Cecelia Health and Beyond Type 1 Diabetes Q&A

By ErinRose Baldry

Cecelia Health and Beyond Type 1 Diabetes Q&A

Cecelia Health hosted a live diabetes Q&A in partnership with Beyond Type 1 and their counterpart Beyond Type 2. The panel discussion was moderated by Victor Baldry (Cecelia Health), Dana Howe (Beyond Type 1), T’ara Smith (Beyond Type 2) and featured diabetes insights from Cecelia Health’s Certified Diabetes Care and Education Specialists Andrea Castleberry, Raylene Foster, and Wendy Gregor.

This event resulted in an extremely interesting discussion for persons living with diabetes, touching upon how to manage various situations during a pandemic including, health, wellness and mental health. Below summarizes the questions discussed.

The video recording of the event can be found below:

Question: What are some of the different ways the shelter in place has impacted the self care in diabetes management? 

Impacts:

This has presented several challenges for persons living with diabetes. The most common impact as a result of quarantining has been increased HbA1c due to decreased physical activity, lack of gym routine, constant visual food cues for increased snacking and eating, and general increased levels of stress associated with potential job losses and/or isolation during quarantine. All of these variables can have a detrimental impact on glucose levels and results in unwanted and unplanned higher than usual glucose levels. 

Tips for success: 

  • Incorporate exercise and movement into your daily habits and schedules, try to find ways to be mindful with your movement, set realistic targets, eg. get up from your seat at least once per hour to stretch or take a short walk.
  • Remove excessive amounts of snack/junk food at home (visual queues), practice more at home cooking to create healthy and interesting meals, prepare more fruits and vegetables so they are readily available to snack on when hunger strikes.
  • Make simple, easy meals with predictable food ingredients especially if you are new to cooking, include fresh herbs, spices, lemon, vinegar to interest and taste to foods. As you get more comfortable with food ingredients and how to dose insulin for these foods, you can slowly add more ingredients to determine how your body reacts and how best to manage glucose levels for these different foods.

Impacts:

People are judging themselves more through negative self talk during quarantine.

Tips for success: 

  • Have self compassion, patience and self love, it is an unprecedented, unplanned time, have grace with yourself and others, managing diabetes is challenging at the best of times and hiccups and unplanned results will happen, correct, move on and keep focused on the positive moments of each day.
  • Remember to connect with other persons living with diabetes, you are not alone.
  • Aim to find mindful ways to manage stress regularly throughout each day to prevent stress from taking over your mental health and happiness. This may include meditation, prayer, mindfulness activities such as yoga and breathing exercises.
  • Be intentional with yourself each day

Question: Are there any trends with care management since COVID?

Impact:

Some find it easier because medications, food and other necessities can easily be delivered to your home. Conversely, others find it hard because they feel isolated at home. 

Tips for success:

  • Where possible, embrace the convenience of telehealth modalities. This allows people to maintain regular contact with their providers for advice, without risking their health or unnecessarily exposing themselves to other potential contagions. In many ways live video telehealth options can result in more personal care by seeing people in their own homes.
  • When it is necessary or preferable to see providers live in person, maintain healthy habits, wear a mask, avoid busy times of day and ask your provider about scheduling a time when their offices are least busy. 

Question: Are there work safety concerns as a result of COVID?

Impact:

You are unable to work from home and you have concerns about your work environment.

Tips for success:

  • Minimize exposure as much as possible, practice frequent hand washing, wear a mask and ensure others around you also wear a mask.
  • Practice good mask hygiene. Make sure hands are clean/sanitized before removing mask, throw mask away after each encounter if disposable, or wash mask daily after removing it with clean hands each evening. 
  • Try to set up a work environment to minimize face to face contact. 
  • Speak with your doctor to assess any comorbidities regarding your health, to determine when and how it’s appropriate to return to work as before, OR if needed, to make modifications at work to ensure your health.

Question: Is there a spectrum of activities that should be returned to and when?

Issue:

Returning to everyday “normal activities” differs wildly on a case by case, and country by country. It depends on several different variables and factors. 

Tips for success:

  • Consider air quality and filtration in your area.
  • Consider population density.
  • Consider whether others are maintaining healthy social distancing habits (mask wearing etc).
  • Consider case numbers in your area and local and national government guidelines.
  • Consider how well your BG is controlled (poorly maintained glucose levels increase your risk of complications if COVID is contracted, conversely, you are at lower risk for complications with well maintaintained in range glucose levels).

Question: Are there any special considerations for the elderly population and living with diabetes?

Impact:

The elderly population living with chronic illness is among the most vulnerable. It is therefore imperative that they do everything possible to take care of themselves, and for us to take care of them in any capacity that is safe and within our abilities. This population also has exacerbated feelings of loneliness, depression, sadness and anxiety. 

Tips for success:

  • Remind seniors how to disinfect homes. Use alcohol on wipes and thoroughly cleanse all surfaces regularly, pay particular attention to commonly touched areas (eg. door knobs, remotes, phones, counters, appliances, handles).
  • If you are visiting an elderly person, everybody needs to maintain distance, wear masks, avoid showing affection physically. 
  • Use kind, reassuring works.
  • Regularly reach out to elderly loved ones using video or phone calls. 
  • Offer to help get groceries and shopping for older members of the community if it is healthy and safe for you to do so.
  • Help them do online shopping.
  • Older people may be too proud to ask for help, take initiative to send medical supplies, medication or food because they may feel ashamed to ask.

Question: How can you stay active at home with gyms closed?

Impact:

Exercise routine and physical activity have diminished significantly as a result of social distancing orders and stay at home orders. 

Tips for success:

  • Find movement throughout your day in routine activities and chores such as cleaning, vacuuming, dusting.
  • Set small targets for yourself to get up out of your chair every hour.
  • Go for a walk, run or bike ride if it’s safe to do so, incorporate some form of movement and cardiovascular activity into your daily routine.
  • Find ways to work your leg muscles every day, they are the biggest group of muscles in the body and working these muscles utilizes the most amount of glucose, thus enhancing insulin sensitivity.
  • Try free at home exercise videos online.
  • Incorporate resistance training bands/light weights into your routine.

Impact:

For people living with Type 1 diabetes, glucose levels can vary wildly depending on type of exercise, activity, this can prove especially challenging for those aiming to maintain or lose weight. 

Tips for success:

  • Choose times of day to exercise when you do not have lots of food or insulin on board, and/or when you tend to have higher glucose levels to mitigate against unwanted empty carb/calorie consumption to combat an unwanted low glucose level.  
  • Adjust basal settings prior to physical activity to prevent unwanted higher or lower glucose levels.
  • Different types of exercise can result in different glucose level reactions. Keep an exercise journal. Log food, activity and behaviors to determine trends to learn your body and glucose reactions depending on these variables, in order to determine what works for your body.
  • Resistance training can cause a small surge in glucose. This is temporary and there often tends to be a latent drop hours later. 
  • Always speak with the provider before making changes to insulin settings. 
  • You can exercise with diabetes, don't let a negative glucose event deter your efforts. 
  • Bodies respond well to routine and recurring habits.

Impact:

People living with Type 2 diabetes may have different needs to maintain in range glucose levels, particularly around meal times. Insulin and types of treatment differ to those living with T1.

Tips for success:

  • For those living with T2, exercise is the best way to prevent spikes in glucose levels.
  • It is recommended to have some form of light exercise or movement post meals to prevent a surge in glucose levels, eg. 10-15minute walk post meals.
  • Find habits and routines, be consistent with healthy eating and exercise. 
  • Whether you are a person living with T1 or T2, if you are trying a new activity, expect for results not to work out as planned, it takes time, practice and routine to learn your body’s reactions to each type of activity. You will have success over time. 

Question: Advice for somebody who has fear of hypo-glycemia, especially overnight.

Impact:

People living with diabetes often have fears of going low overnight, and as a result, they under correct higher than optimal levels. Fear is good and normal, it acts as a checks and balance to our safety and wellbeing. However, too much fear can cause glucose levels to run unnecessarily high over a prolonged period of time, especially overnight.

Tips for success:

  • If possible, utilize a continuous glucose monitor that alerts you of out of range glucose levels, so you can respond quickly to prevent dangerous lows and correct highs before they become sustained. 
  • Consume a high protein and low carb snack to keep glucose levels steady overnight.
  • Keep a glucose journal to help see what type of snacks work well. 
  • Make small adjustments to obtain in range levels overnight, this takes time and patience but is well worth the effort as over half your hBA1c is based on overnight numbers. 

Question: How can one manage diabetes burnout and anxiety, especially during COVID?

Impact:

Burn-out is real and it can be hard to move past.  

Tips for success:

  • Burn-out is normal and it is OKAY to experience these emotions. Diabetes is stressful.
  • Accept where you are in your mental health journal at the present time with living with diabetes. It is okay to feel frustrated, overwhelmed, afraid. 
  • Acknowledge your efforts and take things one step at a time.
  • Aim to make small mindful changes, rather than strive for an impossibility of perfection.
  • Practice the “1 day at a time plan” for coping with diabetes distress. This includes-
    • Find 1 good and positive thing about each day that you want to keep doing,
    • Find 1 thing you want to stop/let go of that’s not helpful or beneficial,
    • Find 1 thing you want to change, or try to add to your day, try it and see if it helps, if it doesn't you don't need to keep it.
  • Recognize the small building blocks of positivity and change, each small accomplish counts.
  • Practice ways throughout the day to quiet the mind and body through “quiet and response,” eg. say a quieting phrase like “it’s alright” or “I’m okay” , then take 2 deep cleansing breaths, and with each exillation, release the physical tension you are holding, such as jaw clenching or tensing muscles.

If you would like to learn more about diabetes management, please refer to the following resources:

Subscribe to the Cecelia Health Blog

Never miss a blog article. Sign up to receive one email per week rounding up our latest diabetes management content, industry innovation updates, and company news.

Orignially published on July 13, 2020, updated on July 13, 2020

Topic: COVID19

ErinRose Baldry

About ErinRose Baldry

ErinRose Baldry is an ACE Nutrition Specialist and Certified Personal Trainer. She integrates her knowledge in fitness, wellness, cooking and nutrition to offer dynamic, engaging, relevant information for her clients and in her writing. She provides effective, manageable guidance and tips for all populations who aim to be the best version of themselves both in health and fitness. In addition, she advocates for local charities and educates families on the importance of healthy eating, nutrition and exercise.