Diabetes Management: How Lifestyle, Daily Living Affect Blood Sugar
Diabetes management requires a conscious approach. Learn what causes your blood sugar to rise or fall and how to control these everyday factors.
Keeping your blood sugar levels within the range recommended by your healthcare professional is important when you have diabetes. But many things can make your blood sugar levels change, sometimes quickly. Learn about some of the factors that can affect your blood sugar. Then learn how to manage them.
Food.
Eating healthy is important for everyone. But if you have diabetes, you need to know how food affects your blood sugar levels. This refers not only to the types of food you eat, but also the amount of food you eat and the types of food you combine in your regular meals and snacks.
Appropriate practices:
Understand a balanced eating plan. A healthy eating plan involves knowing what to eat and how much to eat. Two common ways to plan your diet are counting carbohydrates and the plate method. Consult with a medical professional or registered dietitian to determine if either diet plan is right for you.
Understand the carbohydrate counting method. Counting carbohydrates involves keeping track of how many grams of carbohydrates you consume each day. If you use insulin with meals to treat your diabetes, it’s important to know how much carbohydrate is in your food and beverages. This will allow you to determine the correct dose of insulin needed.
Of all foods, carbohydrates usually have the greatest impact on blood sugar levels. This is because the body breaks them down into sugar, which raises blood sugar levels. Some types of carbohydrates may be better for you than others. For example, fruits, vegetables and whole grains are rich in nutrients. They contain fiber, which helps maintain more stable blood sugar levels. Cut back on highly processed, refined carbohydrates. This includes white bread, white rice, high-sugar cereals, cakes, cookies, candy and chips.
Understand the meal plate method. This type of diet plan is simpler than counting carbs. The plate method helps you balance your diet and control portion sizes.
Use a 9-inch plate. Half of the plate holds non-starchy vegetables. Examples include lettuce, cucumbers, broccoli, tomatoes, and green beans. Divide the other half of the plate evenly into two smaller sections. You may have heard that these smaller sections are called quarters. Put lean proteins in the quarter of your dinner plate. Examples include fish, beans, eggs, lean meats and poultry. Put healthy carbohydrates, such as fruits and whole grains, in the other quarter of your dinner plate.
Watch portion sizes. Know the correct portion size for each food. Everyday items help you remember. For example, one serving of meat or poultry is comparable to a deck of cards. A serving of cheese is about the size of 6 grapes. A serving of cooked pasta or rice is about the size of your fist. You can also use measuring cups or scales to help determine the correct amount.
Balance your diet with your medications. If you use medication for diabetes, it is important to balance your diet with your medication. Foods that are too low in proportion to your diabetes medications (especially insulin) can lead to dangerously low blood sugar. This condition is known as hypoglycemia. Too much food may lead to high blood sugar levels. This condition is known as hyperglycemia. Talk with your diabetes medical care team about how best to coordinate meal and medication schedules.
Limit your intake of sugary drinks. Sugary drinks are often high in calories and provide little nutrition. They can also cause a rapid rise in blood sugar. Therefore, if you have diabetes, it is best to limit your intake of these types of beverages. Unless you experience low blood sugar levels. Sugar-sweetened beverages can be used to quickly raise blood sugar that is too low. These beverages include regular sodas, fruit juices, and sports drinks.
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Exercise
Exercise is another important aspect of managing diabetes. When you exercise and move, blood sugar provides energy for your muscles. Regular physical activity also helps your body use insulin more efficiently.
These factors work together to lower blood sugar levels. The more vigorous the workout, the longer-lasting the effect. But even light activity can improve your blood sugar levels. Light activities include housework, gardening, and walking.
Appropriate practices:
Discuss an exercise program with your healthcare provider. Talk to a medical professional about what type of exercise is right for you. In general, most adults should do at least 150 minutes of moderate-intensity aerobic activity each week. Include activities that promote pumping of the heart, such as walking, biking, and swimming. Aim for about 30 minutes of moderate-intensity aerobic activity most days of the week. Most adults should also aim to do strength training 2–3 times a week.
If you have been inactive for a long time, your healthcare provider may need to check your overall health first. They may then tell you how to properly balance aerobic activity with muscle strength training.
Develop an exercise program. Talk to your healthcare provider about the best time of day to exercise. From there, coordinate your exercise program with your meal and medication schedule.
Know your values. Before you start exercising, talk to your healthcare provider about the right blood sugar level for you.
Check your blood sugar levels. Discuss your blood glucose testing needs with your medical provider as well. If you do not use insulin or other medications for diabetes, you may not need to test your blood sugar before or during exercise.
However, if you use insulin or other diabetes medications, be sure to test your blood sugar. Check your blood sugar before, during, and after exercise. Many medications for diabetes lower blood sugar. Exercise does the same thing, and the effects from exercise can last up to a day after the exercise is over. If you are doing a new activity, the risk of hypoglycemia is higher. The risk is also higher if you start to increase the intensity of your exercise. Symptoms of hypoglycemia to watch for include shivering, weakness, fatigue, hunger, light-headedness, irritability, anxiety, or confusion.
Determine if you need a snack. If you are on insulin and have low blood glucose levels, have a small snack before exercising. A blood sugar level below 90 milligrams per deciliter (mg/dL) or 5.0 millimoles per liter (mmol/L) is considered low. Your pre-workout snack should contain about 15 to 30 grams of carbohydrates. Or you can take 10 to 20 grams of a glucose product. This helps prevent low blood sugar levels. If your blood glucose is 90 to 124 mg/dL (5.0 to 6.9 mmol/L), take 10 grams of glucose before exercising.
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Keep your body well hydrated. Drink plenty of water or other fluids during exercise. Dehydration may affect blood glucose levels.
Be prepared. Always carry a small snack, glucose tablets or glucose gel with you during exercise. If your blood sugar is too low, you will need to raise it quickly. Also carry medical warning labels. In an emergency, a medical alert label can show that you have diabetes. It can also show if you use diabetes medication, such as insulin. Medical alert labels usually come in the form of cards, bracelets, and necklaces.
Adjust your diabetes regimen as needed. If you use insulin, you may need to lower your insulin dose before exercising. You may need to monitor your blood sugar levels closely for several hours after strenuous activity. This is because hypoglycemia may occur afterward. Your healthcare provider can advise you on how to make the correct changes to your medication. You may also need to adjust your treatment program if you increase the frequency or intensity of your exercise.
Medications
If diet and exercise alone are not enough to control your diabetes, insulin and other diabetes medications can help lower your blood sugar levels. However, the effectiveness of these medications depends on the duration and dosage of the medication. Medications that treat medical conditions other than diabetes may also affect blood sugar levels.
Appropriate practices:
Store insulin properly. Improperly stored or expired insulin may not work. Do not put insulin in a particularly hot or cold environment. Do not store in the refrigerator or in direct sunlight.
Inform your healthcare provider of any medication problems. If diabetes medications cause your blood sugar level to drop too low, the dose or duration of the medication may need to be adjusted. Your healthcare provider may also adjust your medication if your blood sugar stays too high.
Use caution with new medications. Talk to your health care team or pharmacist before you try a new medication. This includes over-the-counter medicines and prescription medicines used to treat other medical conditions. Ask how the new medicine affects your blood sugar levels and any diabetes medicines you use. Sometimes different medicines can be used to prevent dangerous side effects. Or a different medication can be used to prevent your current medication from pairing poorly with the new medication.
Disease
For people with diabetes, it’s important to prepare well in advance for periods of illness. When you are sick, your body produces stress-related hormones to help your body fight the disease. But these hormones can also cause your blood sugar levels to rise. Changes in appetite and normal activity may also affect your blood sugar levels.
Appropriate practices:
Plan ahead. Work with your health care team to develop a plan for the period of illness. Include instructions on what medications to use and how to adjust them if needed. Also pay attention to how often you measure your blood sugar. Consult with your medical provider to see if you need to measure the amount of ketone bodies such as acid in your urine. Your plan should also include what foods and beverages you can consume and what cold or flu medications you can use. You should also know when to call your healthcare provider. For example, if you have a fever over 38.3 degrees Celsius (101 degrees Fahrenheit) for 24 hours, be sure to call your healthcare provider.
Continue to use your diabetes medication. Call your healthcare provider if you are unable to eat because of stomach upset or vomiting. In these cases, you may need to change your insulin dose. If you use fast-acting or short-acting insulin or other diabetes medications, you may need to lower your dose or stop taking them temporarily. These medications need to be carefully balanced with food to prevent hypoglycemia. However, if you use long-acting insulin, do not stop taking it. It is also important to check your blood sugar frequently during your illness.
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If you can, stick to a diabetic eating plan. Eating as usual will help control your blood sugar. Stick to foods that are easy to digest. This includes gelatin, crackers, soups, instant pudding, and applesauce.
Drink plenty of water and other fluids that don’t add calories (such as tea) to make sure you stay hydrated. If you use insulin, you may need to drink sugary drinks such as fruit juice or sports drinks. These drinks help prevent your blood sugar from dropping too low.
Alcohol
Some people with diabetes are at risk for drinking alcohol. Alcohol can cause hypoglycemia soon after drinking or even within a few hours. When blood sugar levels drop rapidly, the liver usually releases stored sugar to counteract this. However, if your liver is processing alcohol, it may not be able to give your blood sugar the support it needs.
Proper practice:
Get permission from a medical professional to drink alcohol. For people with diabetes, drinking too much alcohol can sometimes lead to health conditions such as nerve damage. But if your diabetes is under control and your healthcare provider agrees, it’s okay to have a little drink now and then.
Women should have a maximum of one drink a day. Men should have a maximum of two drinks a day. One drink is equivalent to 355 ml (12 oz) of beer, 148 ml (5 oz) of wine or 44 ml (1.5 oz) of distilled spirits.
Do not drink on an empty stomach. If you use insulin or other medicines for diabetes, eat before drinking. This helps prevent low blood sugar. Or drink alcohol with a meal.
Choose your drinks carefully. Low-proof beer and dry wine contain fewer calories and carbohydrates than other alcoholic beverages. If you prefer mixed drinks, it’s best to choose sugar-free mixes that won’t raise your blood sugar. This includes sugar-free sodas, sugar-free tonic water, seltzer water, or naturally sparkling mineral water.
Count calories from alcohol. When calculating daily calories, count the calories from any alcohol you drink. Talk to a medical professional or registered dietitian about how to incorporate calories and carbohydrates from alcoholic beverages into your diet plan.
Check your blood sugar levels before bed. Alcohol may still lower blood sugar levels long after you’ve had your last drink. So be sure to check your blood sugar levels before you go to bed. If your blood sugar is not between 100 mg/dL and 140 mg/dL (5.6 mm/L and 7.8 mmol/L), eat a snack before bed. Snacking may prevent your blood sugar from dropping.
Menstruation and menopause
Both menstruation and menopause have important implications for people with diabetes.
Changes in hormone levels in the week before and during menstruation may cause fluctuations in blood sugar levels.
Appropriate practices:
Look for patterns. Keep careful records of your blood sugar readings each month. You may be able to predict fluctuations in blood sugar levels associated with the menstrual cycle.
Adjust your diabetes regimen as needed. Your healthcare provider may recommend changes in your diet plan, activity level, or diabetes medications. These changes may lessen blood sugar level fluctuations.
Check your blood sugar more frequently. Consult with your healthcare provider if you may be approaching menopause or are in menopause. Ask if you need to check your blood sugar more frequently. Also, be aware that menopause and hypoglycemia share some of the same symptoms, such as sweating and mood changes. Therefore, you should check your blood sugar as often as possible before treating your symptoms. This way you can confirm if your blood sugar is low.
Most birth control can be used safely by people with diabetes. However, combination birth control pills may cause blood sugar to rise in some patients.
Stress
It is important to control stress when you have diabetes. Hormones produced by your body in response to chronic stress may cause your blood sugar to rise. If you are under a great deal of additional stress, it may be more difficult for you to follow your usual diabetes management routine.
Appropriate practices:
Take control. Once you know how stress affects blood sugar levels, make healthy changes. Learn relaxation techniques, prioritize tasks by importance and set limits. Stay away from things that stress you out as much as possible. Exercise often helps relieve stress and lower blood sugar levels.
Seek help. Learn about new ways to relieve stress. You may find that working with a psychologist or clinical social worker can be helpful. These professionals can help you find stressors, address them and learn coping skills.
The more you know about the factors that affect your blood sugar levels, the better prepared you will be to manage your diabetes. If you are unable to keep your blood sugar levels within your target range, seek help from your diabetes medical care team.
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