Type 1 Diabetes: Health and Lifestyle

Daron shares how type 1 diabetes has impacted his exercise routines and how he keeps a positive mindset. Diabetes nurse, Joanna Naylor, explains how working with a diabetes practitioner can help improve mental health and overall blood sugar management. Daron and Joanna also discuss the potential dangers of drinking alcohol as a person living with T1D.

This episode is part of a 5-part series focusing on a different aspects of managing life with type 1 or type 2 diabetes and is kindly supported by Diabetes New Zealand and sponsored by Sanofi New Zealand.

Disclaimer: These episodes are intended for a non-US audience. Units of measurement for blood glucose are referred to in mmol/L rather than the standard US mg/dL.

May 22, 2019

Rebecca: Hi there and welcome to In My Words, Jumo’s podcast series that brings the experiences of real patients directly to you. At Jumo we provide resources for children and families to understand, manage, and own their health.

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Daron: In my words, living a healthy lifestyle with type 1 diabetes means staying on top of your diabetes by testing your bloods, taking your insulin, and you can lead a perfectly healthy lifestyle.

Lee: Hi there! I’m Lee, and welcome back for another episode on diabetes. We’ve been in Auckland, New Zealand speaking with real patients and health care professionals about type 1 and type 2 diabetes. Today, we’ll be hearing from Daron again about living with type 1 diabetes and the impact it can have on your lifestyle and mental health. That was him at the beginning of this episode.

No one chooses to have type 1 diabetes, but you can choose how you live your life with diabetes. For Daron, after he was diagnosed at age 12, he chose to carry on with his life as he had been before, while staying on top of his diabetes.  

Daron: I still played league. As soon as I got out of hospital, I went straight back into league. I just made sure that I tested before a game and had juice at halftime and just took all the steps that you need to, to manage it, and get on top of it. So I’m proud of myself for not letting my diabetes get in the way. I've never taken a step back and thought, like, “no, that's too hard, I can't do that”. There's so many elite athletes in New Zealand that have type 1 diabetes. I know that there are top cricketers, there are top basketball players, athletes, track and field sprinters. For me being a kid when I heard that, it was really reassuring for me because I was kind of beginning to think like I can't do many things now, but when I could see that all these people if they managed their diabetes well were just carrying on and doing more than normal, they were actually like doing really well in their sport, I was just like, “Hell yeah! I can do that too!”

Lee: To this day, Daron still likes to exercise regularly.

Daron: I do, exercise heaps. I've maintained throughout the years. I've stopped playing league just because it's a bit too intense; I've got uni to worry about and all that kind of stuff. But when I can I'm in the gym. I like to pump iron and all that kind of stuff, all that good stuff, being a 21-year old male.

Lee: Exercise can be great for anybody. Particularly in type 1 diabetes, it can help control your blood sugar levels and it can also help protect your general health and wellbeing. When it comes to choosing what to do to be physically active, diabetes nurse, Joanna Naylor, has some useful and simple advice.

Joanna: The exercise I would recommend is whatever you like. So if you like doing Zumba, then do that. And if you like running, do that. So any form of exercise I would say go for it.

Lee: Everyone’s needs and abilities are different, so be sure to consult with your health care provider before starting any new exercise routines. In addition to exercise, what you eat also impacts your health. But how might having type 1 diabetes change your diet?

Joanna: So the dietary modifications that were recommended are very different now to what they were, say, 30 years ago where patients were recommended not to have any sugar and to have a very restrictive diet. And now we're much more relaxed and say you can really eat what you want, but we would recommend that you eat a healthy diet. And what we'll do as a diabetes practitioner is that we help you decide how much insulin you need to take to match different foods. So we would teach you how to look at carbohydrates and food contents. So yeah, you can eat what you want, but we would recommend that you don't have lots of full sugar things like fizzy drinks, and lots of high-carb-load-like sweets, and things like that, and really just a healthy diet. You can eat what you want, but healthy.

Lee: When it came to his diet, nothing much changed for Daron after he was diagnosed.

Daron: I haven't had to change much at all. When I want I can have lollies, I can have a Coke, I can have anything as long as I'm taking it in moderation and taking my insulin with it and that doesn't bother me at all. I just continue eating what I've normally had and it's done me well so far so I'm going to stick with it.

Lee: A well-structured life will make managing your diabetes easier, but even if your routine changes, you can still have good control of your diabetes. To stay on top of it, track it well and take your insulin like you were shown to. On different occasions, you may need to revisit the basics with your health care team and even discuss other options of how to take your insulin that could fit better with your lifestyle.

Joanna: Sometimes you get patients come into clinic and they've had diabetes for many, many years and they can get into quite bad habits when it comes to insulin injections. So it's going through the basics sometimes saying, “Are you rotating your sites properly? Are you giving your shots properly? Are you changing your needles every day?” And all those really basic things that you think, “Oh, I really don't need to be told this”, do make a massive difference. It's also about giving your insulin at the right time, so giving it with the meal rather than after the meal. All those things make a big difference, so it's just reminding patients that these things are important. And also you do get problems with needle phobia even though you have to give injections every day so it's looking at other options about how to give your injections that may make it easier for you.  

Lee: Daron works hard to control his diabetes and to live the life he chooses for himself, but it isn’t always easy. As much as he loves sports and exercise, exercise is what he has the most difficulty with when it comes to managing his diabetes.

Daron: I would say exercise for me in terms of managing diabetes has been the most difficult just because exercise throws in a factor that can affect your blood sugar on top of everything else. So when you exercise you burn all this energy and it can actually contribute to lowering your blood sugar.

The most frustrated I ever get with my diabetes is when I'm just about to train and I'll test my blood sugar and I'm low, because no matter what I do I have to stop what I'm doing and it's the only time in my life—ever—that I have to actually take a step back and let my diabetes do its thing. So, I've never felt so frustrated! I've driven to the gym, like it takes 15-20 minutes to get there, I'm all ready, I've got my gym clothes on, and I'm ready to train, I just want to put on headphones and just train away. And a few times I've had to just pack up my stuff, get in my car and angrily drive all the way home because the stupid thing called diabetes has gotten in the way of it.

Lee: Living with type 1 diabetes can be frustrating, especially when things don’t go as you plan, and it can also be stressful. The relationship between stress and diabetes is circular: stress makes your diabetes more difficult to manage and when your diabetes is harder to control, this can stress you out. Finding ways to manage your stress is key.

Joanna: Stress management for young people with diabetes is the same as stress management for all young people. So, find something that you know that you enjoy, so whether it's a sport or whether it's listen to music or just talking to some friends and having a stress outlet like that. But I think with diabetes and stress I mean there's also the added pressure that you think your diabetes control is so out that it's going to cause you long-term problems and it's just taking things day-by-day, not feeling guilty about things that have gone on with your diabetes in the past, and just moving on forward with it. But it is about talking to it and if you are struggling and you don't know how to manage it then talk to people and talk to your health[care] professional. Sometimes talking to the psychologists about how to manage anxiety about your health or any problem-solving things, they're really useful for helping out with that.

Lee: Diabetes can have a big impact on your mind and emotions, and you may find yourself feeling lonely and isolated.  

Joanna: I think a lot of people, young people have risk of loneliness and isolation, but I think with type 1 diabetes you can feel quite different. Nobody else that you know possibly has diabetes and you can feel quite isolated, especially if people don't understand what it's like to live with diabetes.

Daron: Feeling like you’re all alone, I definitely felt that. There were periods where I felt all alone, like I couldn't speak to anyone about it because no one had it. I can definitely tell you that I've felt down about my diabetes.

Joanna: Depression and diabetes don't go hand-in-hand but there's a higher risk of you having depression if you do have diabetes. It's a condition which is there all the time, and it can get you down and it can be quite tiring to live with it every day - particularly if it's not going as well as you want it to.

Lee: If you’re feeling down about your diabetes, there’s help.   

Joanna: There's lots of help out there so talk to your GP or talk to your diabetes team. And there's lots of counselling services that they can help you with this. Within diabetes services as well we've got specialists, health psychologists that can help support you through this, as well.

Lee: Getting help can give you support to shift the attitude you have toward your diabetes in a direction that will be most helpful to you. A positive attitude goes a long way toward living well with diabetes.

Daron: Everything is about attitude with diabetes. It's not just a disease. It's 80 to 90 percent even more mental. So everyone’s going to have problems with their diabetes and it's all about how you mentally can process that and get back on top of it. I think that's the biggest thing with diabetes. It's not even to do with taking all the insulin and counting your carbs. I think it's dealing with how you feel every single day and just making sure that you can get back on top and processing it and thinking like, “Yup, this isn't that bad, it can be worse”.

At the end of the day, the way that you handle it and look at your diabetes if you look at it in a negative way you're going to suffer and you're going to pretend it doesn't exist. But if you look at it in a positive way that you can actually use as a tool to actually help you achieve anything, then great! Go with that.

Lee: Your mental health is central to living a healthy life. Being mentally fit is something you must work at, but with this work comes the strength within you to accept your diabetes, keep at it, and be the best version of yourself.

The last topic we’ll talk about today is drinking alcohol. This is an important topic because some of our listeners are at an age when they might be thinking about or actually going out drinking with their friends.

Daron: In terms of drinking and having diabetes, I was always warned that it was quite a dangerous mix.

Lee: When you have type 1 diabetes drinking alcohol affects you differently than someone without diabetes.  

Joanna: It doesn't have an effect in the fact that you get drunker than somebody without diabetes, it has the same effect in that way, but it does affect your blood sugar control and you do need to bear this in mind when you are drinking. So when you do drink alcohol and you've got diabetes, it's likely to make your sugars rise initially, but then it puts you at greater risk of hypoglycaemia. And this is because of the liver, which produces glucose, trickles it out all the time, is busy trying to get rid of the alcohol, which it sees as a toxin so that you're more at risk of having lows, or “hypos”, when you've been drinking alcohol.

Lee: When you’re out partying and drinking alcohol, it can be so easy to put your testing to the side, but this is dangerous because drinking alcohol can impair your ability to clue in on how you’re feeling, and you can’t rely on the people around you to realize you’re in very real danger – especially if they don’t know you have diabetes.

Daron: The other big thing for being drunk or drinking with diabetes is that when you are drunk, the symptoms of being low and being drunk are very similar. So if you're even in a packed club or a party with hundreds of people there, they are just going to think, “Oh, this guy is just wasted. He’s falling over and he's on the floor. He's probably just sleeping”. So the first thing that people go through is just “this is normal behaviour” and with a type 1 diabetic there's every chance in the world that you are actually having like a serious medical issue.

Lee: No one wants to end up in the hospital at the end of a night out with their friends. If you plan on drinking, take precautions to make sure you’re safe and consuming alcohol responsibly.

Joanna: So don't get so drunk that you're out of control because you’ve drunk too much. Make sure you've got a friend with you that knows that you've got diabetes so that if you're slumped in a corner they don't think, “Oh, he's just drunk”; they might think, “Oh, actually maybe it's not alcohol. Maybe it’s something do with their diabetes”. And also when you’ve finished your night out and you want to go to bed, we would say make sure you have something to eat to make sure that it kind of buffers your blood glucose level through the night.

Lee: If you have any questions about drinking alcohol and your diabetes, speak with your doctor. Remember, when you’re at a party, always take care of your diabetes first. Be extremely careful if you’re drinking, and make sure someone you’re with, knows you have diabetes and knows what to do if you need help.    

We’ve covered a lot in today’s episode and learned that it is possible to have type 1 diabetes and live a perfectly healthy lifestyle. Daron is a wonderful example of how a positive attitude, commitment to staying on top of your diabetes, and fit mental and physical health can help you live well with diabetes.

Daron: I like to think of my diabetes as it not having a big effect on my life. I think the more you put into it, the more you'll get out of it.

You can 100 percent live a perfectly healthy normal lifestyle if you just handle your diabetes correctly like we've spoken about. All you need to do is stay on top, test your blood sugar, take insulin for the food you eat, and you are same as everyone else. I like that. I like the fact that I can live a perfectly normal healthy lifestyle if I take the right steps and that's all.

Lee: Beautiful! Thank you, Daron, and diabetes nurse Joanna Naylor, for your valuable insight on how to live a healthy lifestyle with type 1 diabetes. Next time on In My Words, we’ll be talking about type 1 diabetes and relationships. Stay tuned!

This episode was created using excerpts from our interviews with Daron McCarthy and Joanna Naylor.

This episode has kindly been supported by Diabetes New Zealand and sponsored by Sanofi New Zealand.

Rebecca: Thanks for listening! Interested in hearing something special - or want us to help share your story? Reach out to us, we’d love to hear from you! See you next time!

The health information contained in this Podcast is provided for educational purposes only and is not intended to replace discussions with a health care provider.

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