Blood Sugar Control and Insulin

Manage Diabetes Through Diet

With both type 1 and type 2 diabetes, you can help manage your glucose level with diet.  Monitoring carbohydrates is key because carbs strongly affect your blood sugar. The best diet includes a variety of vegetables, fruits, and meats, as well as nuts, dairy, and grains. When you live with diabetes it may be a good idea to divide your food for the day evenly across three meals and healthy snacks.

Preventing High Blood Sugar After Meals

To prevent your blood sugar from soaring after meals, follow your meal plan and be aware of your diet, particularly how many carbs you eat and portion sizes.  Research shows that a high-fiber diet -- 25 to 35 grams a day -- can help reduce your risk of type 2 diabetes by controlling blood sugar.  Make sure you exercise, take your medicine, and test your blood sugar regularly.

The Good Exercise Effect

Regular, moderate exercise can positively affect blood sugar, especially with type 2 diabetes. Exercise improves your body's sensitivity to insulin and stimulates your liver and muscles to use glucose. One study found improvement in blood sugars after strength training, which usually involves lifting weights to build muscle.

Exercise Risks

While regular exercise can help control blood sugars, it can cause your sugar to drop. To help keep your levels in check, your doctor may recommend you test your blood sugar before and after exercise. If exercise makes your blood sugar dip, don't avoid exercise. Instead, have healthy snacks -- like fruit -- with you to avoid a serious drop.

Avoiding Low Blood Sugar or Hypoglycemia

Juice, fruit, hard candy, or glucose tablets are all sources of quick sugar that can help if you're feeling the effects of low blood sugar. Feeling tired, weak, or shaky are telltale signs. When your blood sugar drops, your goal should be to get at least 15-20 grams of sugar or carbs. Avoid foods with sugar in combination with fat, like chocolate. Fat can slow your body's ability to get the carbs it needs quickly enough.

Stress and Smoking Can Affect Diabetes

Many other things can affect your diabetes, including your stress level and unhealthy habits like smoking. Stress can send your blood sugar level soaring. Try yoga or meditation or find time to de-stress with a relaxing hobby. Smoking increases your chances of developing diabetes-related complications like foot problems, nerve damage, and eye, heart, vascular, and kidney disease.

Other Life Stresses That Affect Blood Sugar

• Be cautious when drinking alcohol. If you drink, only do so if your blood sugar is stable.
• When sick, test your blood sugar more often, stay hydrated, and try to eat regularly.
• Travel and changes in time zones can also affect your diabetes by disrupting your schedule. Test your sugars before and after meals. Speak with your doctor about making adjustment to medication as needed.

 Follow Your Treatment Plan

It's essential to follow your treatment plan, including exercise and diet, and take your medication as directed. Type 1 diabetes is treated with insulin or an insulin pump, sometimes with another injectable medication. Type 2 is often treated with oral and/or injectable medications like insulin or drugs that help insulin work. Your doctor customizes your treatment plan with your age, body, and lifestyle in mind.

Treating Diabetes With Insulin

With diabetes, your body often doesn't make enough insulin to control blood sugars. Doctors may prescribe insulin based on how long you've had diabetes and what type you have, your blood glucose level, your overall health and lifestyle, and what other medicine you take. When you have diabetes, giving yourself insulin injections and checking your blood sugar can become a part of everyday life.

Medications That Work With Insulin

When you take insulin, you might still need help from other medications to improve your blood sugar. Oral medications for type 2 diabetes can increase insulin in the body or improve how well it works. An injectable medication for type 1 and type 2 diabetes mimics the effects of the hormone amylin. It improves blood sugar by decreasing glucose absorption after you eat and by decreasing appetite.

Tips for Injecting Insulin

When you start taking insulin, a medical professional will teach you how to inject yourself, and you'll practice with her until you're comfortable. When doing shots, rotate where you inject to avoid building up scar tissue. For example, give yourself your shot on one side of your abdomen at breakfast, the other side at lunch, and in your leg at dinner. Avoid injecting near your joints, groin, navel, middle abdomen, or scars.

Different Types of Insulin

Insulin types vary depending on how fast they work, when they peak, and how long they last. Rapid-acting, short-acting, and pre-mixed insulin are timed to meals. Long-acting and intermediate-acting are not timed to meals. The glucose-lowering effects of these insulins can last up to 24 hours.

Timing Mealtime Insulin

If you take shorter-acting and pre-mixed insulin, timing is important. It must be working in your system while food is being absorbed in order to avoid hypoglycemia. Rapid-acting insulin is taken right before or immediately after meals. Short-acting insulin is taken 30 to 60 minutes prior to meals. Pre-mixed insulin is taken twice a day before meals.

When You've Had Too Much Insulin

If you've had too much insulin, or you haven't eaten and you’re on insulin, you can become hypoglycemic. If you start experiencing symptoms -- feeling tired, weak, or shaky -- you usually can treat mild hypoglycemia by eating or drinking something with sugar, such as juice, or taking glucose tablets. Be sure to tell your doctor about your hypoglycemic episode. Sometimes the amount of insulin you take may need adjusting.

For More Control, Pumps May Help

If you're having trouble regulating your insulin and blood sugar, you may want to consider an insulin pump. They come with a programmable dose calculator to easily control your insulin dosage and help maintain steady blood sugar. No matter how you take your medication, know you can always ask your doctor for help in controlling your blood sugar. Together you can find ways to find the right balance between diet, exercise, and medication.

Getting a Better Measure of Blood Sugar Control

In addition to home glucose testing, one of the best ways to know if your diabetes is under control is to ask your doctor for an A1c test. This test can track your average blood sugar level over the past 3 months. The goal is to achieve a level of less than 6.5%. If your result is too high, your doctor may suggest medication or adjust medication you already take. Experts recommend an A1c test every 2-3 months.

Reviewed by Andrew Seibert, MD on October 21, 2011
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