Fall is here, and flu season is just around the corner. Getting sick not only feels miserable but can also make managing your blood sugar more challenging. So how can you stay healthy this flu season? You’ve probably heard about supplements like echinacea, vitamin C, and ginger shots but which approaches actually work? Here are some evidence-based ways to help reduce your risk of getting sick this fall and winter.

1. Get enough sleep

Most adults need between 7-9 hours of sleep but it’s hard to get! Typically, sleep is prioritized last when it comes to our busy lifestyle and may be interrupted to deal with high or low blood sugars or a trip to the washroom. Focus on what you can control, which is doing your best to stick to a bedtime schedule, avoiding screens, caffeine and alcohol close to bedtime and limiting lights from electronics (use a sleep mask if necessary).

2. Eat a healthy diet

There is no one food that will “boost” your immune system. The goal here is to aim for a well-balanced diet with vegetables, fruits, whole grains, healthy fats (like nuts and seeds) and lean proteins (like chicken and fish) while limiting high sugar, fat and ultra processed items.

3. Wash your hands!

This one seems obvious but every time before you eat or touch your face, wash your hands. If you are not able to wash your hands in the moment, then use hand sanitizer.

4. Exercise regularly

Although excessive exercise can suppress the immune system, regular exercise can help by circulating immune cells around the body. Exercise also reduces inflammation. When you are sick however, it’s best to limit vigorous exercise and let your body rest and heal.

5. Get vaccinated

Vaccines work by helping your immune system fight a specific pathogen by exposing it to an inactive or weakened form. Flu and Covid vaccines are updated annually because these viruses constantly change or “mutate.” Speak to your healthcare team to find out what vaccines are recommended for you.

6. Limit or avoid alcohol

Alcohol, even small amounts, can weaken the immune system which increases our susceptibility to getting sick. Alcohol also causes poor sleep quality and can limit your ability to make healthy lifestyle choices. Health Canada has changed their recommendations regarding alcohol consumption for the general population:

• If one does choose to drink, limit consumption as much as possible.
• The new low-risk threshold is no more than 2 standard drinks per week.
• Also, per occasion, do not exceed 2 standard drinks.
  (The Canadian Centre on Substance Abuse and Addiction, 2023)

https://www.ccsa.ca/sites/default/files/2024-05/Canadas-Guidance-on-Alcohol-and-Health-poster-2023-en.pdf

7. Manage blood sugars

This may come as no surprise, but consistently high blood glucose levels can weaken your immune system. Elevated glucose makes it harder for white blood cells to move effectively and fight off bacteria and viruses, which means your body may have a tougher time healing wounds or fighting infections. Even a mild illness can raise your blood sugar further, creating a cycle that makes recovery slower.

Your diabetes team is here to help you if you’ve been experiencing more variable or higher readings!

Happy summer! We hope you are soaking up the sun and enjoying the warm weather. Early 2024, we reviewed the upcoming T1D tech. Since then, the advancements continued, and more tech choices are available, or coming soon to Canadians living with T1D! This newsletter will review what’s now available, and if you’re already using new tech, let your diabetes team know how it’s working for you!

Sensors:

Libre 3+

The current Libre sensor is a small 14-day wear glucose sensor worn on the back of the arm. Users can either scan with a reader or their smartphone. The Libre 3+ will be even smaller – about the size of a penny and more accurate. Bonus, there will be 1 more day of wear on the sensor and it will also be able to link with some automated insulin pumps. This is (hopefully) coming to Canada in July 2025!

Abbott is currently developing the first-of-its-kind dual sensor where it will be able to measure both glucose and ketone levels. Imagine a sensor that can detect early on the risk of diabetic ketoacidosis! No more pee sticks or blood samples! The sensor will be the same size as the Libre 3+.

Dexcom

Dexcom is currently a 10-day wear continuous glucose monitor worn either on the abdomen or the back of the arm. Dexcom is working on a new generation that will be extended to 15 days instead of 10.

Did you know that they extended the Bluetooth range from 6 meters (20 feet) to 10 meters (33 feet) for Dexcom G7? This means less out of range alarms and interruptions!

Insulin Pumps:

Omnipod 5 (OP5)

Omnipod is a tubeless insulin pump which now has the long-waited automated insulin delivery feature. This came to Canada in April of this year, and many have already begun their journey with OP5! The algorithm in this automated insulin delivery system will adjust insulin based on Dexcom G6/G7 sensor readings. It will either increase or decrease background insulin every 5 minutes based on a 60-minute prediction of the blood glucose, and insulin on board. Like all automated systems, the system will work best if you deliver your bolus 10-15 minutes before eating.

Tandem

Tandem t: slim with Control-IQ has been available for a few years now. It works with both Dexcom G6 and G7 with the newest software upgrade. What’s exciting is that Canada will soon have the mobile bolus feature! This will allow users to bolus through a phone app instead of on the pump. The pump may change too! Currently the Tandem Mobi is available in the states. The pump is much smaller with a tubeless infusion set.

Changes to algorithm are expected to come soon as well! While running Control-IQ, users will be able to run a temp basal, along with using a longer duration for extended bolus – useful for that pizza slice!

Tandem users: did you ever notice those white and blue squares at the bottom of your sensor graph on your pump? These little squares are visual prompts to help you know when Control-IQ gave you an auto-correction (white square) versus your own meal bolus (blue square). If you ever wonder when CIQ gave you a correction, just check your graph!

Embracing technology isn’t always easy, but we do hope that some of these options will make managing T1D easier. Ask your diabetes team about current and upcoming technology to learn more!

Looking for a fresh, nutritious, and diabetes-friendly recipe to enjoy this summer? Our Mediterranean Lentil Summer Salad checks all the boxes. Packed with fibre-rich lentils, colourful vegetables, and zesty Mediterranean flavours, this salad is as satisfying as it is healthy. It’s an excellent option for people living with type 1 diabetes, offering a steady source of energy without spiking blood sugar levels. Whether you’re prepping lunch for the week or serving a light side at your next BBQ, this dish is simple to make and full of flavour.

(adapted from Breakthrough T1D)

Ingredients for the salad

• 1 cup dry green lentils 
• 1 English cucumber, chopped 
• 1 cup cherry tomatoes, halved 
• ½ red onion, diced 
• ½ cup fresh mint, chopped 
• 1 can hearts of palm, chopped

Ingredients for the dressing

• 1/3 cup olive oil 
• 2 limes, juiced 
• 2 cloves garlic, mashed 
• 1 tablespoon Dijon mustard 
• 1½ teaspoons sea salt 
• 1 teaspoon ground black pepper

Directions

Start by preparing your lentils; rinse and drain your lentils thoroughly, then add them to a saucepan with three cups of water and a generous pinch of sea salt. Bring the lentils to a boil, then once they’re boiling, cover the pan, reduce the heat to “low”, and let your lentils simmer for about 25 minutes. While your lentils are simmering, prepare the rest of your salad. Wash and chop your cucumber, tomatoes, red onion, hearts of palm, and mint, and set them aside. Then, in a separate bowl, add all of your dressing ingredients together and whisk them to combine. Taste and adjust salt and pepper levels as needed / desired.
Once your lentils are finished, strain the water from them and rinse them with cold water to cool. Then, add your cooled lentils to a large bowl along with the rest of your vegetables. Finally, pour your dressing on top and toss to fully combine. Once your salad is done, serve it right away, or store any leftovers in an airtight container, in the fridge, for up to one week. Enjoy!

Estimated carb count per serving: ~10g

Spring has sprung! Finally, warmer weather and longer days. For many of us, spring is a time to do some cleaning and re-organizing around the house as we shift into a new season. What better time to organize your T1D supplies, appointments and goals! Here are some tips to keep yourself organized, healthy and safe!

Insulin

Check the expiry dates on the insulin you keep in your fridge. Typically, unopened insulin has a pretty long shelf-life (about 2 years) as long as you keep it in the fridge with a temperature between 2 and 8 degrees Celsius. Unrefrigerated and opened insulin lasts 28 days at room temperature. Exceptions are: Tresiba for 56 days, Levemir for 42 days and Awiqli for 3 months. Make sure you get rid of any pens you’ve had open for longer.

Test Strips

Again, check out the expiry on your blood glucose and ketone strips. Expired strips may not give you an accurate reading. Strips should also be stored in the original container away from heat, light and moisture.

Glucagon

Are we noticing a common theme? Check the expiry dates! Baqsimi (nasal glucagon) has a much longer expiry date than regular injectable glucagon. Baqsimi is safe to use for 2 years from the manufacture date. It is recommended to store it in the shrink wrap to avoid moisture exposure. Both nasal and injectable forms of glucagon can be stored at room temperature.

Lancets and Needles

Checking lancets and needles expiry dates are often overlooked. The expiration dates on sharps exist due to the sterilization which can only be guaranteed for a certain amount of time. The good news is generally these expiry dates are quite long. Most can guarantee sterilization for 4 years.

Insulin pump

Inspect your insulin pump and report any cracks, sticky buttons, screen issues etc. to the pump company. They will inform you if the insulin pump needs to be replaced or if it’s okay to continue using it based on a few diagnostic tests they will run with you. If you need to contact your pump company, here is the contact information:

• Tandem: 1-833-509-3598
• Medtronic: 1-800-284-4416
• Omnipod: 1-855-763-4636
• Ypsomed: 1-833-695-5959

It’s a good idea to add this phone number to your contact list in your phone in case of any urgent technical issues.

Insulin Pens

Reusable insulin pens can be cost-effective, convenient, and some can deliver smaller increments of insulin. These can be quite handy to use regularly or as back up! You can ask your diabetes team or your pharmacy to order one for you. Every brand of insulin will have its own reusable pen.

Glucose meters and sensors

Sensors have expiry dates too! Using an expired sensor may give you inaccurate readings. Even if you use a sensor, it’s also important to have a glucose meter for back-up. If your symptoms don’t match your sensor reading, or if you think the readings aren’t accurate, checking with your glucose meter can give you more information to make treatment decisions. We recommend changing your glucose meter every 3 years and it’s usually free at the pharmacy with a prescription of strips. Your diabetes team will also have samples of glucose meters for you to choose from.

Eye, foot, dentist and doctor’s appointments

These appointments are all important to help with prevention of diabetes complications. Check your calendar to see if you have your eye, foot exams, and dental cleanings. The frequency of these appointments will be recommended by your health care provider. They are typically annually. Appointments with your endocrinologist are generally every 3-6 months with bloodwork completed beforehand. Do you have your blood requisition ready for your next appointment?…

Goal setting

Who says we only can set goals on January 1st ? Think of the next few months ahead… what would you like to accomplish for your health? Setting goals for your health can include increasing movement, adding more fibre, increasing water intake, and it can also be about feeling better emotionally. Practicing regular mindfulness, seeing a registered therapist, gratitude journaling are great goals to keep your emotional health in check. Remember, your mental health is just as important as your physical health!

We hope our spring cleaning list helps you stay happy, organized and safe! See you next time!

*adapted from Breakthrough T1D

Start your morning with a light and fluffy twist on traditional pancakes! These Lemon Ricotta Pancakes are packed with bright citrus flavor and creamy texture, making them a perfect weekend breakfast or brunch option. With only ~17 carbs per pancake, they’re a delicious and diabetes-friendly treat the whole family can enjoy. Pair them with fresh berries or a drizzle of sugar-free syrup for a balanced and satisfying meal. Ready to give them a try? Check out the full recipe below!

Ingredients

• 3 eggs, separated
• 3 tablespoons sugar
• 1 pinch kosher salt
• Finely grated zest of 1 large lemon
• 1 cup homemade ricotta (store-bought works fine)
• ½ cup all-purpose flour

Instructions

In a bowl, whisk together the egg yolks, sugar, salt, lemon zest, ricotta, and flour.
In another bowl, using an electric mixer on medium-high speed, or a whisk, beat the egg whites to medium-stiff peaks. Gently fold the egg whites into the ricotta mixture.
Heat 2 non-stick or well-seasoned frying pans over medium heat. Add a bit of butter to the pans, enough to coat the bottom.
Dollop heaping tablespoonfuls of the pancake batter into the pans, leaving a bit of space in between each pancake. You should be able to fit 3 or 4 pancakes into each pan, depending upon how large your pan is.
Cook for about 1 minute, until the bottom is golden brown. Carefully flip the pancake to brown the other side, and cook until the pancake is cooked throughout, another minute or so.
Enjoy!

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/