By Denise Mann Reviewed by Farrokh Sohrabi, MD
Brush Up on Blood-Sugar Control :
As you likely already know, keeping blood glucose (sugar) levels stable is crucial to type 2 diabetes management. If blood sugar swings too high, problems can develop: If untreated, it can potentially lead to a diabetic coma, according to the American Diabetes Association (ADA). Over time high blood sugar levels can lead to complications such as heart disease, kidney disease, and nerve damage. And when blood sugar falls too low, shakiness, nervousness, anxiety, confusion, and eventually seizure or loss of consciousness may occur, the ADA says. You may know that skipping meals can lead to low blood sugar and bingeing on carbs can cause blood sugar to spike. But many surprising factors can also cause blood sugar highs and lows — and knowing about these eight may just make a big difference to your diabetes management.
Alcohol — especially when combined with sweet mixers like soda, fruit juice, or margarita mix — can spike blood sugar levels, says Kristine S. Arthur, MD, an internist at Orange Coast Memorial Medical Center in Fountain Valley, California. But excessive drinking can cause blood sugar to drop to dangerously low levels, as well. "Alcohol can push blood sugar too far in either direction," she says.The ADA suggests that if you drink, alcohol should be limited to no more than one drink a day for women and no more than two drinks a day for men. Alcohol can also interfere with medications you might be on for other health conditions, however, so check first with your doctor to see how much is safe for you to drink .
Whether it's good stress (like the excitement of planning a wedding or a new baby) or bad stress (like pressure at work or problems in a relationship), feeling stressed can get in the way of your blood sugar control, Dr. Arthur says. “Stress can directly cause high blood sugar, and it can also result in changes in behavior — such as skipping meals or drinking more alcohol — that affect blood sugar," she says. Arthur suggests healthy coping strategies such as going for a walk when you're feeling overwhelmed. Other healthy ways to lower stress include yoga, meditation, or taking deep breaths, she says.
Feeling Under the Weather :
“When you have an infection, are sick, or have recently had surgery, your blood sugar can be all over the place,” Arthur says. The stress that illness puts on your body, she explains, causes blood sugar to ebb and flow. “Some of the same hormones produced to fight illness can also cause your blood sugar to rise,” she says. In addition, you may not feel like eating when you don’t feel good, and this can cause blood sugar levels to fall. Arthur’s suggestion: Talk with your doctor when you're feeling good about how to monitor and treat your diabetes when you're sick. When you are sick, follow your doctor’s instructions — or check in with him or her if you don’t remember what to do. On that note…
Medications and Supplements :
Lots of medications can affect blood sugar, Arthur says. Some over-the-counter cough medicines contain sugar, and decongestants and other cold medications can also raise blood sugar levels. Other medications that can affect blood sugar include steroids, some diuretics, and some antidepressants. “When in doubt, ask your doctor or pharmacist for advice,” Arthur suggests. “It’s also a good idea to let your doctor know about any and all supplements or vitamins you are taking, as these may affect your blood sugar levels.”
Your Daily Cup of Java :
Even a single serving of coffee may affect post-meal blood sugar levels, according to a study in the August 2015 issue of the British Journal of Nutrition. Plus, common coffee and tea additions such as cream and sugar can cause a spike in blood sugar, Arthur says. If you have type 2 diabetes, she suggests you talk with a certified diabetes educator, nutritionist, or doctor to find out exactly how much caffeine is OK for you.
Extreme Exercise :
Exercise is good for you if you have diabetes, so extreme exercise should be extremely good for you, right? Not so fast. “If you don’t eat snacks or you skip a meal, you run the risk of developing dangerously low blood sugar — especially with high-impact exercise,” Arthur says. Avoid this scenario by checking your blood sugar before you exercise and always packing healthy snacks when you’re going to work out. If you’re not sure how much exercise you should be getting, check in with your doctor or diabetes educator.
Diet Soda :
The old school of thought was that diet sodas were OK for people with diabetes because they are sugar- and calorie-free — but that thinking has changed, says Dana Greene, RD, a nutritionist in Boston. In fact, diet sodas may actually contribute to blood sugar problems: Artificial sweeteners found in diet soda and sugar substitutes may alter gut microbes in a way that increases the risk for type 2 diabetes and glucose intolerance, according to a study published in 2014 in the journal Nature. Take this challenge; Arthur suggests: “If you drink a lot of diet sodas and are having a hard time controlling your sugars, cut back on soda and see if there is a difference in your blood sugar control.”
Hormonal Highs and Lows :
Hormonal changes — like those that come during the menstrual cycle or menopause —– can wreak havoc on blood sugar levels, Arthur says. “Not all women will experience these changes," she notes, "but if you are one of them, keep a journal and discuss any changes with your doctor so the two of you can develop an action plan.”