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We hope everyone had a restful holiday break! It’s 2025, and a new year comes with new goals. We are here to help you get started. Although there are more and more technological advances such as automated insulin pumps and continuous glucose monitors to help make blood sugars easier to manage, the basics of diabetes self-management still remain a cornerstone in achieving blood sugar targets. This newsletter will review some basics around matching your rapid-acting insulin to your meals.

Carb Counting

You may already be familiar with the basics of carb counting (i.e. reviewing labels, measuring with scales, using measuring cups and spoons, consulting restaurants’ nutrition information ) however most of carb counting work is taking the time and effort to figure it out (especially at the worst time – when we’re hungry!).

There are some popular apps that can help as well. Most recently, if you are a Dexcom user, there is an app that can help you carb count by simply taking a picture of your plate. To learn more about the app RxFood, visit: https://rxfood.co/

Another popular app for any ISO/Android user is Carbs & Cals.

If you need a refresher on carb counting, you can attend our free virtual workshop on carb counting!

If you use an automated insulin pump (Tandem with Control-IQ, or Medtronic with SmartGuard), you get the advantage of automatic basal rate adjustments and automatic corrections if your carb counting is slightly off. However, regardless if you’re on injections, pump or automated pump, carb counting and entering your carbs is one of the best strategies to help you achieve your targets!

If you are interested in learning more about the insulin pumps available, check out our Pump Ready/Ugprade workshop.

Glycemic Index, Balanced Meals and Protein

Carb counting is one thing, but the quality and type of carbohydrate matters too. The Glycemic Index (GI) is a scale that helps you learn how a food will impact your sugar levels. A food item or meal with a high glycemic index (white rice, white bread, most cereals, pineapple) is going to be absorbed in your body faster than your insulin can work! One strategy to help with this is to aim to have protein (meat, fish, Greek yogurt, eggs) and fibre (vegetables, whole grains, nuts, seeds) at your meals to slow down the release of the sugars and work better with the insulin. Another strategy that can work very well is pre-bolusing… which brings us to our next point!

To learn more about the Glycemic Index, you can review the LMC Glycemic Index Handout.

Pre bolusing

We’ve come a long way with our insulin over the years, but the fact remains that our rapid-acting insulin is still pretty slow.

• Apidra, Humalog and Admelog start to work in about 15 minutes
• Kirsty, Novorapid and Trurapi start to work in about 10 minutes
• Fiasp is the fastest onset at 2 minutes.

But remember: The onset does not mean that’s when the insulin is working at its best. It means that the insulin is starting to enter your cells, but will peak in 1-1.5 hours, which is when you can start to see a change in your blood sugars.

Let’s think about our higher GI food. If you know it will quickly increase your blood sugar, but that your Humalog will take 15 minutes to start working. What could you do to help match these? … Pre-bolus (i.e. taking it 15 minutes before eating)

Despite the type of rapid-acting insulin, taking your rapid-insulin before eating is ideal as it has a better chance to match the absorption of your food, versus taking it during or after. However, if you are eating a very low carbohydrate meal or a very low GI carb with your meal, taking it during or after could be a helpful strategy as well.

Like all learning in Type 1 diabetes (T1D), the goal is never to be perfect! These strategies are not easy to put into place. Often starting with 1 meal in your day, or 1 day in your week to practice these skills can be a great place to start.

Remember, your safety matters most! Make sure that you only bolus when you know when your food will be ready/prepared. Avoid pre-bolusing at restaurants or in situations when you are not preparing your own food.

Focusing on the basics of diabetes management is a great place to start when you want to re-focus on your T1D self-management. Carb counting and matching your insulin to your meal is no easy feat, however! Using available apps, attending workshops, and knowing more about the type of insulin that you are using, and how it works, can be a great place to start. Of course, reach out to your diabetes team if you need any guidance. We are here to help you achieve your goals in 2025!

If you’re looking for a hearty, satisfying meal, this Chicken & Spinach Lasagna recipe is a must-try! Inspired by Breakthrough T1D (formerly JDRF), this dish combines tender chicken, creamy ricotta, and nutritious spinach, all rolled up in lasagna noodles and baked to perfection. With just ~24.5 carbs per roll, it’s a deliciously balanced option for those managing their carb intake or simply seeking a wholesome dinner the whole family will enjoy. Easy to prepare and packed with flavour, these lasagna rolls are sure to become a new favourite in your recipe rotation.

Chicken & Spinach Lasagna, ~24.5 carbs per roll

*From Breakthrough T1D (formerly JDRF)

Ingredients

• 9 lasagna noodles (boiled for 6 minutes)
• 2 cups cooked cubed chicken
• 15 ounces low fat ricotta cheese
• 10 ounces chopped spinach – thawed and squeezed
• 1 egg, beaten well
• ½ cup parmesan cheese
• ¼ tablespoon Italian seasoning
• ¼ tablespoon minced garlic
• 2 ¼ cups prepared Marinara sauce

Instructions

• Preheat oven to 350°F.
• Coat the bottom of a 13 x 9 pan with ¼ cup of marinara sauce.
• Combine ingredients (minus noodles and sauce) in a large bowl.
• Place boiled noodles flat on waxed paper to dry.
• Once dry, lie noodles in the pan.
• Divide combined ingredients equally onto noodles.
• Roll noodles and cover with remaining sauce.
• Cover with foil and bake for 45 minutes.

Enjoy!

Fall is in the air, and that means one thing: it’s pumpkin spice season! For those with Type 1 Diabetes (T1D), enjoying a delicious pumpkin spice latte doesn’t have to mean compromising on blood sugar management. With this easy, low-carb recipe, you can enjoy all the cozy fall flavors without the extra sugar. Featuring unsweetened almond milk, pumpkin puree, and a dash of pumpkin pie spice, this T1D-friendly pumpkin spice latte is both flavorful and nourishing!

Ingredients Breakdown:

This latte is made with simple, wholesome ingredients like unsweetened almond milk and pumpkin puree, making it not only delicious but also lower in carbs than your typical café pumpkin spice drinks. The stevia (or your preferred sugar substitute) allows you to customize the sweetness without the sugar spike.

Quick & Easy Preparation:

The preparation is as simple as heating, blending, and sipping! After warming up your almond milk and spices, a quick blend ensures the latte is perfectly frothy. Plus, the added vanilla extract gives this drink the perfect hint of sweetness.

Nutritional Benefits:

With just 15g of carbohydrates, this T1D-friendly pumpkin spice latte offers the perfect cozy treat for a crisp fall day. Enjoy it guilt-free knowing you’re nourishing your body without the extra sugar.

Recipe: T1D Pumpkin Spice Latte

*recipe from: https://gluroo.com/

Ingredients

• Unsweetened almond milk – 1 cup.
• Pumpkin puree – 1/4 cup.
• Pumpkin pie spice – 1/2 tsp.
• Stevia (or preferred sugar substitute) to taste.
• Vanilla extract – 1/2 tsp.

Preparation

• Heat the almond milk, pumpkin puree, and pumpkin pie spice in a saucepan.
• Remove from heat and add vanilla extract and sweetener to taste.
• Use an immersion blender to blend until frothy and then enjoy.

Approximate Nutritional Value

• Calories: 35 kcal
• Carbohydrates: 15g
• Protein: 5g
• Fat: 3g

*Adapted from Yum & Yummer Cookbook
Makes 6 cups

Salad:

• 1 cup uncooked quinoa, rinsed
• 1 ¾ cup water
• 1 cup diced mango
• ¾ cup frozen shelled edamame beans, thawed
• ¾ cup diced red bell pepper
• ½ cup sliced almonds
• 1/3 cup raisins (omit if you’d like)
• 1/3 cup finely miced red onion
• 1/3 cup unsweetened flaked coconut
• 3 tbsp minced fresh cilantro

Dressing:

• 2 tbsp olive oil
• 2 tbsp freshly squeezed lime juice
• 1 tbsp balsamic vinegar (white or regular)
• 2 tsp liquid honey
• Sea salt and ground pepper to taste

In a medium pot, combine quinoa and water. Bring to a boil over high heat. Reduce heat to low, cover and simmer for 12-15 minutes, or until quinoa is tender and water has been absorbed. Remove from heat and let stand, covered, for 10 minutes. Cool completely.

In a large bowl, stir together cooled quinoa, mangos, edamame, bell peppers, almonds, raisins, onions, coconut and cilantro. Set aside.

In a small bowl, whisk together olive oil, lime juice, vinegar and honey. Pour over salad and mix well. Add salt and pepper to taste and mix again. Chill until cold.

Nutrition: Per cup, 269 calories, 13 g total fat, 34 g carbohydrate, 5 g fibre, 101 mg sodium

https://yumyummer.com/california-quinoa-salad/

The feeling of shame can be very common when living with type 1 diabetes (T1D). Shame is a feeling of distress, guilt or humiliation when we feel that we’ve done something wrong. How can anyone live up perfectly to the demands of diabetes without doing something “wrong”? It’s impossible to predict every low and high blood sugar! Between carb counting, the unpredictable effects of some meals and insulin doses, handling sick days, renewing prescriptions, appointments (and the list goes on!) – add these tasks on top of everyday life and it’s easy to feel like we aren’t doing enough, or we aren’t good enough.

Shame can negatively impact our mental health which of course can then impact our physical health. How we manage our feelings of shame can look different for each person living with T1D. For some, they may avoid aspects of our self-care to avoid shame. This might mean avoiding checking blood glucose levels so that they don’t see a high blood sugar reading or avoid a doctor’s appointments so that they can’t hear bad news. That person can usually recognize that this isn’t helpful, yet it is a way to minimize stress. Shame may also show up as anger and we may look to blame and shift the responsibility towards others. On the other hand, we may do the opposite and try to control everything related to blood sugars by minimizing variables. For example: eating a restrictive diet, not engaging in physical activity, avoiding social events, avoiding travel, etc. Living a life limited by T1D can often lead to diabetes burnout. Lastly, some may cope with shame with substance abuse which in turn can also cause havoc on blood glucose levels.

The examples above may not help resolve feelings of shame. Instead, identifying the source of shame and why that feeling is coming up can be a good place to start.  However, learning how to understand and process our feelings is not easy. This tool can be helpful in identifying more specific feelings that might help you understand why you are feeling what you are feeling: https://feelingswheel.com. We recommend taking a screenshot of this wheel, saving it on your phone or printing it for easy access.

In addition to identifying how we feel, we need to give ourselves grace, forgiveness, and compassion. There’s no way to perfectly manage T1D or our health in general! We can only do our best, and remember, T1D has a mind of its own which we cannot control! As health care providers, we often hear someone living with T1D sheepishly admit “I don’t like counting carbohydrates” or “I don’t needles” …. Of course you don’t! This is a very normal reaction! You are normal for feeling that way.  We acknowledge that these behaviours can be challenging, and we want to work with you on how T1D can fit into your life and help you find strategies that can make T1D behaviors a little easier.

Self-acceptance doesn’t happen overnight, and it may take time to shift those negative thoughts into positive ones. Strategies such as practicing affirmations, gratitude and journaling can help reframe some of your thinking to ultimately feel some relief while living with T1D.  Lastly it may be helpful to talk it out. Connect with others in the T1D community, a loved one or your health care provider to express your feelings and challenges – we are here for you.

If you are or someone you know needs help with substance abuse, please visit: https://www.canada.ca/en/health-canada/services/substance-use/get-help-with-substance-use.html

Further reading, references and resources:

https://jdrf.ca/stigma-and-type-1-diabetes/#:~:text=Experiencing%20this%20type%20of%20stigma,with%20friends%20and%20mental%20health.

https://www.knowdiabetes.org.uk/blog/shame/

1. Stay Hydrated: With the heat of summer, it’s crucial to stay hydrated to maintain stable blood sugar levels. Keep a water bottle with you at all times and sip regularly throughout the day.
2. Protect Your Insulin: Insulin is sensitive to heat, so be mindful of where you store it. Avoid leaving insulin in direct sunlight or in a hot car. Consider using a cooling pouch or insulated bag when traveling to keep your insulin at the right temperature.
3. Monitor Blood Sugar Frequently: The summer months can bring changes in activity levels, diet, and stress, all of which can impact blood sugar levels. Be vigilant about checking your blood sugar regularly, especially before and after physical activities like swimming or hiking.
4. Sunscreen is Essential: Spending time outdoors means exposure to the sun’s rays. Protect your skin with sunscreen to prevent sunburns, which can cause stress on the body and affect blood sugar levels.
5. Be Prepared for Summer Activities: Whether it’s a day at the beach, a hike in the mountains, or a backyard barbecue, plan ahead to manage your diabetes effectively. Pack snacks, glucose tablets, insulin, and any other supplies you might need to keep your blood sugar stable while enjoying summer fun.

Makes 4-5 cakes

These mouthwatering quinoa cakes pack tons of flavour into perfectly portioned patties! Eat them any time of day as a meal or a snack!

Ingredients:

• 2 cups peeled, cubed sweet potatoes
• 2 tsp + 1 tbsp olive oil, divided
• 1 cup no-salt added canned black beans, drained and rinsed
• 1 ½ cups cooked quinoa, cooled
• ½ cup finely chopped red onion
• 3 tbsp minced cilantro (optional)
• 2 tsp minced garlic
• 2 tsp ground cumin
• 1 tsp chili pepper
• ½ tsp smoked paprika
• ¼ tsp each salt and pepper
• ½ cup roasted red pepper hummus (store bought is fine!)

Preheat oven to 400 degrees. Line baking sheet with parchment paper
Spread potato cubes and drizzle with olive oil. Mix well with your hands.
Roast potatoes for 20 minutes or until tender. Stir once, halfway through cooking time. Transfer to a large bowl and let cool slightly. Mash with a fork

Mash beans with fork, leaving them a bit lumpy. Add beans to potatoes, along with quinoa, onions, cilantro, garlic, cumin, chili powder, paprika, salt and pepper. Mix until well blended. Cover and refrigerate for 1 hour (important!)

Form mixture into 3.5-inch cakes (½ cup mixture per cake). Heat remaining oil (1 tbsp) i a non-stick pan over medium-high heat. Add cakes and cook for about 3 minutes per side, until outside is crispy and inside is heated through.

Serve with hummus and enjoy!

Nutrition information: Per cake: 237 calories, 33 grams of carbohydrate, 7 grams of fibre, 8 grams of protein, 9 grams total fat (0.8 g saturated fat), 267 mg sodium

Watch it here: https://youtu.be/en1qX5dTdY0

Makes 8 servings

• 1 tbsp olive oil
• 1 cup diced onion
• 2/3 cup each diced carrot and diced celery
• 2 tsp minced garlic
• 3 cups finely chopped mushrooms (1 package of 227g)
• 1 jar (25 oz) your favorite marinara sauce
• 1 can diced tomatoes (with liquid)
• 1 tbsp balsamic vinegar or red wine
• 2 tsp dried Italian seasoning
• 1 can (19 oz) lentils, drained and rinsed
• 2 tbsp minced fresh parsley – optional

Heat olive oil in a large soup pot over medium-high heat.
Add onions, carrots, celery, and garlic. Cook and stir until vegetables begin to soften (about 3 minutes).
Add mushrooms and continue to cook until mushrooms are tender (about 5 minutes).

Stir in marinara sauce, tomatoes with their liquid, vinegar (or wine) and Italian seasoning.
Bring the mixture to a boil. Reduce heat to low, cover for 15 minutes.
Add lentils and cook for 5 more minutes. Remove from heat and stir in parsley (if using).
Serve over your favorite hot pasta or use in any recipe to substitute pasta sauce!

Nutrition information per cup:
156 calories, 2.8 g total fat (0.3 g saturated fat), 7.7 g protein, 26 carbohydrate (7.6 g fibre), 335 mg sodium. Total net carb per cup of sauce: 18 grams Check out how to make it here: https://www.youtube.com/watch?v=aN6KtsxWokk

*Recipe from Yum & Yummer by Greta Podelski