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    Take 5: Diabetes

    Our diabetes expert answers five questions about lifestyle and blood sugar control.

    2. Is it better to eat frequently throughout the day? continued...

    Keeping a food diary, along with testing blood sugar before and after meals, is a good way to see the effect of particular foods on blood sugar level. The immediate feedback can be helpful.

    And pay attention to portion sizes. Food labels are useful (they provide information about carbohydrate content as well as total calories), but the portion sizes they list are often unrealistically small (how many people eat half a muffin?). Although weighing food servings can be annoying, it might help train your eyes as to what a "6-ounce serving" of something really looks like.

    3. How do stress and sleep affect diabetes management?

    There's emerging evidence that people who are chronically sleep-deprived tend to eat more and gain weight, so sleep can be important for diabetes management. There is definitely a biological connection between stress and managing diabetes, too. [The levels of] stress hormones like cortisol and epinephrine go up when people are stressed, and we know those hormones tend to elevate blood sugar.

    It's also difficult for people to focus on managing their diabetes when they're distracted by work problems, family issues, or other kinds of stress.

    Many doctors' offices and hospitals have diabetes education programs that will help people develop skills for managing diabetes. Try stress reduction techniques, and don't forget that exercise is wonderful for helping to manage diabetes and can relieve stress, too.

    4. Why do I need to exercise?

    There's evidence that exercise can have profound effects on blood sugar control -- even if you don't lose weight. When you exercise, insulin's ability to help bring glucose into the cells improves. Aerobic exercise, like running on a treadmill, bicycling, or jogging as well as weight or resistance training can help control blood sugar. Some studies indicate that weight training may be even more effective than aerobic exercise, which is a bit surprising.

    It's interesting to note that exercise is effective at improving insulin sensitivity even in older people -- those in their 60s, 70s, and 80s who get into a regular exercise program.

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