Why Does Diabetes Sometimes Feel Like A Balancing Act?

Why Does Diabetes Sometimes Feel Like A Balancing Act?

Diabetes Care Can Be Overwhelming, But It’s Not Impossible.

MANY THINGS can change or affect your blood glucose level:

  • the foods you eat,
  • the type and amount of activity that you do,
  • the type of diabetes medicines you take.

Meal planning can be one of the most challenging parts of caring for your diabetes. It is not nearly as effective as insulin and it’s a lot harder than taking a pill. Many types of foods cause blood glucose to rise, and some foods cause it to rise more than others.


Diabetes medicines work in different ways to help lower and control your blood glucose. Some help your body use the insulin it makes. Some slow down the amount of glucose your liver produces. Some slow how quickly your food is absorbed, and others help the pancreas produce more insulin. A new class of medicines helps the body get rid of excess glucose in the urine.

Insulin, whether you still make enough of your own or take it by injection, helps glucose enter the cells of the body. If your food intake or level of physical activity is not balanced with your insulin, your blood glucose level may drop too low. This can happen if you eat less than usual or skip a meal, or if you are more active than usual. Talk with your health care provider or your pharmacist about the medicine you use. Ask what it does, when and how to take it and if it can cause you to have low blood glucose. When you first start a new medicine, it’s a good idea to check your blood glucose often to see how the medicine affects it.


working for you. Foods are made up of carbohydrates, protein and fats. It is important to understand the effect of each of these on your blood glucose. That way, you can make smarter food choices and better care for your diabetes.


Carbohydrates have the greatest effect on blood glucose levels. But many are good for you, so don’t stop eating carbohydrates altogether. Choose healthy carbs, such as vegetables, fruit, beans, milk, yogurt and wholegrains.
And eat only the amount that fits in to your diabetes meal plan.


Protein-rich foods don’t cause blood glucose levels to rise as much as carbohydrates. Protein has almost no effect on blood glucose. However, protein still contains calories, so it’s important to watch your portions. Healthy proteins include fish, poultry, lean meat, nuts, eggs, and lower-fat cheese. So how much protein should you eat?

A good rule of thumb is that the protein part of your meal should be about the size of your palm or a deck of cards.


Fats alone won’t cause your blood glucose to rise, but fats have more calories than carbohydrates and proteins. Eating too much fat can cause you to gain weight and may raise your cholesterol, depending on the type of fat you eat.

There are healthy and less-healthy fats. Healthy fats include vegetable oils (olive oil, canola oil), nuts, seeds, peanut butter and avocado. Fatty fish like salmon, sardines and mackerel are also good sources of healthy fat. For snacking on nuts, an ounce is a serving. That’s about 20 almonds or 14 walnut halves (1 small handful).

To find out how many carbohydrates, proteins and fats are in a food, read the label, look in a food counter book or search the Internet.

To see the effect a certain food or meal has on your blood glucose, check your blood right before you eat and then again two hours after you take your first bite. It is a good idea to keep a record of how different foods affect your blood glucose levels.

Physical Activity

Exercise can lower your blood glucose level. It may be as powerful as some diabetes medicines. You may notice that when you are more active, your blood glucose is lower. Physical activity can lower your glucose level right away, as well as hours after you finish your activity. This effect can last up to 72 hours.

If you take medicines that lower your blood glucose, be careful not to exercise if your blood glucose is too low. Physical activity may lower your glucose level even more. Find out how physical activity affects your blood glucose by checking it before you exercise, and then several times during the next 24 hours.

It is very important not to skip meals before you plan to exercise. Some people may need to eat a snack before they exercise to prevent low blood glucose. Others may be able to reduce the amount of diabetes medicine they
take if they are exercising regularly. Talk with your health care provider about what’s best for you.

The Balancing Act

To find out how your food, physical activity and medicine are affecting you, keep records of what you do and when you do it, along with your blood glucose levels.

  • Note the foods you eat.
  • Record the physical activities you do.
  • List the medicines you take.

Review your records with your health care provider so he or she can make changes in your treatment plan, if needed.


By Amy Campbell, MS, RD, CDE

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