How Do You Deal With Diabetes Issues? The Comfy Way Or The Right Way?
The best way to manage uncertainty and fears is to embrace them, understand them and face them upfront.
Uncertainty is a constant. Will I finish this race? What if I cramp? What if I hit the wall? What if I get injured as it always happened in the past?
Then diabetes enters the scene, and even more uncertainty builds up. What if I go into hypoglycemia half way through the marathon? What if I get my insulin wrong? How will my blood sugar behave?
Facing this scenario upfront means to consider all these things and prepare for them in advance, to the best of our ability.
When concerns arise, fears hold me back, there only is one way I operate.
First, I write on paper what is that I find scary or that keeps my mind busy. This step puts me in condition to start seeing the problem physically, make it a priority, and untangle its nature.
Second, I come up with hypotheses about its origin based on my recent experience. I do not put boundaries to myself in this step, I list down everything that comes to mind and trap it on the paper, even if it does not quite make sense at first glance.
As Robert Pirsig puts it in his masterpiece Zen And The Art Of Motorcycle Maintenance, regarding tackling problems:
For this you keep a lab notebook.
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Sometimes just the act of writing down the problems straightens out your head as to what they really are.
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… the statement of the problem, the main skill is in stating absolutely no more than you are positive you know.
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An experiment is never a failure solely because it fails to achieve predicted results. An experiment is a failure only when it also fails adequately to test the hypothesis in question, when the data it produces don't prove anything one way or another.
Third, I leave pen and paper on the table and go for a walk, with no intention other than walking. Often, these walks reveal something to me concerning the issue at hand.
Fourth, I come back to the problem, the fear, the preoccupation, and face it upfront. If the process has worked, I have an idea of a way out. If not, I keep walking and thinking.
Lastly, when the issue is clear, I tackle it from its root. I study its principles and commit to eradicate those: I address the cause, I don’t put patches on the symptom.
This is how I have been approaching pretty much everything over the past year and a half, from physical stress and injury risk, to hyperglycemias and insulin resistance, to lack of energy and performance in my days, to any other more or less trivial life situation. All problems can occupy some mental estate and they require understanding, reflecting and acting in order to be untangled and be turned into another valuable experience we can put in our bag for the future.
Here are some examples, from my own direct experience.
The Running Problem
It was a sunny morning in Bruxelles and I was “running” as any other day. Today, however, I woke up with a small little painful sensation in my ankle. I lace them up and head outside nonetheless. After 5 km my ankle grows in pain, and my right knee sends some alarming signals too. With no idea what is happening, I keep going until I have to stop at km 7, take a bus, go back home, and call the orthopaedic for an appointment.
Running ruins your body, the orthopaedic tells me. I buy this story on the spot, because any other friend who runs has told me the same. With my ankle is fractured and my knee hurting beyond imagination to the point I cannot walk up the stairs I put an orthopaedic boot on my leg and stop running for nearly two years, as per expert advice.
The orthopaedic: “Put this on and just don’t run again”.
It took me a big personal mindset shift and many hours spent studying the biomechanics of the human body to understand how wrong the experts were. There is no such thing as a human not suit for running. There only is the modern human who sits for the majority of the time and never moves the body, and then pretends to run as if the body was ready to do so, and then gets injured. With this idea in mind, I started untangling the issue.
I could write pages on this one alone, because understanding the sources of my knee pains has been a journey of profound transformation that has, and I am not exaggerating, changed me as a person.
The above is the story of my early twenties. Whenever I decided I wanted to pick up running again, I would run for a couple of weeks until the infamous “IT band syndrome” hit me and put me on the couch. I would then go to orthopaedics and physiotherapist only to hear that my body is not fit for this type of activity - an slight imbalance in my hips, an imperfect foot arch, you name it, I’ve heard it. I would have to spend hundreds of euros on custom insoles, exams, possible surgeries (which I never did, luckily for me), only to never solve the problem.
The reality is that humans are born to run, to carry things, to be on their feet for hours on end to chase some animal, to find that fruit tree…and I am not quite sure early Homo Sapiens had perfect, symmetric, balanced bodies.
So I started to take notes on when and how the pain was arising, and began to notice patterns. And to consider the idea that my way of moving was not efficient, and my body was compromised by modern lifestyle - things like sitting for hours, wearing shoes that kill our feet’s ability and mobility, etc.
I welcomed my fear, observed it, understood that I had to be proactive in approaching it, and made the necessary fixes to my lifestyle, to my body and to my habits.
I also understood that there no such thing as a bulletproof human whose body never fails. There exists, however, a kind of mindful humans that is able to pace themselves, to listen to their bodies and recognize any small pain or any signal of excessive stress. Such breed of human is able to reduce the intensity of whatever activities they’re busy with, let the body heal without ever reaching peak pain or injury, and then start again.
Developing this awareness and mastery of the self is how I’m up and running again, in a literal sense.
The Diabetes Problem
It was just another evening, in the midst of the covid pandemic. I had just moved abroad and after a day of work - in complete solitude - dinner time was approaching. As any other day in the previous two years, my meal would consist in a minimal amount of carbohydrates and a large share of proteins and fats.
After all, “with Type 1 diabetes, you should stay away from carbohydrates, because sugar spikes your blood glucose”.
That was the story I was hearing back then from several doctors I consulted, type-1s I was talking with, and from many videos on youtube.
Except that, as on most days, something strange was bound to happen. While avoiding carbohydrates kept my glycemic index in range for the majority of my waking hours, as I hit the bed my blood glucose would start to increase, increase and increase. It almost seemed as if my dinner of tofu and vegetables dipped in ridiculous amounts of tahini contained some hidden substance that would shoot my blood glucose to the roof. I would go to bed with, say, 105, and wake up with, say, 350.
Many more days went by and this pattern had no intention of disappearing. I was scared, I knew my health was being compromised every time this occurred, but I had no idea where to turn. I was following doctor’s recommendations and doing what many others were doing with confidence, at least on the surface.
That was clearly not working. So I started to dig the topic and study and understand what produces insulin resistance - I took ownership of my fear and faced it upfront.
And I started to put together some pieces of the puzzle. I put the time and the effort necessary to understand the factors at play. I understood the role of certain food groups in promoting insulin resistance, and I cleared those out of my diet. It also became evident that I was not sleeping enough, nor resting enough in general, so I fixed that too. Other aspects of my lifestyle, such as not walking after meals or rushing through them, were not helping.
I studied the science, consulted trustworthy and different people (I make it a point to not follow any nutrition guru or any individual who pretends to have the ultimate solution to anything), and worked on myself day after day after day with my Mastering Diabetes coaches. I studied, I observed, I took notes and I made fixes. I kept what worked and gradually removed what didn’t.
Slowly but surely, the process behind my diet and lifestyle turned into an optimization machine, the fact that my blood glucose levels and my type-1 diabetes management improved in sophistication and in ease being a mere logical consequence of it.
It was not after long that my HbA1c dropped to 6.1% and my blood glucose levels hit the 90% time in range mark over 90 days, 30 days, 14 days, 7 days and daily timeframes.
Observing a problem, studying it from the principles, and tackling it at the root.
There’s a lesson I’ve learned here, one that potentially encompasses anything from running to diabetes management. As far as my experience goes, this lesson has generated tremendous benefits when I applied it to my lifestyle, but nothing has stopped me from deploying in my job and other similar daily endeavors.
The lesson for me was: only because they’ve told you thing must be done a certain way, or because everyone else is doing them a certain way, that doesn’t mean it is the right way. And it takes some real effort and courage to allocate the time and energy necessary to draw the line between what is trendy but inefficient and what works for real. This requires that we go beyond the noise and find those First Principles again.
“Yes, Of Course…”
I know, it is nothing you’ve not already heard, as it was for me. I was shocked, however, as I realized that I was still nodding to this lesson only to carry on as usual. That was comfortable and did not require effort on my end.
In running, I was told that knee and ankle pain are the name of the game, an inescapable truth. Everyone has it, and everyone deals with it the same way: buy more cushioned shoes, go see a “specialist”, run on the pain, perhaps destroy your body with a long race (running marathons is a matter of vanity for most people), and then go get a surgery. And turn this into a badge of honor: “no pain no gain”.
I’ve lived in that camp for years, and I too was pitched into a knee surgery “because your knees are not fit for running”.
Then I saw people running with joy, completing incredible races and pulling some incredible performances while crossing the finish line with a smile. And being perfectly ready to go again the day after. Either these people were Super Humans, or they were doing things differently, and better.
I joined them, and asked “How are you guys doing this?“… and developed my own understanding.
As a species, running is hardwired and coded into our DNA. Except that modern life throws many habits and conventions that turn running, and any other physical endeavour, into a time bomb and an injury machine. We sit too much and we weaken our core, spine and joints; we wear shoes that are so comfy that the muscles in our feet do not have to work to keep us upright, losing their functional strenght.
Then, after ten hours of sitting at our desk we head outside running way past our limit, with a body that is too weak to keep up with the effort. And we get injuries.
I realized this, I studied the first principles of running (such as feet and joints mobility, core strength, and looking at chairs as they were evil, escaping them as much as possible), and the injuries are gone. And I run marathons crossing the finish line with a smile.
With regards to type-1 diabetes the process of enlightenment was very similar. I was quickly sold on the idea that the ups and downs are inevitable, that you just have to live with it and chase your blood glucose with more insulin when too high and more sugar when too low. This was hard to eradicate because it was instilled into me on day one. As a result, I was eating what everyone else was: the usual pastas “because you need some energy, but not too much because it’s carbs”, the usual meats and cheeses “because you need proteins”, the usual foods drenched with olive oil “because oil is so healthy”.Little to no fruits, because sugar is bad and some vegs, but with no attention.
I was living that story with many others, hiding the frustration and despair behind laughs “haha, I woke up with 350 again, and after the injection I dropped to 60, and had to eat tons of white sugar to bring it up again haha.”
That was painful and damaging in so many ways I should dedicate one article to that subject alone. However, once again I started to broaden my horizons and observe people with type-1 diabetes feasting on amazing fruits and delicious foods with half the insulin requirements I had and a time in range that was twice as mine. I asked questions, I started to study the subject from First Principles (what foods do to us, how the organism develops insulin resistance and why, etcetera), and the lifestyle changes were right there for me to do.
Fats cause insulin resistance, so oils were out. Proteins, I needed far less than I was having, and animal sources were not necessary if not harmful, so those were out too (yes, I still average 100 grams of proteins a day even on a plant based diet and without putting any effort in hitting that number). Carbs, it then turned out, could promote insulin sensitivity. I was simply getting it all wrong, because so I was told to do and because so everyone was doing.
Refined carbs such as pastas and breads and baked products will skyrocket blood glucose because they have no fibers. Whole plant based foods that are naturally rich in carbohydrates, on the other hand, are packed with fibre and nutrients that coupled with a low consumption of fats and proteins keep your blood glucose in range even on your worst days.
The Bottom Line
Simple life lessons such as “always question the assumptions” are so simple that nobody (me included) really pays attention to them. We nod and we carry on as always.
A diabetic avoiding fruits (and carbohydrates in general) because they spike blood glucose and a runner avoiding running because running hurts your knees are two people hiding behind a thin layer and trying to escape the problem. Those are easy way outs, much more comfortable than trying to understand the scientific principles behind human metabolism and movement.
For me, stopping, understanding, and fixing my lifestyle around such important areas as running and type-1 diabetes management literally turned my life upside down for the better. It’s an entirely different life I am living now, and one that is sustainable and bulletproof in the long term for scientific reasons.
It took effort, and it will take more effort in the future. I was scared and concerned at the beginning, but became bold enough to face my fears. And I’ll gladly keep tackling my blindspots with this mindset and with all the effort that is required. The benefits are so immense and liberating.
What about you?
What are some commonly held beliefs that you could challenge and that could potentially improve how you live your life?
