As I write this, the temperature near Boston, MA, is a balmy negative 9 degrees. So far, we’ve lucked out with a relatively mild winter. But Old Man Winter is certainly paying us a visit. Unless you’re spending time in warmer climates or perhaps shushing down the ski slopes, chances are, you’re spending more time indoors and maybe being less active than usual. If you have diabetes, you might also notice that your blood sugars are higher than usual or, at least, higher than your target. Let’s look at some possible reasons for these high readings and some steps you can take to lower them.
1. More carbs and comfort foods. If you’re unhappy with the numbers on your meter, especially a few hours after a meal, it might be time to take stock of what you’ve been eating. The winter holidays can be one of the culprits: stuffing, pies, cookies, candy, and eggnog are yummy treats and part of family traditions, but (no surprise here), they’re high in carbs and, for the most part, fat. Winter often means eating more comfort foods, like homemade bread, macaroni and cheese, mashed potatoes, and more. These foods may seem good for the soul, but they can do a number on your blood sugars. The carbohydrate (carb) in these foods can lead to blood sugar spikes; the fat, in turn, can lead to insulin resistance, making it harder for your diabetes medicine or insulin to do its job. As a result, blood sugars climb and stay high.
Action steps: You don’t have to stop eating your favorite foods. But it helps to be aware of what, how much, and how often you eat carb-laden goodies. Keeping track of your food intake and your carb grams is a smart move. Plain old paper and pencil works, or try a smartphone app (Lose It!, Calorific, Evernote) to help you stay aware. Taking a balanced approach to your meals and snacks, aiming for low-carb veggies, lean protein, whole-grain carbs, and healthy fats can help to lower those post-meal blood sugars, as well.
2. Less activity. Being physically active is a key part of managing diabetes. Moving more means that your body uses more glucose to fuel muscles. And physical activity helps insulin (whether it’s your own or the kind you inject) work better. For many people, however, the cold weather and the snow make it hard and, often, dangerous, to go out for their daily walk or run. Even getting in the car to drive to the gym seems like a lot of effort on a frigid, blustery night. Unfortunately, curling up on the couch to watch your favorite programs means that blood sugars can climb and stay higher than you’d like.
Action steps: Have a plan for being active throughout the year. Try not to use the winter as a reason to lounge around. If going outdoors to exercise isn’t an option, think about what you can do inside to get and stay fit, and help your diabetes at the same time. Ideas include: joining a gym or fitness center, walking inside at the nearby mall or any large store, climbing stairs, investing in a piece of exercise equipment (such as a treadmill, exercise bike, or elliptical machine) or using exercise videos or DVDs. Resistance bands or small hand weights are great to use, especially when those TV commercials come on. And if the cold doesn’t bother you all that much, bundle up and go skating, snowshoeing, or cross-country skiing.
3. Illness. Yes, you’re more likely to get sick in the winter than in warmer months. One possible reason: As the temperature drops, your immune system doesn’t work as well as it should. This means that you’re more susceptible to catching a cold in the winter. Also, cold, dry winter air allows the flu virus to survive longer and easily be transmitted to others. The flu virus tends to be more resilient in the winter as opposed to the warmer months. Any type of illness (as well as infection) can drive up blood sugars.
Action steps: First, make sure you get your flu shot every year. Second, wash your hands often, especially before, during, and after handling food; after using the bathroom; and after blowing your nose, coughing, or sneezing. And third, as much as possible, limit being around people who are sick (easier said than done, of course). If you do become ill, check your blood sugars often — say, every four hours. Keep taking your diabetes medicines (unless your doctor advises you not to), even if you’re not able to eat as usual. Call your doctor if your blood sugars stay above 240, if you have moderate or large amounts of ketones in your blood or urine, if you’re unable to keep food down or have diarrhea for more than six hours, or if you’ve been sick for a few days and aren’t getting any better.
4. Dehydration. Chances are, you drink more fluids in the warmer months because you probably feel thirsty and you’re more active. When it’s cold out, you may not be drinking enough fluids because you don’t feel as thirsty. If you become dehydrated, your blood sugar levels may increase. And, high blood sugars can, in turn, cause you to urinate frequently, further dehydrating you.
Action steps: While experts don’t agree on how much fluid we all need, a good rule of thumb to go by is to drink at least eight 8-ounce glasses of fluid every day. You may need to drink even more if you are larger in size or very active. The fluids that you drink don’t have to be all water; you can count tea, coffee, diet soft drinks, and milk as fluid, too. Don’t rely on whether or not you feel thirsty as an indicator that you should drink something.
What are the best choices for someone with diabetes when it comes to eggs, milk, and refrigerated snacks? Bookmark DiabetesSelfManagement.com and tune in later today to find out from registered dietitian — and person with diabetes — Regina Shirley!
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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.
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