We’ve all heard that regular physical activity is important to your overall health and wellness. But why? Being active helps to improve your mood, clear your mind, minimize stress, provide more energy, build and maintain muscle, manage your weight and protect your heart.….just to name a few. The recommended amount of physical activity is 150 minutes per week that includes 2 days a week of muscle strengthening activities, also known as resistance training. Did you know that just 20 minutes of resistance training twice a week can lead to major improvements in body weight and blood sugar levels? Examples of these types of exercise include walking, biking, swimming, weight lifting, running, gardening, doing chores around the house and even being intimate.

For people managing Type 1 Diabetes, being physically active can get a little tricky at times. When you are active, your muscles use sugars that are either stored in your body or are floating around in your blood stream for energy like gas for a car. Certain types of exercise can lead to low blood sugars while other types of activity can lead to high blood sugars. It is important to understand how activity and exercise affects blood sugars so that you can plan ahead to stay safe and enjoy what you are doing! As you exercise more, your body may become more sensitive to insulin, increasing the risk of low blood sugars during physical activity or for up to 48 hours after. Finding the right balance with carbohydrates and insulin to manage blood sugars during and after activity can be a challenge. Your diabetes educators are here to help you!

Let’s review the three types of exercise:

• AEROBIC – light to moderate intensity exercise for more than 10 minutes.

Blood sugars tend to drop more often during and after aerobic exercise
e.g. cardio, running, swimming, biking, skating

• MIXED – alternating periods of moderate to high intensity exercise.

Blood sugars tend to stay the same, but you should still watch closely
e.g. basketball, soccer or high intensity interval training (HIIT)

• ANAEROBIC – high intensity resistance exercise.

Blood sugars may spike (go high) and you may need to correct after anaerobic exercise
e.g. weight training, resistance bands, cross-fit, jumping rope

Planning Ahead for Exercise

There are a few different ways you can prepare for exercise to help prevent low or high blood sugars.

Consider using technology:

Take advantage of technology by wearing a continuous glucose monitor sensor that gives you quick access to your blood sugar readings. Use trend arrows to help make decisions about whether to have a snack or take a break from activity. If you do not wear a sensor, check your blood sugars more often with a finger poke while you are exercising and for the next 48 hours after. Set an alarm on your phone to check blood sugars around three o’clock in the morning; especially if you have a very active day.

Adjust insulin before or after exercise:

If you wear an insulin pump or manage your blood sugars with multiple daily injections (MDI), you may want to adjust your pre-meal bolus dose depending on how intense the activity will be, how long you will be active for, how much insulin you have on board (IOB) and when your last meal or bolus was taken. You may need to adjust your insulin up to 90 minutes before starting any activity.

If you are going to be active within two hours of your last meal, or your blood sugar reading is under 7.0mmol/L, you may want to eat 20-30 extra grams of carbs or take only half of your usual insulin dose. If you are wearing an insulin pump and plan to be active more than two hours after your last meal, you may want to run a temp basal rate for 90 minutes before you plan to start exercising. Set it to run during your activity and up to 1-2 hours after you are finished to help manage blood sugars. You may also want to consider setting a temp basal rate at bedtime to reduce your insulin by 10-20% to avoid having a low blood sugar through the night. Your needs may be different, especially as you exercise more or try different activities. Speak to your diabetes educator to find the right temp basal setting for you.

Be careful where you inject insulin before exercise:

Be sure not to inject insulin in or around muscles in your arms or legs before exercise. As muscles get warmed up, sensitivity to insulin increases, which means the risk of a low blood sugar also goes up if insulin is injected in areas that muscles are being used.

Consider ExCarbs:

Speak to your diabetes educator about another strategy you can used, called ExCarbs to help figure out how many grams of carbohydrates you should eat before, during and after your activity or how many units of insulin you should subtract from your usual pre-meal dose.

Stay Safe:

Plan your activities with a friend or loved one who knows how to recognize symptoms of a low blood sugar and what to do to help you if you have a low blood sugar. Make sure to wear medical alert identification and proper shoes that fit well. Do not exercise if you are not feeling well or have ketones.

Follow the GOLDEN RULE: make sure to ALWAYS carry low blood sugar treatment supplies like glucose tablets, juice boxes, regular pop or candies and drink extra water to stay hydrated. As a general guideline, you should drink water before starting activity and drink 250mL of water for every 20 minutes of exercise.

Watch and see how physical activity affects you! 

It may take some time to learn what works best for you to manage your blood sugar when exercising. Try different kinds of activity or make changes to the intensity or amount of time you exercise until you find the right fit. Remember to check your blood sugars before, during and after activity to see how your body reacts to exercise.  You may want to keep a journal to track and look back on what you have already tried and how well it works or what changes need to be made. Always speak with your healthcare team before starting a new activity for help adjusting your insulin or pump settings. Happy Exercising!

Join Diabetes Depot for the ‘Adjusting for Activity’ workshop on July 6^th from 7:30 to 8:30pm ET for more information. Click the link to register: https://diabetesdepot.ca/index.php/workshops-ask-the-expert-sessions/

ADDITIONAL RESOURCES:

Diabetes Canada – Planning for Regular Physical Activity
https://www.diabetes.ca/diabetescanadawebsite/media/managing-my-diabetes/tools%20and%20resources/planning-for-physical-activity.pdf?ext=.pdf

Diabetes Canada Podcast – Diabetes 360 with Dr. Mike Riddell (Season 1, Episode 7)
https://blubrry.com/diabetes_canada_podcast/28940433/diabetes-360-season-1-episode-7/#autoplay

Summer has arrived!  As the weather gets warmer, an increase in activity or insulin sensitivity might affect your blood sugar management.  Here are some insulin pump tips:

Exercise & Activity

Working up a sweat feels good and helps cool down your body, but it can expose your pump to moisture without you even realizing it. Keep your pump dry while exercising and on hot days by wearing it in a case made from water-resistant materials; such as a sports or nylon case or on your belt clip. If you decide to disconnect your pump while working out, make sure it’s put in a safe place.

Summer Pumping

If you’re a ‘podder’, your pump is waterproof, your PDM is not! If you are wearing Medtronic or Tandem pumps, your pump is water resistant, but should be disconnected near water. If you are heading to the beach, pool, or waterpark for the day, consider staying connected to your pump until entering the water, then disconnect and put your pump in a shaded, dry spot. Take breaks from being in the water so that you can check your blood sugars and see if you need to connect to give yourself a correction bolus dose.

Make adjustments to your pump settings or insulin doses if you are more active or if your insulin is working better in the warmer weather.  Not sure how to do this?  Ask your CDE or attend the Diabetes Depot / LMC Diabetes Education workshop ‘Adjusting for Activity’ on July 6^th from 7:30 to 8:30pm ET for more information. Click the link to register: https://diabetesdepot.ca/index.php/workshops-ask-the-expert-sessions/

Healthy Salad Tips for Winter

Salads are a great idea because they require minimal prep, no cooking and are easy to fit into a busy schedule!  Get the most out of your salads by following these tips:

1. Aim to include both dark green and orange veggies such as kale, broccoli, bell peppers and carrots. These coloured veggies have important nutrients such as vitamin A and folate.
2. Keep it fresh and cost effective by using seasonal vegetables.
3. When you do cook, make extra vegetables for leftovers which can be added for variety in a future salad. Roasted cauliflower in your salad is delicious!
4. Dressing choices matter! Vinegar and oil-based dressings generally contain less fat than creamy dressings.  As an alternative, mix flavoured hummus with a small amount of water to your desired consistency and give that a try!
5. Watch the extras! Bacon bits, cheese, croutons, dried fruit and nuts can add up to a lot of extra calories and fat. Use a lighter hand with these additions.
6. If your salad is the main meal, make sure it’s balanced! Ensure there is a whole grain such as quinoa and a source of protein such as legumes, boiled egg, tuna or chicken.
7. Have fun and be creative! Explore salad recipes in cookbooks or online to get inspired.  The combinations are endless. Experiment with some raw and some cooked veggies or add fruit such as fresh berries.

Here are some salads to try from the Diabetes Canada recipe collection:

• Festive Quinoa Salad
• Fruit and Feta Salad
• Garden Veggie Buddha Bowl with Lentils and Tahini Sauce
• Kale, Beet and Chickpea Power Bowl
• Quinoa, Black Bean & Mango Salad
• Roasted Cauliflower Salad
• Spinach Salad
• Wheatberry and Apple Salad

Enjoy!

Welcome to 2023!  The holiday season can be exciting and fun, but also stressful and challenging for managing diabetes.

Many people find this time of year a lot more stressful than the rest of the year.  Stress can be caused by timelines at work, coordinating visits with family and friends, family dynamics, health concerns, finances or just being out of your regular, daily routine.  Feeling stressed can cause blood sugars to rise and can make managing your diabetes challenging.  

Here are some helpful tips to help you get back on track and kick off a happy, healthy New Year when it comes to dealing with stress, feeling down, out of a routine or feeling tired. Learning and trying out different ways to cope with and reduce stress is important to overall health and wellness. If you feel overwhelmed, here are some ideas you may want to explore and try:

• Breathing slowly and deeply. Breathe in for a count of four seconds, hold your breath for 4 seconds, breathe out for a count of four seconds, wait four seconds before your next breath and repeat until you start feeling better. Focus on your breath!
• Try distracting yourself or changing your environment by going for a walk, listening to some music, or watching a funny TV show.
• If you’re feeling pressure to catch up on your to-do list or get started with your new year’s resolutions, remind yourself that it’s perfectly OK to let some things go. Working slow and steady to make new habits for the long-term is always better than setting goals that aren’t realistic and harder to achieve. Try making a schedule of when you can work on your to-do list and resolutions!
• Try planning ahead and writing things down. Plan your meals for the week in advance, make your grocery list based on your meal plan, map out your schedule, ask for help to get things done, and remember that it’s OK to say ‘no’ every now and then!

Holidays aren’t always holly and jolly for everyone. For some people, holidays seem to worsen feelings of depression. Maybe you’ve lost a loved one, are struggling financially, or feel lonely. When diabetes management gets harder and blood sugars go higher, it may cause you to feel depressed. It’s okay to not always feel okay, but it’s important to know what to do when you feel down.  Here are some ideas that may help:

• Try talking to a trusted family member, friend, or healthcare provider
•  Do something nice for yourself each day — go for a walk, read a book, get together with a friend, take a yoga class.
• Create a routine for yourself, which includes getting up at the same time each day, eating regular meals, checking your blood sugars, exercising, and getting to bed at a decent hour.
• Volunteering is a great way to help others and help you feel good about yourself at the same time.
• Take advantage of online support forums.
• If you’re really struggling, seek help through a crisis support line (Immediate Crisis Support: Text WELLNESS to 741741). There are also more resources for you or those you care about at wellnesstogether.ca

Enjoying (too many) holiday treats, experiencing unusual eating and sleeping schedules, having a few more alcoholic drinks than usual, and being less active can quickly throw off your diabetes management. During these times, the blood sugar roller-coaster can make you feel tired, grumpy and less likely to take care of yourself.  It’s important to get yourself back on track with no guilt!  Some tips to get you started again:

• Make it a priority to start eating healthy – fill up on vegetables and pass on (or along) some of the holiday treats leftover in your house!
• Find time to get up and stay active.
• Check your blood sugars more often or back to the routine you had pre-holiday.
• Take your diabetes medicine(s) as prescribed.

Celebrations at any time of year can be exhausting. Feeling tired is your body’s way of telling you to slow down and pay attention to taking care of yourself. It is easier said than done… and constant fatigue can lower your immune defenses and make you more susceptible to becoming ill.  Here are tips to get back on track:

• Don’t skip meals and do limit the amount of foods that are higher in sugars, fats or those that are processed.
• Build up your activity level. Guidelines for adults suggest at least 150 minutes of activity per week.
• Make a point to go to bed at a certain time each night, or plan for a short nap during the day to catch up on lost sleep.
• Find a relaxing activity.  Consider an online or in-person yoga class, treat yourself to a massage, or just set aside some quiet time for yourself.

Give the last gift of the season to yourself!   Whether you are best motivated to improve your diabetes management habits by setting New Year resolutions, or setting a one or two SMART goals (Specific-Measurable-Achievable-Relevant-Timely), or approaching things as they arise – please proceed in a way to set yourself up for success and a healthier future!  

Do something today that your future self will thank you for!

The Diabetes Depot and LMC Teams wish you a happy and healthy 2023!

Sign up for the first workshop T1D Tools & Technology that will cover where we’re at and what exciting new diabetes tech is coming. We are excited to focus on Foot Care in February with a Foot Care workshop, to help make foot care part of your daily routine. More workshops are coming soon! Be sure to bookmark this page, so you can easily find and join our workshops

We’re also kicking off the Ask the Expert Series with Kristen, a Certified Diabetes Educator.   This is an excellent opportunity to ask questions about T1D tools, devices, and technology. Our fabulous expert is full of knowledge and tips to help you self-manage your diabetes with confidence.

February’s ask the expert session will include an LMC Chiropodist, a foot care expert. Find out all the ins and outs of taking care of your feet to avoid complications!

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January 19th at 7:30pm ET	T1D Tools & Technology – Where We’re At and What’s Coming Next Join this workshop for updates on the exciting new diabetes tech coming – pens, pumps, sites, sensors, apps, and more!
January 26th at 7:30pm ET	Ask the Expert Session – T1D Tools & Technology 30-minute Q&A with a live expert who will be available to answer general questions about this month’s workshop topic
February 9th at 7:30pm ET	Put Your Best Foot Forward – How to Take Care of Your Feet Join this workshop
February 23rd at 7:30pm ET	Ask the Expert Session – Foot Care Specialist 30-minute Q&A with an LMC Chiropodist

Be sure to bookmark this page, so you can easily find and join our Diabetes Depot workshops

Did you know?  Diabetes Depot was founded in 2004 by one of Canada’s first CDE pharmacists and a fellow T1D pumper.  In 2019, LMC Pharmacy acquired the business, where we continue the mission to offer supplies, savings and support for people living with diabetes, their family and caregivers!  As an affiliate of LMC Diabetes & Endocrinology Clinics, we are pleased to share the expertise of the LMC Certified Pump Trainers and Certified Diabetes Educator Pharmacists, Dietitians and Nurses with the Diabetes Depot community.

Bonus Education Access to LMC DEP Specialty Workshops!

To learn more to help you get back on track in the New Year, checkout the specialty workshops offered by LMC Diabetes Education. These include:

• Eating on a budget – January 9^th at 7:30pm ET
• ABCDEES of Diabetes – January 17^th at 10:30am ET
• Cooking with Lara – January 25^th at 3:00pm ET
• Lets Get Fit  – January 25^th at 7:30pm ET
• Fad Diets – January 30^th at 1:00pm ET

February is Heart Month, a time to bring attention to the importance of cardiovascular health, and what you can to reduce you risk of cardiovascular disease. Join us for one of our Healthy Heart workshops provided by LMC Diabetes Education.

• February 8^th at 2:00pm ET
• February 14^th at 10:30am ET
• February 22^nd at 2:00pm ET

FYI – About the LMC Diabetes Education Program…..

The LMC Diabetes Education Program is committed to providing quality comprehensive diabetes self-management education and support to those living with diabetes. We want to help you with your diabetes management from developing more skills and confidence, to Making Healthy Easier while living with diabetes.

As an affiliate of LMC Pharmacy, the operators of Diabetes Depot, we are pleased to share our expertise, resources and support with the Diabetes Depot community.