You might feel like you’re really on top of your diabetes game.
Balanced diet with healthy foods? Check.
Physical activity every day? Got it.
Taking your meds at the right time? Of course.
But if you still struggle with your blood sugar, you’re not alone.
“Many people are trying their best to adhere to a healthy lifestyle,” says Clare Lee, MD, who specializes in type 2 diabetes and obesity at Johns Hopkins. But, she adds, “More than half of people that have diabetes don’t achieve their target goal.”
In other words, you’re in good company. And, there’s still plenty you can do.
First Things First
Before you go hunting far and wide for another reason for your struggle, you may want to go back to basics.
“People will say they’re so active at work, and it’s true, but it doesn’t get your heart pumping,” Lee says. When you set aside “specific times in your daily routine to get physical activity like aerobics or weight-resistance training,” she adds, that’s when you’ll really see results.
Plus, “the food industry has done a great job of hiding corn syrup and highly processed sugar,” Lee points out. “You can have the best intentions and think you’re making healthy choices, but you’re getting hidden calories throughout your foods.”
Lee’s advice is to talk with your doctor and dietitian.
“There’s a lot of pitfalls. It’s easy to fall sideways,” she says, even when you’re doing your best.
Things You Just Can’t Change
So if you double down on diet and exercise and still have no luck, what then? For starters, it may help to know that some things, like genes and aging, are just out of your control.
Your genes had a role in why you got diabetes to begin with. Because it tends to get worse the longer you have it, getting older doesn’t help, either.
But don’t lose hope just because you don’t have a fountain of youth.
“It’s no fault of your own,” Lee reminds you. “Everyone with diabetes will age.” That means doctors work with this problem all the time. You may need to add a new drug to the mix to keep things in check.
Check Your Meds
Drugs you take for other conditions might be to blame.
“One obvious medication that comes to mind is steroids,” Lee says. They’re used to manage everything from asthma to rheumatoid arthritis.
In most cases, you don’t use them regularly over a long time. But even a single dose can spike your blood sugar.
A range of other drugs can have the same effect, including some:
- Beta-blockers for heart problems
- Birth control pills
- Decongestants you take for a cold
- Diuretics for high blood pressure
Check with your doctor about any meds you’re not sure about. You may be able to choose safer ones, or you may need a tweak to your insulin dose.
Stress, Sickness, and Pain
What do work pressure, a serious cold, and sunburn have in common?
“Your body is under attack and will produce stress hormones in response,” says Lee. And those hormones happen to drive up your blood sugar.
It may seem odd that such different things can have similar effects, but as Lee points out, “Stress is stress.” To some degree, it doesn’t matter if it’s physical or mental. Anything from family problems to sickness and surgery can make blood sugar rise.
So it pays to manage emotional stress with things like deep breathing, a relaxing bath, or exercise -- whatever works for you. If you’re sick or have a medical condition, you might work with your doctor to adjust your medicines.
Those Pesky Fat Cells
Diet and exercise help do a lot for diabetes. For one, they help keep extra fat at bay.
When you have diabetes, that's important.
“That’s something I spend a lot of time in my clinic discussing with my patients,” Lee says.
When you put on more pounds, insulin doesn’t work as well.
“Fat cells are not just storage bags,” says Lee. They also make hormones that boost your blood sugar. So more fat means more spikes.
“On the flip side, if you lose the weight, it would be effective in lowering blood sugar,” she adds. That’s why your best bet is to work with your doctor or dietitian to keep your weight in check.
The Rebound Effect
“[People] often feel terrible when they have low blood sugar, and they feel like they have to correct it. But they take way more than needed to get back in a safe range,” Lee points out.
Your body also makes an effort on its own to get things back in the right balance. All in all, you end up swinging hard toward the high range. It’s like yanking the steering wheel instead of making a gentle turn.
If you’re hitting a lot of lows, talk with your doctor. You may need to change your insulin dose or medications. And be mindful about going too far when you try to correct things.
This one isn’t the most common, but it can be a doozy.
Diabetes can cause gastroparesis, where food takes longer than normal to leave your stomach. Your insulin thinks it’s all done, even though you’ve still got more to digest.
Some drugs can have the same effect. Even a high-fiber or high-fat meal can do it. If you notice you often have low blood sugar just after a meal and high blood sugar for hours after, this could be the problem.
If so, Lee says, “you’re stuck between a rock and a hard place, especially if you’re an insulin user.”
You’ll need to work very closely with your doctor to sort out the best approach. You may need to adjust some eating habits, like eating smaller meals. Or, you may need tweaks to your medicine.