Diabetes management requires awareness. Know what makes your
blood sugar level rise and fall — and how to control these day-to-day factors.
Keeping your blood sugar levels within the range recommended by
your doctor can be challenging. That's because many things make your blood
sugar levels change, sometimes unexpectedly. Following are some factors that
can affect your blood sugar levels.
Keeping your blood
sugar levels within the range recommended by your doctor can be challenging.
That's because many things make your blood sugar levels change, sometimes
unexpectedly. Following are some factors that can affect your blood sugar
levels.
Food
Healthy eating is a
cornerstone of healthy living — with or without diabetes. But if you have
diabetes, you need to know how foods affect your blood sugar levels. It's not
only the type of food you eat but also how much you eat and the combinations of
food types you eat.
What
to do:
·
Learn
about carbohydrate counting and portion sizes. A key to many diabetes management plans
is learning how to count carbohydrates. Carbohydrates are the foods that often
have the biggest impact on your blood sugar levels. And for people taking
mealtime insulin, it's crucial to know the amount of carbohydrates in your
food, so you get the proper insulin dose.
Learn what portion size is appropriate for
each type of food. Simplify your meal planning by writing down portions for the
foods you eat often. Use measuring cups or a scale to ensure proper portion
size and an accurate carbohydrate count.
·
Make
every meal well-balanced. As
much as possible, plan for every meal to have a good mix of starches, fruits
and vegetables, proteins, and fats. It's especially important to pay attention
to the types of carbohydrates you choose. Some carbohydrates, such as fruits,
vegetables and whole grains, are better for you than are others. These foods
are low in carbohydrates and contain fiber that helps keep your blood sugar
levels more stable. Talk to your doctor, nurse or dietitian about the best food
choices and the appropriate balance of food types.
·
Coordinate
your meals and medications. Too
little food in proportion to your diabetes medications — especially insulin —
may result in dangerously low blood sugar (hypoglycemia). Too much food may
cause your blood sugar level to climb too high (hyperglycemia). Talk to your
diabetes health care team about how to best coordinate meal and medication
schedules.
·
Avoid
sugar-sweetened beverages. Sugar-sweetened
beverages — including those sweetened with high fructose corn syrup or sucrose
— tend to be high in calories and offer little in the way of nutrition. And
because they cause blood sugar to rise quickly, it's best to avoid these types
of drinks if you have diabetes.
The exception is if you are experiencing a low
blood sugar level. Sugar-sweetened beverages, such as soda, juice and sports
drinks, can be used as an effective treatment for quickly raising blood sugar
that is too low.
Exercise
Physical activity is
another important part of your diabetes management plan. When you exercise,
your muscles use sugar (glucose) for energy. Regular physical activity also
helps your body use insulin more efficiently.
These factors work
together to lower your blood sugar level. The more strenuous your workout, the
longer the effect lasts. But even light activities — such as housework,
gardening or being on your feet for extended periods — can improve your blood
sugar level.
What to do:
·
Talk
to your doctor about an exercise plan. Ask your doctor about what type of exercise is appropriate
for you. In general, most adults should exercise at least 30 minutes a day on
most days of the week. If you've been inactive for a long time, your doctor may
want to check your overall health before advising you. He or she can recommend
the right balance of aerobic and muscle-strengthening exercise.
·
Keep
an exercise schedule. Talk to your
doctor about the best time of day for you to exercise so that your workout
routine is coordinated with your meal and medication schedules.
·
Know
your numbers. Talk to your
doctor about what blood sugar levels are appropriate for you before you begin
exercise.
·
Check
your blood sugar level. Check
your blood sugar level before, during and after exercise, especially if you
take insulin or medications that lower blood sugar. Exercise can lower your
blood sugar levels even a day later, especially if the activity is new to you,
or if you're exercising at a more intensive level. Be aware of warning signs of
low blood sugar, such as feeling shaky, weak, tired, hungry, lightheaded,
irritable, anxious or confused.
If you use insulin and your blood sugar level
is below 100 milligrams per deciliter (mg/dL), or 5.6 millimoles per liter
(mmol/L), have a small snack before you start exercising to prevent a low blood
sugar level.
· Stay
hydrated. Drink plenty of
water or other fluids while exercising because dehydration can affect blood
sugar levels.
· Be
prepared. Always have a
small snack or glucose tablet with you during exercise in case your blood sugar
drops too low. Wear a medical identification bracelet when you're exercising.
· Adjust
your diabetes treatment plan as needed. If you take insulin, you may need to reduce your insulin
dose before exercising or wait awhile after exercise to inject insulin. Your
doctor can advise you on appropriate changes in your medication. You may also
need to adjust treatment if you've increased your exercise routine.
Medication
Insulin and other
diabetes medications are designed to lower your blood sugar levels when diet
and exercise alone aren't sufficient for managing diabetes. But the
effectiveness of these medications depends on the timing and size of the dose.
Medications you take for conditions other than diabetes also can affect your
blood sugar levels.
What to do:
·Store
insulin properly. Insulin that's
improperly stored or past its expiration date may not be effective. Insulin is
especially sensitive to extremes in temperature.
·Report
problems to your doctor. If
your diabetes medications cause your blood sugar level to drop too low or if
it's consistently too high, the dosage or timing may need to be adjusted.
·Be
cautious with new medications. If you're considering an over-the-counter medication or
your doctor prescribes a new drug to treat another condition — such as high
blood pressure or high cholesterol — ask your doctor or pharmacist if the
medication may affect your blood sugar levels. Liquid medications may be
sweetened with sugar to cover their taste. Sometimes an alternate medication
may be recommended. Always check with your doctor before taking any new
over-the-counter medication, so you know how it may impact your blood sugar
Illness
When you're sick, your body produces stress-related hormones
that help your body fight the illness, but they can also raise your blood sugar
level. Changes in your appetite and normal activity may also complicate
diabetes management.
What to do:
· Plan ahead. Work with your health
care team to create a sick-day plan. Include instructions on what medications
to take, how often to measure your blood sugar and urine ketone levels, how to
adjust your medication dosages, and when to call your doctor.
· Continue to take your diabetes medication. However, if you're unable to eat because of nausea or vomiting,
contact your doctor. In these situations, you may need to adjust your insulin
dose or temporarily stop taking your medication because of a risk of
hypoglycemia.
· Stick to your diabetes meal plan. If you can, eating as usual will help you control your blood
sugar levels. Keep a supply of foods that are easy on your stomach, such as
gelatin, crackers, soups and applesauce. Drink lots of water or other fluids
that don't add calories, such as tea, to make sure you stay hydrated. If you're
taking insulin, you may need to sip sugar-sweetened beverages, such as juice or
a sports drink, to keep your blood sugar level from dropping too low.
Alcohol
The liver normally releases stored sugar to counteract falling
blood sugar levels. But if your liver is busy metabolizing alcohol, your blood
sugar level may not get the boost it needs from the liver. Alcohol can result
in low blood sugar shortly after you drink it and for as many as 24 hours more.
What to do:
·Get your doctor's OK to drink alcohol. Alcohol can aggravate diabetes complications, such as nerve
damage and eye disease. But if your diabetes is under control and your doctor
agrees, an occasional alcoholic drink is fine. Moderate alcohol consumption is
defined as no more than one drink a day for women of any age and men over 65
years old and two drinks a day for men under 65. One drink equals a 12-ounce
beer, 5 ounces of wine or 1.5 ounces of distilled spirits.
·Don't drink alcoholic beverages on an empty stomach. If you take insulin or other diabetes medications, be sure to
eat before you drink or drink with a meal to prevent a low blood sugar level.
·Choose your drinks carefully. Light beer and dry wines have fewer calories and carbohydrates
than do other alcoholic drinks. If you prefer mixed drinks, sugar-free mixers —
such as diet soda, diet tonic, club soda or seltzer — won't raise your blood
sugar.
· Tally your calories. Remember to include the calories from any alcohol you drink in
your daily calorie count. Ask your doctor or dietitian how to incorporate
calories and carbohydrates from alcoholic drinks into your diet plan.
· Check your blood sugar level before bed. Because alcohol can lower blood sugar levels long after you've
had your last drink, check your blood sugar level before you go to sleep. If
your blood sugar isn't between 100 and 140 mg/dL (5.6 and 7.8 mmol/L), have a
snack before bed to counter a drop in your blood sugar level.
Menstruation
and menopause
Changes in hormone levels the week before and during
menstruation can result in significant fluctuations in blood sugar levels. And
in the few years before and during menopause, hormone changes may result in
unpredictable variations in blood sugar levels that complicate diabetes
management.
What to do:
· Look for patterns. Keep careful track of your blood sugar readings from month to
month. You may be able to predict fluctuations related to your menstrual cycle.
·Adjust your diabetes treatment plan as needed. Your doctor may recommend changes in your meal plan, activity
level or diabetes medications to make up for blood sugar variation.
·Check blood sugar more frequently. If you're likely approaching menopause or experiencing
menopause, talk to your doctor about whether you need to monitor your blood
sugar level more often. Symptoms of menopause can sometimes be confused with
symptoms of low blood sugar, so whenever possible, check your blood sugar
before treating a suspected low to confirm the low blood sugar level.
Most forms of birth control can be used by women with diabetes
without a problem. However, oral contraceptives may raise blood sugar levels in
some women.
Stress
If you're stressed, the hormones your body produces in response
to prolonged stress may cause a rise in your blood sugar level. Additionally,
it may be harder to closely follow your usual diabetes management routine if
you're under a lot of extra pressure.
What to do:
·
Look for patterns. Log your stress level on a scale of 1 to 10 each time you log
your blood sugar level. A pattern may soon emerge.
· Take control. Once you know how stress
affects your blood sugar level, fight back. Learn relaxation techniques,
prioritize your tasks and set limits. Whenever possible, avoid common
stressors. Exercise can often help relieve stress and lower your blood sugar
level.
· Get help. Learn new strategies
for coping with stress. You may find that working with a psychologist or
clinical social worker can help you identify stressors, solve stressful
problems or learn new coping skills.
The more you know about factors that influence your blood sugar
level, the more you can anticipate fluctuations — and plan accordingly. If
you're having trouble keeping your blood sugar level in your target range, ask
your diabetes health care team for help.
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