Everything You Need to Know About Pre-Diabetes
The CDC and National Institutes of Health estimate that tens of millions of American adults have pre-diabetes, with approximately 80%–85% remaining undiagnosed. This is largely because pre-diabetes typically presents no noticeable symptoms, leading individuals to feel healthy and not seek blood glucose testing. Factors such as limited access to healthcare and infrequent routine check-ups and blood work further contribute to underdiagnosis.
Why pre-diabetes happens.
There is not one single cause, it usually develops from a combination of genetic predisposition and lifestyle-related factors.
Genetics, you may have a higher risk if:
You have a parent or sibling with type 2 diabetes
You are Asian, Black, Hispanic/Latino, Native American, or Pacific Islander
You experience gestational diabetes
Lifestyle-related factors
Nutrition & Patterns of eating
Highly processed foods
Frequent sugary drinks
Large portions + irregular meals
Low fiber intake
Physical Inactivity
When we move less insulin becomes less effective
Glucose stays in the bloodstream longer
Stress, Sleep and Hormones- this is often ignored…
Stress hormones increase glucose and insulin resistance
Poor sleep affects appetite, cravings, and energy
Chronic inflammation worsens body feedback loops
What pre-diabetes feels like
May people have no symptoms at all. Others may notice:
· Fatigue, increased hunger, difficulty losing weight, brain fog, sugar cravings, skin darkening around the neck or armpits.
These are signals—not failures.
Your A1C Matters
How your body processes glucose is an indicator for pre-diabetes. Pre-diabetes occurs when blood glucose levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. Think of a diagnosis of pre-diabetes as a warning light, your body is telling you to it needs a tune up and to make some changes. A blood test (different from a finger-stick) measures your A1C, showing average blood glucose over 90 days. A1C percentages are utilized because they do not require fasting, provide insight into long-term glycemic patterns, serve as effective predictors of potential complications, and assist in monitoring the impact of lifestyle or medication adjustments.
Your A1C measures how much glucose (sugar) has attached to hemoglobin a protein in red blood cells which carry oxygen. Red blood cells last around three months, which is why the measurement covers a 90-day span. While an A1C test reflects your average glucose levels over that period, a finger stick provides your blood sugar level at that specific moment. The US standard for A1C is important to know as this is how you would be diagnosed with pre-diabetes or diabetes. A normal A1C is 5.7%, pre-diabetes is 5.7%-6.4% and diabetes is 6.5% or higher. Do you know your A1C? When was the last time you had blood work?
With an A1C mildly elevated, 5.7%-5.9% (estimated glucose finger reading is 117 mg/dL) this is considered early pre-diabetes. Your body may be starting to struggle with insulin efficiency. You have the opportunity to reverse your A1C in 3-6 months with lifestyle and diet changes. Moving to moderate risk, 6.0%-6.2% (estimated glucose finger reading is 126 mg/dL) this is where insulin resistance is occurring. You may see post-meal spikes due to the body needing more insulin to regulate glucose. This can also be reduced with a more structure diet, movement and stress reduction exercises. And the high end of pre-diabetes is 6.3%-6.4% (estimated glucose finger reading is 137 mg/dL) this is very close to the type 2 diabetes cutoff number. This can be reduced by active management with the support of medical doctors, diet, sleep, stress management and daily movement.
Some important limitations for A1C percentages
· You have anemia, low iron, or vitamin B12 deficiency
· You have kidney disease
· You’re pregnant
· You recently had blood loss or transfusion
· You have hemoglobin variants which are more common in
African/African American,
Mediterranean populations including Greeks, Italians and southern Europeans,
Southeast Asian especially, Thailand, Cambodia, Laos, Vietnam and Myanmar,
South Asian especially India, Bangladesh, Pakistan and Sri Lanka,
Middle Eastern especially Arabian Peninsula, Iran, Iraq, Yemen, Lebanon, and Jordan.
If you have a hemoglobin variant other lab work can be done such as fasting glucose, oral glucose tolerance test,
SMBG and/or a continuous glucose monitor (CGM) may be used to get an accurate A1C percentage.
If you think you have a hemoglobin variant be sure to talk with your medical doctor.
Truth is Pre-Diabetes is Reversable
Pre-diabetes is a warning to make some changes. Lifestyle, nutrition and movement changes can stop the progression to type 2 diabetes, lower blood glucose, improve energy and insulin sensitivity, and improve mental health. Consistency and small changes are key to positive lifestyle changes. Your journey is personal. Enjoy. Breathe. Be present.
You Don’t Have to Apologize for Eating: Holiday Food and for Diabetes.
The holiday season is supposed to be about connection, and celebration. But if you live with diabetes, holiday meals can feel like walking through a minefield of comments, questions, judgements and unsolicited advice.
“Should you eat that?”
“Isn’t that bad for your blood sugar?”
“I thought diabetics weren’t supposed to have carbs.”
Suddenly you’re no longer a person enjoying a moment—you’re an object being monitored by everyone at the table. This is not only uncomfortable and often embarrassing but it makes us feel less then. We have to eat, diabetics have to eat, everyone has to eat. Let’s talk about why you do not owe anyone an apology for eating anything during the holidays.
Food Isn’t a Moral Issue.
Somewhere along the way, our culture turned food into a scorecard: good vs. bad, clean vs. unhealthy, allowed vs. forbidden. For people with diabetes, the pressure becomes a heaviness, a source of negative thoughts and feelings about us. The problem is… none of this is how diabetes management actually works.
Food is nourishment, comfort, celebration, and culture. It’s how many of us connect with the people we love. It’s also about tradition, memories and well-being. You don’t have to lose yourself, your traditions and your memories because you have diabetes.
Diabetes Management Is Personal
The reality is that diabetes is not one-size-fits-all. Each of us has our way of managing our sugars, our eating, our medications and our routines. Only you and your healthcare team understand how your body responds to food. A plate of mashed potatoes or a slice of pie doesn’t suddenly mean you’re “failing.” It means you’re living your life.
Let’s Retire the Word “cheat” and “cheat meal”
The phrase “cheat meal” is damaging. It implies: You’re breaking rules, you’re doing something wrong and you should feel guilty. What you’re actually doing is participating in a social habit, a family gathering or just spending time with those you care about. You aren’t cheating on yourself. If you choose dessert, it isn’t a secret act of rebellion or shame. It’s a moment of joy and it’s normal to want to end a nice meal or begin the meal with a sweet treat. Feeling joy with food is not unhealthy.
Setting Boundaries at the Table and with your plate
For many people with diabetes, the hardest part isn’t the food—it’s the comments. You don’t need to justify your plate, your medication, or your glucose numbers. You can set gentle boundaries that protect your peace:
“I’m managing my health in the way that works for me.”
“I appreciate your concern, but I’m okay.”
“My diabetes is personal—let’s just enjoy the meal.”
“I’m working on my health.”
You’re not being rude. You’re practicing self-respect and good boundaries.
Diabetes isn’t managed in a single meal.
A holiday plate is a moment in time—not the entire story of your health.
It is okay to:
Eat that cookie, pie, cake or whatever you choose!
Take seconds of your favorite holiday food
Taste something your family member or friend made with love
You’re not irresponsible. You’re not weak. You’re not doing anything wrong.
You’re a human being enjoying a holiday meal—just like everyone else.
If you needed to hear this:
You deserve peace at the dinner table.
You deserve to be included.
You deserve food without guilt and joy without explanation.
Eat without apologizing.
Happy Thanksgiving!
World Diabetes Day November 14th 💙Diabetes, Well-Being & Work
World Diabetes Day 2025
Today is World Diabetes Day 💙
Know more and do more for diabetes at work.
This year’s theme, Diabetes, Well-Being & Work. Which reminds us, diabetes isn’t “just about blood sugar.” It impacts mental health, energy, work, relationships, and self-worth. Around the world, an estimated 1 in 9 adults live with diabetes or around 589 million adults worldwide – and many are trying to manage it quietly at work, between meetings, with limited breaks and under stress.
Diabetes care does not stop upon arriving or clocking in at work. It follows us…
What diabetes at work really looks like is needing to check glucose before/after a meeting or meals, taking medications and/or insulin on schedule, managing stigma about food and being “diabetic” all while managing fatigue, brain fog, mood changes and stress. And some days, lunch was skipped.
Living with type 2 diabetes can increase stress, anxiety, and depression. Especially when we feel like we have to hide what we are managing. We deserve workplaces that offer flexible breaks to check our glucose or eat, flexibility and normalization for medical appointments without guilt, having a private space for injections, finger pricks or CGM checks and understanding instead of stigma. We deserve a non-judgmental workspace with open conversations. Afterall, it all starts with a conversation.
This may be a good time to have a conversation with your medical doctor about reasonable work accommodations. Diabetes is a disability and you can ask your employer for reasonable accommodations in the workplace. A good resource for work accommodations is the American Diabetes Association, https://diabetes.org/advocacy/know-your-rights/common-reasonable-accommodations.
If you live with type 2 diabetes, please know: you are not a burden, you are not “too much,” and you deserve support. You deserve safety and compassion. Your needs at work and at home are valid. Taking a break to check your glucose is healthcare and self-care, NOT laziness. Asking for support is strength, not weakness.
If you’re an employer or coworker: Your empathy can change someone’s day—and their health. By asking, one simple question, you can change everything: Is there anything you need to help manage your health at work?
To everyone living with diabetes: I see you. Your health matters every day of the year.
The Hidden Link Between Mental Health and Type 2 Diabetes: What Most People Don't Know.
Type 2 diabetes is not just about blood sugar numbers-- it's also about burnout, anxiety, depression and emotional resilience. Often times mental health symptoms are ignored.
There is a cyclical effect with chronic stress on blood glucose. When we are in a state of chronic stress our cortisol increases, which directly impacts blood glucose. Cortisol is a hormone produced by the adrenal glands; it is often referred to as the “stress hormone.” Cortisol in the short term helps our body increase alertness, gain energy which raises blood glucose and suppresses our digestion and immunity. This is part of our body is the normal survival mechanism of fight or flight.
People with type 2 diabetes, who have chronic stress and elevated cortisol levels are going to have high blood sugar. Cortisol raises our blood glucose in three distinct ways, 1. Increased gluconeogenesis, when this occurs cortisol signals our liver to produce and release more glucose into the bloodstream. 2. Reduced insulin sensitivity, this happens when our cells become less responsive to insulin. Glucose builds up in our blood instead of entering our cells. And 3. Inhibited glucose uptake. When this occurs our muscles and fat tissues absorb less glucose due to high cortisol levels. Over time, our blood glucose is elevated when fasting, we have post-meal spikes, and it becomes more difficult to maintain our normal glucose range.
When we have chronic stress, this equals chronic blood glucose problems. Psychological stress, poor sleep, pain, overworking, etc. contributes to insulin resistance, fat gain, erratic blood glucose, and high A1C’s. For those with type 2 diabetes this can look like unexplained glucose spikes, energy crashes, fatigue, mood swings, brain fog, anger, frustration and diabetes burnout.
How can we lower our cortisol and blood sugar? The answer is lifestyle changes and increasing self-care that targets stress reduction. This balance will help regulate cortisol levels and blood glucose. Some strategies include, mindfulness exercises focusing on self-compassion, increasing our sleep to 7-9 hours, increasing exercise like walking, using breathwork and relaxation exercises, going to therapy and increasing our social support. Grab a coffee with a friend!
Some key takeaways, cortisol is part of the body’s natural survival system. With chronic stress, we are always “on.” If you have type 2 diabetes or are at risk, understanding and managing cortisol levels are vital to maintaining normal range blood glucose. If you are in need of assistance, contact me for coaching (in the USA) and/or therapy (for CA residents only).
New Year…Open up your right brain!
I have taken some time to reflect and give myself some self-care over the past few months. As we approach the second month of 2025, reflecting seems like an appropriate thing to do. The new year always seems to be a new start or a new beginning. I don’t know about you but for me this past month was hard. So many people are going through crises and all of the tragic events that have occurred, seems to make the world a hard place to be in right now. When I feel like a need some time to reflect or re-center, I increase my self-care.
For me, self-care this year so far has been about setting firm boundaries, not apologizing, taking adult time outs to read, cook or unplug from my phone. I have also started an art journal. I was on LinkedIn and saw a post about an art journal and was instantly hooked. I have a blank sketch book that I bought at the start of 2025 and every weekend I have been creating in my art journal. The beautiful things is, there are no rules! You can write words, draw, paint, cut out pictures, print pictures and/or just be present with your feelings. I have found that this art journal is a way for me to reconnect with my right brain and be creative. I have created a space in my house that is my art/creative corner. I have all of my art supplies in one place, and they are easy to get to. I have an art desk that I bought after Christmas and a table to spread out my ideas. This year seems to be about rediscovering my creative side and opening up my right brain to feel and allow myself to be creative. The creativity of an art journal has been a nice outlet for me to process my feelings, dreams, grief and worries.
Our right brain differs from our left brain with creativity, imagination, insight, emotion, music and art being the center. It is also where our dreams generate, where our sleep wake cycle occurs and personality traits of intuition, creativity and emotional sensitivity lie. You may hear the right brain be referred to as the “creative brain” or “artistic brain.” Both the right and left brain work together to process information and perform complex tasks. It can be said that people with right brain dominance pursue careers in art, music or psychology. I feel like I do so much analysis in my job, which is mostly left brain dominant, that my right brain has become less dominate in some ways. My art journal has become an outlet of healing and has opened up new neuro pathways for my right brain to once again find some balance.
I encourage you to find an outlet for your creativity and increase your self-care through right brain activities.
World Diabetes Awareness Day, November 14, 2024
In the month of November, we are kicking off National Diabetes month! Today, Thursday November 14th is World Diabetes Day. I challenge you to wear blue or find the blue circle which is a global symbol of diabetes awareness. Post on your social media and help spread awareness.
There are many ways you can participate in National Diabetes Month; one is by joining the #BlueBalloonChallenge and tag @medtronicdiabetes. The Blue Balloon Challenge is to raise awareness of the burden of managing diabetes. You can find more information at https://www.medtronicdiabetes.com/blue-balloon-challenge?utm_source=blog&utm_medium=web&utm_campaign=10ways-diabetesawareness. Or you can share your own story or support by wearing blue on Fridays in the month of November. The American Diabetes Association offers many ways to get involved including posting on your social media. Here is the link for resources https://diabetes.org/adm.
If you’re wondering if you may have Type 2 Diabetes the American Diabetes Association has a free risk test available online. https://diabetes.org/diabetes-risk-test. This may be a great way to begin your own health journey of discovery or ask important questions of your family members who have pre-diabetes or diabetes. It is never too late to begin taking care of you!
November is National Diabetes Month.
In the month of November, we are kicking off National Diabetes month!
I wanted to share my diabetes story. I was 24 when I was diagnosed with Type 2 Diabetes. When I heard this diagnosis, I was shocked. I had no idea how this happened to me. The only thing I did know, was my family history of T2D. My primary care doctor sent me to a diabetes community class where I leaned about blood sugars, how to test my blood sugars and track them using a meter and logbook. I was the youngest person in this diabetes class, and I felt very out of place. I spent years in denial, ate what I wanted and trying to figure out how diabetes and I could be friends.
If I am honest, I really did not begin to understand how diabetes and my body fought each other until I was diagnosed with gastroparesis in my 40’s. The condition is weakness in the stomach and significantly effects digestion. The gastroenterologist, gave me an outdated piece of paper from the 90’s and told to eat a Low Fodmap diet https://www.monashfodmap.com/ibs-central/i-have-ibs/starting-the-low-fodmap-diet/. He said the only way to reduce the symptoms was the diet and he could give me medication for the nausea only. Again, a moment of shock set in.
I found myself hearing once again hearing a diagnosis that was diabetes related with an outdated piece of printed paper about a diet that was dated 1994. Little did I know this diagnosis would change the way I eat, how I look at food and ultimately effect how I manage my diabetes. At this point, I was so miserable from not eating much food and felt so sick because my stomach was not emptying. And the nausea and dry heaving were unbearable. I was fortunate that it was the Christmas season, and I was scheduled to take time off of work. During my time off, I threw myself into Monash University’s Low Fodmap class and downloaded their free app. The Low Fodmap diet was intense and took months to complete the 3-step diet process. The app saved me so much time and it is extremely easy to use. Here is the link if you’re interested in learning more, https://www.monashfodmap.com/ibs-central/i-have-ibs/get-the-app/
After months of eliminating foods and finding out which FODMAPs my body could tolerate, I found myself eating a diet of gluten- free and eliminating garlic, onion, gluten, alcohol, protein powders and most processed foods.
During this time, I also started food prepping every Sunday for my work week ahead because I could not eat out due to the severity of my symptoms. I also advocated with my insurance company that I needed a CGM because I was on insulin, and I wanted to begin to monitor how my body was processing and digesting food. I know it takes 2-3 hours for my body to process a meal. Eventually the insurance company agreed to give me a CGM. I know this may sound like many changes all at once and it was overwhelming, but I felt like I had no choice. I was desperate for relief and to feel “normal” again even with T2D.
I can honestly say the past two years of changing my diet, understanding how my body processes food and gathering data from my CGM has gotten me to a better place mentally and physically. If anything, I learned that I come first when it comes to my health. I advocate constantly with my doctors and when eating out. I order from the gluten-free menu and I make sure to bring my own food when I can. It makes my life easier.
For the rest of November, I am showing support for all people with Diabetes by wearing blue on Fridays. The American Diabetes Association offers many ways to get involved including posting on your social media. Here is the link for resources https://diabetes.org/adm.
If you’re wondering if you may have Type 2 Diabetes the American Diabetes Association has a free risk test available online. https://diabetes.org/diabetes-risk-test. This may be a great way to begin your own health journey or prompt you to ask important questions of your family members who have pre-diabetes or diabetes. It is never too late to begin taking care of you!
Type 2 Diabetes and Perimenopause Part 3
In wrapping up this month’s blog series on perimenopause and type 2 diabetes. The transition stage of perimenopause can impact us biological females in many ways. We have learned the effects of perimenopause symptoms and mental health. Research has shown that 60-86% of women experience menopause symptoms so severe they seek out medical care. Due to lack of patient care and concern most female’s week their own solutions to reduce symptoms. Nutrition is an area to explore to reduce the risk of chronic diseases and help control perimenopause symptoms. Finding a dietician or certified diabetes education and care specialist that can help you focus your food and weight goals is the best option when support and guidance is needed. Learning about a healthy diet and healthy food options for you, will assist in managing some perimenopause symptoms. With the diet culture being heavily individualized and money focused at $30 billion a year, it seems we need to know we have choices when it comes to our nutrition.
Some research studies have shown the Mediterranean diet, and low-calorie diets can have positive effects on chronic illness and weight management. Consulting with your medical team is important to figure out which dietary recommendations fit your health needs. The National Institute of Health recommends eating a healthy fiber-rich diet with more vegetables, fruits, whole grains, legumes, nuts, seeds, fish and lean meats along with healthy fats like olive oil, which can relieve or prevent some symptoms. Things to keep in mind when incorporating a fiber rich diet, 1. always check your food labels, 2. start slow and 3. drink more fluids. According to the Mayo Clinic, the examples listed begin with the most fiber and end with the lease amount of fiber. Fiber-rich vegetables include 1 cup of green peas, boiled; 1 cup chopped broccoli, boiled; 1 medium potato with skin baked; 1 cup sweet corn, boiled; 1 cup chopped raw cauliflower; and 1 medium carrot, raw. Some examples of fiber-rich fruits include 1 cup raspberries; 1 medium pear, 1 medium apple with skin; 1 medium banana; and 1 cup of strawberries. Some examples of fiber rich grains include 1 cup cooked whole-wheat spaghetti; 1 cup cooked Quinoa, 1 cup instant cooked Oatmeal; 3 cups air-popped popcorn; 1 cup brown rice cooked; and 1 slice Rye bread. And examples of legumes, nuts and seeds include 1 cup split peas, boiled; 1 cup Lentil, boiled; 1 cup Black beans, boiled; 1 ounce chia seeds; Almonds 1 ounce (about 23 nuts); and Pistachios 1 ounce (about 49 nuts).
According to the American Diabetes Association, our plates should be 1/2 non-starchy vegetables, ¼ carbs and ¼ protein. Non-starchy vegetables include dark leafy greens like spinach, collards and kale. They also recommend avocado as a heart healthy fat. Proteins include beans- kidney, pinto, navy, or black beans. Legumes- chickpeas, split peas, and lentils. Fish high in Omega-3 fatty acids include salmon, herring, sardines, mackerel, trout and albacore tuna. Nuts- walnuts, flax seeds are also rich in omega-3 fatty acids. For carbs ADA recommends berries, citrus fruit and whole grains of whole oats, quinoa, barley, farro and whole wheat. If you’re on a budget and want to start eating as the ADA recommends, shop local for in-season and on sale items. Frozen or canned vegetables and fruits is a great option. Be sure to choose no added sugar or sauces. Rinsing canned vegetables can reduce sodium. Frozen or canned fish and low sodium nuts is recommended. Dry beans and legumes is also recommended. If you are searching for type 2 diabetes recipes, the American Diabetes Association has a food hub on their website that is free!
In ending this blog series, my hope is that you have gained some knowledge and feel empowered to make better choices for yourself.
Type 2 Diabetes and Perimenopause Part 2
In continuing this month’s blog series on perimenopause and type 2 diabetes. I wanted to focus more on mental health symptoms. Perimenopause can cause symptoms of anxiety, depression, brain fog and memory problems. And we can also experience irritability and anger. Research has shown that 1 in 5 American’s will experience a mental illness or disorder at some point in their lifetime and that people with type 2 diabetes are 20% more likely to have anxiety than those without. Some common symptoms of anxiety include sweating, shaking, trouble sleeping, trouble concentrating or making decisions, feeling irritable, tense or restless, experiencing nausea, and having a sense of impending danger, panic or doom. These symptoms can to a type 2 diabetic who is insulin dependent feel like a hypoglycemic episode. How you can tell the difference is test your blood sugar. If you are below 70, you’re most likely experiencing a hypo-episode.
Symptoms of depression include increased anger, irritability, feeling restless, or on edge, wanting to isolate or feeling detached, greater impulsivity, and feeling down. Exercising, self-care, diabetes management and/or medications are great ways to reduce depression. Also seeing a mental health provider who also has knowledge of type 2 diabetes can be beneficial.
In addition, brain fog can look like difficulty concentrating or focusing, confusion, fatigue, forgetfulness, losing your train of thought, not having the right words and slow thought process and reaction time. These symptoms should be taken seriously and if you are experiencing more than one of these on a daily basis, making an appointment with your health care provider is recommended. The difference between brain fog and memory problems is you could be experiencing a physical complication from a concussion, head injury, blood clots, brain infection, thyroid, kidney or live problems, medication side effects, and sleep problems. We also see mental health symptoms of depression and/or anxiety with memory problems. If you are also misusing alcohol or drugs, you may be experiencing memory problems. These symptoms should be taken seriously and if you are experiencing more than one of these on a daily basis, making an appointment with your health care provider is recommended.
Lastly, the complications of perimenopause, type 2 diabetes and mental health symptoms are things we should see our health care providers about. It may be a good time to schedule blood work and a physical or your annual diabetes exam(s). Most importantly, you are not alone and if you need help, please reach out to those you trust. Type 2 diabetes can be isolating enough but when you add on perimenopause and mental health struggles, it can feel very overwhelming. If you are experiencing any mental health symptoms, there is help available 24/7 by calling or texting 988 the national suicide and crisis lifeline.
Type 2 Diabetes and Perimenopause Part 1
This month’s blog serious is going to focus on perimenopause and type 2 diabetes. Recently, I have been going through some perimenopause symptoms and wanted to do some research, share my story and my findings with all of you. I am hoping this will also help others understand the noticeable changes within their biologically female bodies. Some symptoms I currently am going through include hot flashes, trouble sleeping, mood changes, night sweats, headaches and being more emotional than what we would consider to be the normal ups/downs. What I have noticed with these perimenopause symptoms is it makes managing my type 2 diabetes and blood sugars more difficult. This from what I have read is a classic symptom of perimenopause and type 2 diabetes. As the production of estrogen and progesterone decrease this can cause blood sugar fluctuations. This news was incredibly helpful to me as I sat stumped a few times a month over the past year wondering why my insulin dose was “not working.” I soon figured out that my insulin dosage was correct, but it was the biological aging process of my female body being in perimenopause and the reduction of hormones was why my insulin seemed to “not be working effectively.” When it comes down to the science of perimenopause and type 2 diabetes, we as biological women can feel off mentally and physically.
Also, in my reading and research physical symptoms of stress and fatigue due to perimenopause can feel like a double whammy to those of us with type 2 diabetes. Fatigue has set in less for me as I have increased my exercise routine. But I do have days where I feel physically tired and fatigued. If I am feeling this way, I rest.
Lastly, other common perimenopause symptoms include irregular periods, hair changes, vaginal dryness, weight gain and redistribution. With some of these symptoms it can further explain those changes we might be seeing within our bodies, but it can also help us advocate to our health care providers when we need to. Type 2 diabetes is a numbers and weight game in our healthcare system. If we know as a biological woman, we are going through perimenopause, we now have explanations for the biological struggles of trying to lose weight and lowering our A1C and blood sugars. We can try as hard as possible to manage our type 2 diabetes, our food portions, our exercise routine and still not get any results or the results our healthcare providers want. We need to give ourselves some grace knowing that perimenopause is a natural part of aging for biological females and all we can do is manage what we can.
Diabetic Foot Tips & Care During The Summer Months
As we continue this month’s blog posts about diabetes and heat, it’s only fitting to discuss our feet. For some of us feet are gross and for other’s feet are what we use to move around. As a diabetic my feet are the most sensitive and most affected by having blood sugar fluctuations. During the summer I am always tempted to walk around barefoot, my feet get hot easily and I am one of those people that lives in sandals year-round. The summer brings challenges of keeping my feet clean and dry. I want to be barefoot and in the water!
Wearing sandals every day can actually dry out our feet because we lose moisturizing oils, which can lead to dry skin and cracking. It is recommended by some doctors that we inspect our feet daily if we wear sandals a lot and wear shoes with socks a few days a week.
Diabetes and heat can present challenges of increased insulin use and can also cause foot fungus, moisture and sweat. Some symptoms to look out for with diabetes and feet are changes in skin color, going from red to brown, purple or green. Also swollen feet or ankles, pain in legs, cool skin to the touch, severe pain or loss of feeling can also be related to diabetes foot complications.
The diabetic foot guide: Wagner-Meggitt Classification of Diabetic Foot
Grade 0 - Foot symptoms like pain, only.
Grade 1 - Superficial ulcers involving skin and subcutaneous tissue.
Grade 2 - Deep ulcers involving ligaments, muscles, tendons, etc.
Grade 3 - Ulcer with bone involvement.
Grade 4 - Forefoot gangrene.
Grade 5 - Full-foot gangrene.
Daily Foot Exam Tips & Care
Daily foot care by washing feet in warm soapy water and check feet for sores, cuts, blisters or redness. Apply some moisturizer and avoid moisturizing between the toes which can cause infections.
Footwear is important. At home wear slippers or house shoes. Try and not go barefoot. Adding socks can help with moisture control, keeping feet clean and dry.
Trimming toenails to avoid sores and in-grown toenails. Cut straight across the toenail, cutting or filing corners to be sure there are no sharp corners.
Schedule your yearly foot exam with your doctor!
Summer Dry Skin
Dry skin in the summer! Diabetes often causes dry skin, which sometimes becomes itchy. Cracks can develop which can lead to an infection. Having moisturizer handy and bathing in a moisture rich body wash can be a great ways to prevent dry skin. You may be asking yourself why your skin is dry in the summer? The answer is the sun! Sunlight absorbs the moisture from our skin leaving it dry and flaky. If you have skin inflammation like dermatitis, the sun, swimming in a chlorinated pool and stress can all activate a flare-up.
For myself, dry skin is a year-round issue which is an annoyance. My hands seem to be the dryest year-round. My diabetes does not care about the season, and it seems my skin does not either when it comes to dryness. I have learned to keep a small bottle of lotion in my purse to help with my dry hands when I am out. I also have lotions in my kitchen, office and bedroom. These are all places in my home where I frequent and have options for some moisturizer. Somedays I want a moisturizer that smells good, I find in the kitchen is where I have my scented hand lotions. I place mine in a dish next to my dish and hand soaps.
Giving your skin some moisturizer or cream is the best solution to fight dryness. Finding a lotion or cream designed for diabetic or dry skin especially after bathing and applying it throughout the day can help heal dryness. After every handwashing is also a good time to apply a moisturizer or cream. It may take some time to find a moisturizer or cream you like. I recommend visiting your dermatologist and asking for some samples. I also recommend adding a lotion or cream to places in your home where you frequent to signal yourself to moisturize when you feel your skin is dry. Here’s to healthy and happy moisturized skin!
Diabetes Tips For Beating The Summer Heat
It is only fitting to write a blog post about the summer heat when it’s blazing hot out in the Central Valley of California where I currently live. I have been thinking about some tips I use when it’s hot outside and thought I would share.
Health Tip 1: Staying Hydrated
Staying hydrated means packing a nice size water bottle 24-48oz for me, with ice cold water and you may want to consider packing a sugar-free electrolyte powder as back-up if you find yourself thirsty. I personally like the individual packs, they are easy to fit in my purse or gym bag. I also carry extra ones in my gym bag and in my car.
Health Tip 2: Pack Healthy Snacks
Snacking is very individualized for me. I always pack candy or dried mangos for any hypo-episodes. And I pack a granola bar or some type of gluten-free bar. I personally love the brand, “88 Acres.” They have a dark chocolate and sea salt bar which I highly recommend if you’re gluten-free and/or love chocolate. You might also find in my snack bag nuts of some kind usually plain almonds and a kid size apple sauce with cinnamon. I love the brand “Go Go Squeeze.” They can fit into any purse or bag and can also come in handy for any hypo-episodes. What I have found helpful is, if I pack the snacks and I enjoy eating the snack, I am much more likely to eat it.
Health Tip 3: Leave The House During Cooler AM Hours
To reduce heat illness if you must leave your house on very hot days over 95F, plan to run errands or schedule appointments in the morning time. This will help reduce the amount of time you will be in the heat of the day. The risk of heat illness reduces during the cooler times of day as well.
Health Tip 4: For *Insulin Users Like Myself
Higher temps and heat can change how your body uses insulin. Testing your blood sugars more often and adjusting doses in the heat may help you feel better. And if you are active, test your blood sugar! You may also need to pack a cooler for your insulin to stay cool, read the label and/or box on your insulin before leaving the house for the day.
Health Tip 5: Clothing
Wear loose-fitting, light weight, and light colored clothing. This will help you stay cool and comfortable. Also don’t go barefoot and protect your feet! Don’t forget to pack a hat to wear and some sunscreen. Did you know a sunburn can raise blood sugar levels!
Health Tip 6: Symptoms Of Both Hypoglycemia and Heat Exhaustion
Sweating, dizziness, blurry vision, hunger, feeling shaky, and feeling irritable.
Diabetes & Anxiety: Five tips to help with anxiety symptoms
Are you ready to talk about five tips to help with your anxiety? If you are a diabetic on insulin, most likely you have felt some anxiety related to low blood sugar or aka a hypo episode. I bet you are wondering why anxiety occurs, anxiety meaning thoughts or body response. Biologically when our blood sugar drops below 70mg/dL on your meter or continuous glucose monitor your body is going to start to respond. How our bodies respond to a low blood sugar include, feeling shaky, nervous, or anxious, sweaty, chills, clamminess, irritability, confusion, fast heartbeat, feeling lighted headed, hungry, nauseas, feeling sleepy or weak. Sometimes we also can have trouble walking, feel a headache or have blurred vision. Your body is telling you need to eat and eat something with sugar to bring your sugar levels back to normal. For those of us on insulin having a hypo episode is much more common. What is also occurring biologically is a dump of adrenaline to give us energy to get to some food. When we feel some or all of these symptoms of a hypo episode, this can cause anxiety. The anxiety and fear can look like watching our CMG have a double arrow down and an alert or we just feel off and check our blood sugar and see a 70 or below. Just the number can cause anxiety because we know what is coming. No one wants to feel uncomfortable and if we have experience any of these symptoms before, we certainly want to avoid feeling them again, which can also cause anxiety.
When we are talking about anxiety, we cannot avoid the thoughts that can go through our head. The rapid and panicky thoughts of… I need food, I need sugar, I need to sit down, I feel scared, what is going on, why cannot my blood sugar just stay in the normal range and why is this happening to me? These thoughts are common when we see the low number or hear an alert. I am here to tell you; you are not alone if you are having these thoughts or ones similar. The biological symptoms and the thoughts that we as diabetics have can be exhausting. This is one of the reasons why being diabetic can be so exhausting mentally and physically. It feels constant sometimes.
Let’s talk about the 5 tips to reduce anxiety. Tip 1 begin to learn to slow your breathing and heart rate. Make sure your chest is open and try to begin to slow your breathing one breath at a time. Tip 2 carry snacks or juice with you in your purse or work bag to reduce trying to find some food when you have a hypo episode. I like to have a pouch in my purse to carry a variety of snacks that are healthy like a granola bar. I do carry candy which sometimes can be a quicker way to get your sugars back into the normal range. Tip 3 make a list of your favorite snacks or candies that you can put into your purse or work bag. Plan for your week ahead. Tip 4 also have at your desk some snacks or candy that you can grab if you have a hypo episode. Tip 5 begin to build a support network of fellow diabetics. You can learn from others and make their suggestions your own. Have a support network can make all the difference when you need additional support, especially from those that can relate and know how you feel. My group coaching program is a great place to start building that network. For more information check out my website, www.diabetestateofmind.com and look out for more information coming soon! If you would like a or coaching consultation, please email me at diabetestateofmind@gmail.com
Slaying The Beast Part 2: Being sick edition
Let's talk about the emotional toll that living with type 2 diabetes can have on our mental and physical health. Living with a chronic condition like type 2 diabetes, we can experience low moods or depression like symptoms, and we can also experience some anxiety when our blood sugars go low or into a hypo episode or when our blood sugars go too high, like a hyper episode. I don't know about you, but I feel like I've been sick since the beginning of this year 2024 and when I am sick my blood sugars tend to be high. By wearing a CGM, this helps me monitor my blood sugars, but it also can cause me some stress and anxiety when I see the arrow climbing straight up, I know that it's something biological related to T2D and also how my body digests food because when I'm sick or I've eaten too many carbohydrates in a meal, I go high. The only time I stay in range is when I don’t eat any complex carbs in my meals or I half the carb serving. I'm curious how many of you experienced this same stress or anxiety when your sugars are high, especially when you’re sick?
With being sick as a T2D, my entire body often hurts and usually I have no appetite. What helps me in these types of situations is choosing low carb snacks like nuts, string cheese or low carb crackers. If my blood sugar is low, I really like Nuka fruit pouches that have antioxidants and zinc. The berry one is my favorite. They are full of sugar from a variety of fruits and when I am having a low, these are a good replacement for me instead of juice or sugared soda.
Also when I am sick I struggle with having energy, not only physical energy but also mental energy. I am also often irritable and uncomfortable. I have found if I increase my hydration with sugar free electrolytes this really helps with my energy and helps me feel a little better. I also like a heated compress for my head and face to relieve pain and sinus pressure.
For my mental health I choose to open my right brain and do something creative like watercolors or some other type of painting. I also like to make jewelry from different stones and beads that I find. I have found that for me, self-care is using more of my creative right brain. This allows my stress to melt away and my mind to have a break from the chaos and busyness of my work week.
Another great way to cope with stress, being sick and T2D, for me is music. Anyone a 90’s country fan? Me! Anyone an 80’s music fan? Me! On the weekends music is usually playing all day long. I like the background noise when I am cooking, cleaning and doing laundry. It also helps me get some exercise in, I stop for a moment and dance to my favorite song playing. Music for me is a great coping mechanism and good self-care. I highly recommend it!
Don’t be discouraged, slay the beast! In honor of Toby Keith, I should have been a cowgirl. I should have learned to rope and ride.
Slaying the Beast!
Living with Type 2 Diabetes and being insulin dependent for me looks like slaying the beast, daily. Remembering water, snacks, insulin, diabetes supplies and being prepared. Slaying the beast for me is just that, being ready for anything. How many days have you wished that you could not do a single thing related to your diabetes? For me this was weekly until I decided to change. I changed my mindset surrounding diabetes from negative to a positive. Instead of being negative about all the diabetes related things I must do, I reframed this to, I have diabetes and it does not control me. I have all the power and control. A positive mindset can make all the difference in letting diabetes control you versus you taking back the control.
Slaying the beast requires control, it requires me to be prepped and ready. With this new positive mindset, I am less stressed and anxious when my blood sugar fluctuates. Being prepared means being in control and I like to be in control. Sometimes when I have a hypo episode my anxiety increases, but I know what to do, which gives me the control and peace of mind.
In slaying the beast, I have also found that wearing a CGM a (continuous glucose monitor) has changed how I view my diabetes and how food and exercise are monumental to my diabetes management. I am curious what have you learned about your diabetes? I preface “your” because diabetes is very much individualized, meaning each person’s blood sugar fluctuates based on age, weight, food intake, digestion, and/or exercise to name a few. I can be out with a friend and have some ice cream and I know about two hours later my blood sugar is going to be high. Whereas maybe you know that eating ice cream does not spike your sugars like me. I also know that as I see my CGM climbing, if I go for a walk and get my heart rate increased my sugars will come down and I am less stressed and in control.
I have found over the years that slaying the beast for me is about learning, planning, prepping and ultimately being in control. You are not defined by diabetes! You don’t have to feel guilty about your food choices, your weight, or dealing with diabetes. You too can learn a positive mindset and slay the beast!
It all begins with self-love and a growth mindset.
It all begins with self-love and a growth mindset.
What does a positive mindset mean to you? For me having a positive mindset means growth, possibilities and staying positive when things get hard. Having a positive mindset when you have diabetes can help you navigate the daily struggles we all have. Instead of thinking, I have to plan or pack my food. Maybe a new thought is, I get to pack whatever food I want and I know it will taste good because I made it.
How you think about your diabetes can make all the difference in how you manage it. For me having a CGM really helped me understand how food metabolizes in my body and what foods increase my sugars. Since getting my CGM last year, I have gathered so much diabetes date on myself to make planning less of a stressor. I know which foods will spike and which ones won’t.
Take a minute and think, what things you know about your diabetes? Do you know if exercising after a meal will help lower your sugars, will help you digest your meal easier or make you spike? Often time with diabetes we go off of how we feel. Meaning, how our bodies feel in the moment. This can be helpful but it can also be deceiving. I encourage you this week to look at the postives you have control over with your diabetes. Move that negative heavy mindset into a positive one.
Self-Care is not selfish
Self-care
When you think of self-care, what comes to mind? I can’t do that, I don’t have time for that, or I can’t even think about it. Most people think they don’t have time for self-care. I am here to share, you actually do have time.
Self-care is about carving out time in your day, week or the weekend for you. If you like to schedule your days or weeks, this is the time to pencil in self-care. Having a visual hand written note or a calendar notification, may help inspire you to carve out that much needed self-care time.
I often hear from my patients that self-care is selfish. I am here to remind you, it is not selfish. It is much needed down time and “un-plug time.” There are many things you can do for yourself that include self-care, such as a walk outside, drink a nice hot coffee from your favorite local spot, time to read your favorite book, or hand write someone a note. You decide, that is what self-care is about.