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Diabetes management: How lifestyle, daily routine affect blood sugar

Illness

When you're sick, your body produces hormones to help fight the illness. These hormones raise your blood sugar level by preventing insulin from working effectively. This can help promote healing — and wreak havoc with your diabetes management plan.

What to do:

  • Plan ahead. Work with your health care team to create a sick-day plan. Include instructions on what medications to take, how often to measure your blood sugar and urine ketone levels, how to adjust your insulin dosage, if you need insulin, and when to call your doctor.
  • Continue to take your diabetes medication. If you are unable to eat because of nausea and vomiting, contact your doctor. In these situations, you may need to temporarily stop taking your medication because of risk of hypoglycemia.
  • Stick to your diabetes meal plan. If you can, eating as usual will help you control your blood sugar level.

Alcohol

The liver normally releases stored sugar to counteract falling blood sugar levels. But if your liver is busy metabolizing alcohol, your blood sugar level may not get the boost it needs. If you take insulin or oral diabetes medications, even as little as 2 ounces (59 milliliters) of alcohol — the equivalent of two shots of hard liquor — can cause low blood sugar.

What to do:

  • Get your doctor's OK to drink alcohol. Alcohol can aggravate diabetes complications, such as nerve damage and eye disease. But if your diabetes is under control and your doctor agrees, an occasional alcoholic drink with a meal is fine.
  • Choose your drinks carefully. Light beer and dry wines have fewer calories and carbohydrates than do other alcoholic drinks. If you prefer mixed drinks, stick with sugar-free mixers — such as diet soda, diet tonic, club soda or seltzer.
  • Tally your calories. Remember to include the calories from any alcohol you drink in your daily calorie count. Ask your doctor or dietitian how to incorporate calories from alcohol into your diet plan.

Hormone levels

Hormone levels fluctuate for women during their menstrual cycle, as can blood sugar levels — particularly in the week before a period. Menopause may trigger fluctuations in blood sugar levels as well.

What to do:

  • Look for patterns. Keep careful track of your blood sugar readings from month to month. Soon you may be able to predict fluctuations related to your menstrual cycle.
  • Adjust your diabetes treatment plan as needed. Your doctor may recommend changes in your meal plan, activity level or diabetes medications to make up for monthly blood sugar swings.

Stress

If you're stressed, it's easy to abandon your usual diabetes management routine. You might exercise less, eat fewer healthy foods or test your blood sugar less often — and lose control of your blood sugar in the process. The hormones your body may produce in response to prolonged stress may even prevent insulin from working properly, which only makes matters worse.

What to do:

  • Look for patterns. Log your stress level on a scale of 1 to 10 each time you log your blood sugar level. A pattern may soon emerge.
  • Take control. Once you know how stress affects your blood sugar level, fight back. Learn relaxation techniques. Prioritize your tasks. Set limits. Most importantly, take good care of yourself.

The more you know about factors that influence your blood sugar level, the more you can anticipate fluctuations — and plan ahead accordingly. If you're having trouble keeping your blood sugar level in your target range, ask your diabetes health care team for help.

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References
  1. Your guide to diabetes: Type 1 and type 2. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.diabetes.niddk.nih.gov/dm/pubs/type1and2/YourGuide2Diabetes.pdf. Accessed March 26, 2009.
  2. Frequently asked questions: Diabetes and exercise. Centers for Disease Control. http://www.cdc.gov/diabetes/faq/exercise.htm. Accessed March 26, 2009.
  3. McCulloch DK. Initial management of blood glucose in type 2 diabetes mellitus. http://www.uptodate.com/home/index.html. Accessed March 26, 2009.
  4. Alcohol. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/alcohol.jsp. Accessed March 26, 2009.
  5. Stress. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/stress.jsp. Accessed March 26, 2009.
  6. Diabetes and women's sexual health. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/women-sexual-health.jsp. Accessed March 26, 2009.
  7. Diabetes medications. National Diabetes Education Program. http://ndep.nih.gov/diabetes/WTMD/diabets_suppl_2.htm. Accessed March 26, 2009.
  8. What you need to know about eating and diabetes. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/eating_ez/Eating_Diabetes.pdf. Accessed March 25, 2009.

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June 20, 2009

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