Vladimir Diaz, MD. on Winning The War Against Diabetes

Keeping physically active drives your insulin levels down, which is one of the most powerful ways to reduce your cancer risks. Try to exercise at least 3 times a week for 30 minutes and maintain a healthy body weight.

Why is my blood glucose high in the morning?

People with diabetes may have a morning high glucose once in a while, but if it is consistently high, then they need to consult their doctor regarding their medications. Some cases of a morning high glucose may be due to hormones that are released in the early morning. The recommendation is to check your blood sugar in the middle of the night, around 3 a.m. If the blood sugar is high, it may be the dawn phenomenon. If it is low, it may be a rebound high blood sugar causing a high blood sugar in the morning. This happens if you have a low blood glucose level at night and your body is releasing hormones as a defense mechanism against low blood glucose. The general blood glucose level guidelines according to the American Diabetes Association are between 70-130 mg/dl before meals.

How should I manage my diabetes when I’m sick?

Drink fluids, even if you are able to eat food. You need to replace the fluids that your body is losing due to high blood glucose levels, fever, vomiting and diarrhea and to prevent dehydration. It is recommended that you drink fluids every hour that you are awake. Drinks that have caffeine will only make the dehydration worse.

Check your blood glucose every 2-4 hours when you are sick, especially if you are vomiting. Report any glucose levels to your physician or diabetes educator. If your blood glucose is high every time you check it, you may need to consult your physician and change your diabetes medication or dose.

Never skip insulin injections or medications.

Check your blood or urine for ketones whenever you are sick or if your blood sugar stays higher than 240 mg/dl. If you have diabetes, ketones in your system indicates that your body is in trouble.

Take your temperature. Fevers can cause dehydration.

Call your healthcare provider immediately if you have trouble breathing, vomit more than once during a 6 hour timespan, have diarrhea more than 5 times or longer than 6 hours, have a fruity odor to your breath, have moderate to large ketones in the urine, lose 5 pounds or more during the time you are sick, have a temperature over 101° F and have 2+ blood glucose readings in a row that are greater than 240 mg/dl or lower than 70 mg/dl.

What do I eat if I have food allergies and diabetes?

You still need to eat healthy. Focus on fresh vegetables, fruits, low-fat dairy products, chicken, and lean meats. Avoid prepared foods that may contain allergenic ingredients. Try to cook your own meals so that you know exactly what you are eating. You can also work with a registered dietitian to develop a specialized plan.

Does insulin cause weight gain?

Individuals with diabetes may experience weight gain when they first start taking insulin. When blood glucose levels are high, your body wastes the calories you eat because there’s no insulin to help the body convert the food into glucose. When your blood glucose is controlled with insulin, your body makes better use of the food you eat. Insulin can make blood glucose too low if not adjusted correctly. If you’re repeatedly treating hypoglycemia with food, this can result in excess calories and weight gain. It is best to work with your healthcare provider to adjust your insulin doses to minimize hypoglycemia.

How many grams of carbs should I eat?

There is no usual amount of carbohydrates a person with diabetes should eat. Also, this can vary from a type 1 diabetic to a type 2 diabetic. In general a person with diabetes can start at 45-60 grams of carbs per meal. However, like I said some people may need more and some may need less. I recommend that you have an individualized meal plan that will better meet your diabetes goals.

Do type 1’s Need to Eat differently than type 2’s?

Type 1 Diabetics and Type 2 Diabetic in general do not to eat differently. Both type 1s and type 2s should choose good, healthful foods from all the food groups.  People who have type 1 diabetes need to take insulin. Most often they take rapid- or short-acting insulin before meals to cover the amount of carbohydrates they plan to eat. People with type 2 diabetes may or may not need insulin. They usually have to focus more on controlling calories along with controlling carbohydrates.  No matter if you have type 1 or 2, you should choose foods from all food groups, variety, and moderation. In fact, if everyone ate the way people with diabetes are encouraged to eat, we would all be healthier.

How should I treat Hypoglycemia?

Hypoglycemia is very serious and occasional episodes can happen with type 1 or type 2 diabetes. Frequent episodes can cause long-term damage. In order to help prevent hypoglycemia, do not skip or delay meals, and make sure you eat the planned-for carbohydrates in your meals and snacks. If you are having frequent hypoglycemia talk with your healthcare provider about whether you need to adjust your medication or eat additional carbohydrates for physical activity. Blood glucose levels lower than 70 mg/dl can be defined as hypoglycemia. Some common symptoms are sweating, a pounding heart, a fast pulse, hunger, weakness, headache, and/or a general sense of something not feeling right.

To treat hypoglycemia, you need eat or drink something that contains 15 grams of glucose or carbohydrates containing glucose. Foods that have a lot of fat as well as sugars and carbohydrates, such as chocolate or cookies, do not work as quickly to raise blood glucose levels. The following are a few good options:

3 to 4 glucose tablets

4 to 6 ounces of fruit juice or regular soft drink

3 to 5 peppermint hard candies

8 to 10 small flavored Life Savers candies

2 tablespoons of raisins

4 or 5 saltine crackers

1 tablespoon of honey

Once you’ve checked your blood glucose and treated your hypoglycemia, wait 15 or 20 minutes and check your blood again. If your blood glucose is still low and your symptoms of hypoglycemia don’t go away, repeat the treatment. After you feel better, be sure to eat your regular meals and snacks as planned to keep your blood glucose level up

Can some medications, including over-the-counter pain relievers affect blood glucose?

In general, over the counter pain relievers do not affect the blood glucose levels. Tylenol does not have an effect on blood glucose levels. It is always best to consult you healthcare provider before taking any over the counter medications.

by: Vladimir  Diaz, MD.