Tips to Lower & Control Blood Sugar
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Take Small Steps Toward a Healthy Eating Plan
You likely know all too well that choosing healthy foods for meals and snacks is an important part of taking care of your diabetes and your overall health. When it comes to eating healthfully with diabetes, today’s nutrition guidelines from the American Diabetes Association (Diabetes Care, November 2013) are in sync with how all Americans are being encouraged to eat.
There’s not a one-size-fits-all “diabetic diet” or eating plan. If you’ve got some work to do on your food choices and eating habits, take a one-step-at-a-time approach to making changes. Change what’s easiest for you at first. Get a few successes under your belt. Then it will become easier to make more changes over time. Don’t be hard on yourself. This is all hard work in our food-focused world.
Need some assistance? Find a registered dietitian or diabetes educator to work with at a local diabetes education program. If you don’t have access to these professionals, think about joining Weight Watchers; look for a program at your local community center, YMCA, or place of employment; or get a few friends or neighbors together and start a support group.
Your healthy eating plan should help you get to or stay at a healthy weight. Start with a few of these suggestions:
• Continue to include the foods you enjoy, but in healthful-size portions.
• Include healthy sources of carbohydrate: fruits, vegetables, whole grains, legumes, and low-fat dairy foods. These foods are excellent sources of many vitamins, minerals, and dietary fiber.
• Lighten up on added sugars and sweets. Cut down on sugary drinks, breakfast pastries, candy, and desserts. You can continue to enjoy small portions on occasion.
• Trim and skim your fat grams. Use less salad dressing, mayonnaise, sour cream, cream cheese, and other sources of saturated fat. Fat is a very concentrated source of calories.
• Minimize the amount of salt and sodium you eat. Use fewer processed foods, and cut down on restaurant meals. Use less salt in cooking and at the table.
Try to Eat Consistently
“The benefit of eating regular meals, which are spaced [throughout] the day, can help provide your body with the energy and nutrients you need, as well as keep your metabolism humming along,” says, Kelly O’Connor, RD, LDN, CDE, director of diabetes education at The Center for Endocrinology at Mercy in Baltimore, Maryland. “This can also help, perhaps along with the glucose-lowering medications you take, keep your blood glucose levels stable from the beginning of the day to the end.”
If your meal times and food intake fluctuate, it’s hard to control your blood sugar levels. This can also make it hard for you and your health care providers to determine what’s affecting your blood sugar, O’Connor says. “If you eat similar amounts of foods at similar times, it will be easier for your health care providers to know whether you need to take blood glucose-lowering medication and/or how to alter your blood glucose-lowering medications to get and keep your blood sugar under control,” she says.
If you tend to skip meals, be honest with your health care provider about this so you can work together to determine a medication plan best suited for you. If you take a blood glucose-lowering medication that has the potential to cause hypoglycemia, skipping meals can increase the risk of experiencing low blood sugar.
“Envision the healthy foods you eat as a form of medication. Like dosing your medications, try to eat about the same amount of carbohydrate at roughly the same time each day,” says Jennifer Ventrelle, RD, LDN, CPT, a registered dietitian at Rush University Medical Center in Chicago. People with diabetes can usually achieve better blood sugar control if their meals and amount of carbs they eat are consistent.
Don’t have time to eat a meal? Think ahead. Have quick-to-grab and easy-to-eat healthy foods on hand, or try a meal-replacement bar or shake. Pack a to-go bag with these foods to give your body the healthy nutrients it needs to keep you feeling awake and vibrant throughout the day.
Focus Attention on Carbs
After you eat foods that contain carbohydrate, the carbohydrate will break down into glucose and enter the bloodstream. Carbohydrate is the main nutrient in foods that raises blood glucose (or blood sugar) after eating. The carbohydrate you eat will not raise your blood sugar too high and/or too fast if you have enough insulin available—either insulin your pancreas produces or insulin you take by injection or pump. The fact that the carbohydrate in foods can raise blood sugar doesn’t mean you have to completely avoid foods with carbs.
Carbohydrate is your body’s main source of energy. Foods that contain carbohydrate provide essential nutrients, vitamins, minerals, and dietary fiber. These foods include fruits, vegetables, whole grains, legumes, and low-fat dairy foods. About half your calories should come from carbohydrate. The more you can limit or avoid unhealthy sources of carbohydrate, the better. Carbs to limit or avoid include refined grains, sugary beverages, and foods with added sugar.
Carb counting is the practice of meal planning with the goal of balancing your blood sugar levels. The method is taught by many diabetes educators, registered dietitians, and health care providers. You learn how to count the grams of carbohydrate in the foods you eat, and then set an amount of how many grams of carbohydrate you need or want to consume at your meals and snacks.
“For people with type 2 diabetes who don’t take blood glucose-lowering medication or for those who take a medication other than insulin, eating a consistent amount of carbohydrates each day and distributing the carb evenly throughout the day can help maintain a stable blood glucose level, as long as your medication is adjusted properly,” O’Connor says.
Maintaining your blood sugar at a controlled or stable level over many years can help decrease the risk of diabetes complications.
Select Foods High in Fiber
Research shows eating a diet with sufficient fiber can keep you healthy. It can also help you stay fuller longer. Although you see only the word fiber on the Nutrition Facts labels, our foods actually contain hundreds of different dietary fibers. There are three main categories: fibers that add bulk to help with regularity, fibers that help reduce blood fats, and fibers that can help lower blood sugar and decrease insulin resistance.
Eating enough fiber has been shown to help prevent heart disease, type 2 diabetes, and colon cancer. But to reap these benefits, you must consistently eat enough fiber. Most Americans eat well under half of the 25 grams of dietary fiber recommended per day for adults. To eat this large amount of fiber takes effort. It means getting your fill of foods that contain dietary fiber: most whole grains, fruits, vegetables, some starchy vegetables, and the shining star, legumes. Most of these foods also contain carbohydrate, but they are the healthy sources of carbs.
Dietary fiber can lower blood sugar by a small amount after eating, but only if you eat upward of 25 grams of fiber per day.
Think Before You Drink
Americans sip and slurp hundreds of calories from their beverages. Think about it—jumbo jugs of carbonated soft drinks, sports drinks, coffee drinks, sweetened iced tea, and more. Plus, for all these calories, you get next to no nutrition. If you choose drinks that don’t come loaded with extra calories from added sugar or other sweeteners, you’ll quickly cut your calorie and carb counts.
If you start your day with a hot beverage, don’t sweeten it with sugar. Lighten up on the type or amount of creamer, half-and-half, or whole milk you use. If you sip a soda at lunch, make it a diet soda. Down a sports drink after a workout? Make it a low-calorie version.
When possible, opt for sugar-free, no-calorie beverages. Good choices are water, club soda or seltzer water with lemon or lime slices, sugar-free soft drinks, and tea that's unsweetened or sweetened with a sugar substitute.
Practice Portion Control
One of the biggest challenges in managing calories and carbs is simply eating too much, which also includes healthier foods—brown rice, whole grain pasta, chicken, and fish. Excess calories can come from indulging in dessert or high-fat meals, but an extra 100 calories here and there might play a bigger role in thwarting your weight loss efforts or maintenance goals more than occasional splurges.
Get to know the proper portion sizes for foods and how to estimate them with common household objects or your hand. Weigh and measure foods at home once a week to keep your eyes in check. Then whether you eat at home or away, you can use them as your portion guideposts to track calories and carbs.
Serving Size Examples:
• A deck of cards or the palm of your hand is about the size of a 3-4 ounce portion of cooked meat, fish, or poultry, or 1/2 cup of starch, such as rice or cut-up fruit
• A baseball or tennis ball is the size of a piece of fruit
• A closed fist equals about 1/2 cup
• An open hand equals about 1 cup
• A thumb (whole finger) is about 1 tablespoon
• The tip of the thumb to the first knuckle is about 1 teaspoon
Fill Half Your Plate with Nonstarchy Vegetables
Research shows most people don’t eat nearly enough vegetables each day. Yet we know that vegetables of all stripes and colors provide excellent nutrition with very few calories. Think lots of value for their volume: About ½ cup of cooked vegetables and 1 cup of raw vegetables have only about 25 calories and 5 grams of carb per serving.
Choose from a wide array of nonstarchy vegetables including cucumbers; green and wax beans; leafy greens such as lettuce, kale, and spinach; peppers; cruciferous vegetables such as cabbage, broccoli, and bok choy; and allium vegetables such as onions, garlic, and leeks. Each vegetable has its nutritional strengths and weaknesses. Selecting a variety each week helps ensure that you get the nutrients you need. Make this easier by thinking in colors and buying vegetables from each color type: orange, red, green, and purple. Eat the rainbow!
You can also eat a variety of forms—fresh, frozen, or canned. If you buy frozen or canned vegetables, try to stay away from those that have sauces and seasonings. These may add fat grams and increase the sodium count.
Take Blood Glucose-Lowering Medications if You Need Them
People who have type 1 diabetes need insulin to survive. For people with type 2 diabetes, experts agree that the blood glucose-lowering medication metformin should be prescribed when their diabetes is diagnosed. Type 2 diabetes is a progressive disease, and over the years most people need additional blood glucose-lowering medications to keep blood sugar under control. After 15 years or more, a person with type 2 diabetes will most likely need to take insulin to keep their blood sugar levels in the target range. This is due to the dwindling supply of insulin being made in the pancreas combined with continuing insulin resistance.
If your health care provider has prescribed a blood glucose-lowering medication, it's important that you take the medication(s) according to the directions. Make sure you work with your provider and pharmacist to know the best time to take your medications, whether you should take them with food or on an empty stomach, and any other critical details. Do not stop taking any medication without first consulting your health care provider. If you are not able to follow your medication plan due to your budget, side effects, or your schedule, talk to your health care provider about other options before you stop taking the medication.
Know Your Blood Glucose-Lowering Medications
It's also important to understand how each medication works.
• Stay informed. Ask your health care providers or pharmacist how your medications work. Learn about the potential side effects.
• Ask how long it will be before each medication will lower your blood sugar. (Some of them start to lower blood sugar soon after you start taking them, and others can take a few weeks.)
• Ask how much you can expect a new medication to lower your blood sugar and how much the medication is likely to lower your A1C.
• Ask about the maximum dose of the medication that your health care provider can prescribe.
• Test and track your blood sugar to keep a record of patterns or anything out of the ordinary to discuss with your provider.
Attempt to Reduce Stress
The effects of stress can raise your blood sugar levels, as well as your blood pressure and heart rate. To maintain a healthy mind and body, it’s important to learn how to reduce stress in healthful ways to better manage your diabetes and improve your mental and emotional well-being.
Try one or more of these simple stress busters:
• Take five slow, deep breaths.
• Play soothing music.
• Do a few simple stretches or try a few yoga poses.
• Get seven to nine hours of sleep each night.
• Cuddle with your spouse, child, or pet.
• Take time to do something you really enjoy.
• Spend time doing your favorite hobby.
• Talk it out with a friend, counselor, or diabetes educator.
Move Your Body
To get and stay healthy, the American Diabetes Association recommends that you stay moving. Accumulate 30 minutes of aerobic activity on most days, and do resistance activities (pushing, pulling, lifting) two or three times a week.
Exercise has many benefits:
• Lowers blood sugar levels.
• Helps your body become more sensitive to the insulin it continues to make.
• Decreases total cholesterol and triglycerides and increases HDL (good) cholesterol.
• Decreases blood pressure.
• Fosters weight loss and helps keep the lost weight off.
• Increases strength, endurance, and flexibility.
• Increases energy and feelings of well-being.
Check Your Blood Sugar Levels in a Variety of Situations
Tips for when to check your blood sugar:
• At different times on different days, rather than the same time every day. One day, check before and after breakfast; another day, check before and after dinner. Over the course of a week, you'll get a good look at your ups and downs and level of control.
• One to two hours after a meal.
• When you try something new, whether it be food, exercise, medication, or dosage. Use your blood glucose meter as a barometer of change.
• Don’t just collect blood glucose data; discuss your findings with your provider, and agree on actions to take (if needed) to improve your glucose control.
Track Your Blood Sugar Levels
Noticing patterns and varying the times that you check your blood sugars during the day will help you and your health care providers make more effective decisions about your health. “Taking insulin and/or other blood glucose-lowering medications without testing your blood glucose and tracking it is a bit like driving a car without a speedometer,” says dietitian Kelly O’Connor. “You may have a general idea of how fast you are driving or how well you’re managing your diabetes, but without the gauge, you don’t likely have a clear picture. Plus, your health care team won’t be able to identify patterns to help you make specific changes in your regimen.”
Go over your records and focus on trends rather than individual blood glucose readings. Think about what you typically eat and how much physical activity you get. Bring your blood glucose data and questions or concerns to your appointments. If you're frequently experiencing extreme low or high blood sugar readings, call your health care provider before your next visit to make changes.
If you monitor regularly, you can compare your day-to-day results with your A1C level. You can also quickly learn how certain foods, meals, stress, illness, or activities can affect your blood sugar.