In a consult today with a diabetic, the person told me that their blood sugars varied from 280 (or even as high as 320) to 75. Also, this happened regularly. The A1C value was 9.5 for this person - who does clearly have a severe sugar problem.....
But why the wild swings? And their PCP's solution wants to put the person on an insulin pump (he is already on insulin).
This is not a root-cause solution because artificial insulin makes you MORE insulin resistant - thus MORE diabetic (coming in a future blog).
Here are some things that can lead to wide variations in glucose that is monitored at home - without fasting:
Your blood sugar can rise after you have coffee -- even black coffee with no calories -- thanks to the caffeine. The same goes for black tea, green tea, and energy drinks. Each person with diabetes reacts to foods and drinks differently, so it's best to keep track of your own responses. Caffeine (coffee and other beverages) aren't always bad for you - but diabetics need to be mindful of changes in their sugars as related to what they are taking in.
2. Sugar-Free Foods:
Many of these will raise your blood sugar levels. Why? They can still have plenty of carbs from starches. Also, even though low in calories, many sugars still stimulate an "insulin" response and insulin's job is to keep you blood sugar in a range that is not chronically inflammatory to your vessels.
3. Chinese Food:
We all know when we hit the buffet, we are hungry within 2 hours. Why? The processed, carb-laden foods and MSG trigger insulin to spike, driving the sugar out of your blood. These foods are often loaded with processed oils like soybean oil. When you dig into a plate of sesame beef or sweet and sour chicken, it isn't just the white rice that can cause a problem. The same is true for pizza, french fries, and other goodies that have a lot of carbs and inflammatory omega-6 and trans fats
4. A Bad Cold
Your blood sugar rises as your body works to fight off an illness. When you are insulin resistant, that includes your immune cells as well. Thus, you whole body has to work harder to fight off infection - virus, bacteria, and other pathogens. Not only that, the pathogens are "stealing" some of your energy. Being diabetic (insulin resistant) magnifies this response.
5. Job Stress
Overwhelmed or unhappy at work? It takes a toll. When you're under stress, your body releases hormones that can make your blood sugar rise. It's more common for people with type 2 diabetes - for many of the same reasons this happens when you have a cold or flu.
What's the difference between eating a slice of white bread and a bagel? Bagels are packed with carbohydrates -- more than a slice of bread. They have more calories, too. There is no "free lunch" with wheat-based carbs of any type including the "heart healthy" whole grain options. They are still super high in carbs that are very quickly absorbed - and the insulin quickly follow with that "spike" and then "crash."
7. Sports Drinks
Sports drinks are high sugar drinks. The zero calorie ones don't have the natural sweeteners, generally - so they spike your insulin too. They're made to help you replenish fluids quickly, but some of them have more sugar than a soda. Plain water is probably all you need for a moderate workout of less than an hour. Add a little sea salt to your water to replenish electrolytes at very low cost and no insulin surge.
8. Dried Fruits
Fruit is a healthy choice, but be aware that dried versions will pack more carbohydrates in a smaller serving size. Just 2 tablespoons of raisins, dried cranberries, or dried cherries have the carbs of a small piece of fruit. Three dates give you 15 grams of them. They seem like a healthy choice but go with nuts like walnuts and pecans instead.
9. Steroids and Water Pills
There is NEVER a "free lunch" with pharmaceuticals either. People take corticosteroids, such as prednisone, to treat rashes, arthritis, asthma, and many other conditions. But they can boost your blood sugar, and may even trigger diabetes in some people. Diuretics that lower high blood pressure, also called water pills, can do the same. Some antidepressants also raise or lower blood sugar. There is natural solution to these drugs that help, rather than hurt, your diabetes / insulin resistance.
10. Cold Medicines
Decongestants that have pseudoephedrine or phenylephrine can raise blood sugar. Cold medicines also sometimes have a little sugar or alcohol in them, so look for products that skip those ingredients. Prepare your body in advance to fight the inevitable cold. Take cod liver oil regularly. The natural forms of vitamin A and D are pathogen-fighting. When my family feels a cold coming on we do large doses of a quality vitamin C for a couple of days and the cold seldom lingers.
11. Birth Control Pills
Types that have estrogen can affect the way your body handles insulin. The testing we do for inflammatory markers like hs-CRP, homocysteine, fibrinogen, sed rate and other tests seldom done in the standard-of-care also elevate significantly, over time, in many women. These markers, when elevated, indicate a high risk for stroke and other heart-related disorders.
Women have high incidences of heart disease - their symptoms and underlying pathologies are different, however. These pills can increase your risk. Heart disease is the cause of death in 1 of every 3 women. https://www.cedars-sinai.edu/About-Us/HH-Landing-Pages/When-it-comes-to-heart-disease-women-and-men-are-not-equal.aspx
A future blog will cover the many common things that cause your blood sugar to go down or fluctuate in either direction.
Work to get or stay well!