Slideshow: 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. A balanced diet includes a variety of vegetables and fruits, whole grains, beans, fish, lean meats, and nonfat dairy. When you live with diabetes, it may be a good idea to follow a schedule for meals and snacks.
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 muscles to use glucose. Studies consistently find improvement in blood sugars after strength training, which usually involves lifting weights to build muscle.
Exercise Risks
While regular exercise can help control blood sugar, in some people it can cause a 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 it. Instead, take some fruit with you or adjust your medications. If your sugar dips, eat a snack and wait 15 minutes. Make sure it's above 100 before starting again.
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. Wait and then test again 15-20 minutes later. If it's still low, eat another snack. 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 Factors 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 adjustments to your 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 other injectable medications. 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. Injectable medications may mimic the effects of hormones like amylin or incretin. They improve blood sugar through various actions such as slowing 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 outer thigh 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 5-15 minutes before or immediately after meals. Short-acting insulin is taken 30 to 60 minutes prior to meals. Pre-mixed insulin is typically taken 15 minutes 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 2-3 months. Experts suggest that most people with diabetes aim for a goal around 7%. If your result is too high, your doctor may suggest medication or adjust medication you already take. Experts recommend an A1c test twice a year.
Reviewed by Brunilda Nazario, MD on March 21, 2013
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SOURCES:
American Association of Clinical Endocrinologists.
American College of Physicians: Physician Information and Education Resource (PIER).
American Diabetes Association.
American Heart Association.
Cleveland Clinic.
Doyle, E.A. Diabetes Care, 2004.
Joslin Diabetes Center.
National Diabetes Education Program.
National Diabetes Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases.
New Zealand Ministry of Health.
News release, FDA.
PDR Network.
Sanofi-aventis Group in the United States.
The Hormone Society.
Thomson Micromedex.
This tool does not provide medical advice. See additional information:
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