Illness

When you're sick, your body produces stress-related hormones that can help your body fight the illness, but they can also raise the level of blood sugar. Changes in your appetite and normal activity may also complicate diabetes management.

What to do:

  • Plan ahead. Work with your health care team to create a sick-day plan. Include instructions on what medications to take, how often to measure your blood sugar and urine ketone levels, how to adjust your medication dosages, and when to call your doctor.
  • Continue to take your diabetes medication. However, if you're unable to eat because of nausea or vomiting, contact your doctor. In these situations, you may need to temporarily stop taking your medication because of risk of hypoglycemia.
  • Stick to your diabetes meal plan. If you can, eating as usual will help you control your blood sugar level. Keep a supply of foods that are easy on your stomach, such as gelatin, crackers, soups and applesauce. Drink lots of water or other fluids that don't add calories, such as tea, to make sure you stay hydrated.

Alcohol

The liver normally releases stored sugar to counteract falling blood sugar levels. But if your liver is busy metabolizing alcohol, your blood sugar level may not get the boost it needs. Alcohol can result in low blood sugar shortly after you drink and for as many as eight to 12 hours more.

What to do:

  • Get your doctor's OK to drink alcohol. Alcohol can aggravate diabetes complications, such as nerve damage and eye disease. But if your diabetes is under control and your doctor agrees, an occasional alcoholic drink with a meal is fine.
  • Choose your drinks carefully. Light beer and dry wines have fewer calories and carbohydrates than do other alcoholic drinks. If you prefer mixed drinks, stick with sugar-free mixers — such as diet soda, diet tonic, club soda or seltzer.
  • Tally your calories. Remember to include the calories from any alcohol you drink in your daily calorie count. Ask your doctor or dietitian how to incorporate calories from alcohol into your diet plan.

Menstruation and menopause

Changes in hormone levels the week before and during menstruation can result in significant fluctuations in blood sugar levels. And in the few years before and during menopause, hormone changes may result in unpredictable variations in blood sugar levels that complicate diabetes management. Also, the similarity of some symptoms of menopause and low blood sugar can result in errors in adjusting what you eat.

What to do:

  • Look for patterns. Keep careful track of your blood sugar readings from month to month. You may be able to predict fluctuations related to your menstrual cycle.
  • Adjust your diabetes treatment plan as needed. Your doctor may recommend changes in your meal plan, activity level or diabetes medications to make up for blood sugar variation.
  • Check blood sugar more frequently. If you're likely approaching menopause or experiencing menopause, talk to your doctor about monitoring blood sugar levels. You may need to do so more often or when you're experiencing symptoms that you normally interpret as low blood sugar.

Stress

If you're stressed, it's easy to abandon your usual diabetes management routine. You might exercise less, eat fewer healthy foods or test your blood sugar less often — and lose control of your blood sugar in the process. Additionally, the hormones your body produces in response to prolonged stress may prevent insulin from working properly.

What to do:

  • Look for patterns. Log your stress level on a scale of 1 to 10 each time you log your blood sugar level. A pattern may soon emerge.
  • Take control. Once you know how stress affects your blood sugar level, fight back. Learn relaxation techniques, prioritize your tasks and set limits. Whenever possible, avoid common stressors.
  • Get help. Learn new strategies for coping with stress. You may find that working with a psychologist or clinical social worker can help you identify stressors, solve stressful problems or learn new coping skills.

The more you know about factors that influence your blood sugar level, the more you can anticipate fluctuations — and plan ahead accordingly. If you're having trouble keeping your blood sugar level in your target range, ask your diabetes health care team for help.

Jun. 21, 2011 See more In-depth