Healthy habits
Establishing a routine and healthy habits is important for all young adults, but especially those with type 1 diabetes.
Transitioning to adult care
Pediatric endocrinologists are experts regarding type 1 diabetes in children, however they may be less familiar with managing T1D throughout adulthood. The transition from your pediatric endocrinologist to an adult endocrinologist can be tricky, and young adults going through this transition may experience trouble managing blood sugar as well as other mental health concerns. It is normal to feel overwhelmed by this transition.
Transitioning to adult care refers to the preparation to move from a pediatric provider to an adult provider. It typically involves:
- A gradual shift of diabetes management responsibilities from parents/guardians to the adolescent/young adult.
- Seeking treatment for psychosocial or mental health challenges that may affect this transition.
- Asking your doctor to send a medical summary to your adult endocrinologist. View an example of information your new doctor will want to receive.
- A referral to an adult endocrinologist by your pediatric endocrinologist.
- Before you transition to an adult endocrinologist, practice taking charge of your endocrinology appointments. For example, you could come prepared with a list of questions you would like your doctor to answer, and when your doctor asks how things are going, try responding before your parent or guardian responds!
- Try to begin the transition process as early as possible. For example, in early adolescence, parents/guardians can gradually begin transitioning diabetes management tasks to the adolescent. At least one year before transferring to adult care, ask your pediatric endocrinologist for an adult endocrinologist referral to ensure no gaps in your care.
- If possible, transfer to an adult primary care provider before you transfer to an adult endocrinologist. It’s best not to transfer to two new doctors at the same time!
Meal planning
- Keep a regular meal routine to prevent overindulgence and subsequent blood sugar lows and spikes.
- Healthy meal plans include non-starchy vegetables, few added sugars, and refined grains (white bread, rice, and pasta with <2g / serving).
- Whole foods are better than processed foods.
- Eating protein helps improve blood sugar and increase satiety (less hunger).
- Fiber is broken down slowly and may help to prevent blood sugar spikes.
- It is best to consume less sugar and simple carbs.
- Consider using the ‘Plate Method’ to guide your portion sizes and meal choices.
Eat snacks with proteins, healthy fats, and 10 to 15 grams of carbohydrates to help your blood sugar stay near the target range. Work with your healthcare team to understand your insulin dosing for snacks.
Examples of 10-gram carbohydrate snacks include:
- 4 sliced strawberries with 3/4 cup cottage cheese
- 4 animal crackers with 1 string cheese stick
- 3 turkey roll-ups (slice of turkey wrapped around a pickle spear, slice of avocado, and slice of tomato)
- 2 ants on a log (3-inch slice celery with 1/2 tablespoon peanut butter and 3 to 4 raisins)
- 1 rice cake with 1 tablespoon peanut butter
- 2 ounces hummus with celery
- 2/3 cup shelled edamame
- 1 slice low carbohydrate bread toasted with 1 hard-boiled egg
Examples of 15-gram carbohydrate snacks include:
- 1/2 apple with 2 tablespoons peanut butter
- 1/2 cup fresh fruit with 1/2 cup cottage cheese
- 4 animal crackers with 4 ounces milk
- 1/2 sandwich (turkey, chicken, tuna, or peanut butter) on whole-wheat bread
- 1 tortilla (6-inch) wrap sandwich (turkey, chicken, tuna, or peanut butter)
- 1 6-inch waffle with 1 tablespoon peanut butter
- 3 graham cracker squares with 1 tablespoon peanut butter
- 3 tablespoons hummus and 6 whole grain crackers
I was initially hesitant to start meal prepping, as I was under the impression that I would have to eat the same bland, flavorless meal every day in order to maintain my blood sugar and reach my goals in the gym. This is the exact opposite of the truth! There are a myriad of cookbooks, recipes, and social media accounts with healthy, delicious meals and snacks that won’t have a detrimental effect on your blood sugar.”
Mental health
- Living with T1D can be very stressful and lead to feelings of burnout, anxiety, and depression, but you’re not alone!
- Building resilience is an important tool in stress management.
- Psychologists, social workers, and other clinicians can help equip you to deal with the everyday challenges of living with T1D.
- Consider joining activities that facilitate connection within your local T1D community.
- T1D can change your relationship with food or how you view mealtimes, so it’s important to seek help if you find that you’re experiencing anxiety around meals and snacking.
- It’s important to know when to ask for help. Click here for tips on finding a mental health professional!
After being diagnosed with T1D at age 24, so much information was being thrown at me all at once that it was very overwhelming. My mental health was the lowest it had ever been. What helped was educating myself in a way that allowed me to understand what was happening in my body. I also got involved in my local T1D community and take every opportunity to educate others.”
Exercise
- Set realistic goals and don’t try to do too much too quickly.
- Consult a doctor or Certified Diabetes Care and Education Specialist (CDCES) about adjusting insulin levels around your exercise routine and keep them updated on any changes to your fitness regimen.
- Exercise can result in decreased insulin requirement so be sure to appropriately adjust insulin based on exercise routine.
- Pumps and other diabetes-related technologies may have ‘exercise’ settings, which could help prevent hypoglycemic episodes.
- Strive to get approximately 30 minutes of aerobic exercise several days a week.
- Check blood glucose before exercising, keep snacks on hand during a workout, and be sure to eat afterward to prevent hypoglycemia.
- Continue to check blood glucose after exercising, as levels can be affected for up to 24 hours.
- The relationship between exercise and glycemic control varies–find what works for you and stick to a routine.
- Work with your healthcare team to adjust insulin and food as needed for exercise.
- During exercise, fats and glycogen are used to make energy.
- Exercise can help reduce your risk of complications. It helps you reach blood sugar goals, lowers blood pressure, and can help your body use insulin better.
- Type of exercise, insulin on board (IOB), temperature, humidity, hydration levels, and time of day can affect how blood sugars react to exercise.
- Strenuous activity can contribute to hypoglycemia.
- Work with your healthcare team to find the best exercise regimen for you.
Drinking responsibly
- Drinking alcohol in excess increases the risk of hypoglycemia.
- It’s best to avoid drinking large amounts of alcohol in one session.
- Make sure you always have some carbohydrates to eat before you drink.
- Be sure to stay adequately hydrated by drinking plenty of water.
- Test your blood glucose levels before you go to bed and if your level is normal to low, eat a snack before you head to sleep.
- Be very cautious about lows the night after drinking, have a low snack prepared for a sudden drop in glucose levels while sleeping.
- Closely monitor your blood sugar the next day as alcohol can cause you to go low hours after consumption.
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