More threads by Daniel E.

Daniel E.

daniel@psychlinks.ca
Administrator

When you first found out you had diabetes, you tested your blood sugar often to understand how food, activity, stress, and illness could affect your blood sugar levels. By now, you’ve got it figured out for the most part. But then—bam! Something makes your blood sugar zoom up. You try to adjust it with food or activity or insulin, and it dips really low. You’re on a rollercoaster no one with diabetes wants to ride.

Knowledge is power! Look out for these surprising triggers that can send your blood sugar soaring:
  1. Sunburn—the pain causes stress, and stress increases blood sugar levels.

  2. Artificial sweeteners—more research needs to be done, but some studies show they can raise blood sugar.

  3. Coffee—even without sweetener. Some people’s blood sugar is extra-sensitive to caffeine.

  4. Losing sleep—even just one night of too little sleep can make your body use insulin less efficiently.

  5. Skipping breakfast—going without that morning meal can increase blood sugar after both lunch and dinner.

  6. Time of day—blood sugar can be harder to control the later it gets.

  7. Dawn phenomenon—people have a surge in hormones early in the morning whether they have diabetes or not. For people with diabetes, blood sugar can spike.

  8. Dehydration—less water in your body means a higher blood sugar concentration.

  9. Nose spray—some have chemicals that trigger your liver to make more blood sugar.

  10. Gum disease—it’s both a complication of diabetes and a blood sugar spiker.
Watch out for other triggers that can make your blood sugar fall. For example, extreme heat can cause blood vessels to dilate, which makes insulin absorb more quickly and could lead to low blood sugar. If an activity or food or situation is new, be sure to check your blood sugar levels before and after to see how you respond.
 

Daniel E.

daniel@psychlinks.ca
Administrator
I've just started testing my blood sugar at home since I have a touch of prediabetes (after gaining weight during the pandemic). So far, it was highest after eating take-out Chinese food. So I will be saving money by going back to my old Subway routine.

The home testing is very helpful because I no longer have to deal with competing theories. Like this morning, my blood sugar was even a little better/lower after eating eggs than it was fasting.
 
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Daniel E.

daniel@psychlinks.ca
Administrator

Common in diabetes are such responses as denying the presence of the disease, self-soothing by eating when experiencing distress, and eating unhealthful foods in order to make urges to do so go away. Given the often asymptomatic nature of the disease and the fact that people often don’t feel different than before they were diagnosed, denial and attempts to eliminate diabetes-related thoughts and feelings are common.

The next level of analysis is also behavioral. When individuals with diabetes deny the presence of the disease or engage in unhealthy behaviors to regulate emotion or eliminate urges, successful management of blood sugar becomes very difficult. When avoidance occurs in response to private events, this may interfere with necessary self-management behaviors, such as adhering to a proper diet and exercise regimen, performing blood sugar tests, adhering to medication regimens, and doing self-checks for foot problems or signs of infection...

Diabetes is a difficult disease to manage well, so a consistent focus on values and related goals gives those with the disease a meaningful structure in which to experience the difficult private events associated with the disease.
 

Daniel E.

daniel@psychlinks.ca
Administrator
Similarly:


Underestimating type 2 diabetes

The second mistake I made was underestimating the disease. I had it in my mind that with a little medicine, it would go away. This is not like high blood pressure or high cholesterol. For most people, without significant lifestyle changes, you probably won’t have much luck with non-insulin medication. However, that was not going to be the case for me.

I was going to take the magical metformin and everything would be ok. Not so much. My A1c went up after being on metformin. I learned the hard way there is no magic pill that will reduce blood sugar with no changes in lifestyle. This is much more difficult to tackle and requires much more discipline than many other conditions...

Dietary changes are where I really failed. When I was diagnosed, I tried to cut out some of the junk I was eating. What I essentially ended up doing was exchanging one bad food for a seemingly healthier version of junk food. I also kept up my habit of grazing at work on foods that would still raise my blood glucose levels. While not the only factor, I do believe constantly grazing on food at work is the main reason my A1c went up. In my opinion, this is one of the worst habits a diabetic can have.
 

Daniel E.

daniel@psychlinks.ca
Administrator
App recommended by my nutritionist for my pre-diabetes:

mySugr - Make Diabetes Suck Less

My doctor at 9am.health put me on a maximum dose of metformin (titrating to 2,000 mg daily) since I wanted a more aggressive approach as my A1c of 6.1 hasn't moved yet on a low dose.

Along with major lifestyle changes (like hitting the hiking trails instead of Olive Garden), my goal is to go from pre-diabetes to "pre pre" diatebes and then eventually to the ideal, below 5.0 A1c:

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Daniel E.

daniel@psychlinks.ca
Administrator
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Calorie-Bomb Food Favorites​

Most of our calories come from foods high in fat and sugar. Burgers, sandwiches and tacos top the list, followed closely by deserts and sweet snacks. We also load up on sugar-sweetened sodas, and diet drinks. Rice, pasta and grain-based dishes pile on more calories. Unless you count chips, crackers and savory snacks, fruits and vegetables don't even make a dent in our daily calorie count.
 
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Daniel E.

daniel@psychlinks.ca
Administrator

Pasta Sauces​

They taste savory, not sweet -- but many have between 6 and 12 grams of sugar per half-cup serving. That’s what you’d get from a chocolate chip cookie. The American Heart Association recommends that women have no more than 100 calories of sugar per day (about 6 teaspoons' worth) and men have no more than 150 calories (about 9 teaspoons). Check the label for the sugar content of your favorite marinara or Alfredo sauces to help you plan.
 

Daniel E.

daniel@psychlinks.ca
Administrator
May 2018

...To further explore the surprise findings researchers recruited 14 people, who also underwent the OCD treatment. Although none of them had type 2 diabetes, the researchers said even healthy people’s ability to take up insulin via their fat, liver and muscles can vary.

The brain stimulators affected the subjects’ insulin sensitivity, and turning them off and on made the levels rise and fall. The researchers found their metabolic function was better when their brain stimulators were turned on, than when the devices were turned off.

Dr Alonso-Alonso said these findings “suggest that the brain may play a much more active and complex role in the regulation of metabolism than we usually believe”.

He added: “This makes sense, because at the end, metabolic needs should align well with the overall state of the individual. I think there are real good opportunities here for this integrative research; we need to learn more about this connection.”

The findings have been published in the journal Science Translational Medicine.
 
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Daniel E.

daniel@psychlinks.ca
Administrator
What level of A1c causes neuropathy?


In the general population, the prevalence of neuropathy in prediabetes is intermediate between overt diabetes and subjects with normoglycemia. This prediabetic neuropathy is, generally, milder in comparison to diabetic neuropathy and mainly affects small fibers mediating sensory function [as opposed to motor function]. Hyperglycemia, microangiopathy, dyslipidemia and the metabolic syndrome have been implicated as pathogenic mechanisms...

Several lines of evidence indicate that prediabetic neuropathy exists [11, 12, 13•, 14•, 1523]. It is more closely associated with IGT rather than with IFG [12, 13•, 14•, 15, 6875]. In general, it is less severe than genuine diabetic neuropathy and affects sensory modalities, mostly those mediated by small fibers including pain [22, 24, 28, 29, 30•, 31, 32].
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Neuropathic pain was detected in 13.3% of diabetes patients, 8.7% of patients with IGT, 4.2% of patients with IFG and 1.2% of patients with normoglycemia, consistent with preferential small fiber involvement in patients with prediabetes. In addition, bodyweight, peripheral arterial disease and age were risk factors for neuropathic pain development amongst diabetes patients.
 
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Daniel E.

daniel@psychlinks.ca
Administrator

What you can do​

Your doctor may recommend a number of options to help you prevent or correct high blood sugar levels in the morning:
  • Avoid carbohydrates at bedtime.
  • Adjust your dose of medication or insulin.
  • Switch to a different medication.
  • Change the time when you take your medication or insulin from dinnertime to bedtime.
  • Use an insulin pump to administer extra insulin during early-morning hours.
 
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Daniel E.

daniel@psychlinks.ca
Administrator
The higher dose of metformin -- along with lifestyle changes -- seems to be working already reading my blood sugar readings, which are "normal" more often now. And my appetite between meals is less (in a good way).

So I would recommend the online startup I have been using, 9am.health, to anyone in the US with prediabetes or diabetes for medication management, prescription delivery, lab monitoring, and online/remote coaching.

They have a relatively low monthly fee and provide way more intervention than my always busy primary care. And their nutritionists -- almost all of whom have diabetes themselves -- are not pushing Akins or keto like some dietitians do. For example: Yes, you can still go to Olive Garden and have breadsticks, but maybe eat at home more often.
 
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Daniel E.

daniel@psychlinks.ca
Administrator


Work it out​

Exercise can also help you manage your morning highs. If you have waning insulin, an after-dinner walk or other workout can help keep your blood sugar down overnight. But use caution when exercising before bedtime. The blood sugar-lowering effects of exercise can last for hours, so if you work out before bed, you risk going low overnight.

Morning exercise may be best if your blood sugar data has shown a trend of nighttime lows after late afternoon or evening exercise. Working up a sweat in the a.m. is a good idea for anyone experiencing the dawn phenomenon, too—it can help burn up that extra blood glucose.

Try, try again​

There’s no single recipe to control morning highs. What works for one person may not work for you. It may take time to find the best strategy to keep your blood sugar at the right level in the morning while avoiding hypoglycemia overnight. In rare cases, the ideal balance can’t be found. For those people, their doctors might change their morning blood sugar goal so that it’s a little bit higher, as long it stays within goal the rest of the day. But most people will be able to figure out what’s happening and what to readjust.
 

Daniel E.

daniel@psychlinks.ca
Administrator
Potential bonus with metformin:


Collectively, these results suggest that metformin may confer a benefit as an add-on therapy to conventional antidepressant for the comorbidity between metabolic and mental disorders. Human trials would be needed to examine whether a significant benefit is observed in humans.



The anxiolytic effect of metformin could be due to the direct activation of the AMPK pathway in the anxiety-related brain nuclei.
 
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Daniel E.

daniel@psychlinks.ca
Administrator

If you have high blood sugars before you go to sleep, the elevated level can persist until morning. A large dinner or a snack at bedtime can cause elevated blood sugar levels that last all night, as can too low a dose of insulin with your evening meal. Adjusting your medication or what and when you eat may help.
 

Daniel E.

daniel@psychlinks.ca
Administrator
A great meal-planner book for prediabetes (and healthy eating in general), written by a dietician and free with Kindle Unlimited:

Amazon product

An excerpt:


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The book has a number of recipes like "Greek-Style Turkey Burgers" and vegetarian recipes like mushroom gravy and "Butternut Squash and Mushroom Lasagna."

The author's latest blog post:


Her other books:

Amazon productAmazon product
 
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