Living Well with Type 1 Diabetes: Balancing Nutrition, Activity, and CGM Wear

Living with type 1 diabetes is a constant balancing act of numbers, decisions and technology. Between keeping track of blood sugar trends and staying on top of the latest technological advances, there’s a lot to manage.

In recent years, continuous glucose monitors (CGMs) have advanced diabetes treatment. Compared to traditional fingersticks, CGMs provide much more insight into blood sugar trends, especially in response to exercise, food and stress.

Living well with type 1 diabetes requires implementing good nutrition and physical activity with CGM security and proper skin care.

A big part of diabetes management is nutrition. Understanding macronutrients and carb-to-insulin ratios are key to keeping blood sugar in range.

The three macronutrients include carbohydrates, fat and protein. It is recommended that people with type 1 diabetes get 50-55% of their calories from carbs, 25-30% from fat and 15-20% from protein. Depending on age and gender, fiber needs range from 20-30 g per day.

Carbs come from the following sources:

• Grains: bread, tortillas, granola, oats, crackers, popcorn
• Produce, including all fruit and starchy vegetables: potatoes, corn, peas and winter squash
• Legumes: black beans, kidney beans, lentils, chickpeas
• Dairy: yogurt, ice cream, milk
• Snacks and desserts: chips, cake, cookies, pastries

You can get protein from the following foods:

• Legumes & Plant Proteins: Edamame, pinto beans, peas, tofu, tempeh, nuts
• Dairy & Eggs: Greek yogurt, cottage cheese, eggs
• Meat & Seafood: Fish, poultry, venison, beef, shrimp

Fat sources include:

• Nuts & Seeds: Almonds, walnuts, flaxseeds
• Plant-Based Fats: Avocado, olive oil
• Oily fish: Salmon, tuna

These foods contain heart-healthy fats. Saturated fats, which come from foods like butter, coconut oil, processed meats, fatty cuts of meat and desserts, should be limited.

You should avoid trans fats all together. These are found in products with hydrogenated oils, deep-fried foods and some baked goods.

Fiber is found in plant foods such as:

• Whole wheat bread
• Oatmeal
• Legumes
• Broccoli
• Raspberries
• Pumpkin seeds
• Almonds

Pairing carbs with fat, protein and fiber helps slow down digestion, which makes your blood sugar less likely to spike. You can easily track post-meal blood sugar trends on your CGM to better understand how your body responds to various foods.

Type 1 diabetes and exercise can be a challenging combination. On one hand, a sure way to bring down high blood sugar or keep your blood sugar in range is to do some type of physical activity. This is because moving your body allows glucose to more easily enter your cells for energy, decreasing your blood sugar. However, exercise can also make blood sugar go low.

Various types of exercise affect blood sugar differently. Aerobic exercise such as biking and walking lowers blood sugar during physical activity and for up to 24 hours after.

Anaerobic exercise happens when you do vigorous activity, such as sprints. Your blood sugar can rise for up to an hour thanks to the stress of pushing your body hard. You can easily see this trend by pairing a CGM and exercise together.

Before exercising, you should make sure your blood sugar is above 100 mg/dL. If it’s below that number, eat or drink 15 grams’ worth of carbs and wait 15 minutes. If your blood sugar still isn’t high enough, repeat the process.

If you use an insulin pump, adjusting basal rates or temporary blood sugar targets before exercise can help prevent low blood sugar as well. Your healthcare provider would be able to help you make personalized changes to pump settings.

Because aerobic exercise can cause low blood sugar for up to 24 hours after working out, nighttime lows are possible. CGMs can alert you when blood sugar is trending low in order to prevent serious hypoglycemia (low blood sugar), which is a major benefit of this technology.

While major benefits of CGMs include easy access to blood sugar trends and setting alerts to prevent low or high blood sugar, there are downfalls, such as CGM adhesive problems, as well.

Wondering how to keep a CGM on when dealing with sweat, friction and high-impact movement is a common question. While many people struggle to keep a CGM on during the hot summer months, it’s a challenge for some people during the colder months as well.

Fortunately, there are products such as Eloquest Healthcare’s Mastisol Liquid Adhesive, which helps prevent your CGM from falling off mid-session.

Not only is Mastisol latex-free with low risk of adverse reactions, it’s also very easy to use. Before applying your CGM, all you need to do is apply the Mastisol to where the CGM’s outside border will be, and then let it dry for 20-30 seconds. You should always clean your skin with alcohol to avoid infection before applying your CGM as well.

There’s nothing worse than trying to remove a CGM without a removal product. Not only is it painful, but there’s always residue left on your skin.

To make CGM removal easier, you can use Detachol Adhesive Remover. This is easy to use; all you need to do is squeeze the vial to saturate the dressing as you remove it from your skin.

Detachol also decreases the risk of Medical Adhesive-Related Skin Injury (MARSI) and completely removes residue, which can harbor bacteria.

Managing type 1 diabetes isn’t easy. It’s a combination of using nutrition, movement and technology strategically to promote balanced blood sugar. Finding the tools that work for you might take time and trial and error.

Don’t be afraid to seek help and ask questions. Speak to your healthcare team, including a certified diabetes care and education specialist (CDCES) when making changes to your treatment regimen or activity plans.

Kourtney Johnson, RD, LD is a registered dietitian living with type 1 diabetes. She lives in Minnesota but enjoys traveling, especially to the ocean! Kourtney is also an avid reader. She was inspired to study dietetics thanks to her experience working with registered dietitians after being diagnosed with diabetes at age 11. She enjoys living a healthy lifestyle by trying new nutritious recipes and staying active.