The impact of protein on insulin dosing

In a fast-paced world where many people eat on the go, little time is spent wondering whether we are getting the recommended daily intake of nutrients from our food and how it can affect our bodies’ performance. People living with type 1 diabetes (T1D), on the other hand, require structured meal planning and a solid understanding of how carbohydrates can impact their blood sugar levels in order to avoid complications such as hyperglycemia (high blood sugar) or hypoglycemia (low blood sugar).

Recently, investigators have been examining evidence that suggests fat and protein can also affect glucose levels, and need to be considered when calculating insulin dosing. According to a new study partly funded by JDRF, researchers in the United Kingdom and Australia have discovered that people with T1D need nearly 50% more insulin to keep blood sugar levels stable mostly in the two hours following a high-protein meal. This is the first study to observe insulin requirements for a high-protein meal compared with a low-protein meal, when carbohydrate and fat content are kept the same.

Eleven teenage participants ate pasta meals that contained 30g of carbs, 8g of fat, and then either 60g or 5g of protein for the high-protein and low-protein meals respectively, a week apart. The researchers then measured how much insulin was needed and when for the teenagers to maintain stable blood glucose levels during and after the meals.

According to their findings, while needs did vary greatly among participants, they required on average 54% extra insulin following the high-protein meal compared with the low-protein one. These results demonstrate that carbohydrates are not the only food group that affects glucose levels and insulin dosing.

Further research will be necessary before the development of new recommendations around the optimal timing of insulin delivery to manage high-protein meals.

For more informative articles on health and type 1 diabetes, visit our JDRF Blog

Making continuous glucose monitoring accessible to all

New technologies for people with type 1 diabetes (T1D) can significantly improve quality of life, but only a limited number of individuals have access to them. Such is the case with continuous glucose monitoring (CGM) systems in Canada, which have the power to revolutionize diabetes management, yet are not covered under provincial health plans. Those Canadians with T1D whose private or group insurance plan does not include CGM or who have no such insurance must go out-of-pocket.

Continuous glucose monitoring involves a thumb-sized, wearable sensor that tracks your blood sugar levels throughout the day and night, notifying you of highs and lows so you can regulate your glucose and insulin intake. Worn with or without an insulin pump, it leads to better glycemic control and lessens the risk of T1D complications.

Continuous glucose monitoring devices help improve self-management of T1D by regulating overall blood sugar, enabling people to spend more time in target range and relieving them of the anxiety that surrounds the disease, as well as aiding them to achieve excellence in exercise and in life. Furthermore, a recent JDRF-funded research study has shown that CGM leads to a reduction in neonatal health complications, and is a viable option for pregnant women with diabetes and their children.

In an interview with the Montreal Gazette, Dr. Preetha Krishnamoorthy, an endocrinologist at the Montreal Children’s Hospital, says CGM is a promising technology from which many children have benefitted.

“In children who have difficulty feeling whether their blood sugar levels are low or high, this can be really a wonderful technology for them,” she explains. “It is certainly something that can help in gaining control of their diabetes and is also fantastic for families to be able to know what the blood sugars are doing.”

At present, no province extends medical coverage for CGM systems. Continuous glucose monitoring has also not been a standard offering for most Canadian insurers. However, the Yukon recently announced a two-year pilot project to provide free CGM to residents under the age of 18, and a provincial advisory panel in Ontario recommended the public funding of CGM for people living with T1D who are “symptom unaware.” The Government of Quebec has also publicly stated that the reimbursement of CGM devices is under consideration.

Through advocacy initiatives and collaboration with The Government of Canada, JDRF is hopeful that CGM coverage will be accessible to all in the near future.

For more informative articles on health and type 1 diabetes, visit our JDRF Blog. 

Does pollution cause type 1 diabetes?

As the incidence of type 1 diabetes (T1D) continues to grow, Canadians have long speculated whether environmental factors – namely pollution – could be responsible for triggering an autoimmune attack.

While a number of chemicals, including those found in pesticides and some of which are now banned, have been linked to type 2 diabetes, exposure to pollution is not a significant factor in the development of T1D, according to a new study. In fact, researchers from the University of Helsinki have excluded 27 common pollutants and chemicals as possible causes after analyzing hundreds of blood samples from Finnish and Estonian children at genetic risk of T1D. The young participants, who were part of two existing studies, were tracked to see if they had developed the condition by 2017. The researchers also looked at cord blood samples from the children’s mothers following delivery in order to determine whether exposure to pollution in the womb and in early childhood plays a role.

Among their findings, children who lived in the larger, capital city of Helsinki had higher levels of chemicals in their blood than those residing in smaller cities or the outskirts. As well, there was no connection between the levels of chemicals present in the blood and an increased risk for T1D.

The use of harmful substances has grown considerably among industrialized countries in recent years, and researchers will continue to explore environmental factors with the hope of discovering a link to T1D.

For more informative articles on health and type 1 diabetes, visit our JDRF Blog. 

Surviving winter with type 1 diabetes

 

While the winter season can be a fun time filled with skiing, sledding and mugs of steaming cocoa, it can also be marked by not-so-fun events like the flu, sick days and visits to the clinic.

Although many Canadians embrace the cold weather like experienced pros, people living with type 1 diabetes (T1D) tend to have more difficulty managing their condition when the temperature drops. This is due to fluctuating sugar levels often stemming from a weaker immune system and slower circulation during the winter months that reduce the effectiveness of insulin. As a result, these individuals are more susceptible to a common cold, which can pose additional problems since their bodies rely on hormones to combat the stress associated with being ill.

However, T1D should not keep anyone from getting outside and enjoying the pleasures of the season. With a little foresight and a plan of action in the case of extreme weather conditions, your blood sugars can be managed without worry!

Below are a few tips for surviving winter with T1D:

Boost your immune system

Stay healthy by eating well, drinking lots of water and sleeping 7 to 8 hours each night. Consider taking vitamin supplements and getting the flu shot as per your doctor’s recommendations.

Monitor your sugar levels

Monitor your blood sugar often and carefully because you can get false hypoglycemia (low sugar) and hyperglycemia (high blood sugar) readings in extreme temperatures. Elevated ketone levels may also occur when blood sugar readings are above normal. This can be a sign that the body is using fat and muscle for energy and could lead to diabetic ketoacidosis, a dangerous medical condition that can be fatal.

Keep moving

A little activity each day will improve insulin sensitivity by allowing the body to better regulate blood sugar levels. Exercise also lets you stay warm and helps your mind to better cope with the challenges of your self-management. Just keep in mind that activity can affect blood glucose for up to 48 hours.

Take care of your feet

People who suffer from neuropathy may not realize just how chilly their feet are, which can pose a risk for frostbite. Warm socks that keep feet dry are especially important this time of year. Winter can also make skin more susceptible to drying and cracking, leading to infections. Moisturize your feet daily and limit their exposure to the cold.

Protect your insulin and medical supplies

Fluctuations in temperatures and power outages can put injectable insulin at risk since it must be refrigerated and is only be safe for use between 0°C and 30°C. Diabetes equipment like blood sugar monitors can also stop working in cold weather conditions, so be sure to plan ahead when traveling and/or participating in any outdoor activities.

We hope these tips help you enjoy good times with your family and friends during this season while keeping your blood sugar levels in check. Wishing you a safe and happy winter!

For more informative articles on health and type 1 diabetes, visit our JDRF Blog

 

 

A top JDRF fundraiser from West Vancouver shares her story with Prime Minister Trudeau

In April, 10-year-old Grace Bull boarded a plane in Vancouver with her parents, David Bull and JoAnne Strongman, on the way to Palm Desert in California. She was planning to spend her spring break relaxing by the pool and soaking up the sun. She had no idea that when she arrived back home, her life would never be the same.

When the Bull family arrived in Palm Springs, Grace became very ill. “I was so hot and tired… I couldn’t get out of bed. I had spots all over my legs.” After being rushed to the emergency room at Eisenhower Hospital, Grace was transferred to Loma Linda Children’s Hospital, where she was diagnosed with type 1 diabetes (T1D). “I had no idea what was happening. I just felt really, really scared.” The first question she asked the doctors was, “Can I still dance? I was so clueless…I didn’t know anything about T1D.”

 

Grace met PM Justin Trudeau last year in West Vancouver

Since then, Grace, and her parents, who live in West Vancouver, have been avid supporters of JDRF. “We love JDRF… supporting them gives us the chance to feel like we can make a difference, where otherwise we feel helpless,” David and JoAnne said. "They have so many people working for them who have devoted their lives to finding a cure… they’ve given us hope. And made us feel like we’re not alone. JDRF is our light at the end of the tunnel and we’re proud to support them" says David and JoAnne.

In June, less than two months after learning of her diagnosis, Grace participated in the Sun Life Walk to Cure Diabetes for JDRF. “I went door-to-door all around Vancouver with my friend who has T1D. And I made so many phone calls to family and friends. We explained what T1D was and asked to donate to help fund research.” And she was one of the top 10 fundraisers nationwide! “I’ll keep going to events and do my best to raise money. It’s just what I can show in return for all that JDRF has done for me."

 

Grace and other youth delegates at the 2018 Kids for a Cure Lobby Day

Grace and the Bull family didn’t stop there. She asked her father, the President and CEO of John Bull Investments, to become a corporate sponsor for the JDRF Gala and they worked together to invite all of her family and friends to attend and donate. “I’ve seen how hard JDRF is working to find a cure… and I want to do everything I can to help them."

In November, during National Diabetes Awareness Month, she was one of 28 young delegates who attended JDRF’s Kids For A Cure Lobby Day in Ottawa, where she represented JDRF in the House of Commons and in front of Members of Parliament. “It was really cool meeting them… talking to them and sharing my story. They were so nice. Because of us, the MPs are going to join the All Party Caucus for T1D and write to the Minister of Finance in support of the recommendation for JDRF’s pre-budget submission."

And, recently, she shared her story with Prime Minister Trudeau. "He told me to keep doing what I’m doing, that I can make a big difference in the world… that I already have. It’s motivated and inspired me to keep working hard to raise awareness for T1D."

 

Grace at the Sun Life Walk to Cure Diabetes for JDRF

After forming a special bond with Pamela Goldsmith-Jones, the current MP for West Vancouver and a strong advocate for T1D, she was invited to meet with Prime Minister Trudeau at a fundraising event. Grace, proudly wearing her JDRF Kids For A Cure jersey, spoke with the Prime Minister about her experience with T1D and how JDRF has helped those living with it. “He asked me a bunch of thoughtful questions and was really engaged. He even signed my scrapbook, ‘Thank you, Grace, for sharing your strength and leadership with us all.’"

“Grace wasn’t just speaking for herself, she was representing every child in Canada with T1D,” says her father. “I have never been more proud."

“At the end of the day, having T1D isn’t the worst thing. Life only gives you what you can handle,” says Grace. “And with JDRF’s help, we’re going to find a cure in my lifetime."