Things That Make Diabetes Tough to Control

Medically Reviewed by Michael Dansinger, MD on April 30, 2023
3 min read

Sometimes your blood sugar can get out of whack no matter how hard you try to control it. That’s because a lot of common things can derail your best efforts. But knowing what to watch for can help you stay on track.

Portion control is crucial to prevent blood sugar spikes after meals. You can still eat many of the things you love -- just not as much as you used to. Whether you count carbs or divide your plate, stick to the portions your care team recommends.

You don’t have to give up your favorite IPA, but watch how much you have. Too much alcohol stops your liver from releasing glucose, so your blood sugar can get too low. Your doctor may call this hypoglycemia.

To keep things in check, follow the same rules everyone else should:

  • Have no more than two drinks a day if you’re a man, and no more than one if you’re a woman.
  • Drink with food, not on an empty stomach.
  • Never drink and drive. The symptoms of low blood sugar and high blood alcohol are almost the same.

If you take insulin or certain other diabetes meds, you probably need to eat the same amount of carbs at the same time every day. If you’re not on these meds, your meal plan may be more flexible. Either way, it’s important not to skip breakfast. This can cause daylong sugar spikes. And eating late at night can lead to high glucose in the morning.

When you have diabetes, your body loses more water. When you don’t drink enough to replace it, your blood sugar shoots up. This makes you pee more often, and you get even more dehydrated.

To get what you need, try to drink water regularly, even when you’re not thirsty. Have a glass when you first wake up, then set your phone to remind you to have more every few hours during the day.

If you don’t like plain water, add lemon slices, mint leaves, or crushed berries.

Hot spells and cold snaps make it harder for your body to use insulin. In extreme weather, you may need to check your blood sugar more often and adjust what you eat and drink. Be careful with your insulin and glucose strips and meters, too. Keep them in a cool place in the house, not in your car.

And check the forecast if you order meds or supplies by mail. If it’s going to be very hot or very cold, make sure someone can put your medicine in your home as soon as it's delivered.

Just one bad night’s rest -- less than 6 hours -- can make your blood sugar higher the next day. When you’re sleep deprived, your body makes less insulin and has trouble getting glucose into your cells.

A solid 7 to 8 hours of sleep helps insulin work the way it should. Also, try to hit the sack at about the same time most nights. That way, you don’t mess with your body’s internal clock, which also helps control glucose levels.

Exercise is the best way to keep your blood sugar on an even keel. You might even say it’s “the perfect drug for diabetes.”

Besides glucose control, it helps stave off:

If you take insulin or a sulfonylurea, your blood sugar can take a nose dive when you’re active. That’s because your muscles are using your glucose more efficiently.

Your health care team can help you plan to prevent these swings. For example, you might take less insulin or eat some carbs before you work out. Your doctor might also ask you to check your blood sugar before and after you exercise.

Don’t let these tweaks to your routine keep you on the couch. Try to get at least 30 minutes of cardio exercise -- the kind that gets your heart pumping -- most days. You’ll need an hour if you want to drop extra pounds.

To keep your muscles strong, your best bet is weight training at least two or three times a week.