A1C-Chronicles:

January 2025

Empowering Your Diabetes Journey,  Together 💙

 👋 ,

Welcome back to A1C-Chronicles!

To Our Diabetes Express Family,

As we settle into the rhythm of the New Year, we find ourselves looking forward with a renewed sense of purpose and a deep gratitude for the strength of this community.

We know we’re a little late in getting this first update of the year into your inbox, but the start of January often feels like its own unique mountain to climb. In this edition, we’re focusing on the "science of the self" and the practicalities of staying resilient during the winter months. 

Thank you for your patience and for letting us be part of your journey as we kick off 2026. Here’s to a month of steady numbers, warm meals, and the confidence that comes from knowing your community has your back.

It's all a part of...

Empowering Your Diabetes Journey, Together!

Josie's Tips: Navigating Sick Days with Confidence

Hi everyone, Josie Here!

For most people, a cold is just a nuisance, but when you’re managing insulin needs, being sick requires a bit more strategy.

When your body is fighting off an infection, it releases stress hormones like cortisol and adrenaline. These hormones help fight the illness, but they also tell your liver to release extra glucose for energy and can make your body more resistant to insulin. This is why blood sugars often climb even if you aren't eating much!

Your Sick-Day Game Plan 🌡️

Being prepared before you feel under the weather is the best way to stay safe. Here is how to handle a "Sick Day":

1. Check More Often 🔍 Don't wait for your CGM alarms. When you're sick, check your blood glucose every 2 to 4 hours, including overnight. If you don't have a CGM, this is the time to lean heavily on your finger-stick meter to ensure accuracy.

2. Never Stop Your Insulin 💉 This is the most important rule! Even if you are vomiting or not eating, your body still needs basal (background) insulin to prevent your blood from becoming acidic. In fact, you may actually need more insulin than usual due to those stress hormones.

3. Check For Ketones 🧪 If your blood sugar is consistently high, you must check for ketones. High ketones + high blood sugar = a high risk for DKA (Diabetic Ketoacidosis).

Josie’s Pro Tip: For accuracy, ketones should be checked, using a blood ketone meter so keep a fresh bottle of ketone strips in your medicine cabinet. Check the expiry date today—they often expire faster than glucose strips!

4. Hydration is Non-Negotiable 💧 Sickness can lead to dehydration quickly, especially if you have a fever. Aim for at least one cup (250ml) of fluid every hour.

• If blood sugar is high: Stick to water, broth, or sugar-free electrolyte drinks.
• If blood sugar is low/dropping: Use ginger ale (regular), apple juice, or popsicles to keep your levels up while soothing your stomach.

5. Choose Medications Wisely 💊 Many over-the-counter (OTC) cough syrups and lozenges are packed with sugar. As a pharmacist, I recommend looking for "sugar-free" versions of cold and flu meds. Also, be wary of decongestants (like pseudoephedrine), as they can sometimes raise blood sugar levels even further.

When to Call the Doctor or Head to the ER 🚑

Sometimes, home management isn't enough. Seek medical help immediately if:

• You have been vomiting or had diarrhea for more than 6 hours.
• You have moderate to large ketones that won't go away.
• You are struggling to keep your blood sugar above 4.0 mmol/L.
• You feel confused, extremely sleepy, or have trouble breathing.

More Resources for You:

• Diabetes Canada: Stay Safe When You Have Diabetes and Are Sick or at Risk of Dehydration

• Diabetes at School: Guidelines for the Care of Students Living with Diabetes at School

Stay hydrated and rest up! Being prepared means you can focus on getting better rather than worrying about the numbers.

Until next time...

Disclaimer: This information is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before  making any changes to your diabetes management  plan.

Thai Coconut Soup

Prep time: 20 minutes; Cook time: 30 minutes; Serving: 8 

Ingredients:

• 1 tbsp avocado oil (or vegetable oil)
• 2 tbsp grated fresh ginger
• 2 tsp red curry paste (check label to ensure no added sugar)
• 1 stalk lemongrass, minced (or 1 tbsp lemongrass paste)
• 4 cups low-sodium chicken broth
• 3 tbsp fish sauce
• 1 tbsp Brown Sugar Alternative 
• 3 cans (13.5 oz each) Unsweetened Coconut Milk (Full fat or light, depending on your calorie preference)
• ½ lb fresh shiitake mushrooms, sliced
• 1 red bell pepper, thinly sliced 
• 1 lb medium shrimp - peeled and deveined (or substitute diced chicken breast)
• 2 cups baby spinach or chopped bok choy
• 2 tbsp fresh lime juice
• ¼ cup chopped fresh cilantro

• Optional: Sliced Thai chilies or jalapeños for extra heat

Directions:

1. Sauté Aromatics: Heat the oil in a large soup pot or Dutch oven over medium heat. Add the grated ginger, red curry paste, and minced lemongrass. Cook and stir constantly for 1 minute until fragrant.
2. Build the Base: Gradually pour in the chicken broth, stirring to scrape up any browned bits. Stir in the fish sauce and your brown sugar alternative. Reduce heat to low and let it simmer gently for 15 minutes to infuse the flavors.
3. Add Veggies & Creaminess: Stir in the coconut milk, sliced shiitake mushrooms, and sliced red bell pepper. Cook for about 5 minutes until the mushrooms are soft.
4. Cook Protein: Add the shrimp (or chicken) and the optional spinach/bok choy. Cook for about 5 minutes, or until the shrimp is pink and opaque (or chicken is cooked through).
5. Finish & Serve: Remove the pot from the heat. Stir in the fresh lime juice. Taste and add salt or more sweetener if needed to balance the sour and salty flavors. Ladle into bowls and garnish generously with fresh cilantro.

Glucotypes and Smart Insulin: The Science of Personalization

Investigating "Glucotypes": Why Your Spikes are Unique

For decades, diabetes management was based on the "one-size-fits-all" approach: a slice of whole-wheat bread or a banana was assumed to have a predictable effect on everyone's blood sugar. However, the rise of CGM technology has revealed a different reality.

Researchers at Stanford University recently coined the term "Glucotypes" to describe how individuals fall into different categories based on how their glucose levels fluctuate throughout the day.

• The Discovery: In a landmark study, researchers found that people (even those without diabetes) could be classified into three "glucotypes": low, moderate, and severe, based on their glucose variability after eating identical meals.
• The "Banana Effect": In another famous study out of Israel, two people ate the exact same banana; one person's sugar barely moved, while the other's spiked to diabetic levels.
• Why it Matters: Your glucotype is influenced by your gut microbiome, genetics, and even your stress levels. This explains why a "healthy" snack might cause a massive spike for you but not for your friend. Understanding your specific glucotype helps move the focus away from "good" or "bad" foods and toward bio-individuality

The Future of "Smart" Insulin: The Glucose-Responsive Molecule

While understanding your glucotype helps you predict spikes, the "Holy Grail" of treatment remains a way to automatically handle those spikes without the risk of a "low." Enter Glucose-Responsive Insulin (GRI), commonly known as Smart Insulin.

Current insulin is "dumb"—once you inject it, it starts working regardless of whether your blood sugar is 4.0 mmol/L or 14.0 mmol/L. Smart Insulin aims to change that.

How it Works:

GRI is a chemically modified insulin molecule designed to act like a thermostat:

• Activation: The molecule contains a "sensor" that detects glucose levels in the blood. When glucose is high, the insulin molecule "unlocks" and becomes active.
• Deactivation: When glucose levels return to a normal range (the "euglycemic" state), the molecule locks back up or slows down its activity.

The Impact:

• Eliminating Hypoglycemia: Because the insulin "turns off" when you are in range, the risk of severe lows is virtually eliminated.
• Reducing the Mental Burden: This would remove the constant need for "correction boluses" or the fear of miscounting carbs.
• Once-a-Day Potential: Some versions of GRI currently in clinical trials (like those from Novo Nordisk and Eli Lilly) are being designed to be injected just once a day, staying dormant in your system until you actually need it.

Strides Toward Precision Care

By combining the knowledge of our individual Glucotypes with the upcoming power of Smart Insulin, the future of diabetes care is shifting from "management" to "precision." We are moving toward a world where your treatment understands your body’s unique code as well as you do.

We would be thrilled if you left us a review 💙

How can we help?