How to stay fit when you have type 1 diabetes

The team at isoshealth enjoyed reading this useful article in the telegraph a few months ago.  It very much reminded us of the need to get tailored bespoke advice  on fitness and well-being.

We are very happy to share the  advice given but with the caveat that we are all different .  Broad trends and advice can be useful but its much more reassuring to have a one to one consultation with a  physiotherapist or dietitian  who understands your unique circumstances.

Carbohydrate intake during exercise

“If you are exercising intensely or over an extended period of time you’re likely to need extra carbohydrate during exercise. Less carbohydrate is required the longer it was since your last insulin injection.”

After you exercise

“Be aware the around eight to 12 hours after you exercise, your blood glucose level could drop too low. This is because your adrenalin levels drop and your muscles and liver will start to take up extra glucose to replace their stores. You will need to take this into account when estimating your insulin dose prior to, or immediately after, exercise.

“Checking your blood glucose before and then every few hours after exercise, and recording what exercise you do and food you’re eating, will make it easier to see trends and assist you and your healthcare team to develop good ways of managing it.

“If you exercise in the late evening after dinner, it may increase the risk of a hypo overnight, often around 2-3am. To reducing the risk of this, you might need to take less evening insulin or eat a low GI snack before bed.

“In general, if your insulin levels during exercise were sufficient, your blood glucose should be back down to your pre-exercise level within three to six hours, without additional insulin.”

isoshealth and Mumsnet

I am delighted to share that @mumsnet and @isoshealth are now working together to make affordable health and wellbeing guidance, for real life, available from qualified practitioners, via online video sessions.

It is widely understood and evidenced that the three main influences on our health are what we eat, our physical activity and how we manage our thoughts and emotions. @isoshealth is a place where, working with experts online over video, you can successfully manage these influences. Work with one practitioner or all three as a team, to achieve a happier, healthier diet, body and mind.

“When we began this journey, building @isoshealth, we knew that we wanted to offer a more effective solution that the wellbeing quick fixes targeted at mums across the UK. Kim Page – isoshealth Founder and CEO. “During our trials, the feedback from @mumsnet users confirmed the amazing difference it makes, in a 30min session, to speak to an expert you can trust and get the personalised advice and answers that actually work in real life. It’s fantastic to be joining forces with @mumsnet, to put trusted dietitians. physiotherapists and psychologists within easy and convenient reach of mums across the UK.”

Can health apps plug the motivation gap?

Whether we like it or not, health apps are becoming the norm. Not only are they being used all over the world for everything from sports performance tracking, diet and nutrition, meditation, weight loss and speaking to Practitioners. Apps now not only are for personal use and gain but are endorsed by the NHS with 40 of them being listed as useful.

Health apps and Mhealth solutions meet us where we already are – our phones and devices. There’s no need to change how we already live our lives apps integrate into our every day and synch up with wearables too. In this way, it is easy to make their use routine just like checking our emails or scrolling through social media might be.

But what about that first step? Good healthy habits are the goal, but how can apps really tap into our psyche and motivate us?

One type of health app that’s looked to do just that are those that play on the human need for reward. Making a change to our health or lifestyle, no matter how big or small can be tough. “Motivation has always been a key stumbling block when it comes to keeping fit and healthy. Health apps aim to bring a goals-based approach to the problem giving us unprecedented access to data about ourselves. This data helps us feel good about achieving new personal bests and seeing improvements over time.”, says founder and creator of fit-count Marc Asher.

But for some this type of data can be overwhelming or have no real meaning to people, especially in the beginning when progress might be slow. This stops them from having true ‘intrinsic’ motivation – pursuing changes because it makes them feel good because they enjoy it or get a mental benefit. And this is what Marc cleverly played on, “Combine data with a rewards-based approach such as financial incentives to do exercise that an app such as fit-count provides, and you have a powerful tool to make a positive lasting change to your lifestyle.”. fit-count effectively pushes people through the initially tough stage by giving a form of extrinsic motivation – offers and discounts in reward for steps and other activities.

In this way, you can really see the potential of health apps, not only fitting into our everyday lives but challenging our everyday habits. We’re proud to be represented on fit-count, with offers from us being unlocked at different stages of steps. They are soon to release their Android version and are already live on iOS. So, if you’ve got an iPhone, make sure you download fit-count today to get access to offers from us and plenty of other great businesses and brands.

The power of three: why mind, body and nutrition all matter


When we want to make a change to our health, it’s easy to have tunnel vision. Adopting a quick-fix weight loss diet, embarking on a fitness programme or doing a meditation programme, of course, have effects and even benefits. But when it comes to health, we have to consider that our mind, body and nutrition all work in sync. All sounds a bit much, right? We agree. That’s why we created isoshealth – a place you can get help with all three aspects of your health from Practitioners that really know their stuff. So, let’s go back to how we know that focusing on all three works.

In clinic

MDT or ‘multidisciplinary teams’ are common in the NHS. A key place where they’re found is in obesity treatment, working with patients in a community setting to transform their lifestyles. Together they address all aspects of obesity, managing the challenges that come along with weight loss and recovery. This structure has proven to be very successful in not only reducing weight but creating a lasting lifestyle change for patients.

In sport

Our Olympic athletes, of course, follow a very disciplined lifestyle – working tirelessly to improve their performance. But surrounding each of them is a team of experts all working with them to optimise their mind, body and nutrition. A winning mindset is needed for results, the right food to fuel and, of course, training are all essential to success.

In the celebrity world

All too often we see celebrities drop several sizes in a matter of months or even weeks. Perhaps it might be to publicise a new work out DVD or tell their transformation story in a weekly glossy. One thing they seem to always leave out is the team behind them. There’s no doubt they put the work in. But by their side, a team of nutritionists, personal trainers, mental coaches and even doctors paved their path to great health. It was not just through their workouts or reported ‘tips’ given in a double page spread, but the knowledge and expertise of a team who completely personalised their plan for them.

In real life

Finding it hard to relate? We will all know someone or perhaps be someone that wants to lose weight. In the weight loss world, we’re told a diet and perhaps an exercise plan will work. Eat less move more. It’s not a lie. It works but it doesn’t stop so many people from falling off the wagon. Often, our relationship with food is emotional – we feel attached to it, scared of it, comforted by it, guilty about it or do not understand it. And this is where working on your mental wellbeing comes in. With so much emotion around food and exercise, there needs to be time to work on your thoughts and feelings towards the whole journey. Crafting a good relationship with food and self-belief is essential to making lasting change.

We truly believe that everyone should have access to a team of three Practitioners, whenever and wherever they need them. Why not see if it’s for you with a free online appointment today?

Finished Veganuary? Let’s talk about the physical effects of a vegan diet

Veganism – it’s not only been on the rise in the public but it’s something which has now been embraced by brands, restaurants and pubs alike. From Gregg’s vegan sausage rolls to Alpro’s nut milks’ and Whetherspoon’s vegan breakfast, it’s fair to say a vegan diet is now ‘mainstream’.

This year saw the highest numbers of the public signing up for Veganuary – over 250,000 people, and that’s just the number of those who physically signed up with the official campaign. Since the launch of the campaign in 2014, we’ve seen an insurmountable amount of growth in the vegan foods and product sector, becoming widely available and a very profitable market to start a business within.

Social media, arguably, has been a huge part of this growth, with many influencers not only documenting their vegan journey but also becoming fierce advocates for the movement. It’s been a place to share the positive sides of veganism – the recipes, ways to make small changes and benefits to your body and the world. However, it’s also been a platform where ‘non-vegans’ are potentially shamed for their choices. This has been seen, ironically, in the reaction to several self-branded vegan influencers having to step away from the lifestyle for health reasons. Their decisions have been met with hate and isolation from a movement they helped to grow – a real shame.

And so this brings us to the most contentious of issues; health and veganism. Aside from the anecdotal evidence from those who have turned vegan, the BDA has affirmed that a well-planned vegan diet can “support healthy living in people of all ages” in an official document signed by its CEO. This has been echoed across the professional community, with most agreeing more fruit and vegetables on our plates is never a bad thing – but it is not a lifestyle which should be entered into without any consideration.

Of course, the voice of Dietitians is vital in this conversation, but we rarely consider other individuals which also encounter those following a vegan lifestyle. We spoke to Stephen Parkus, a Registered Physiotherapist about his views on veganism.

“There are a very large number of potential issues. Ultimately, it is important to have a balanced diet, with all necessary nutrients in balance. This requires some education and planning. A vegan needs to put more effort into this, as they have far fewer choices available in their diet.”

He went on to discuss some of the key nutrients which he finds those following a vegan lifestyle might need to consider in terms of supplementation or in their food sources. So what do you need to look out for to keep your body, mobility and movement in check?

  • Watch out for a lack of protein as this may lead to increased likelihood of injuries like pulled muscles or ligaments, or delayed healing from these injuries, as well as a loss of muscle in general.
  • Long-term low levels of calcium, which so many of us just see as being sourced from dairy, may lead to early osteoporosis. This can increase the risk of broken bones. However it is not something that is just from dairy; soy products, cruciferous vegetables (cabbage, brussel sprouts and kale), almonds and even mustard are great sources.
  • A lack of vitamin C may lead to an increased risk of coughs & colds, and therefore reduced activity due to illness as well as reducing the absorption of iron. To combat this broccoli, red peppers and of course the classic oranges are great sources.
  • For women,  menstruation naturally decreases your iron levels and can lead to fatigue. Eating more iron-rich foods around this time, such as green leafy vegetables, beans or lentils, along with a source of vitamin C for absorption will help combat this. Also, it may be useful to minimise calcium-rich foods at this time, which reduce iron absorption.

From a Physiotherapists perspective, it is about having an optimal body that can keep moving and support a healthy active lifestyle. The scaremongering of nutrient deficiencies often stems from people not really looking at what they need. Something that Stephen has also seen “Some people may be supplementing because they think they need to, but if they already have a balanced diet, they may be wasting money. This means they may be overconsuming certain nutrients, leading to weight gain and other problems which ultimately make it harder to get moving. For example, excess protein can lead to dehydration and calcium loss associated with osteoporosis.”

And so, the verdict from both Physiotherapists and Dietitians is to find a diet that really works for you. Regardless of whether you’re vegan or not, we all need a healthy and balanced diet to keep our bodies ready to move and well enough to exercise. Finding what truly works for YOU and that benefits YOUR health is the only thing that truly matters from a professional perspective.

Interested in speaking to a professional to start your journey on what works for you? Have a different conversation about your health with a free session with a Registered Dietitian, Physiotherapist or Dietitian



Hints and tips – get the knowledge

Danny Donachie (BSc) Physiotherapist and isoshealth Advisory Board Chair thinks that knowledge is power when it comes to losing weight.


Top tip for losing weight is to find the best research that hasn’t been biased by the researchers or the organisations funding the research. Get the facts and your pathway to weight loss will be effortless and effective. The myths of fad diets will not see your goals attained and you have to make sure you find an expert with the best and most validated knowledge. When you have this knowledge, use it.

Hints and Tips – Identify the “why”

Mariette Abrahams (BSc, MBA) Dietician and isoshealth advisory board member reveals her number one tip for effective lasting weight loss.


Identify your “why” for wanting to lose weight. That one thing can help you to stay motivated and make it through the harder times. Weight loss is a journey and you may learn new things about yourself that you did not know or were aware of. Therefore identify your “why”, write it down, remind your self daily and stick with it, because once you have found your why, you will not only feel great, you will also have the mental strength and clarity to tackle other goals.

Hints and Tips – Mindset

We asked isoshealth Advisory Board member Dr Bijal Chheda-Varma  what her top tip is for any one wanting to lose weight.

Explore what mindsets make it difficult for you to prioritise your self and body? Challenge these mindsets if they are unhealthy and distorted. This mindset shift along with behaviour change will sustain your recovery in the long term.

Q How do I become motivated again?


Hi, I have recently lost all motivation to diet or exercise. Is it possible I have a hormonal problem like low-testosterone? How do I become motivated again?

A! From advisory board member Dr Bijal Chheda-Varma

Maintaining weight loss requires re-building your relationship with food and your body. One has to change mindsets about the way you eat and what you eat in order to build healthy behaviours around food. How much of your battle with low mood is about your difficult relationship with your sense of self, which includes your body? Food is not a reward or punishment towards how you feel about your body. To release yourself from this viscous cycle, get to know what the link between your mindsets around food and body and your consequent behaviours is. Work on changing the unhealthy patterns, both in your mind and through your habits.