By Diane Herbert MSW, LSW, CDE (pending)
If you’re living with diabetes, you have been told many times and in many ways – Check your sugar, test, monitor your glucose, do your finger sticks….. You have also likely been told that this is how you learn your current glucose (sugar) level.
I’m wondering how much information you’ve been given about why checking your blood sugar is helpful to you and what it means at different points in your day?
Your Body at Work
The pancreas and the body are truly amazing when it comes to keeping checks and balances within our systems. As far as your blood sugar goes – the pancreas and the liver perform a seamless dance to metabolize food/energy/sugar to make sure that all the other systems get just the right amount they need at just the right time when they need it.
When you live with diabetes, your body’s ability to do that dance breaks down and requires that a third partner be entered into the mix – that partner is you! Your non-diabetes pancreas and liver had blood sugar management skills literally hardwired into their DNA. These are skills that we from the outside continue to only dream about matching.
Effortlessly these amazing organs knew how much to adjust for exercise, when to release insulin quickly, when to dole it out slowly over hours, and how to auto-correct with a perfect shot of glucose if we added a late variable to the mix (say going on a roller coaster after eating pizza).
Now living with diabetes – that balancing act largely rests on you to perform manually. How can you hope to be able to return to the smooth, graceful dance of two, when you’re now three and one of your partners (the pancreas) has developed a severe limp or fallen out of the dance all together? This is where blood sugar checks come into play.
Blood Sugar Checks – Your Best Resource for Smoother Gliding
Blood sugar checks are our best tool to crack the code on how our bodies are responding to different events in the day. Performing these checks can provide critical pieces of information to understand how your body is processing sugar (energy) and what it needs to do it better. Having a view into our individual blood sugar patterns is our best hope of being able to apply treatment options (insulin, fast acting carbs, exercise) in a way that will most closely match the body’s original blood sugar response.
Now don’t gloss over the “most closely match” part of that last sentence – no matter how closely we monitor blood sugar levels, we from the outside will never be as perfect as the original dancing duo and that’s OK. The goal is to learn what we can about our individual blood sugar patterns so that we can keep our blood sugar in our target range as much as realistically possible.
The Big 3 Blood Sugar Events
A recent study I read stated that there are 48 known factors that can impact a person’s blood sugar level. This is one of the key reasons that diabetes management isn’t about perfection it’s about doing the best we can while still leading our normal, non-diabetes management lives.
Thankfully, tackling the big three blood sugar events – food, exercise & our own production of glucose goes a long way to improve overall blood sugar control. Believe me this still leaves plenty to manage but armed with information about our individual blood sugar patterns as they relate to these events, you and your health care professional can develop a care plan to keep blood sugars in a healthy range the majority of the time.
Enter Blood Sugar Checks
Nobody enjoys having to prick his or her finger – let alone having to do it multiple times a day. Despite the lack of enthusiasm for this task – the benefits of doing it at specific points in the day are many.
Keeping our blood sugar in range reduces our risk of complications and improves our long-range health for sure. But it also greatly improves our mood and how we feel physically throughout the day – today and everyday. Wide swings in blood sugar levels cause headaches, nausea, shakiness, sweating and moodiness that can last for hours. In short, when blood sugar levels are out of range or spiking/dropping we don’t feel good! So let’s see how we can use blood sugar monitoring to help us feel our best.
Food & Blood Sugar
Taking a blood sugar check in the morning before eating and then again two hours after eating tells us how our body responded to the specific food choice we had that morning. Performing those same checks on different mornings with different foods tells us which food choices spike our blood sugar beyond our target post meal level and which ones don’t. Think breakfast cereal vs. bacon and eggs v. oatmeal and fruit etc.
Armed with this information we can then make smart decisions how to keep our blood sugar in range. One way would be to decide to choose the low spiking breakfast most mornings. Or since we know how the other breakfast choices impact our blood sugar levels, we can now share this information with our health care provider to develop an insulin dosing that will reduce the blood sugar spike if we choose to eat the higher spiking meal from time to time.
We all agree that exercise and movement are good for us. In general, exercise lowers blood sugar levels both during as well as for as much as 24 hours following exercise. Keeping blood sugars in range during and after exercise can be really difficult without blood sugar information.
By checking blood sugar before, during and after each type of exercise do, you can learn which raise your blood sugar, which lower it and by how much, and whether or not you experience a delayed drop in blood sugar in the hours/day following exercise. All of this information can then be used to determine if and when you need to make adjustments to your carb or insulin intake so that you’ll feel your best during and after exercise.
Your Own Glucose Production
Even when you’re not eating, your liver releases glucose into the blood stream to “feed” your cells. The amount of glucose that your body produces varies greatly person to person and is also impacted by periods of growth, stress and illness.
By checking blood sugars during periods of fasting (4 or more hours without eating) you can see your blood sugar levels during different periods of the day and night.
Nighttime is a great place to start since we typically don’t eat or exercise during the night anyway. By doing a blood sugar check at bedtime and then again in the morning before we eat – we can quickly determine if we need to make any adjustments to our dinner and/or long lasting insulin. Additional checks in the middle of the night can insure that we aren’t missing any overnight spikes/drops as well.
This is really an opportunity to get a big bang for your blood sugar checking buck – so to speak. Nighttime has the fewest variables, is the time when low blood sugar can present the most risk and once you get your blood sugar stable during the night you’ve got roughly 1/3 of your time in your target range right out of the gate!
Maintenance v. Pattern Checks
All this checking sounds like too much; will I be checking my blood sugar all day everyday? Definitely not! The idea of pattern checks – when you preform more frequent checks around a certain activity (food, exercise, fasting)- is to identify your body’s patterns related to that activity.
Once you know that, you can make adjustments to your care routine and go back to preforming just the checks advised by your healthcare provider. The number of maintenance checks that is right for you will vary based on the type of diabetes you have and your life stage. Whether your checking to identify a pattern or performing regular blood sugar checks – those drops of blood can go a long way in helping you stay in control of feeling well.
Note: Diane Herbert is available for emotional health counseling through Integrated Diabetes Services. Please call (610) 642-6055 for details