T1D


Special Episode #4: Life & Blood Sugar [Show Notes]

For someone with diabetes, everything they do in life affects their blood sugar.  They could be eating 100% right and taking their medicine 100% right, and something would cause the blood sugar to be off.

Exercise

It is well-accepted that exercise is good for you.  Your body will store extra sugar as a large molecule called Glycogen.  Imagine a line of kindergarteners hold hands trying to make it through the museum, Glycogen is just a bunch of glucoses holding hands.  When you’re not eating, your body will snip off a glucose at a time as it needs it.  The liver stores and directs the glycogen most of the time.  Your skeletal muscles also store some glycogen, because when they do work (i.e. exercise), it takes too long for the liver to snip off glucose from glycogen and send it to them.  

After exercise, the body replenishes the muscles’ glycogen stores.  This can cause the blood sugar level to drop, for someone with diabetes, this can be dangerous because they can’t “untake” medicine.  When protein and carbohydrates are eaten together, before or after exercise, the blood sugar changes can happen more slowly – the nutrient absorption in the gut causes a “traffic jam” of sorts.

Sleep

Certain metabolism processes happen only when you sleep.    Some people with diabetes wake up with really high blood sugar, others wake up with really low blood sugar.  Sleep is not restful and restorative if the blood sugar is out of balance, but also if sleep is not restful, then blood sugar levels can be jacked up – not just in the morning, but for the rest of the day.

Stress

The hormones that are triggered by stress – even something as basic as adrenaline, can cause the body to respond to insulin and glucose differently.  

Sickness

Your body is going to responds things differently when the immune system is in high gear – that includes insulin, glucose, the food you eat.  An infection requires an antibiotic because you are infected with a bacteria.  Bacteria are living organisms.  Living organisms consume energy sources and produce waste.  This can affect the sugar levels in your bloodstream.  You’re immune system doing work also burns sugar.

Allergies

Works about the same as sickness.  Your immune system is actively trying to protect you from something (allergens) and so it responds differently.

Smoking

If you smoke, STOP!  The nicotine and other chemicals make you more resistant to insulin.  This is most troublesome in Type 2 Diabetes.

Hormones

Especially for women, hormone cycles can affect sensitivity to insulin differently during different times of the month.  Adrenaline can override almost any response to any previous hormone response.

Life is hard

Life with diabetes is super hard.  Diabetes and other chronic diseases are silent and it doesn’t show on the outside at first sight.  Extend grace, extend compassion.

The Nashville chapter of JDRF is having their annual One Walk on September 24th. Friend of the show and previous guest, Rachel Mayo has been #T1D for over 10 years and she is passionate about the cutting edge research and support JDRF provides for people and their families. Her goal is for her team to raise $5000, you can contribute!

Connect with me

Support us on Patreon

*NEW* Join the Pharmacist Answers Podcast Community on Facebook

Subscribe: iTunesStitcherGooglePlayTuneIn Radio

Like the Facebook page

Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/


Special Episode #3: Meds & Blood Sugar

People with chronic diseases don’t get holidays or vacations from their medication.

4 ways medication can affect blood sugar

Type of medication

The goal of the medication that people with diabetes take is to lower blood sugar – either by increasing insulin sensitivity, encouraging the pancreas to make more insulin, or to replace insulin that’s not naturally made anymore.  Metformin is like insulin’s wingman; it helps make the cells ready for insulin when it comes by.  So usually these medications (including insulin) will lower blood glucose no matter if you eat or not.

Timing of medication

Most of the medications should not be taken if a meal is going to be skipped.

Dose of medication

The more sugar you eat, the more insulin you need.  The higher the blood sugar level, the higher the dose is needed.  It needs to stay proportional.  Any form of sugar you eat gets turns into glucose, the complexity of the sugar determines how fast it raises your blood sugar.  Even diabetics are at risk for hypoglycemia.  If one little thing gets out of whack, it can cause a drop in blood sugar and require a “rescue”.  Favorite hypoglycemia rescue “go to” is orange juice (lots of simple sugars).  Regular soda can be used, as well as hard candy or glucose tablets.  NO DIET SODA – artificial sweeteners do not affect sugar enough.  High blood sugar can cause coma, lower blood sugar can cause coma.  Bottom line: Coma is bad.

Interaction with medication

Fluoroquinolones can causes changes in blood sugar control and require a person to check their levels and adjust their medicines more often.  Steroids can also cause blood sugar to be more uncontrolled – this is true for acute (short term) use or chronic (long term – like autoimmune diseases) use.  Beta blockers used for blood pressure control can mask the symptoms of low blood sugar because the symptoms are very similar.  Symptoms of low blood pressure:  tiredness, weakness, dizziness, shakiness, inability to focus.  The only way to know which one you’re experiencing is to check your blood sugar and your blood pressure.

The Nashville chapter of JDRF is having their annual One Walk on September 24th. Friend of the show and previous guest, Rachel Mayo has been #T1D for over 10 years and she is passionate about the cutting edge research and support JDRF provides for people and their families. Her goal is for her team to raise $5000, you can contribute!

Connect with me

Support us on Patreon

*NEW* Join the Pharmacist Answers Podcast Community on Facebook

Subscribe: iTunesStitcherGooglePlayTuneIn Radio

Like the Facebook page

Music Credits:  “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0  http://creativecommons.org/licenses/by/3.0/


Special Episode #2: Food & Blood Sugar

Blood Sugar Basics

Your blood sugar affects how tired you are, your productivity, and your moods.  This is 1000x more true for those with diabetes.

Hypoglycemia = Low blood sugar

3 main energy sources in your food

Carbohydrates are some complex form of sugar that your body can turn into glucose very quickly.  Glucose is the main form of sugar that your body uses for energy.  Because your liver is very efficient in this process, you can get a blood sugar spike (sugar high) and then you crash after it’s over.  Insulin is the key to the door to let the glucose in your cells.

Fats can be turned into sugar by your liver is your glucose stores are depleted.  So, this can affect your blood sugar levels, although it’s less of an impact that carbohydrates.  Insulin has another job – fat storage.  If there’s a lot of fat, the insulin is being used up storing fat rather than allowing glucose into cells.

Proteins are promoted as a counterbalance to the carbs.  It causes a traffic jam in the absorption and metabolism processes that allows the sugars into the blood stream much slower.  The liver does have a process called gluconeogenesis (the creation of new sugar) where it can make sugar out of protein, but it’s a last resort.

Other things in your food

There is some evidence that shows caffeine causes temporary insulin resistance while it’s in the body.  You still get an “energized” feeling b/c caffeine increases the heart rate but the energy usage is not very efficient because the glucose is not being used well.

Alcohol can drop your blood sugar initially, especially if it’s consumed on an empty stomach.  When the liver is steadily detoxing the alcohol out of your bloodstream, the replenishment of the glucose supply slows down.  This contributes to what make you feel sleepy after drinking alcohol.  On the flip side, it will increase your blood sugar because 1) alcohol is usually mixed in a sugary drink (i.e. cocktails) and 2) alcohol is distilled from “high carb” sources (grapes, wheat, barley, rye, corn, etc).

Any changes to eating habits need to be exactly that – new habits.  It can’t just be a program that you do once without permanent change.  If you’re cutting out all or most of one of the 3 main energy sources, you have to make sure you keep up with your caloric needs.

Calorie Math

1 g of Fat = 9 calories

1 g of Carb = 4 calories

1 g of Protein = 3 calories

Calories are calories when it comes it energy, so the other nutrients from your foods are a more important to consider when choosing what to eat.

There are lots of things your body would have to adjust to when changing eating habits (digestion adjustments, for one) and 30 days may not be enough to get it “normalized”.

JDRF

The Nashville chapter of JDRF is having their annual One Walk on September 24th. Friend of the show and previous guest, Rachel Mayo has been #T1D for over 10 years and she is passionate about the cutting edge research and support JDRF provides for people and their families. Her goal is for her team to raise $5000, you can contribute!

Connect with me

Support us on Patreon

*NEW* Join the Pharmacist Answers Podcast Community on Facebook

Subscribe: iTunesStitcherGooglePlayTuneIn Radio

Like the Facebook page

Music Credit: “Radio Martini” Kevin MacLeod (incompetech.com)  Licensed under Creative Commons: By Attribution 3.0 http://creativecommons.org/licenses/by/3.0/