(Originally published on the Quin Diabetes Management app blog)

Insulin sensitivity 101

Why is it important for anyone with type 1 diabetes to view their management through the lens of insulin sensitivity? Well, the goal is for us to keep blood glucose levels within a target range without losing our sanity (restriction is not the answer). A great way to manage blood glucose is to work on something called insulin sensitivity – the converse insulin resistance. You might think that resistance is exclusively an issue for those with type 2 diabetes. Well, it’s possible that insulin resistance is also a problem for you and your type one diabetes management.

When I work with clients, we implement changes that allow us to zoom out, look at the bigger picture and work on increasing insulin sensitivity in the background i.e. across the whole day, week, month. This then allows them to enjoy a meal out (with unknown carb quantities) or tuck into a slice of birthday cake without entering the blood sugar rollercoaster too much. A slice of birthday cake might push you up and out of range, but what’s important is that we minimise how high blood sugars go and that we encourage them to come back down quickly. Working on your insulin sensitivity allows for this.   

---

How to improve insulin sensitivity

It’s necessary to focus on a range of areas – hormones, nutrition, exercise, sleep cycles, inflammation, biochemistry i.e. the cornerstones of insulin sensitivity. Let’s look at a few topics below. 

Nutrition

Get Carb Smart: Current research indicates that insulin sensitivity can be increased by prioritising carbohydrates that come from whole foods and complex sources. The Mediterranean diet also prioritises complex carbs and is another approach that supports not only blood sugar balance, but overall health and longevity in the long run. Why? Mostly because it has powerful anti-inflammatory properties, is high in fibre and focuses on both what you’re eating and how you’re eating (think big family celebrations, mindful consumption & healthy food relationships). Clinical and personal experiences have shown me that an anti-inflammatory Mediterranean approach with a diversity of complex carbohydrates can be highly effective at boosting insulin sensitivity.

Importantly, no one size fits all when it comes to food and type 1 diabetes. Maybe you follow a plant-based approach but your T1D pal adopts a lower-carb lifestyle. There is not one ‘perfect’ way of eating and lots of people can achieve their glycaemic goals in a myriad of ways. 

What’s key is that no matter how many carbs you choose you eat, it’s sensible to focus on complex sources and get Carb Smart. This way you will be consuming carb sources that offer the most nutrition and prevent any blood sugar spikes. Not all carbs are created equal:

• Focus on whole foods, low glycaemic load and complex carbs (instead of simple sugars)

• Oats in porridge or overnight oats

• Root vegetables roasted (butternut squash, sweet potato, parsnips)

• Lentils and pulses (add these to soups, stews, salads)

• Grains like quinoa, brown rice, buckwheat

• The humble potato, or sweet potato if you fancy an extra dose of vitamin A.

Watch The Fat: particularly saturated and trans saturated. It’s easy for us with type 1 diabetes to default to fat-heavy foods as they have little impact on blood sugars in the immediate term, but they will affect control over a longer period of time. Aim for mono- and poly-unsaturated fats like olive oil, nuts and seeds, avocado, oily fish.

Power To The Plants: I’m not vegetarian or vegan, but I am a huge plant lover. And for good reason! Fruits and vegetables are packed full of antioxidants (basically, substances that prevent or slow damage to cells). For those living with T1D, upping your antioxidants is a smart move. Whenever blood sugars go out of range (which is inevitable, type 1 diabetes is not a perfect science and people with T1D are not robots), this can cause damage to our body cells.

So, it’s smart to include a healthy number of antioxidants in your diet. Think of them as like mops that are able to ‘mop up’ any free radical damage. The more colour, the better and diversity is key. Aim for 8 portions a day. If you can manage 10, you’ll be my new hero.

---

Exercise

After nutrition, exercise is the next best insulin sensitizer. Exercise allows glucose to shuffle into the cell (to be used for respiration) in the absence of insulin. Increasing exercise can increase insulin sensitivity for a few days post-exercise. Research also suggests that a combination of resistance and cardio exercise works best. This is because cardio is the most potent insulin sensitizer, but resistance training can reduce blood glucose levels for the longest period post-exercise (up to 72 hours!). That being said, what’s important is that you find a way of moving that suits you and you can stick with – consistency is key! ⠀

---

Sleep 

I know, I know – another healthcare professional banging on about the importance of sleep, but hear me out! Getting that shut eye is super important for all aspects of health, not just T1D management. It allows the body to conduct important maintenance work, to repair any damage and to stave off any illness. Latest research suggests a correlation between sleep loss and increased insulin resistance in populations of people with T2D, and one small study has shown that even 24 hours of sleep deprivation can lead to elevated fasting and post-meal blood glucose levels.   

---

Stress management

Ever find that when you’ve got a stressy day at work, or you have to present in a meeting, you might find your blood sugars persistently elevated? Well this is all thanks to our stress response. 

When we’re in sympathetic nervous system activation (fight or flight), a few things happen:

• the body wants to ensure there is readily available sugar that can be used for energy.

• the liver kicks in and releases stored glycogen into the bloodstream i.e. increasing blood glucose levels.

• the body releases stress hormones including cortisol which make us more insulin resistant, increasing blood glucose levels.

Stress is a tricky one. The body is trying to help us out, but it’s a struggle for anyone who’s pancreatically-challenged. The main issue is that stress is unpredictable. Unlike carb counting, it’s hard to bolus the correct amount for stress. Plus, as soon as the stressor disappears, our blood glucose levels can drop quickly.

So, what can we do? Well, you can support your nervous system by using techniques to get your body into parasympathetic nervous system activation (rest and digest, the opposite of fight or flight).

Here are three destressing tips that you can adopt today:

1. Breathing techniques. This is an excellent way to shift into rest and digest and begin to unwind. You could try box breathing (inhaling for a count of four, holding for a count of four and exhaling for a count of four), or 4-7-8 breathing (inhale for a count of four, hold four a count of seven and exhale for a count of eight).

2. Meditation. Even if only for a few minutes a day, taking a pause to meditate can be an excellent way to lower stress levels (& lower blood glucose levels while you’re at it!). I like apps like Headspace, Insight Timer and Ten Percent, but there are also lots of free recordings on YouTube.

3. Have different insulin ratios or basal profiles when you know you’re going to be feeling more stressed i.e. an exam.

---

Anti-inflammation

Let’s talk about inflammation for a minute. Acute (short-term) inflammation is triggered by damage to the body and should be “switched off” once the body has healed. Chronic (long-term) inflammation occurs when the switch doesn’t work correctly and turns inflammation from a helpful healing tool into something that causes unnecessary damage – and this is what’s been linked to heart disease and Alzheimer’s.

Type 1 diabetes can be considered a pro-inflammatory condition. It is also an autoimmune condition. Autoimmunity arises when incorrect immune responses target self-tissues causing inflammation. In T1D, cells attack the insulin producing beta cells in the pancreatic islets, causing irreversible damage.

Hence, adopting an anti-inflammatory diet is a great way to go for anyone with autoimmunity. 

Top tips:

1. Oily fish are packed with omega 3 fatty acids that are known to modulate the inflammatory response. Focus on salmon, mackerel, herring, sardines and aim for 2-3 portions per week.

2. Vitamin E is anti-inflammatory (find it in nuts, particularly almonds & seeds).

3. Garlic, ginger and curcumin (found in turmeric) are excellent anti-inflammatory compounds. Add them freely to curries, stews and stir-fries.

4. Vitamin C is another great option (you can load up by eating kiwi fruit, red bell pepper, strawberries, oranges).

---

Pre-bolusing

One of my favourite tools in our T1D toolkit. Ensuring consistent pre-bolusing is really important when it comes to reducing those post-meal spikes. 

Questions you need to ask when deciding how long to pre-bolus for:

1. What is my current blood glucose?

2. What food am I about to eat? (specifically, the glycaemic load of carbs)

3. Am I eating protein, fibre or fat with this meal? (These slow down the absorption of carbs)

4. What meal is this? (i.e. breakfast may have the dawn phenomenon at play.

You can use the Quin app to create a quick reminder to have the food you’re planning to eat. In the process, you can also record your insulin to track exactly when it starts taking effect. The app will ensure you don’t forget. Alternatively,  timer on your phone so you don’t forget. For more detailed guidance on the latter method, read this Instagram post. 

---

What About Supplements?

Certain supplements have been indicated to improve insulin sensitivity. For example, alpha-lipoic acid, chromium, myo-inositol and magnesium. It’s really important to work with a healthcare professional if you’re thinking of using supplements – in some cases, you might not need to supplement, or it may even be unsafe if you do.  

• Working with a nutrition professional to help you target your individual challenges and blocks. If you’re struggling with insulin resistance, are getting fed up of going round in circles, now might be the time to reach out for professional help.

---

You Do You

At the end of the day, you know your body best. The above suggestions are based on what the current research is indicating, but some points might not resonate with you. That’s totally cool! I’m here to honour your individual biochemistry and accept that you’re in the driving seat of your condition.

I hope that’s helpful! You can follow me on Instagram where I share more tips and support to help you on your T1D journey. I also have plenty of resources on this blog. If you would benefit from 1:1 work with me, find out more about my way of working here.

Why you should up your antioxidants if you live with type 1 diabetes

What’s the deal with antioxidants?

Why do people like me (nutritionists!) always bang on about these little powerhouse compounds?

Let me explain.

There's a balance between oxidants and antioxidants inside our body.

Oxidants – are produced due to oxidative stress and include things like Reactive Oxygen Species i.e. free radicals, which you’ve probably heard of.

Oxidative stress in the body can be caused by things many things i.e. micronutrient deficiencies, pollution, immune responses to an infection, high and low blood sugars (this is pertinent!).

Oxidative stress can be balanced out by our own internal antioxidant system and antioxidants we eat.

Antioxidants – compounds that can protect your cells from damage caused by potentially harmful molecules known as free radicals (think of them as coming along and ‘mopping up’ the free radicals).

If you live with T1D, it’s impossible to keep your blood sugars in range ALL THE TIME – you will have some highs and lows. That’s why it’s important to get lots of antioxidant-rich foods into your diet.

Antioxidants = fruits and vegetables! Specifically, phytonutrients found in the pigmentation. This is where eat the rainbow comes from (a cliché, but you can see why now!)

---

Aim to get as many different colours as possible

• Red (apples, tomatoes, radish)

• Orange/yellow (carrots, mangoes, turmeric, papaya, sweetcorn)

• Greens (spinach, sprouts, watercress, broccoli, peas)

• Blue/purple (blueberries, beetroot, aubergine, grapes)

• White/black (cauliflower, coconut, parsnips, black garlic)
  

Which colour are you going to focus on this week?

How to manage your T1D in the heat

Beth Edwards Nutrition | Type 1 Diabetes Nutritionist | London Nutritionist | How to manage type 1 diabetes in the heat

Has the heat got your type 1 diabetes hot under the collar?

Lots of my type 1 diabetes clients are noticing differences in their blood glucose levels now the temperatures have started to rise. Maybe you are too?

So what's going on? Well, it all comes down to PHYSICS. The extra heat increases the kinetic energy of the particles in our bodies and our insulin. This provides more kinetic energy (i.e. the insulin moves around quicker and therefore does its job quicker). Additionally, the heat expands your blood vessels, which in turn can speed up insulin absorption and possibly lead to lows.

---

What can you do?

1. Keep a close eye on BG levels. If you're dropping low across the whole day, you might need to reduce your background (basal) insulin.

2. Maybe you find you go higher in the heat. This could be due to your insulin overheating. Ensure you keep your pens and vials in cool, shady spots when out and about, and change your infusion sites (if using a pump) more often if you feel your insulin reservoir is getting too warm.

3. Always carry lots of water with you, particularly if you're running a little bit on the high side. When the body is dehydrated, BG becomes more concentrated due to the decrease in blood flow through the kidneys. This makes it harder for the kidneys to remove any excess glucose from urine.

4. It's extra important to keep hypo treatment on you if you know you're prone to going low in the heat.
   

What is your experience - high or low in the heat? (Or both?)

5 ways to manage the dawn phenomenon if you live with type 1 diabetes

Beth Edwards Nutrition | Dawn phenomenon | type 1 diabetes | breakfast | blood sugar balance

How to manage the dawn phenomenon

Virtual show of hands: who feels mornings can be the trickiest time of day to get a handle on blood glucose levels? Who also feels the morning rush of doing all the real life things that gotta be done, and wishing blood glucose just played ball so you can get on more easily?

If this is you, you're not alone. Managing mornings (the dreaded dawn phenomenon) comes up in the Beth Edwards Nutrition clinic a lot. I near enough discuss it with every 1:1 client who walks through my Zoom meeting room.

It's a tricky time of day with our normal circadian rhythms giving us a dose of stress hormones to get us up and out, but this indirectly raising glucose levels can be unhelpful for the t1ds among us.

Adopting a holistic, 360 approach is the way I play it. This covers all bases. But it can feel relentless work, and I get that. So let’s break it down into easier chunks - here are 5 nutritionist-approved tips you can adopt today!

1) Pre-bolus

Ensure you pre-bolus your insulin before eating breakfast. We know that ‘quick-acting’ insulin isn’t all that quick, and it needs at least 15 minutes to activate. You may find you need to try different lengths of time to establish the best pre-bolus for you (+ this may be different for each meal, too!). For further specific guidance, please see a detailed post I wrote on Instagram.

2) Movement

Do some gentle movement in the morning. We know that movement is a great way to shuffle glucose into the cell (to be used for energy) and that this can happen in the absence of insulin! Try some gentle stretching, a morning stroll, some yoga or reiki. It doesn’t need to be a full on sweat. The key is consistency, so find something you enjoy!

3) Sleep

Where possible, aim to get between 7-9 hours of quality sleep each night. The benefits of sleep on health are endless and when it comes to type 1 diabetes, getting decent shut eye will lower morning cortisol levels (the stress hormone that drives up blood sugars) and improve glucose tolerance. Both are important to prevent those post-breakfast spikes - winning!

4) Balance your breakfast

And I don’t mean on one finger… eating a breakfast full of complex, low glycaemic load carbohydrates (whole grains, whole fruits, oats), good quality protein (eggs, clean protein powders, chia seeds) and healthy fats (nuts, seeds, flax, avocado) will ensure your plate is nice and balanced. Most typical Western breakfasts - cereals, toast and jam - are just carbohydrates. If you pair carbs with protein and fats, this will slow down the absorption of the carbs, reducing the post-meal spikes in blood glucose levels.

5) Eat dinner earlier

And consider avoiding late night snacks. This will increase the fasting window between meals, allowing your body to reset, your digestion to do its importance maintenance work and your insulin sensitivity to increase. It also means you won’t be going to bed with insulin on board, which makes blood sugar management a whole lot easier overnight - fewer CGM beeps and more chance of good-quality sleep (see point 3!).

---

So there we go, some top tips you can easily implement today to help you better manage and get on top of the dawn phenomenon. Let me know below - do you have any other T1D tried and tested tips?

{Interview} Ellie Selby, Person with T1D

T1D Inspiring Interviews Series

Hey guys. Happy 2021. It’s a new year and it’s time for a new interview!

I had a little chat with Ellie Selby, person with type 1 diabetes and all-round good egg! She’s got a great Instagram account that I encourage you all to check out!

Ellie shares the ups, the downs (+ everything in between) which such candour and honesty. Her refreshing take on T1D is a welcome relief, and for anyone reading along, I hope you feel a little less alone with your condition.

Full disclosure: Ellie was a client of mine last year and she was a DREAM to work with. It’s so great we’ve continued to stay connected over IG.

Without further ado, on to the reason why you’re all here - the interview with Ellie!

---

1) Tell us your type 1 journey! What age were you when you were diagnosed / what symptoms did you have?

I was 20 and felt terrible. I'd not noticed I'd lost 3 stones and was going out/drinking a fair amount to try and forget the fact I felt terrible. I remember I told one of my friends after I'd eaten that my blood felt like thick syrup (I freaked out about this when I was later diagnosed). My Dad had recently been diagnosed with Type 2, so I stole one of his ketostix and and then tried to forget the fact it turned black. A week later I felt even worse, so booked a GP appointment. I was tired,  constantly thirsty and going to the toilet, dizzy and had blurred vision. The GP pricked my finger and called the nearest hospital, who saw me an hour later. I was supposed to be admitted but begged to go home - our family dog had been put down that morning and not gonna lie, I just wanted my mum and my own bed haha. 

2)  What do you wish you'd known when you were newly diagnosed?

I wish someone had fully explained the implications and seriousness of the diagnosis. I feel like the consultants and nurses I saw were treading on eggshells because they didn't want to upset me. 

3) What is the worst thing about T1D?

I know everyone says it but the fact there is no escape. Sometimes when a hypo hits after a bad day I just don't have the energy left to power on and these moments are probably my lowest points. 

4) (Curveball) What is the best thing about T1D? 

Hands down this community, I owe so much to so many people and I'm grateful every day. 

5) What are the main challenges of living with type 1?

Trying to smile and remain positive when low at work. The exhaustion. The annoyance of post gym hypos. The mental burden on loved ones. Trying not to worry about "what ifs", and last but not least, shitty and inaccurate type 1 representation in the media and on tv, urgh. 

6) How do you deal with these challenges?

Yoga, meditation, coffee, puppy cuddles. My partner does a truly amazing job of supporting me, especially when I'm struggling to cope and want to give up. 

7) Where do you find support/how do you access support?  

My first DSN was amazing - she's the reason I have a pump and a cgm. Unless I have a medical issue that does need specialist input, I generally access support and advice online, primarily through Instagram. I still find it insane that I discovered the Type 1 IG community 7 years ago and am still in contact with the same inspirational and kind-hearted people today.

8) Can you recommend any great podcasts or blogs?  

Every time I go to listen to a podcast I can never choose and just listen to music and read instead. Am I old? 

9) Have you ever 'hidden' your type 1?

Not intentionally. There have been occasions where I've been in meetings and I've ignored the fact that I needed to bolus for 30 minutes because I'm too embarrassed to pull my pump out from my bra. It's usually when I'm the only female in the room and I'm concerned about appearing unprofessional to those that aren't diabetes tech-aware by rummaging around in my top. Why is it so hard to find dresses and skirts with pockets?!

10) How do you think type 1 has affected your relationship with your body?

Sometimes bruises and site insertions gone wrong get me down, but on the whole type 1 has actually improved my relationship with my body. I'm more in awe of what bodies do and am grateful that mine functions every day, with a little help from modern medicine and myself. I'm considerably less hard on myself and in a weird way I actually respect myself more and have greater self-worth. 

11) How do you think type 1 has changed your approach to life and living? 

I'm certainly more grateful for what I do have. I'm more aware of death and for the potential for things to go wrong which scares me. I rely on other people more (which I absolutely detest) and I force myself to rest when run down.

12) Type 1 is classified as a physical condition, but we all know there is an emotional burden too. Could you describe your experiences?

I struggle with separating the diabetes-related mental burden from the non-diabetes related... and I also have Bipolar Disorder. I've never experienced a distinct, prolonged phase of what I'd consider "burnout", but when stressed and struggling emotionally, I will let the tiniest diabetic frustration completely dominate my mood for hours. I hate the fact that sometimes before I've even got up, I've already got 6-8 hours of terrible blood sugars under my belt, which will then go on to affect my mood for the rest of the day. In terms of which I find harder to deal with, the emotional burden of type 1 far outweighs the physical, for me.

BONUS quick-fire round:

Omnipod or Medtronic?

Medtronic

Libre or Dexcom?

(Have tried both plus Medtronic and still Medtronic Enlite for me, sorry)

Juice or jelly babies?

Juice. Jelly babies scare me

Balmy summer nights or crisp wintry mornings?

Frozen wintery mornings!

Yoga or gym bunny?

Both!

Porridge or pancakes?

I eat porridge more but I definitely prefer pancakes

Diet Coke or Kombucha?

Can I opt for water pls?

Novorapid or Fiasp?

Novorapid

Halo Top or Oatly ice cream?

Halo Top

Morning bird or night owl?

Night owl

IGTV or Instagram Stories?

Definitely stories

Thank you so much, Ellie, for your wisdom and light in this T1D community of ours!

---

{Interview} Pete Lomas, Founder of NJaP

T1D Inspiring Interviews Series

Hey guys [waves]. Welcome back to another interview!

I had a little chat with Pete Lomas, person with type 1 diabetes and founder of patch company Not Just a Patch.

Not Just a Patch is designed to give maximum protection for your Freestyle Libre, Dexcom, MiaoMiao or Medtronic devices. The patch design is completely unique and original, designed by Pete after he found himself preoccupied with just how loose his Libre was getting - before the 14 days of wear was up.

If you’re familiar with the patches, you’ll know how colour they are . They’re designed to make a statement, so you can own your T1D tech and wear your diabetes on your sleeve (as a badge of honour).

Pete kindly sent me a sample of patches earlier this year and I haven’t looked back. I am always 100% confident that my Dexcom is going to stay in place if I use NJaP. I also wrote a guest blog post for them which you can read here: it’s ALLL about CGMs.

So if you’re a device wearer and you’re in need of some patches - check out NJaP!

Without further ado, on to the reason why you’re all here - the interview with Pete!

---

Hey Pete! Welcome. Please tell us your type 1 journey! What age were you when you were diagnosed / what symptoms did you have? 

I was 30 and living in London. I was training for the London Marathon and looking forward to spending Christmas in an Italian farmhouse with friends. I started peeing like crazy, was thirsty as hell and then my eyesight got blurry. I was telling my mate my symptoms and he suggested a Boots test kit. This led to a GP visit then a hospital trip. Woke up non-diabetic, went to bed diabetic. The twists and turns of life huh ;-)

What do you wish you'd known when you were newly diagnosed?

Nothing really…but if you want an answer, I wish I'd known what the catalyst was for the autoimmune response that killed the beta cells in my pancreas.

What is the worst thing about type 1 diabetes?

General inconvenience.

(Curveball) What is the best thing about type 1 diabetes?

I have a richer understanding of my body and its relationship to the things I put in it. And it's led me to create a business which has become a fulfilling passion and given my life a purpose that it previously lacked.

What are the main challenges of living with type 1?

1) It makes people around me worry and I don't want them to.

2) It impacts my health and my mood.

How do you deal with these challenges?

I try to reassure the people that it’s all OK and I take a balanced approach to life - enjoying as much as I can, not held back by diabetes.

Where do you find support/how do you access support?

I've just found a nurse educator, but until now I'd been pretty solo.

Can you recommend any great podcasts or blogs?

1) Beth's nutrition blog is practical and digestible (excuse the pun).

2) I like Dr. Rhonda Patrick's advice on nutrition.

3) Joe Rogan's podcast for entertainment and new perspectives.

4) Sam Harris's podcast for cultural, philosophical, political and social perspectives. 

Have you ever 'hidden' your type 1 diabetes?

Hmmmm…no.

How do you think type 1 diabetes has affected your relationship with your body?

As above, much richer appreciation for the effects of food, exercise, stress and all internal and external stimuli.

How do you think type 1 diabetes has changed your approach to life and living? 

Very little actually. I have found a community and feel part of that, as well the Not Just a Patch business has given me purpose and passion. I love helping T1Ds.

Type 1 diabetes is classified as a physical condition, but we all know there is an emotional burden too. Could you describe your experiences?

When I have hypos I tend to want to be left alone and can become frustrated. I don't like it when my partner thinks that I can manage my T1D better. I don't like my friends and loved ones worrying about me.

When did you launch NJaP and what was the reason behind that?

I had the idea in January 2019 and our first sale in July 2019. The reason was that I had been wearing the Libre for a year and found that by the end of the two weeks it was always getting loose and I was constantly thinking about it. I was also swimming more and had started doing hot yoga. With swimming 40 laps there was no way that the Libre stayed in place so I was making my own makeshift patches. I had been thinking about starting a business for a while and after listening to a podcast on entrepreneurship, this galvanised the idea to launch a CGM patch business. The design is unique and original and I am very proud of it.

What is your favourite patch / colour from the online shop?

Haha, well it was black at the start but now I tend to rotate with yellow being my current fave :-) 

BONUS quick-fire round:

Pump or pens?

Pens

Finger pricks or CGM?

Finger pricks

Orange juice or jelly babies?

Jelly babies or dates or Haribo

Balmy summer nights or crisp wintry mornings?

Damn! Got to be a tie tbh - love them both

Yoga or swimming? 

Haha probably yoga now, my body is falling apart and yoga is a little more gentle

Beach or mountains? 

Damn again…tie

Porridge or pancakes? 

Neither, I don't eat much breakfast these days as I do intermittent fasting as often as I can. If I do have breaky, it will be a bacon egg and cheese everything bagel or bacon, eggs, avocado, mushrooms and sourdough toasted

Diet Coke or Kombucha?

DC

Novorapid or Fiasp?

Novo

Vegemite or Marmite?   

Haha got to be Vegemite but I do also like Marmite

Morning bird or night owl? 

I've been both. Currently night owl due to business demands

Melbourne or Sydney?

I live in Sydney and it's the most naturally beautiful city in the world. I have many friends in Melbourne and have spent much time there and think that its culture and people are second to none

Thank you so much, Pete, for your wisdom and light in this T1D community of ours!

---

{Interview} Dan Newman, Type 1 Diabetes Blogger + Podcast Host

The T1D Inspiring Interviews Series is back!

Well, hey - hasn’t it been a hot minute since I did an interview with someone marv from the type 1 community?

Fear not, we’re back with a bang!

Dan Newman developed type 1 diabetes at the age of 10. He went on to experience diabetes distress in his teenage years and then developed chronic kidney disease in 2013. He places emphasis on being open in discussing his complications in a bid to reduce stigma and shame that can engulf these challenges. I for one (& I know there are many others) am extremely grateful for his honesty.

I first came across Dan on Jen Grieves’ podcast Type 1 on 1 - a pod where she interviews people doing wonderful things in the type 1 space. Dan’s episode is here. His wisdom and perspective shines through and his calming voice is a total tonic for the soul - you’ll be pleased to know you can hear more of his wisdom (& soothing voice) on his own fantastic podcast, The Talking Type 1 Podcast. Give it a listen (after you’re done with this blog post, of course!)

---

Without further ado, on to the reason why you’re all here - the interview with Dan!

Hey Dan! Welcome. Please tell us your type 1 journey! What age were you when you were diagnosed / what symptoms did you have? 

I was diagnosed when I was 10 years old during the summer holidays. I remember that I was drinking a lot but because it was hot outside my family didn’t think anything of it. My aunt took myself and my cousins to the cinema (movies) and I was unwell and that continued during the rest of the evening. My mum called the emergency doctor and he said you need to take him to accident and emergency (emergency room) now. What seemed like many hours the doctor told me that I had diabetes. I think I was in the hospital for a week or two but I can’t remember because it was so long ago!

What do you wish you'd known when you were newly diagnosed?

That there would be difficult times particularly the mental aspect that comes with living with type 1 diabetes. I think just seeing type 1 diabetes as a physical condition didn’t help me because it’s a physical, mental, and emotional condition all wrapped into one.

What is the worst thing about type 1 diabetes?

The, at times, unpredictable nature of type 1. The fact you can do the same activities, eat the same foods two days in a row and have two different results can be frustrating at times.

(Curveball) What is the best thing about type 1 diabetes?

The best thing for me is the skills and qualities it has taught me as a person. These qualities include me being more resilient, understanding of others and determined to succeed in whatever I do in life.  

What are the main challenges of living with type 1?

The challenge is that it’s an unpaid full-time job which you didn’t ask for, with no annual leave and you are the only employee. Type 1 is always there in the background no matter how much you tell yourself it isn’t. One challenge for me was to overcome trying to be the perfect diabetic who was always in range no matter when I tested my levels. I would think as the numbers as either good or bad and not just what they are - which is numbers.

How do you deal with these challenges?

I learnt to realise that trying to always have perfect levels whilst living with type 1 diabetes just isn’t possible. I learnt that the data from my blood glucose monitor was giving me information on what I needed to do next and that I was attaching emotion to the numbers.

Where do you find support/how do you access support?

The diabetes online community, in particular Instagram. I enjoy speaking to other type 1s from all over the world and speaking about the ups and downs of living with type 1. It’s nice to speak to people who just ‘get it’.

Can you recommend any great podcasts or blogs (as well as your own)?

One of my favourites is Type 1 on 1 | Diabetes Stories by Jen Grives. Jen is a great host and interviewer and I had the pleasure of being interviewed for her podcast. There’s also Emily and Miriam at Pancreas Pals and Brandon and Matt at Bolus Maximus both great podcasts. Finally, I have a podcast called The Talking Type 1 Podcast.

Have you ever 'hidden' your type 1 diabetes?

Definitely. I found type 1 particularly during my teenage years, so I would not tell many people at school. I’d inject under the table in class or go to the toilets to do my injection just so that I could appear normal to everyone else. I’ve hidden it in the workplace so in some jobs I only told one or two people who I felt needed to know just in case but I never actively spoke about my type 1.

How do you think type 1 diabetes has affected your relationship with your body?

I think being diagnosed at 10 I went through many life stages with type 1 so it was always part of my body. It has had a positive impact because I’m more aware if something isn’t quite right for example my levels usually go out of sync a week or so before I come down with a cold.

How do you think type 1 diabetes has changed your approach to life and living? 

It’s taken a long time to get here but I now aim to do my best every day when it comes to managing type 1 which I use in my everyday life. Type 1 has also shown me that I can get through the worst situations, it’s not easy or pleasant at times but there is an end and I also use this in my approach to life and living.

Type 1 diabetes is classified as a physical condition, but we all know there is an emotional burden too. Could you describe your experiences?

I’ve had diabetes distress and diabetes burnout particularly in my teenage years and early 20s. I never knew that there was a reason for how I was feeling at the time it was just how I felt. I had two changes in my life which put me on the right path to coming out of diabetes burnout and I’m thankful that they happened when they did. I also set myself small goals of testing my levels once a day and build on it. If I missed a test that day I wouldn’t be hard on myself and start again the next day and build-up momentum. A big challenge related to this is that I had to overcome (still occasionally do) is not attaching emotion to my blood sugar levels. I’ve learnt that the numbers aren’t judging me they are just giving me information on what I need to do next. I do think it’s important to celebrate when your hard work being a pancreas has paid off, for example, if you lower your HbA1c, you hit your target time in range.

When did you launch your podcast, The Talking Type 1 Podcast, and what was the reason behind that?

I launched my podcast in March 2020. My reason was to help others living with type 1 by interviewing different people about their lives with type 1 and sharing their experiences with others who live with type 1 diabetes. I like learning about people and believe that everyone’s story of living with type 1 is unique and can help another person.

I remember how I felt alone at different times when living with type 1 and I don’t want anyone else to experience that feeling. Overall, It has been a rewarding experience to speak to each guest.

Do you have a favourite episode, or one that you're particularly proud of?

Good question! An episode that I’m proud of is episode 10 called Black, Diabetic and Proud. I speak to other black people living with type 1 diabetes about their experiences living with type 1. We cover a number of topics including diabetes and health discussions within the black community, representation within the diabetes community and more. I like this episode because it was an opportunity to amplify the voices of other black people living with type 1. I have other episodes which I like; I’ve spoken to someone who had a pancreas only transplant, someone who has recovered from diabulimia, someone who has lived with type 1 diabetes for over 47 years and a mum who wrote a letter to her son on his first diaversary which spoke about their experiences as a family during that first year. I’ve spoken to some great people.

BONUS quick-fire round:

Pump or pens?

Pump

Finger pricks or CGM?

Finger pricks

Juice box or jelly babies?

Both, but if pushed, juice box

Balmy summer nights or crisp wintry mornings?

Balmy summer nights

Diet Coke or Kombucha?

Diet Coke

Morning bird or night owl?

Night owl

Porridge or pancakes?

Porridge

Breakfast, lunch or dinner?

Dinner

The smell of insulin, love or hate?

Love

Thank you so much, Dan, for your wisdom and light in this T1D community of ours!

---

Nutritionist-approved banging summer salad

Nutritionist-approved banging summer salad

Like me, you may love salads (guilty as charged) but perhaps - also like me - you get a bit bored of your current rotation?⁣⁣

⁣⁣
Welcome into your arms and your kitchens, this little beauty.⁣⁣
⁣⁣
Firstly, it's delicious. ⁣⁣
⁣⁣
Secondly, it's rich in lycopene (from tomatoes) which has antioxidant properties and is loaded with fibre and micronutrients. ⁣⁣

Ingredients:

Serves 2

• 3 large on-the-vine tomatoes⁣⁣

• 1 pack of mozzarella⁣⁣

• 2 cups of edamame beans (I use frozen)⁣⁣

• Handful of roasted hazelnuts⁣⁣

• 6 mint leaves⁣⁣

• Handful of basil, chives, tarragon, parsley⁣⁣

• Dressing: 3 tbsp olive oil, 1 tbsp red wine vinegar, Dijon mustard, zest of 1 lemon, salt + pepper⁣⁣

How to:

1. Slice up tomatoes and pop onto plates⁣⁣

2. Boil the edamame for 4-5 minutes (or whatever your packet instructions say)⁣⁣

3. Once done, drain and add to the tomatoes⁣⁣

4. Slice mozzarella and add

5. Chop up the herbs and stir through the dressing, then add this to the tomatoes⁣⁣

6. Garnish with the hazelnuts (go on, FLOURISH)⁣

Enjoy! Let me know if you make the recipe in the posts below - and tag me in your pics on Instagram!