Diabetes : How to manage high and low blood glucose levels properly

Each diabetic patient is unique. There are general guidelines, but at the end of the day the same food can affect diabetics differently. The guidelines that follow work for the majority diabetics:-

• Food – The blood sugar source

The glucose in food makes blood sugar go up within an hour or two after having eaten. How quickly and how high will be determined by what has been eaten and quantity of food and your insulin resistance.

1. Adjust your meal

When the guidelines that you got from your dietician do not work, you have to go back to the drawing board. Monitoring your blood sugar will supply yourself and the medical team with valuable information that can be used to make better choices.

2. Be consistent

Use your monitoring data as a guide to identify the foods that can maintain blood sugar levels within safe ranges. The more you control the glucose going into your body, the more you will be able to predict and control the rise and fall of your blood sugar.

3. Limit alcohol

Alcohol will lower your blood glucose. Limit alcohol to the minimum (never more than 1-2 drinks per occasion) and have alcohol with food. Alcohol can cause hypoglycemia. Alcohol is not food, and it does not provide essential nutrients; even though your body can use the calories for energy, it cannot use the alcohol itself to make glucose. When kilojoules from alcohol are not used for immediate energy, they are changed to fat and stored as triglycerides. See alcohol as being like a fat, rather than a carbohydrate. Actually, as Sheldon Gottlieb, MD stated in the April 2004 issue of Diabetes Forecast: “Alcohol is not a carbohydrate. Alcohol is a drug, the most widely available and the most widely consumed drug in our culture.”

4. Consider medication

If you cannot control your blood sugar with food and exercise – you most properly needs medication.

• Exercise: The glucose gobbler – glucose levels tend to drop when you are exercising

1. Adjust your drug regimen

Vigorous exercise can lower blood sugar levels for hours after exercise – it can remain 1-2 days thereafter. You need to monitor your blood sugar levels after exercise and adjust the medication or insulin – if you do not it can cause hypoglycemia. Discuss this with your doctor.

2. Tank up ahead of time

When you plan to exercise heavily, you might want to eat earlier in the day or take less insulin to make sure you have enough glucose available to fuel working muscles. It is better to exercise 1-2 hours after mealtime when blood sugar levels are high.

3. Keep well fuelled afterwards

If you had a serious workout you might have to increase your food intake and / or adjust your medication for up to 24 hours after exercise to make sure your blood sugar levels do not fall too low.

4. Use exercise as medication

Exercise can have a similar effect on blood sugar as insulin. You might experiment and use exercise as an insulin substitute.

5. Be alert to expect any changes – up or down

Weight lifting can release stored glucose from muscles and that can increase your blood sugar levels.  Insulin and medication should be adjusted.

• Insulin: Fine tuning the control

Monitoring can help you keep glucose levels steady.

1. Inject earlier to bring down highs

Intermediate or long-acting insulin is normally taken 30-45 minutes before eating. When you find by monitoring that blood sugar levels stay high before or one hour after eating, you may want more time between eating and injecting so that the insulin can bring down the glucose more. Exercise can have a similar effect – try it. This advice does not apply to fast acting insulin – which has to be injected 15 minutes before eating.

2. Wait a bit to rise up lows

When your blood sugar level tends to be on the low side 30-45 minutes before a meal – inject closer to your meal. This advice does not apply to rapid-acting insulin.

3. Eat small snacks

Injections may cause hypoglycemia and eating a few almonds and a fruit (like apple, pear or strawberries) between meals might help. In addition, dosages might have to be adjusted.

• Illness: can cause high blood sugar levels

Illness and stress can activate hormones that cause glucose to be released from muscles and the liver, which can increase your blood sugar levels. Sunburn can also raise blood sugar levels. You have to address the above, but also take the necessary steps to combat raised blood sugar levels.

1. Drink more water

When your blood sugar level is higher than normal, your kidneys are working harder and producing more urine and you might be at risk to become dehydrated – thus it is important to drink a glass of water every 30 minutes.

2. No exercise

Rather rest and get well – exercise might stimulate glucose release from muscles.

3. Adjusting insulin

You might have to increase insulin injections while sick.

• Morning: blood sugar problems

Morning insulin levels might be high because the body clock triggers release of hormones that inhibit insulin so that glucose is available to start the new day. This is natural and not necessary a problem.

1. Take insulin later

Take insulin just before bedtime if you normally take an evening dose.

2. Skip the bedtime snack

Try to eat less food at night so that there is less glucose in your blood when day breaks. You might also eat less at breakfast.

3. Exercise early evening

Exercise after dinner can help to lower blood sugar levels the following morning.

Handling hypoglycemia

Preventing, Recognizing, and Treating Insulin Reactions (Hypoglycemic Episodes)

An insulin reaction or hypoglycemic episode occurs when the blood sugar level falls lower than 3.3 mmol/L

To Prevent Insulin Reactions

• Eat regular meals on schedule
• Avoid sudden changes in diet, exercise, or insulin
• Eat a snack before exercising

Symptoms of Mild Hypoglycemia

• Hunger
• Cold sweat and a clammy feeling
• Dizziness, weakness, or shakiness
• Pounding heart or increased heart rate

Symptoms of Moderate Hypoglycemia

• Nervousness or confusion
• Headache
• Blurred or double vision
• Numbness or tingling in lips or fingers

Symptoms of Severe Hypoglycemia

Note:  When the following symptoms are present, immediate medical assistance is always required.  Don’t wait; call 10111 immediately. If glucagon, a hormone that raises blood sugar levels quickly, is available, administer it via injection.

• Paleness and slurred speech
• Bizarre behavior
• Convulsions

Strategies to Treat Mild to Moderate Hypoglycemia

Use one of the following:

• Lifesavers sweets (4-6)
• Coke or other soda
• Orange juice
• Jelly beans (6)
• Milk (small carton)

Do not over treat a mild to moderate insulin reaction by consuming more than the recommended amount. Stop what you are doing and sit or lie down. Wait 10 to 15 minutes. If you do not feel better, take the food again. After you feel better, if you are between meals, eat a low-glycemic-index snack. If it is close to mealtime, have your next meal.

Sample Snacks for after a Hypoglycemic Event

½ cup nuts or seeds

One or two carrots or celery sticks

Low-glycemic-index food bar

Piece of fruit

After a reaction, you may feel tired and have high blood sugar, but do not make a permanent change in your insulin dosage without consulting your physician.

Be sure to wear diabetes identification to inform others of your condition in case of an accident or loss of consciousness due to a reaction. Teach your family, friends, teachers and co-workers how to spot a reaction and how to help if you have one. If you ignore reaction-warning symptoms and do not take sugar, you could become unconscious. While this occurrence is quite rare, you can protect yourself by teaching family and friends how to give an injection of glucagons in an emergency.

Do not let uncontrolled diabetes dictate your health, manage it properly and you can live a long life without heart attacks and amputations. Do you need guidance for better diabetic control or are you at risk for diabetes? Consult your Integrated Healthcare Practitioner now.

 

Please subscribe to the South African Journal of Diabetes: Tel no: 0880117879366 or 011-787-9366

 For more information contact The Centre for Diabetes on 011-712-6000 // 0861113913

Join the Diabetes South Africa Network at 011-792-9888/7 or www.diabetessa.co.za

Email: info@diabetessa.co.za

 

References:

1. New Optimum Nutrition Bible – Patrick Holford
2. Prescription Alternatives – Earl Mindell
3. The SA Journal of Natural medicine
4. Herbal Medicine – expanded commission E Monographs
5. Genesende Voeding – Dr Willem Serfontein
6. Gesondheid vir `n leeftyd – Dr Christiaan
7. Stopping diabetes in its tracks – Richard Liliberte
8. Food is better medicine than drugs – Patrick Holford
9. Food remedies – Selene Yeager
10. Alternative cures – Bill Gottlieb
11. Beat Diabetes Naturally – Michael Murray & Michael Lyon
12. Discovery Summer 2011 issue 41