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Dieting

Oftentimes, dieting and other strategies are used to normalize lifestyle, along with regular insulin injections, in order to keep your blood sugar stable. A general rule of thumb is to increase fiber intake, and avoid saturated fats. 

Carbohydrates are key to a diabetic diet, due to their direct effect on blood sugar. Typically, per meal, you want to eat 15 grams of carbohydrates before checking your blood sugar. If it's low, eat another 15 grams.

 

15 grams of fast carbohydrates can be found in 

  • 1/4 cup of 100% fruit juice

  • 1 small fresh fruit, about 4 oz

  • 4 - 6 crackers, a la Ritz or Triscuits

  • 2 tablespoons of raisins

  • 1 tablespoon of honey  

Foods to avoid include 

  • Sodas, both regular and diet

  • processed and refined sugar, like in white bread, cookies, chips, pastas, and pastries

  • trans fats (anything labeled hydrogenated) and high-fat animal products

Protein will not have much of an effect on your  blood sugar levels, but are helpful, and should be eaten in beans, eggs, and non-fatty meat. 

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Hyperglycemia

Hyperglycemia is when there is too much glucose in your bloodstream for your body to properly absorb. 

Mayo Clinic generally recommends the following target blood sugar levels before meals:

  • Between 80 and 120 mg/dL (4.4 and 7 mmol/L) for people age 59 and younger who have no other underlying medical conditions

  • Between 100 and 140 mg/dL (6 and 8 mmol/L) for people age 60 and older, those who have other medical conditions, such as heart, lung or kidney disease, or those who have a history of hypoglycemia or who have difficulty recognizing hypoglycemia.

Hemoglobin A1C test

  • During an appointment, your doctor may conduct an A1C test. This blood test indicates your average blood sugar level for the past two to three months. It works by measuring the percentage of blood sugar attached to hemoglobin in your red blood cells.

  • An A1C level of lower than 7 percent means that your treatment plan is working and that your blood sugar was consistently normal. If your A1C level is higher than 7 percent, your blood sugar, on average, was above the normal. However, for older adults and those with preexisting medical conditions or limited life expectancy, a higher A1C level of up to 8 percent may be appropriate.

  • Keep in mind that the normal range for A1C results may vary somewhat among labs. If you consult a new doctor or use a different lab, be sure to ask their benchmark range.

  • How often you need the A1C test depends on the type of diabetes you have. Most people with diabetes, however, receive this test between two and four times a year.

Hypoglycemia

Hypoglycemia

Hypoglycemia (hypos) are when your blood sugar is dangerously low. 

Hypos’ early symptoms include:

Without treatment, you might get more severe symptoms, including:

Diabetes Drugs Linked to Hypos

Insulin treatment can cause low blood sugar, and so can diabetes medicines under the type "sulfonylureas."

Commonly used sulfonylureas include:

Older, less common sulfonlyureas tend to cause low blood sugar more often than some of the newer ones. Examples of older drugs include:

You can also get low blood sugar if you drink alcohol or take allopurinol, aspirin, Benemid, probenecid, or warfarin with diabetes medications.

You shouldn't get hypoglycemia if you take alpha-glucosidase inhibitors, biguanides, like metformin, and thiazolidinediones alone, but it can happen when you take them with sulfonylureas or insulin.

Diet and Hypoglycemia

You can get low blood sugar if you take too much insulin for the amount of carbohydrates you eat or drink.

For instance, it can happen:

  • After you eat a meal that has a lot of simple sugars

  • If you miss a snack or don't eat a full meal

  • If you eat later than usual

  • If you drink alcohol without eating any food

Don't skip meals if you have diabetes, particularly if you're taking diabetes medications.

Testing Glucose

The most common method of testing insulin would be the “finger prick” method, where a small drop of blood is drawn from the patient, usually from the index finger. This blood sample is put onto a special strip of glucose paper, which is fed into a glucose meter (glucometer). the glucometer reads this number and provides you with your blood sugar level. It’s as simple as that. According to the Mayo Clinic, “If you take insulin to manage type 2 diabetes, your doctor may recommend blood sugar testing a few times a day, depending on the type and amount of insulin you use.

Testing is usually recommended before meals and at bedtime if you're taking multiple daily injections. You may need to test only twice daily, before breakfast and dinner if you use a long-acting insulin. If you manage diabetes with noninsulin medications or with diet and exercise alone, you may not need to test your blood sugar daily."

 

What if I have a continuous glucose monitor (CGM)?

Many type 1 and 2 diabetics choose to use a CGM. These devices measure your blood sugar every few minutes using a sensor inserted under the skin.

Some devices show your blood sugar reading at all times on a receiver, and will alert you if a hyper/hypo is suspected. Others require you to wave the receiver over the sensor. 

Most of these devices still require "finger prick” checks to calibrate the machine. These may need to occur monthly to yearly, and you should check your user’s manual for more information. 

Know your target range

Your doctor will set target blood sugar test results based on several factors, including:

  • Type and severity of diabetes

  • Age

  • How long you've had diabetes

  • Pregnancy status

  • Diabetes complications

  • Overall health

For many diabetics, Mayo Clinic recommends the following target blood sugar levels before meals:

  • Between 80 and 120 milligrams per deciliter (mg/dL) for people age 59 and younger who have no other medical conditions

  • Between 100 and 140 mg/dL for people age 60 and older, or for those who have other medical conditions, such as heart, lung or kidney disease or reduced hypoglycemia awareness

The American Diabetes Association generally recommends the following target blood sugar levels:

  • Between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) before meals

  • Less than 180 mg/dL (10.0 mmol/L) two hours after meals

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