Sugar Matters
May 27, 2014
Some thoughts on life: how it affects diabetes

Yes, you did read the title correctly: how life affects diabetes, not the other way around! It occurred to me that we spend a good bit of time talking about how diabetes affects your life, and it certainly does so! However, we sometimes forget to really talk a bit about how regular life can affect diabetes itself. Sometimes there are small things in life, at other times large changes, which can cause big effects.{{more}}

This week we start out walking through your day. In a usual day for most people, we do a few things in common: we wake, get dressed, eat, go to work/do something of purpose, eat again, rest maybe, do something again of purpose, eat, then go to sleep. Right? The “something of purpose” may be work, getting kids taken care of, reading, cleaning your house, visiting somebody etc. Even those of us who do not have regular employment, somehow we end up with a “schedule” from day to day which includes those basic elements of wake, eat, purposeful something, rest.

If you have diabetes and need to take medication, your daily “schedule” is actually quite important. Why? Because most often it dictates when you take your diabetes medication – for most, medications (insulin or pills) are taken at breakfast time and later again at dinnertime, if they are taking medication twice daily. Even if you wake an hour late or eat an hour early, most people still keep that pattern going through the week and weekend. Let’s look at one scenario today:

You wake up late and REALLY need to catch a ride with your neighbour to go into town. You run out the door and later in the car you realize you missed your diabetes medication. Needless to say, this happens relatively frequently. I hear it all the time, or some version of rushing out of the house and missing morning medication, usually because patients missed breakfast, so the pattern of “medication + breakfast,” was broken. What to do then?

You ask: should I skip breakfast, then? NO. But I do suggest having a lighter breakfast with specifically less starch than usual, since that is what will drive your blood sugars high. Skip juices entirely, something you probably should be doing most of the time anyway, and have water, tea WITHOUT SUGAR, or coffee instead. Fruit is fine, as long as it is a small portion – do not eat three mangoes for a healthy breakfast and think your blood sugars won’t go up. They will, and you know it!

You ask: should I take my medication when I get back home, then? Depends on when you return home and what type of medication it was. If you return home before noon, and you take diabetes pills once or twice a day, then yes, you can take your medication, and plan to also take your dinner dose as usual. BUT, if you return home later in the afternoon, it is best you forget about that morning dose entirely for that day, eat dinner early and take your usual medication then, and return to your usual pattern the next day. This is especially true if you take insulin 70/30. This insulin is best separated by at least eight hours; so, taking two doses within less than eight hours apart can land you in some trouble with low blood sugars. When in doubt, call your clinic and ask a nurse or doctor there.

We continue on next week! Until then stay safe and healthy Vincies!

Anita Ramsetty, MD

Medical Director Endocrine Care Group

Tel: 843-798-4227