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Dieting With Diabetes? Watch Out!

When you have diabetes and start a diet, controlling blood sugar levels is vital.
WebMD Feature

You have diabetes and you're ready to lose weight. First up: Be prepared to monitor your blood sugar carefully.

That's because changes in your eating pattern - and weight loss itself -- affect your blood sugar level, so you'll probably need changes in your diabetes medicines.

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"Diabetes is about balance - balancing food, activity, insulin, pills every single day," says Larry C. Deeb, MD, a diabetes specialist in Tallahassee, Fla. and president-elect of the American Diabetes Association.

"As you ratchet down calories, as you lose weight, you'll ratchet down insulin and medications," says Deeb.

Losing weight, after all, means making changes in eating and exercise patterns - and that affects everything in your diabetes treatment.

If you're starting a weight loss plan, now is the time to make sure you know how to spot and deal with low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia).

Low blood sugar (hypoglycemia). Blood sugar levels below 70 occur when your insulin level is higher than your body needs. This is common when people lose weight because cutting calories affects blood sugar levels.

If you don't reduce your insulin dosage to compensate for the calorie shift, you'll risk low blood sugar, whose early warning stages include:

Be vigilant. In its later stages, low blood sugar can be very dangerous -- possibly causing fainting, even coma.

High blood sugar (hyperglycemia). Blood sugar levels above 240 can develop when your insulin level is too low to control blood sugar. This leads to ketosis, a condition in which you're unable to use glucose for energy, so your body switches to burning fat instead.

In ketosis, fat is converted to ketones which get into your blood and your urine. Glucose also builds in your blood and spills into your urine -- pulling water from your body and causing dehydration, a potentially life-threatening condition.

"Ketosis decreases oxygen delivery to the tissues, which puts stress on eyes, kidneys, heart, liver," says Christine Gerbstadt, MD, MPH, RD, LDN, a spokeswoman for the American Dietetic Association and a diabetes specialist in Philadelphia.

That's why a low-carb, high-protein diet, like Atkins, for example, is not really safe for people with diabetes, says Gerbstadt. "Diabetics need to try to stick with a more balanced diet so your body can handle nutrients without going into ketosis."

If your blood sugar level is under control, hyperglycemia or ketosis isn't a risk, Deeb explains.

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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