Diabetes management: How lifestyle, daily routine affect blood sugar

Keeping your blood sugar levels within the range recommended by your doctor can be challenging. That's because many things make your blood sugar levels change, sometimes unexpectedly. Following are some factors that can affect your blood sugar levels.

Food

Healthy eating is a cornerstone of healthy living — with or without diabetes. But if you have diabetes, you need to know how foods affect your blood sugar levels. It's not only the type of food you eat but also how much you eat and the combinations of food types you eat.

What to do:

• Learn about carbohydrate counting and portion sizes. A key to many diabetes management plans is learning how to count carbohydrates. Carbohydrates are the foods that often have the biggest impact on your blood sugar levels. And for people taking mealtime insulin, it's crucial to know the amount of carbohydrates in your food, so you get the proper insulin dose.
  Learn what portion size is appropriate for each type of food. Simplify your meal planning by writing down portions for the foods you eat often. Use measuring cups or a scale to ensure proper portion size and an accurate carbohydrate count.
• Make every meal well-balanced. As much as possible, plan for every meal to have a good mix of starches, fruits and vegetables, proteins, and fats. It's especially important to pay attention to the types of carbohydrates you choose. Some carbohydrates, such as fruits, vegetables and whole grains, are better for you than are others. These foods are low in carbohydrates and contain fiber that helps keep your blood sugar levels more stable. Talk to your doctor, nurse or dietitian about the best food choices and the appropriate balance of food types.
• Coordinate your meals and medications. Too little food in proportion to your diabetes medications — especially insulin — may result in dangerously low blood sugar (hypoglycemia). Too much food may cause your blood sugar level to climb too high (hyperglycemia). Talk to your diabetes health care team about how to best coordinate meal and medication schedules.
• Avoid sugar-sweetened beverages. Sugar-sweetened beverages — including those sweetened with high fructose corn syrup or sucrose — tend to be high in calories and offer little in the way of nutrition. And because they cause blood sugar to rise quickly, it's best to avoid these types of drinks if you have diabetes.
  The exception is if you are experiencing a low blood sugar level. Sugar-sweetened beverages, such as soda, juice and sports drinks, can be used as an effective treatment for quickly raising blood sugar that is too low.

Exercise

Physical activity is another important part of your diabetes management plan. When you exercise, your muscles use sugar (glucose) for energy. Regular physical activity also helps your body use insulin more efficiently.

These factors work together to lower your blood sugar level. The more strenuous your workout, the longer the effect lasts. But even light activities — such as housework, gardening or being on your feet for extended periods — can improve your blood sugar level.

What to do:

• Talk to your doctor about an exercise plan. Ask your doctor about what type of exercise is appropriate for you. In general, most adults should exercise at least 30 minutes a day on most days of the week. If you've been inactive for a long time, your doctor may want to check your overall health before advising you. He or she can recommend the right balance of aerobic and muscle-strengthening exercise.
• Keep an exercise schedule. Talk to your doctor about the best time of day for you to exercise so that your workout routine is coordinated with your meal and medication schedules.
• Know your numbers. Talk to your doctor about what blood sugar levels are appropriate for you before you begin exercise.
• Check your blood sugar level. Check your blood sugar level before, during and after exercise, especially if you take insulin or medications that lower blood sugar. Exercise can lower your blood sugar levels even a day later, especially if the activity is new to you, or if you're exercising at a more intensive level. Be aware of warning signs of low blood sugar, such as feeling shaky, weak, tired, hungry, lightheaded, irritable, anxious or confused.
  If you use insulin and your blood sugar level is below 100 milligrams per deciliter (mg/dL), or 5.6 millimoles per liter (mmol/L), have a small snack before you start exercising to prevent a low blood sugar level.
• Stay hydrated. Drink plenty of water or other fluids while exercising because dehydration can affect blood sugar levels.
• Be prepared. Always have a small snack or glucose tablet with you during exercise in case your blood sugar drops too low. Wear a medical identification bracelet when you're exercising.
• Adjust your diabetes treatment plan as needed. If you take insulin, you may need to reduce your insulin dose before exercising or wait awhile after exercise to inject insulin. Your doctor can advise you on appropriate changes in your medication. You may also need to adjust treatment if you've increased your exercise routine.

Medication

Insulin and other diabetes medications are designed to lower your blood sugar levels when diet and exercise alone aren't sufficient for managing diabetes. But the effectiveness of these medications depends on the timing and size of the dose. Medications you take for conditions other than diabetes also can affect your blood sugar levels.

What to do:

• Store insulin properly. Insulin that's improperly stored or past its expiration date may not be effective. Insulin is especially sensitive to extremes in temperature.
• Report problems to your doctor. If your diabetes medications cause your blood sugar level to drop too low or if it's consistently too high, the dosage or timing may need to be adjusted.
• Be cautious with new medications. If you're considering an over-the-counter medication or your doctor prescribes a new drug to treat another condition — such as high blood pressure or high cholesterol — ask your doctor or pharmacist if the medication may affect your blood sugar levels. Liquid medications may be sweetened with sugar to cover their taste. Sometimes an alternate medication may be recommended. Always check with your doctor before taking any new over-the-counter medication, so you know how it may impact your blood sugar.

Resource: mayoclinic.org