Are you diabetic? Is your blood sugar level too high?
In 20 years of caring for diabetic patients, one becomes familiar with certain patterns of illness and behavior. Any experienced physician can list a dozen reasons why a patient’s blood sugar may be out of control.
Here is my list of the top 10 reasons why your blood sugar may be too high.
1. Your total calorie intake is too high. For most type 2 diabetics, the body is still capable of producing some insulin, but perhaps not enough to help it metabolize food properly. Cutting your calories by a third may be all you need to do.
2. Eat foods with a high glycemic index. When it comes to diabetes, not all foods are created equal. Simple carbohydrates (sugars, bread, cereals, rice, potatoes, pasta) are absorbed quickly, thus raising the blood glucose level quickly, too quickly for the pancreas to respond adequately. Eating the same calories in the form of foods that are absorbed more slowly (protein, fat) will cause a lower increase in blood sugar.
3. Your body mass index is too high. Having too much fat tissue inside the body makes it harder for the body to use insulin. Once you’ve lost your extra weight, you may be able to eat the same number of calories, but better control your diabetes.
4. You don’t take your medicine as directed. Many patients not only “cheat” by eating a cookie now and then, but they skip their medications more often than they admit. Lying to yourself will make it difficult for both you and your doctor to keep your diabetes under control.
5. You are not taking enough diabetes medicine. Although your diabetes treatment probably started with just one medication, it is quite common to require additional medications as time goes on. This can be achieved by using a higher dose of the drug you are already taking or by taking a combination of two or more drugs.
6. You don’t get enough exercise. Not only does exercise help lower blood sugar, but it also builds muscle mass, which uses blood glucose more efficiently than fat tissue.
7. Your pancreas is wearing out and needs to take insulin. By the time you’re taking three or even four oral diabetes medications, you’re getting to the point where your pancreas simply won’t be able to make enough insulin to counteract your blood sugar level. If your pancreas is just wearing thin, there is no drug that can make it ‘young’ again.
8. You have an infection. Some infections are obvious, others less so. Urinary tract infections, for example, often raise blood sugar, but can cause some other symptoms. Patients also often confuse frequent urination associated with an infection with that caused by diabetes. Any type of infection can raise your blood sugar, from stomach flu to ear infection, influenza, or pneumonia.
9. You are taking medications that raise your blood sugar level. Steroids and diuretics are the two most common medications that raise blood sugar in both diabetics and non-diabetics. Every time you start taking a new medicine and notice that your blood sugar is rising, you have reason to ask your doctor if the medicine could be the culprit.
10. A combination of several of the above. This is actually the most common. Diabetics often eat too much and / or too many inappropriate foods, exercise too little, are already overweight, and are taking multiple medications.
If your blood sugar is too high, the list above is a place to start. Talk to your doctor about what you can do to change your lifestyle. Diabetic teaching classes are a good idea and can provide you with general information and specific guidance relevant to your particular situation. Once you’ve identified the cause, you’re on your way to finding an answer.
Copyright 2010 Cynthia J. Koelker, MD