LEARN TO BE YOUR OWN BLOOD SUGAR SLEUTH

Next time a reading is off and you can’t figure out why, take a look around – the culprit could be right under your nose. These seven factors can all impact BGLs in surprising ways

1 You’re bogged down by stress

Whether it’s “bad” stress (you’re unhappy in your job, your child is struggling in school or you’re caring for an ageing parent) or “good” stress (you’re getting married, moving or planning a holiday), your body responds in a similar fashion.

“Rising levels of the stress hormone cortisol can contribute to insulin resistance and may also affect other hormones related to blood [glucose] management,” explains Nicole Bereolos, certified diabetes educator, clinical psychologist and a Diabetic Living USA adviser. “The end result is that there’s more [glucose] in the blood, and your cells are not using insulin as well as they normally would. It’s a double whammy.”

You can’t scrub stress out of your life completely, but you can work on changing how you respond to it. A session with a behavioural health specialist (in-person or virtual) can help you develop strategies and coping techniques for day-to-day stress. If you’re feeling overwhelmed in the moment, try belly breathing: expand your belly as you inhale and contract it as you exhale. With regular practice, this technique may help lower cortisol levels and lessen the negative effects of stress. ➤

2 You logged a terrible night’s sleep

Losing sleep is about so much more than feeling groggy. “Even one or two nights of poor sleep can lead to higher blood [glucose] the next day,” says Michelle Griffith, assistant professor of medicine, Division of Diabetes, Endocrinology & Metabolism, at Vanderbilt University.

Cortisol levels can increase during sleep deprivation, affecting BGLs. If you find yourself thrown off your sleep routine, the best advice is to try to get back on track as soon as you can. But, if sleeping poorly is an ongoing issue, bring it up with your GP. “There’s some evidence that chronically poor sleep may change how the body handles glucose,” says Griffith. A condition called obstructive sleep apnoea – brief pauses in breathing during the night – can negatively impact sleep and is linked to diabetes progression. If you notice sleep apnoea symptoms (such as falling asleep in the day despite being “asleep” for eight hours at night, or waking your partner with your snoring), mention it to your doctor.

3 You’ve got a case of the sniffles

Whether it’s a cold or the flu, a urinary tract infection or even an ingrown toenail, “any inflammation or infection in the body can raise BGLs because it’s a stress on the body,” says Griffith. “Some patients report that this increase in blood glucose is an early warning sign of an infection,” she says. If you’re sick, stay hydrated and eat small amounts of carbs throughout the day. Griffith also recommends checking BGLs every four hours, or before meals. And, if you take insulin, continue your long-acting dose. Many people with diabetes fear taking long-acting insulin when they’re ill, but your body still needs this type of insulin, explains Griffith. But, if you’re eating fewer carbs while unwell, your short-acting insulin doses may need to be decreased. Ask your doctor about sick-day plans at your next visit.

4 You’re taking OTC medication

As if being sick didn’t already tax your system enough, some medications you take for symptom relief can affect your blood glucose, too, including over-the-counter (OTC) cold medicines and cough syrups. Some of these medicines have been found to contain excess carbs. If you take a medicine that has carbs you’re not aware of, this could lead to an unexpected high blood glucose reading. Instead, look for medicines and syrups that are both sugar- and alcohol-free. Another OTC medicine to watch out for is the congestion-busting drug pseudoephedrine. “This medication constricts blood vessels, which is great for relieving nasal pressure, but it can also raise your blood pressure and may affect blood glucose too,” explains Nicole Pezzino, a certified diabetes educator. A short-term (three-day max) use of a nasal spray containing oxymetazoline is a potentially safer alternative, as it’s not as readily absorbed into the bloodstream, says Pezzino.

5 You missed your regular workout

Maybe today was particularly nasty outside and you didn’t take the dog out for a walk. Or you drove to work instead of walking to the train. “Regular exercise helps with blood glucose control by improving insulin sensitivity,” says Martin Abrahamson, a physician in endocrinology, diabetes and metabolism at Beth Israel Deaconess Medical Center in Boston. But, while one sweat session can lower BGLs for up to 24 hours post-workout, adds Griffith, we need to continue to be active to see those benefits. On days when your routine gets knocked for a loop, remember: any movement – be it doing chores, getting up to stretch every half hour or taking a quick walk around the block – can help lower BGLs and boost insulin action, too.

6 You didn’t miss a workout

You know exercise is a great way to improve blood glucose management. But what if, post-sweat, your BGL reading is raised? More intense activities (such as sprinting, vigorous aerobic exercise and heavy strength training) can raise blood glucose as they can spur your body to generate hormones such as adrenaline, which causes more glucose to be released into your blood for muscles to use, says Griffith. This spike is temporary and won’t impact your HbA1c. Regardless, it can be deflating.

Try doing resistance training first and then finishing your workout with cardio. Or, try ending it with a gentle cool-down. A final note: check in with your healthcare team – they may need to adjust your medication if you’ve started a new exercise routine.

7 Your inner voice is driving up your anxiety

If there’s one thing your healthcare team wants you to know, it’s that life goes on. “I don’t want a person with diabetes’ life to stand still because of the fear and anxiety related to not being able to manage their diabetes,” says Bereolos. Don’t tell yourself that you can’t go on an airplane, take a hike or participate in activities because you have diabetes. “You can do what you want … you can do just about anything,” she says. It’s about planning and problem-solving. Create ‘if-then’ statements to anticipate situations. For instance, “If I go cycling and leave my only bottle of insulin in the car, then I will call my pharmacist for next steps.” These if-then plans come with another perk: they can reduce anxiety, which can lower the stress hormones surging through your system, which can help keep your BGLs steady.