Are you diabetic? Is your blood sugar too high?
In 20 years of seeing diabetic patients, one becomes familiar with certain patterns of illness and behavior. Any seasoned physician can list a dozen reasons why a patient’s blood sugar may be uncontrolled.
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Here is my top 10 list of reasons why your blood sugar may be too high.
1. Your overall calorie intake is too high. For most Type 2 diabetics, the body is still capable of producing some insulin, but perhaps not enough to help you metabolize your food adequately. Cutting your calories back by a third may be all you need to do.
2. You eat foods with a high glycemic index. When it comes to diabetes, not all food is created equal. Simple carbohydrates (sugars, bread, cereal, rice, potatoes, pasta) are absorbed quickly, thereby elevating the blood glucose level quickly – too quickly for the pancreas to respond adequately. Eating the same calories in the form of foods that are absorbed more slowly (protein, fat) will cause less of a spike in your blood sugar.
3. Your body mass index is too high. Having too much adipose tissue within the body makes it more difficult for the body to utilize insulin. Once you’ve dropped your extra weight, you may be able to eat the same number of calories, but have your diabetes under better control.
4. You don’t take your medication as directed. Many patients not only ‘cheat’ by eating a cookie now and then, but by skipping their medicine more frequently than they admit to. Lying to yourself will make it difficult for both you and your doctor to keep your diabetes under control.
5. You’re not on enough diabetic medicine. Although your diabetic treatment probably started with only a single medication, it’s quite common to require additional medicine as time goes by. This may be accomplished by using either a higher dose of the drug you’re already on, or by taking a combination of two or more medications.
6. You don’t exercise enough. Exercise not only helps lower blood sugar, but also builds muscle mass, which utilizes blood glucose more efficiently than fatty tissue does.
7. Your pancreas is wearing out and you need to be on insulin. By the time you are taking three or even four oral diabetic medicines, you are getting to the point where your pancreas is just not able to produce sufficient insulin to counteract your blood sugar. If your pancreas is simply wearing out, there is no medication that can make it ‘young’ again.
8. You have an infection. Some infections are obvious, others less so. Urinary tract infections, for example, frequently elevate the blood sugar, but may cause few other symptoms. Patients also commonly confuse the frequent urination associated with an infection with that caused by diabetes. Any type of infection may raise your blood sugar, from stomach flu, to ear infection, to influenza or pneumonia.
9. You’re taking medicine that elevates the blood sugar. Steroids and diuretics are the two most common drugs that elevate the blood sugar in both diabetics and non-diabetics. Any time you start a new medication and notice that your blood sugar is running higher, you have cause to question your doctor whether the medicine might be the culprit.
10. A combination of several of the above. This is really the most common. Diabetics often eat too much and/or too much of the wrong foods, exercise too little, are already overweight, and are taking multiple medications.
If your blood sugar is too high, the above list is a place to start. Talk to your doctor about what you can do to modify your lifestyle. Diabetic teaching classes are a good idea and can provide you both general information and specific guidance relevant to your particular situation. Once you’ve identified the cause, you’re well on your way to finding an answer.
Copyright 2010 Cynthia J. Koelker, M.D.
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Cynthia J. Koelker, MD is a family physician of over twenty years, and holds degrees from MIT, Case Western Reserve University School of Medicine, and the University of Akron. She is the author of “101 Ways to Save Money on Healthcare.”
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