Missing Meals? Avoid Dangerous Blood Sugar if You Have Diabetes
If you have diabetes and you’re not feeling up to eating much, you may need to adjust the way you monitor your illness. Here’s how.
Skipping a meal is typically no big deal. But if you have diabetes, missing meals can throw off the important balancing act between food intake and medication.
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The result is blood sugars that are too low (hypoglycemia) or too high (hyperglycemia) — and that’s dangerous.
“If you take medications for diabetes that can cause low blood sugars, you should try not to skip meals,” says registered dietician Dawn Noe. “If you’re just not up to eating on a regular schedule, talk to your doctor about diabetes medications that won’t cause low blood sugars,” she says.
When you’re ill or just don’t feel like eating much, it’s important to monitor your blood sugar levels more closely than ever. How often depends on whether you have type 1 or type 2 diabetes and what medications you take.
For type 1 diabetes: Be sure to monitor your blood sugar before meals and before bedtime, typically four times per day, says diabetes specialist Bartolome Burguera, MD.
Beyond that, check your blood sugars if you notice symptoms of low blood sugar. Those symptoms include:
For type 2 diabetes: If you are taking a sulfonylurea medication, check your blood sugars at least twice a day — in the morning and at bedtime.
“It’s important to keep in mind that sulfonylureas may cause blood sugar to drop during the day if you don’t eat anything after taking your medication,” Dr. Burguera says.
If your only treatment is metformin, you may not need to check your blood sugar more than once a day. This medication doesn’t typically cause hypoglycemia.
It is important to be aware of the symptoms associated with low blood sugars and be ready to check your blood sugar and to eat or drink something to correct a low blood sugar if needed, Dr. Burguera says.
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If you’re not eating due to an acute illness (e.g., the flu or an infection), it’s also common for your blood sugars to rise.
“When you have diabetes and are acutely ill, you should check your blood sugars up to four times per day, drink plenty of fluids and contact your doctor if your blood sugars are consistently over 250,” Ms. Noe says.
If you find that you’re eating less due to an illness or other factors, your medications may need adjusting, so it’s important to talk to your doctor. Meanwhile, here are some general guidelines:
Although you may think you’ll know from experience when your blood sugar is out of whack, regular monitoring is the only way to make sure.
“It’s important to keep in mind that the symptoms of high or low blood sugars may fade away after several years of living with diabetes, especially if your blood sugars have not been well controlled,” says Ms. Noe.
“Also, some of the symptoms of high blood sugars and low blood sugars are the same, so it’s important to check your blood sugar first, if possible, before treating it,” she says.