Growing up with type 1 in the Middle East.

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I sat down with Mariam El Keraby from Canada to talk with her about growing up with type 1 in the Middle East, experiencing diabetes burnout and how changing to a plant-based vegan diet helped her manager her diabetes better than ever.

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What was your biggest challenge growing up with type 1 diabetes?

I feel with every age diabetes offers a different challenge. However, if I picked one I would say the biggest challenge is accepting and being OK with the imperfection that diabetes offers.

That to me is definitely a struggle that still lives on.  The perfection that I try and strive for with my diabetes care is just not possible, there are many factors that affect my blood sugars on a daily basis that even with my best efforts I won’t always get the results I want.

I know you grew up in the Middle East – how is type 1 diabetes perceived and people with diabetes within the Islamic culture?

I grew up in Saudi Arabia, which is a very conservative country in terms of socialization. I didn’t really interact with people outside my social class.

By the way I was treated by my endocrinologist I can say that diabetes isn’t well understood. My endocrinologist treated me as a type 2 diabetic in many ways. I was put on metformin (and insulin). I was very limited in my food options. Every appointment was a case of what I did wrong and ate wrong. There was a lot of focus on my food choices. The thing I remember most was her telling me if I wanted to eat out with friends (which I should limit to once a month because of my diabetes) I should eat half the bun of burger and only 10 FRENCH FRIES.

There was a very limited view on how to manage type 1 diabetes. 

You’ve experienced diabetes burnout in the past – how did you manage that and come out on the other side?

There were about 3-4 very unpleasant months. I’m not quite sure how I managed it upon reflection. I was done with caring for my diabetes and I also wanted to lose weight which I was struggling with at the time.

I slowly started to test my blood sugar levels less, than I decided to omit some of my meal time insulin and let my blood sugars run high. 

I had a continuous glucose sensor on too, but that was useless because it kept alerting I was running high so I disconnected it and a week after I decided to go back on insulin shots.

My blood sugars would range anywhere from 25mmol/l (450mg/dL) and higher all day long. While I felt awful and lethargic with very little energy I kept feeding the cycle and wasn’t sure how to break the bad habits.

I lost my energy to workout, I was moody and didn’t want to socialize with many people. I wasn’t me! I was happy to lose the weight and I believe that helped feed the the bad patterns I was getting into. I ate everything and whatever came to mind. Nothing I ate was in moderation, and certainly things I wouldn’t eat today. I would have 2 packs of biscuits followed by 2 protein bars and a family size pack of chips…without any insulin. I put myself in a naive mentality that I wasn’t doing anything that was harming my body, when in fact my a1c hit its highest ever of 8.6% in 8 years following my burnout period and a visit with my eye doctor showed that there was a slight change in my eyesight. With a lot of tears, help and support from various people around me I was finally woke up.

It was not easy, but I hooked myself back on my insulin pump to ensure a constant flow of insulin was going in me. I set daily goals for myself (like injecting insulin for one meal). Slowly overtime I broke these bad habits. I assured myself that every day is a fresh start.

What are the biggest changes you’ve recently made to manage your diabetes?

Following my burnout, I was really in need to get back on track and have control over my diabetes again. I knew I had to change something up. Low carb wasn’t the thing for me and my diabetes.

Before my burnout I was starting to get interested in veganism…I follow a couple vegan diabetics on instagram (@mindfuldiabeticrobby@mangomannutrition@amymckinnonnutrition) – seeing their control was something I really wanted to achieve. In January I took the new year resolutions serious and I went vegan overnight. Since going vegan I’ve been able to have better control of my blood sugars and the low GI vegan food has been able to help me predict my blood-sugar response (for the most part).

My mind seems to be clearer and while I still have the rough frustrating blood sugar days, my emotions don’t seem to be as bad as they were leading up to my burnout.

I’ve always loved working out but once again following my burnout I started to run.

I noticed my fitness level decreased drastically. I could no longer complete a 1-hour workout class…I could only go 10-15mins before being tired and out of breath. Running was my way to build up my stamina again, I took it at a nice and easy pace one KM at a time. While sometimes at the beginning running felt like a chore because it kept reminding me how unfit I was I kept pushing. Now running is my escape from the world to distress and enjoy the nature around me. While at the start of the year I could barely finish a kilometer, I’m proud to be averaging 6-7km a run today.

Hopefully one day I get to run a half marathon.

What is your favourite food/recipe?

I have quite a few favorite foods, but, at the top of my list is always French fries. Although I eat the occasional oily French fry. I enjoy making them at home in a much healthier way that provide nutrition to my body and don’t send my blood sugars on a rollercoaster.

Here is my super simple recipe: 

Cut up some potatoes (regular or sweet potatoes) into wedges and place them in a bowl – keep the skin on for extra fiber to slow the rise in BGLs.

Add some salt, pepper, paprika, and French fries seasoning and that place them on a baking sheet and pop them in the oven on 400F till they are yellowish brown in colour.

And VOLIA…some oil free, crispy and delicious fries.

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What is one food you never thought you would eat and you really love?

Before going vegan my pallet of food was basically non-existent. I can name you the foods I liked because that’s how few there were. And because most of these foods weren’t very healthy or weren’t vegan I really had to force myself to adventure out and try new foods. I had to try everything from chickpeas, beans, strawberries, oatmeal…seriously everything!

The one food that I never thought I would like though would be bananas.

I couldn’t even come near a banana because the smell was horrible. Now though, I don’t think there is a day I go without having at least one banana.

Bananas are the perfect snack, perfect for smoothies and perfect to treat my low blood sugars.

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What is one piece of advice you would give to a young girl (or boy) newly diagnosed with type 1 diabetes?

If I met a newly diagnosed child, I would tell them diabetes sucks…I feel it is important to acknowledge the fact that diabetes does suck.

But then I would tell them that they have so much strength in them to conquer and show diabetes what they are all about.

I would empower them and assure them that they have what it takes to do whatever they want to do even with diabetes.

I would tell them that they are super heroes and superheroes never ever give up.

If people want to follow your story where can they find you?

If people want to follow my story they can find me on Instagram @keraby_t1d. I share my story of living with type 1 – the ups and downs and daily life.

I also have a blog, you can read it here: The Human Pancreas

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