Tag Archives: blood sugar level

Seven Tips On How to Maintain Healthy Blood Sugars During The Holiday Season

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I recall a number of years ago, when a patient left my office based practice and sent me a very nasty note three months later. She expressed how disappointed she was that I was not a person of my word. I had assured her that due to the fact that her blood sugars were well controlled and her A1C was less than 7% that I would attempt to wean her off some, if not all her medications.

The catch was that at the time that this discussion was going on, the holiday season was also upon us. I had made a mental note to address this in the New Year, as I hate to see anyone fail due to no fault of his or her own.
I should have educated my patient on what it was that I intended to accomplish and my reasoning.

For people living with type 2 diabetes, this is one of the more challenging times of the year. Blood sugar levels may gradually begin to rise with each holiday party. And with that, the A1C rises.

By following these seven simple steps, you can survive the holiday season and come out a winner ready to embrace 2017 as you live powerfully!

Tip number 1- Plan your meals

In order to keep blood sugars within a normal range, planning your meals is very important at this time of the year.

Here’s a simple tip-If you know that you are going to be out at a holiday party later on in the day, consider having a light snack just before leaving home. That way you are less hungry and less likely to go for the sweets that will cause your sugars to rise.

Also consider cutting down on the portion sizes of your earlier meals. Be careful if you are on insulin or an oral hypoglycemic agent not to cut down too low so that you do not experience hypoglycemia.

Tip number 2- Increase your amount of fiber intake

Fiber is a complex carbohydrate. The average American diet contains a low level of fiber. Most nutritionists recommend a daily fiber intake of up to 35G.

Studies have shown that by increasing the amount of fiber in the diet can help control blood glucose levels. This is especially if it is soluble fiber. An example of soluble fiber is oatmeal.

Fruits and vegetables are all good sources of fiber. By making a conscious choice to increase the amount of fiber rich foods in your diet will get you to your goal of maintaining a normal blood sugar range throughout the holiday season and beyond.

Tip number three- Plan to incorporate physical activity

The Winter & Holiday season is traditionally the time when the average American gains between 7-10 lbs. Studies have shown that people living with type 2 diabetes can achieve normal blood sugar range by increasing physical activity. During the winter months make an effort to maintain some form of physical activity. Choose an exercise regimen that is easy to follow.  As always be sure to see your physician before starting out on an exercise program. So if you have not already scheduled your annual physical, now is a great time to go ahead and do so.

Tip number four- Drink enough water

There are a myriad of benefits to drinking water. The important thing in a type 2 diabetic is to maintain good kidney function. Drinking water may also keeps you feeling full and so help with weight loss. The traditional recommendation has always been 8 glasses of water a day. However something else to consider is drinking half of your body weight in ounces. So if you weigh 170 lbs. that equals 85 ounces of water a day.

Tip number five- be consistent with monitoring your blood sugars

This is not the time of the year to slack off testing your blood sugar levels.  It is not the time to stick your head in the sand and rationalize that your blood sugar levels are going to be high and there’s nothing you can  do about it anyway. Your mindset is very important. If you have not been checking your blood sugar levels regularly, this is the time to start. By regularly checking your blood sugar levels,  you get instant feedback. Living powerfully with diabetes, requires that you have an awareness attached to action. High blood sugar levels just do not happen to you. You can make the necessary adjustments in your lifestyle in order to control your blood sugars.

Tip number six- Keep all scheduled appointments with your healthcare providers

This is the time to make your healthcare provider aware of any challenges that you may be encountering during the holiday season. That way you both can explore ways to better control your blood sugar levels.

Depending on your A1C, your healthcare provider may decide to adjust your medications. This is a much better option than starting out the New Year with high A1c levels and blood sugar levels out of control. Sometimes it can take more than 6 months to normalize the blood sugars.

Tip number seven- Enlist the support of family and friends

I have written in a previous article about the importance of a support network. Now more than ever is the time of the year to enlist the support of family and friends. Want to get started in an exercise program? Call up a workout buddy. Not sure how to handle ‘Aunt Martha’s’ three layer chocolate cake? Have a family member share a portion with you. It takes teamwork to make the dream work. Do not be afraid to ask for support. Sometimes just knowing there is someone else looking out for you is what makes the world of difference.

I’d love to read your comments and any other strategies that you may have in place to ensure that you keep your diabetes type 2 sugar levels normal this holiday season and beyond.

Until next week,

Here’s to your Health & Wellbeing,

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Pregnancy and Diabetes

Gestational DiabetesDiabetes in pregnancy is called gestational diabetes. Women who develop gestational diabetes usually did not have either borderline or type 2 diabetes before they got pregnant.

According to the centers for disease control, gestational diabetes occurs in about 9.2% of pregnancies. Just like type 2 diabetes, the incidence of gestational diabetes is rising.

Women with gestational diabetes usually do not have any symptoms. This is why it is important to screen for it in all pregnant women.

 

How gestational diabetes is diagnosed

Gestational diabetes is usually diagnosed after 24 weeks of pregnancy. If diabetes is diagnosed before 24 weeks, more than likely this is type 2 diabetes. Your healthcare provider will order a test called the oral glucose tolerance test. For more information about the oral glucose tolerance test, click here.

 

The cause of gestational diabetes

Gestational diabetes is felt to be caused by insulin resistance just as in type 2 diabetes. The high levels of insulin cross the placenta into the baby. The excess insulin converts glucose into fat. Babies born to women with gestational diabetes usually have a high birth weight of over 9 lbs. This is because they are large. This can lead to the baby getting injured as it is being delivered through the birth canal. If the baby is too large to be delivered naturally it may have to be delivered by cesarean section. Cesarean section is major surgery and just like any surgical procedure there are inherent risks to both the mother and the child. A woman who has a cesarean section may have to have another cesarean section in future pregnancies.

 

Treatment for gestational diabetes

 Women with gestational diabetes will need to be monitored very closely by an obstetrician who specializes in high-risk pregnancies. This is to prevent complications to the mother as well as the unborn child. Sometimes these appointments may be on a weekly basis as the pregnancy advances. It is important to know when these appointments are and to keep them.

Diet and moderate exercise are usually the first steps to treating gestational diabetes. If a woman has not been physically active before getting pregnant this is not the time to start a vigorous exercise program. Starting a walking program is a good idea, however it is important she speak with her healthcare professional prior to starting any physical activity.

If diet and exercise do not get control the blood sugars, then it may be necessary to start on medications. A lot of women are started on insulin because it allows for better control of insulin. It is also important that to check blood sugars frequently when pregnant with diabetes. Just as in type 1 or type 2 diabetes this can be taught and will need to be done at home several times a day. It is important to inform your healthcare provider if the blood sugars are not in the target range.

 

Gestational diabetes and future risk of developing type 2 diabetes

Gestational diabetes usually resolves after pregnancy. However women who have had gestational diabetes have an increased risk of developing type 2 diabetes. There is also a chance for recurrence in future pregnancies.

Risks for developing gestational diabetes

 

  • Certain ethnic groups such as African Americans, Latina, or Native Americans
  • Having borderline diabetes
  • Being overweight or obese
  • Family history of type 2 diabetes
  • Being over the age of 25 years

 

Steps to reduce gestational diabetes

 Just as in type 2 diabetes prevention is the key. Taking preventive steps does not reduce the risk of developing gestational diabetes to zero, but it is still a step to having a pregnancy with few complications and delivering a healthy baby.

Here are a few steps every woman planning a pregnancy can take to reduce her risk of developing gestational diabetes

 

  • Try to get as close as possible to your ideal body weight prior to getting pregnant.
  • Start an exercise program. I am a proponent of walking as a simple form of exercise. If you are planning to get pregnant now may not be the time to start training for a marathon, but it is easy to start walking. Purchase a fitness tracker and commit to walking 10,000 steps a day.
  • Eat more fresh fruit and vegetables. These contain nutrients rich in antioxidants, is a good source of fiber. Fiber helps with weight control. Fruits and vegetables are also a good source of folic acid that is necessary to prevent birth defects and support a healthy pregnancy. Juicing is an excellent way to get a variety of fruits and vegetables into your diet.
  • Get an annual physical. Inform your healthcare provider that you are planning a pregnancy and they may order some blood tests such as a fasting glucose, lipid profile and blood chemistry. For instance if you find out through blood tests that you have borderline diabetes, you can take some pro-active measures prior to getting pregnant.

 

Diabetes in pregnancy affects both a woman’s health as well as the health of her unborn baby. To avoid complications, it is important to seek medical care during pregnancy and to follow the advise of your healthcare professional.

To your health and wellbeing,

 

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Blood Glucose Monitoring-Some Strategies to Check Blood Sugar Levels Once a Day

blood glucose monitoringWelcome back! Over the last few weeks I shared some of the lows and highs of living with type 2 diabetes. Namely hypoglycemia and hyperglycemia.

According to American Diabetes Association guidelines, normal fasting blood sugar levels range between 80-130 mg/dL. Blood sugars should also be checked after eating. This is called postprandial blood sugars. The best time to check postprandial blood sugars is  two hours after a meal. Normal postprandial blood sugar levels should be below 180 mg/dL. In order to reduce diabetes complications, it is important to try and keep blood sugars within this range.

Sometimes it may be necessary to check blood sugars several times a day in order to make the necessary adjustments to get blood sugars in the healthy range. This is usually where I would encounter a lot of resistance from my patients. They complain that testing their blood sugars several times a day is painful. Test strips cost a lot of money. Or it may be that because of their work schedule they just don’t have the time.

I found that the more I argued with my patients about monitoring their blood sugars more than once a day, the more resistant some patients became. In fact some even stopped coming in as scheduled. They would stretch out their appointments. For instance, instead of coming in every three months, they made it twice a year.

Now that can be harmful as it is a surefire way to develop complications related to diabetes!

So I had to get creative with that segment of my patients that just were not going to check their blood sugars consistently.

Well here are some strategies that I came up with. For the most part they ended up being about compromise, which I think is something that is very important if you are committed to living powerfully.

Strategy number 1-alternate checking fasting blood sugar levels with post prandial blood sugar levels

This is by far my favorite strategy. This is how it works:

On a calendar, divide the month into odd numbered and even numbered days.

On odd numbered days of the month, check your fasting blood sugar levels.

On even numbered days, check your postprandial sugar levels.  Try to vary the times that you check your postprandial levels. For instance on one day check the levels after breakfast, the next time after lunch. At another time after dinner.

This is a great way to get a general view of how your sugars run during different times of the day and not test more than once a day.

Remember to make a note of the times that you check your sugars so that your doctor can understand the trend. Some blood glucose monitors allow labeling the blood sugars also. Check your glucose monitor to see whether you can do this.

Strategy number 2- check postprandial sugars over the weekend

Here is when I would recommend this strategy:

If a patient cannot check their postprandial levels during the week due to their work schedule, then I encourage them to check the fasting levels during the week and then over the weekend, just to focus on checking their postprandial levels.

They can do this by alternating postprandial levels between breakfast, lunch and dinner over the weekend

Strategy number 3- check your blood sugars for two weeks before you see your healthcare provider

I only bring out this strategy when I am pushed to the wall. Literally I am begging a patient to work with me so that I can help them reach their blood sugar goals.

There is nothing more frustrating than not having an idea about how the blood sugars of a patient are running in between scheduled office visits. It is like shooting in the dark. You get a blood test result that is high, but you have no idea how to go about correcting it.

As I tell my type 2 diabetes patients, on average they get to see their healthcare provider between three to four times per year for routine diabetes care. What happens the remaining 361 days is left in their hands.

With blood sugars taken consistently for even two weeks before an office visit, when combined with the hemoglobin A1C most times it is much easier to spot the problem.

Why is it important to check both the fasting and postprandial blood sugar levels?

In an earlier article I shared some important numbers that a person living with diabetes needs to know. One of those numbers is the A1C also known as the glycosylated hemoglobin. The target range for the A1c is less than 6.5- 7%.  In order to achieve that goal, the fasting blood sugars are within the target range of 70-130 mg/dL. The postprandial levels also have to be consistently less than 140 mg/dL two hours after a meal.

If your A1C is high, then by keeping a log of the blood sugars, you will be able to pinpoint the problem.

For instance if the fasting blood sugar levels are within normal range, but the post prandial levels are high, then perhaps you need to adjust portion sizes.

If the fasting levels are running high, it may be that the evening medications need to be adjusted or that a late night snack needs to be cut out. Sometimes this may even mean that the nighttime medications may need to be cut down. But your physician needs to see your glucose log so that they can target the problem and create a customized plan for you.

Start today to check your blood sugars

Perhaps you are a newly diagnosed diabetic or even if you have had diabetes for some time but just never thought it important to check your blood sugars. Let’s start out fresh.

Review the instructions of your glucometer. If you do not understand how to use it then check to see whether your local pharmacist can help you. If not call your doctor’s office and schedule a visit with the nurse. Most times they can help you. Most times the machines work the same way. A few have extra ‘bells and whistles’ attached to them.

Just as I share in my upcoming book, “Dr Eno’s A-Z Guide to Living Powerfully with Type 2 diabetes”,  two of the hallmarks of living a powerful life with diabetes is being committed and persistent. If you do that you will go a long way to living free of diabetes complications.

I welcome your comments or questions so please leave them here. I’d also love to hear some of the issues that you have as a type 2 diabetic. Come over to my Facebook page and share some of your thoughts with me. It just may be a topic for an upcoming article.

Until next week Here’s to your Health and Wellbeing,

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How to Bring High Blood Sugar Levels Down Without Feeling Lousy

high blood sugarHello and welcome back to another edition of Women Living Diabetes,

Last week I wrote about low blood sugars also known as hypoglycemia. Today I am going to discuss the other extreme- high blood sugar levels. This is also known as hyperglycemia. Hyperglycemia can be as equally a challenging to treat.

‘But doctor I feel perfectly fine even though I have high blood sugars. In fact I feel really lousy when my blood sugar levels are normal. So this must be normal for my body’

I cannot tell you how many times I have heard that statement or something similar. One of the things I emphasize to all my patients is the importance of achieving normal blood sugars.

The American Diabetes Association recommends the fasting normal blood sugar should be between 70–130 mg/dL for fasting blood (3.9-7.2 mmol/L). Two hours after eating the blood sugar level should be less than 180 mg/dL (10 mmol/L).

Some people with type 2 diabetes begin to feel like they have low blood sugar levels even though they may be in the normal range. In other words their body tricks them into feeling this way. Next they eat to counteract the feelings and their blood sugars rise.

High blood sugar levels can lead to complications of type 2 diabetes.

So why do some people with diabetes feel ‘bad’ when their sugars are in normal blood sugar range?

Here is a simple explanation as to why this happens:

Every human body has a set ‘thermostat’. This thermostat is set to a range for each person. Everyone has a set level that his or her body systems function at.

For instance, the normal fasting blood sugar level is a range, between 70 to 99 mg/dL.  This normal range spans about 20 points. Which means it is going to be different numbers in that range for different people. But so as long as the blood sugar levels are in that range they are considered normal.

In type 2 diabetes, one of the things that happens is that the body reset it’s thermostat to a higher blood sugar level. So instead of functioning with blood sugars between 70 and 99 mg/dL, the body makes an attempt to function at a higher blood sugar level.

By the time diabetes symptoms set in, the blood sugars are usually well over 180 mg/dL.

This is why it is important to screen for diabetes early.

So now the body has reset it’s thermostat. Think about it like an air-conditioning system. If the thermostat is set at 73 degrees then the system does not come on until the temperature rises above 73 degrees and then it cools the room down till it is below 73 degrees and then turns off.

In the case of a person living with type 2 diabetes, the ‘blood sugar thermostat’ has been reset to a higher level.

Now here comes an ambitious healthcare provider such as myself. ☺ Our goal is to achieve normal blood sugars. Because we know from research that with normal blood sugars, the complications of type 2 diabetes are reduced.

However, as the blood sugar levels begin to come down with treatment, the body sends out alarm signals. These alarm signals feel just like low blood sugar (hypoglycemia). As I explained in my recent article, hypoglycemia is a very scary feeling for someone living with type 2 diabetes. Once they experience it once, most diabetics will usually do everything they can to avoid experiencing again.

So how can you bring your blood sugars down to target range without feeling lousy?

  • Keep a log of your blood sugar levels. You may need to check your blood sugars several times a day to see if there is a pattern.
  • Discuss your concerns with your healthcare provider. Remember open communication produces better outcomes.
  • Your healthcare provider may decide to bring the sugars to normal range slowly. This way the body ‘thermostat’ resets itself slowly without sending out those alarm signals.
  • If you feel that your blood sugars are dropping low, check the levels first before deciding to eat something. This serves a purpose of reassuring you what the level is. Most times the blood levels are still outside of range.
  • Do not to skip a meal. Try to eat smaller more frequent meals.

Remember that your goal is to achieve normal blood sugar levels. This requires that you are committed to your health and wellbeing.

As always I welcome any questions or comments that you have. If you have found this information useful, please share it with someone else.

Until next week,

To your health and wellbeing,

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