10 Keys to Controlling Your Blood Glucoseby David Mendosa Patient Advocate
A comprehensive guide to all the factors that influence our blood glucose level is What Makes My Blood Glucose Level Go Up...and Down? which I co-authored. The second edition, which Marlowe & Company published in 2006, is still in print. One of its three parts is 18 food factors and six non-food factors that make our levels rise. This slideshow summarizes, updates, and simplifies my first book.
Carbs are the biggest factor
Your daily carb total is the most important key to blood glucose control. The more carbs you eat the higher your blood glucose. The two biggest guides are (1) the carbs you eat in the morning will raise your level more than the same ones later in the day and (2) lots of carbs in any one meal will raise it more than the same amount spread out over the day. Check this yourself with your blood glucose meter.
Use the glycemic index
Use the glycemic index, which rates how much individual foods will raise your blood glucose levels. Of the high carb foods, starchy ones raise it the most, followed by sugary ones. In the U.S. we consider fiber to be a carb, but it has relatively little effect on our blood glucose. Protein has a little effect and fat has none.
Avoid or limit the highest glycemic foods
The highest glycemic foods will make the blood glucose level of anyone who has diabetes go through the roof. These are the most starchy foods. The one food that will do the most damage is the potato, particularly a baked potato followed closely by mashed potatoes. Foods that have a lot of wheat flour in them, like wheat bread and bagels, are nearly as fast acting as potatoes.
Avoid or limit milled or juiced foods
Milling and juicing have in common that they break up the structure of the food, and this makes it work faster when we eat it. That means it affects our blood glucose more than whole foods do. So the flour of a grain is higher glycemic than whole grain kernels. Likewise, juiced fruits or vegetables will raise our level more than whole fruit or whole vegetables will.
Weight makes blood glucose control harder
When you gain weight, it’s harder to keep your blood glucose level under control. That’s because even a small increase in how much body fat you have increases your body’s resistance to the action of the insulin your body makes. It’s insulin that drives glucose out of your blood and into the cells of your body that need it. This explains why there’s a strong correlation between diabetes and being overweight.
When you are sick, your blood glucose goes up
When you have a cold, feel sick to your stomach, get the flu, have surgery, or are injured, you are sick. Your body becomes more intolerant to carbohydrates than usual, more resistant to your own insulin. Drugs you need when you’re sick can also raise your blood glucose. Sickness happens, so you have to deal with it. To keep your blood glucose in control, you will need to cut back your carbs even more then.
When you are stressed out, your body releases hormones that mobilize energy stores. This helps people who don’t have diabetes deal better with stress, but people with diabetes can’t use these hormones well, so blood glucose levels go up. Anti-anxiety drugs can help, but behavioral programs like meditation can manage stress even better without drugs.
Drugs can raise blood glucose
Many different drugs can cause blood glucose level to shoot up. The best documented reports are the big increases in blood glucose levels that a powerful steroid called prednisone can cause. It’s necessary to treat difficult conditions, but people with diabetes will need to increase the insulin or pills that they take and reduce still further the amount of carbohydrates they eat when they are on prednisone.
The good news is exercise
Being physically active is great for everyone’s health. But at the right time it can be especially powerful for anyone who has diabetes. A short but brisk walk right after a meal when people who have diabetes consume too many calories can bring down blood glucose even better than a shot of insulin. But strangely, if your blood glucose level is above about 200 mg/dl, exercise can actually raise it.
The best news is low carb
The best news is that anyone who has type 2 diabetes can keep his or her blood glucose level down to normal all the time by following these guidelines that are based on following a low-carb diet. People who have type 1 diabetes will need to continue to take insulin injections, but they will need much less insulin and their levels won’t be swinging up and down.