Living By The Numbers, With Diabetes

Life alone can be hard, but living with diabetes is harder.  I learn a lot from clients with diabetes. They talk about the challenges they face each day, above and beyond the normal life stressors. One thing that many clients talk about is the feeling of "failure".  People living with diabetes get a lot of unsolicited advice, such as"Don't eat anything white!" or "Take your medicine every day, don't forget!", "Are you supposed to be eating dessert?", and of course, "How many times did you check your blood sugar today?".  Sometimes it can feel overwhelming.  We all know why it's important to have good blood sugar control and we want to prevent complications, but it may not always be clear why you are asked to do so many things.

So, today, let's look at one behavior, that is supposedly good for people with diabetes and see if it can be a more effective tool for you in your management.  Let's look at blood sugar checks.  I don't know about you, but I certainly "believe" and "remember" better when I experience something for myself, rather than taking someone's word for it. Every "body" is a little different and everyone's experience of diabetes is different.


Consider trying this:

1. Set a time period for your upcoming experiment based on your life and what you feel you have time for.  Do you want to try this experiment for 2 days or for 2 weeks?  You decide the length.

2. Plan to eat the way you normally would, don't change anything.

3. Pick one of your larger meals in the day.  Check your blood sugar before you eat, write down what you ate after the meal, and finally, two hours after the start of the meal, check your blood sugar again.


The key here is to see your blood sugar rise, because that's normal, but not too much.  About a 30-60 point increase from before you eat to the 2 hr after mark is a reasonable increase.  If your blood sugar rises more than that, the following things should be considered:

1. too much carbohydrate food

2. not enough medicine

3. not enough activity


How to fix it?

1. eat a smaller portion of carbohydrate food or a different type of carbohydrate

2. Try walking for a few minutes immediately after your meal

3. Talk to your doctor about a medication adjustment.


If your blood sugar does not rise 30 points and your blood sugars are in a target range, then:

1.  You are likely doing a nice job with your carbohydrate portions. But, are you hungry in an hour or two? You may have too much medicine in your body because your lifestyle changes are paying off.

2. If you exercised after the meal, it's really helping!

3.  If you take rapid acting insulin with meals, beware, because it peaks at about 1 1/2 hr, but it hangs around in your body for 4-5 hours, so you may be at risk of a low BG in the next couple hours.  You may need to talk to your doctor about a medicine adjustment.

The experiment described above is referred to as paired testing.  It's a nice tool for when you are getting frustrated or if you aren't sure what you need to change.  It gives immediate feedback on how your food affected you.  Then, it's up to you to decide what needs to change and if you want to make a change!  People always ask about how often they should check their blood sugar and my answer is always, as many times as you feel the information you get from your machine will be helpful.  Don't just do it to do it, use it to provide you feedback on medicine, exercise and food.

Blood Glucose Targets for the general population (you may have slightly different goals):

 - Fasting or Pre meal 80-130mg/dl

 - 2 hours post meal less than 180mg/dl

You may have discussed other target numbers with your healthcare professional and that's OK, the above guidelines are for the general population, recommended by the American Diabetes Association. 

Finally, if your blood sugars are running high before you even start eating, you may want to have a discussion with your doctor about what medications your are taking and if they are still effective choices for you.

Good luck with experimenting!  Feel free to contact me if you have any questions!