Managing blood glucose

The best way to delay or avoid the complications of diabetes is to maintain your blood sugars within a reasonable range. Whilst blood glucose for someone without diabetes would be mostly in the range of 4 - 8 mmol/litre, that is a very tight target for someone with diabetes. Managing your blood sugar levels mostly in a range of 4 - 10 mmol/l is generally considered to be very good control for anyone with diabetes. Most importantly, you want to manage your blood glucose levels in a way that avoids hypoglycemia, i.e. low blood sugar.

Managing diabetes is a matter of balance...

The diagram below provides a simple illustration of the things that have the greatest effect on your blood glucose levels. Food tends to increase your blood sugar, while insulin and aerobic exercise will pull your blood sugar down. Understanding the interplay between these things will assist you in managing your blood sugar levels.

Food is the key input that will raise blood sugar. So it is important to make wise food choices:

eat a good variety of foods to ensure that all of your body's needs are met;
ensure that you food intake is sufficient for your needs, but don't overeat as the excess consumption will simply be stored as body fat;
favour foods that have a low glycemic index (there are lots of resources online, but see this link for a useful overview https://healthify.nz/media/1001/glycaemic-index-of-foods-factsheet.pdf);
avoid processed food wherever possible;
when selecting processed foods, check the label, particularly for fat, sugar and carbohydrate content - you want to know what you are eating; and
limit (or eliminate) junk food from your diet.

Insulin, or anti-diabetic agents used for treating T2D, will lower your blood glucose levels. Your GP or diabetes care team will offer personalised advice on dosage and, particularly for those with Type 1 diabetes, dosage adjustment for different circumstances.

Most exercise also has a lowering effect on blood glucose and that is because exercise has the effect of increasing insulin sensitivity (whether the insulin is your own or is being injected). It is worth remembering that the increased insulin sensitivity may last for up to 24 hours if the exercise is sustained (such as a long hike or many hours working in your garden). There are certain exercises that have the effect of raising blood glucose levels, such as heavy weightlifting, sprints, and competitive sports. The reason for this is that such exercise has a tendency to increase stress, causing the body to release stress hormones. Stress hormones such as adrenaline and cortisol can stimulate the liver to release glucose into the bloodstream. We don't mean to imply that these kinds of exercise should be avoided, just that you need to be aware of the effects.

This is a simplified overview and there is a good reason for that: everyone who has diabetes has their own, unique, set of characteristics. The job of everyone who has diabetes is to learn to manage that condition in a way that maintains their health while allowing them to live a fulfilling life. That job might seem overwhelming at times, and the trick is to find the right balance for you of time attending to your condition and time simply living.

Don't let diabetes define you, better to accept that you have a condition - diabetes - that needs to be managed, rather than identifying with "I'm a diabetic". Indeed, making a tyranny of managing diabetes can be counterproductive by creating stress and even inducing depression when the desired outcomes aren't achieved. Managing diabetes is a journey, be open to learning, be willing to be flexible and, most of all, be kind to yourself!