A question I get asked frequently is what my diet is like. I deviated from my regimen last night . I went out for my trainer’s birthday for about an hour at a later time than I usually go out.  My life is very routine - I try to eat at the same times every day, work out at the same times, and wake up and go to bed at the same time.  In the time that I was out, I danced briefly; however, my last meal had no carbs and left me with an empty stomach.  In other words, I didn’t have any food in me when I went dancing, so my blood sugars went low.

When your sugar goes low, you go into panic mode.  You worry about fast acting carbs , when will they work, will it be enough, is it going to affect my weight, my sleep, my morning routine.  Unfortunately my body required more than 60 carbs overnight which left me exhausted this morning.  Not only did I lose an hour of sleep due to Daylight Savings, I didn’t have energy to go to the gym, which I do every Sunday morning.  I never sleep in because my first meal was at 7 am in the morning.  So what did I do about breakfast?  I ate my morning breakfast as planned but I removed my second meal.  I had the opportunity to go back to sleep and I did as it’s important to keep your body well rested.  I had to go to work this afternoon.  Daylight Savings affected me and I was exhausted, but I got through the day as we all do when we’re tired.  It’s very common to ask ourselves, I’m tired do I need to skip the exercise today? As I’ve mentioned in a previous blog, it’s the days that I’m tired that I feel the most productive with my workout.  After work, I went to the supermarket, to buy my key staples for the week.  This leads me back to what does my diet consist of.  Keep in mind a healthy eating and exercise regimen, I pushed through my fatigue, focusing on the key staples I eat on a daily basis as a diabetic.  I thought I’d share these healthy choices with you.  These products are all great complex carbs, low in sugar and high in protein, that are good staples for your diet, whether you’re a diabetic, athlete, or anyone who’s trying to watch their weight.  I always eat a complex carb with a protein, use portion control, and read the labels on the packages. 

My blood sugar dropped low while shopping for groceries.  I went back to my most recent blog about the hypoglycemia rule of 15.  This time, I used glucose tablets that I had on hand.  This required me to use 45 carbs within a 30 minute period.  As I sat in the parking lot waiting or my sugar to go up, it was around 4 pm in the afternoon, I was tired, hungry from low blood sugar, daylight savings time-lagged, yet knowing I need to do a work out. I did self talk using my own blogs to help motivate me and get the energy to do a workout at the gym.  I could have used exhaustion or low blood sugar as an excuse to not exercise. Instead I used it as a positive, and went to the gym despite my exhaustion.  I had a very productive workout, I feel refreshed, and I’m glad that I was able to give myself the positive reinforcement using self talk.   This is why I like to blog; I take my own life experiences, which you might be experiencing too, so that we can all learn together.  All of us are in the same boat.  Managing Diabetes is a science.  There’s no explanation for the highs or the lows, but there are healthier ways to self-manage.

Alissa interviewed Dr. Blevins, M.D., Endocrinologist, Texas Diabetes & Endocrinology on the effects of balsamic vinegar on blood sugar

Alissa:  For the last two weeks, I've experienced my blood sugars increase and I realized today after doing some research it was balsamic vinegar.  How does balsamic vinegar affect blood sugar?  Do you recommend using it and how much should you use if you use it?

Dr. Blevins:  Balsamic Vinegar does certainly have calories and it depends on how much you use.  Tell me this – how much were you using?

Alissa:  I use the big bottles you get at Costco – I was using a bottle every 4 days, so probably a quarter bottle a day

Dr. Blevins: I have to admit I don’t know what those bottle look like but, how much is in a bottle? 

Alissa: Let me check… 1 liter

Dr Blevins:  Vinegar can be formulated in different ways, but usually a cup is about 40 grams of carbs or so, but what does it say on the label?

Alissa:1 tablespoon has 2 grams of carbs and 10 calories and 2 grams of sugar

Dr Blevins: A liter is 1000 CCs, so you’re talking about 70 tablespoons.  There’s definitely carb in balsamic vinegar.  The story here has more to do with being very careful about food and look at the label carefully. 

Alissa: Yes

Dr Blevins:  It’s low fat and that’s good, but it’s pretty high in sugar.  It’s liquid, readily absorbable, and it could spike your sugar since it does have a lot of sugar.  So 1 tablespoon is 2 grams, and you’re taking 250 ccs/day, a quarter of the bottle per day.  The math on that would be about 17 tablespoons, so you’re getting mid-30s of grams of carb per day.  That’s quite a bit of quickly, readily absorbable carb.

Alissa: Yes, I’m cutting it out of my diet permanently!

Dr Blevins: Although it’s not hidden, I think the perception many people would have is the same as yours which is that it’s not a high carb source.

I learned something new today that I felt is important.  Sharing the kind of information that can help people is the reason why I enjoy blogging.  I provided my endocrinologist with information from my dietician appointment - the diet for the week and carb counting. I provided my weekly blood sugars as well. 

I was asked what I do when my blood sugar runs low.  I told him I eat my staple of two 3 ounce sweet potatoes and that if my sugar was below 50 and doesn’t go up right away, I’ll eat 6 ounces of sweet potatoes.  The Dr. was surprised at my response, saying that all complex carbs(a sweet potato is a complex carb) take longer for your body to digest, which in turn causes glucose to go up more slowly.  In other words, a complex carb is not a good rescue carb.  In all my years of competing, I had been concerned about sugar ruining my competition, yet 15 grams is 15 grams no matter what kind of carbs you put in your body. 

Quick sugars are any simple sugar such as orange juice, glucose tablets, or glucose gels that get in and out quickly.

HYPOGLYCEMIA SYMPTOMS:  Fast heartbeat, fine tremor, sweating, anxious, hunger, headache, irritable, weakness, and fatigue.

HYPOGLYCEMIA REMEDY:

Check blood sugar → low is considered less than 70mg/dl

1. Treat according to reading
   • Fast-acting carbs 50-59: treat with 30 grams
   •  Less than 50: treat with 45 grams 
2. Wait 15 minutes for conversion to blood glucose and for symptoms to subside
3. Re-check blood sugar - if still less than 70 then treat again, according to the new reading

Examples for 15 grams of carbs:

• 4 oz juice
• 8 oz milk (1 cup)
• 1/3 can regular soda
• 3 square of 4 round glucose tabs
• 3 round peppermint candies (chew)

Today there was black ice on the roads in Austin which created many accidents and closed off roads.  Despite the weather and bad roads, I was determined to get my work out in.  I was on my way to the gym, but had to turn around and come home. 

Being stuck at home due to inclement weather gives you the unwanted opportunity to eat too much food since the refrigerator is always there! So how do I preoccupy my time and redirect myself to avoid unhealthy foods? Here are some suggestions to make sure you stay fit while staving off cabin fever when bad weather hits! Even though all these activities do not pertain to everyone there is always an activity to preoccupy your time.

My children and I eat healthy and occasionally they have yummy treats. Today we decided to take out a cookbook and make a recipe to eat for our meals.  My children love chocolate pudding. It's an easy and delicious recipe that children and even adults love. Since my daughter and I are diabetic, we buy sugar free. We also enjoy dairy and vegetarian meals, so we chose carb-counting cottage pancakes, homemade applesauce, vegetables stir fried in Pam spray and a turkey meat loaf with baked potatoes, measured and mashed in the food processor.

Later today we will have sugar free hot chocolate and light the fireplace. We have sugar free marshmallows and graham crackers with a few sugar free chocolate chips, counting out with serving size on the bag. My kids love making s'mores, however we limit it to two each for portion control. We will have popcorn tonight watching a movie. These are all great choices.

We have monopoly at home and we also enjoy playing many other family games. Even if you are spending the day on your own, there are card games, cross word puzzles, reading, and movies, amongst other activities.

I’m hungry as I write this - I eat the same meals every three hours per the strict diet for my figure competition. I look at the clock hoping it's another meal time soon because I'm bored and food consumes my mind. So, how do I get through it? Although we are in the kitchen near all the food, having a prearranged meal help keep your mind off of food and even gives you apples or vegetables to snack on. I keep my mind preoccupied using all of the tips I've provided – this is the way to promote a healthy discipline with the foods you consume.

My sugar just dropped low. I blogged previously about low blood sugar and how to stop yourself from binging. I wanted to eat but I remember what Dr. Blevins mentioned (Cravings and Low Blood Sugar an Interview with Dr. Blevins) and it worked. I stopped myself from binging.

Whatever you decide to do, remember your ultimate goal of keeping fit and eating healthy!  I’d love to hear what you do during inclement weather – please scroll down and tell me in the comments section.

Alissa: A question I’ve been asked, and it’s a problem both myself and my diabetic daughter - when your blood sugar drops low, what do you suggest eating to stop cravings and hunger - because I know for myself and my daughter, that’s we go on a binge and it’s so hard to avoid, what do you suggest for that?

Dr Blevins:  You’re talking about a craving, and when you get low, your body is saying , protect me, I want to survive.  Somehow all of the hunger mechanisms go haywire.  You can talk yourself through it, but logic doesn’t always win out when it comes to craving. 10-15 grams of simple carbs is the advisable amount to take for a low.  The best approach, generally speaking, is to use a finite amount of carb for example three glucose tabs.  Then you can tell yourself I just took in more or less 15 grams and I know that’s going to work.  That’s probably the best approach.  There’s no particular food that’s going to help a craving .  I tell people you can have half a glass of juice which is about 15 grams or you can have a barrel of juice which is a huge amount of carbs, but your sugar’s not going to go up any faster.  And you’re going to end up with this mega high sugar afterwards if you have a lot to drink or eat.  But the trouble is that it is hard because people notice that they’re very hungry and their body is telling them to eat and drink more of that juice.  So if you can be disciplined to use a finite amount like 15 grams, and be confident that it’s going to work, then you just have to talk yourself through it.  There’s no perfect food that raises it and satisfies cravings immediately

Alissa: I see

Dr. Blevins: I do think that using rapidly absorbed carbs is absolutely what you want to do.  Athletes can use gels sometimes when get low when they’re working out. A common one is hammer gel.  That’s a particular brand, there are tons of them. The glucose tablets you get at the regular pharmacy are good for routine use. 

I'd love to hear how you handle cravings when your blood sugar is low.  Please scroll down and make a comment

Alissa interviewed Dr. Blevins, M.D., Endocrinologist, Texas Diabetes & Endocrinology on caffeine and blood sugar.

Alissa:  Does caffeine affect blood sugar and what effect does it have on exercise?

Dr. Blevins:  I’ve seen some studies that caffeine and coffee can be shown to prevent Type 2 diabetes.  It depends on the person, whether they have diabetes or not, whether it affects their blood sugar or not and also it’s very individual.   We’ve seen quite a number of people who have noticed that when they drink coffee by itself, with nothing in it, no creamer, no sugar, no carbohydrate added, coffee fundamentally doesn't have carbohydrates in it, especially people with type 1 diabetes, that their glucose sometimes briskly, not sky rockets, but rises after drinking coffee.  It’s complicated a bit because, in the morning when people drink the coffee typically, the hormones in the body that normally rise, for example cortisol growth hormone, can cause blood sugar to rise too.  So if a person has nothing to eat in the morning sometimes the blood sugar will rise whether they have coffee or not because of the hormones rising in the morning.  Many people experience when they drink coffee, their glucose, their sugar bumps up even more. That’s not everybody.  It’s not a rule – it’s more of an observation. 

Alissa:  If that were the case and somebody realized that the caffeine in coffee was spiking their blood sugar, do you have a recommendation as an alternative form of caffeine?

Dr. Blevins: I think it’s fundamentally the caffeine in the coffee.  Usually when somebody drinks decaf you don’t see it happen, but I think caffeine probably interacts with the sympathetic nervous system a bit and that can sort of push the blood sugar up a bit, and it has that stimulatory affect and that’s what coffee’s all about and I think it acts on the sympathetic nervous system to cause the glucose sugar to go up.

Alissa: It’s been suggested to me as a figure competitor to stop drinking caffeine and coffee because it creates cellulite.  Is that true? Does caffeine cause cellulite?

Dr. Blevins:             No I wouldn't say so.

Please scroll down and make a comment - I'd love to hear what you think!

Watch for the next blog where the interview with Dr Blevins is continued.

We often feel time pressured to prepare meals and wonder what to eat during the day.  Sometimes we might feel pressed for time, or lazy, and choose to eat out for many meals. Being that I have a busy schedule, I can relate to the added unnecessary stress we experience over what to eat, did I eat right, or why didn't I eat healthier. As a diabetic who avidly exercises, I make all of my meals in advance (usually  the night before) that is measured and weighed using portion control as well as  carb-counted on the bags and containers I travel with.

When I prepare for my day, I easily pull out the meals I've selected in advance to eat for that day. This allows me to leave the house on time in the morning and starts out on a good note, which makes it easier to eat and feel healthy. 

Here is an example of what my refrigerator looks like. 

Here is what my meals are for today and here is how I prepare them ahead of time.

I also carry two 3 oz sweet potatoes for low blood sugar. For those who are unable to prepare food due to traveling, appointments, or work commitments etc. I recommend using similar choices when dining out and ask for the chef to prepare the food how you request.  If you know in advance where you are going to eat, call that restaurant ahead of time and see if they can accommodate you. I try to order everything steamed and request that it isn't cooked in any butter, oil, or sautéed.   I’d love to hear what’s in your refrigerator – please scroll down and tell me in the comments section

It’s estimated that 58 million pounds/$345 million dollars of chocolates will be consumed by Americans leading up to Valentine’s Day.  Let’s not fall into the sweets trap and remember that Valentine’s Day is a special day to spend with loved ones.  Although it's very tempting to find sweet foods and chocolate to eat as a treat, the loved ones I spend this day with, my 2 children, find healthy ways to celebrate. Since my daughter is also diabetic, we plan meals in advance – we went to the grocery store and picked out replacements for unhealthy sweets. We purchased a vegetable platter and vegetables to make into kebabs using vegetarian soy meat.  Below is a list of carb-counted healthy treats we got at the grocery store.  I’d love for you to tell me how you are celebrating Valentine’s Day in a healthy way – please scroll down and make comment.  Have a happy and healthy Valentine’s Day!

Food options

VEGETABLES

• Asparagus                1 cup = 2 carbs
• Green Beans           1 cup = 4.14 carbs
• Broccoli                    1 cup = 5.8-7.3 carbs
• Cauliflower             1 cup = 2 carbs
• Red Beets                1 cup = 9 carbs
• Kale                            1 cup = 6 carbs (loose, raw, cooked)
• Spinach                     1 cup cooked = 5.7 carbs, uncooked 1.9 carbs
• Carrot                        3 oz = 8 carbs
• Cucumber                ½ cup – 1.6 carbs
• Romaine                      2 cups = 1 carb
• Celery                       2 oz = 1 carb
• Bell Pepper             1 Cup 1 whole or 5 mini 1 = 6 carbs

I recommend using a dry measuring cup

 FRUIT

• Berries(Not strawberriesI)       ½ Cup = 15 carbs
• Apple (Small)                                  (5 oz) = 17 carbs
• Banana                                              1 whole = 24 carb
• Melon                                               ½ cup = 7 carbs
• Grapefruit                                         ½ cup = 10 carbs

DAIRY

• Lactaid Cottage Cheese              ½ cup = 7 carbs
• Fage 0% yogurt                              1 cup = 9 carbs

COMPLEX CARBS

• Spelt Bread                                     1 slice = 22 carbs
• Rice Crackers                                  (I use Mary’s) 13 Crackers = 21 carb( .61 each)
• Black Beans                                     1 cup = 25 carbs
• Edamame                                         Cooked =1 cup 5.7 = 7 carbs
• Lentils                                               1 cup = 25  carbs
• Rice Cakes (originial)                   Quaker 1 = 7carbs Lundbergs 1 = 13 carbs
• Cream of Rice                                 ¼ cup = 36 carbs
• Hummus                                           2 TBSP = 5 carbs (1TBSP = 2.5 carbs)
• Quinoa                                              ¾ cup = 34 carbs
• Sweet Potato                                 4 oz = 16 carbs
• Butternut Squash                         1 cup = 21,5 carbs
• Red Potatoes                              1 oz = 7 carbs
• Mung Bean Pasta                          2 oz = 6 carbs
• Rice Tortilla                                   1= 22 carbs ( I buy it at Whole foods see label)

TASTY OPTIONS

• PB2                                         2 TBSP  = 5 carbs (Not regular Peanut Butter)
• Unsweetened Chocolate           1 TBSP=  3 carbs
• Almonds                                  ¼ cup (20 almonds) = 2 carbs
• Salsa or Pico De Gallo            2 TBSP = 1 carb

A diet and training change that resulted in 2% body fat loss and 2 pounds of weight loss in a week has created hyperglycemia for 5 days.  I have provided my logbook of what consistent high blood sugars look like and how I handled it.  I’m very independent with caring for my diabetes and am familiar with the ratios that have been working up to this point.  My endocrinologist Dr Blevins, says in times like this, that availability is important (Dr. Blevins interview). After my 5 day pattern of hyperglycemia, I followed this advice and made an appointment with my endocrinologist. The result - my insulin was increased to adjust to my new diet and rigorous exercise regimen.    Over the next week, I must closely monitor for a similar consistent pattern of high sugar levels accompanied with weight and body fat loss over the next week and continue the close contact with my endocrinologist.  This is what makes an athlete successful in a professional sport.  

As a figure competitor in training season I'm often asked questions such as what is my hemoglobin A1C or what are my blood sugars on a regular basis or how well regulated am I. The answer to that question is just the same as you or I or anyone else. What I enjoy about blogging is being able to share my experiences from an athlete’s point of view.

My diet changes weekly. Some weeks are higher in carbs than others. This week I'm on a low carb depleted diet as preparation getting closer to my show in April. What I have found is that every time my carb counting changes, my basal rate changes. I went from 11 units of lantus 2 weeks ago and experienced two days of low blood sugars so I went down to 9 units of lantus. That seemed to have worked well for me once I found the right amounts. This week I continued on Monday with 9 units of Lantus and I've experienced unexplained high blood sugar.

It's very frustrating, upsetting thinking what did I do wrong, and it affects my mood and sleep. What I have realized and learned as part of being an independent diabetic who knows how to properly increase or decrease my insulin, is that my blood sugar changes as I eat less carbs and do more cardio.

How do I treat myself independently? A must is wait two days to develop a pattern. Write EVERYTHING down form your carbs that you ate per meal to insulin to carb ratios, to insulin administered and the time of both that meal or blood sugar testing and activity level. After 2 days, you will have a clearer picture of what needs to be changed. Here is my blood sugar logs for the last two days.

What changes I have discovered is I need stronger lantus in the morning, so I've decided to increase my basal insulin from 9 units to 10 units. I gradually increase it. If I'm still high the next day, I will increase it to 11 units. One thing to emphasize is never make too many changes at once. If my blood sugars are still high in two days, I know my insulin to carb ratios needs to be changed. This is where I need my doctor’s assistance. I call in with my blood sugars and provide them with my weekly diet. Once I see a consistency, they help me in making changes.

I would love to hear your experiences with maintaining blood sugar and hemoglobin A1C with a nutrition plan and exercise – please scroll down and make a comment.