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Diabetes Positive Approach, Issue #1204-- Cope with Diabetes; Live Healthy
April 03, 2012

Welcome to this month's issue on blood sugar management. Remember that last issue we started “The ABC’s of Diabetes Tips”. We started with B for blood sugar. This issue, we have to watch out for night time hypoglycemia so this is an important issue where there will be tips to prevent this from happening.

This certainly will help us move in the right direction for once we get this right, our world will be right at least on night time hypoglycemia. We have the ability to do this and we will do it. We don’t want to be part of what the psychologists say that people use only 2 to 5% of their ability. With diabetes, we cannot afford to use only that much of our ability. That is why we keep on learning about diabetes so we can be proactive in dealing with it.

In This Issue:

  • Avoiding Overnight Low Blood Sugars
  • Must Reads Around the Web
  • Blood Sugar Management
  • A Success Quotation of the Month
  • Dessert Recipe
  • Some Humour
  • Q&A: "Should I stop taking Glucosamine because my blood sugar has gone up?"

Avoiding Overnight Low Blood Sugars

It is scary to have hypoglycemia in the middle of the night but we can prevent it by having a good bedtime routine. For one thing we should always test before going to bed. In this connection, it is wise to have the blood sugar monitor right on the night table as a reminder to monitor the blood sugar before going to sleep.

It is also wise to be responsible when drinking because that causes the blood sugar to go down. If you have had a few drinks, set the alarm for 2 am to check the blood sugar. A high protein snack like the snack bars with uncooked cornstarch will also help which has recently been found to prevent night time hypoglycemia. There are now several commercially available products that are specifically designed to prevent night time hypoglycemia like the following:

Ensure Complete Balanced Nutrition Drink, Butter Pecan, 8-Ounce (Pack of 24)

ExtendBar, Peanut Butter Chocolate Delight, 1.41-Ounce Bars (Pack of 15)

Biogenesis Ultralean Bars, Chocolate Mint 30-Bars

Those who get multiple insulin injections to intensively control their blood sugar are three more times liable to have night time hypoglycemia than their counterparts who are on standard course of therapy. There are ways to lower the risk though like the following:

1. Try eating a late night snack of commercially prepared products that are now available and designed to lower the risk for night time hypoglycemia and at the same time not making the blood sugar rise significantly. Snack smart by experimenting on different types to see which one will keep the blood sugar within target level.

Peanut butter with crackers or apple slices have helped some. It’s because peanut butter has both protein and fat and so it is metabolized more slowly than carbohydrate, keeping the blood sugar more stable through the night. Try different things to see which can handle the blood sugar drop in the middle of the night.

2. Talk to the doctor about adjusting the insulin treatment. Taking the NPH for example at dinner may peak in the middle of the night when you least need insulin so perhaps taking it at bedtime may lead to better blood sugar control. Whatever you do, check with the doctor before making any change.

3. If the dinner is late at night, see if the doctor will replace the Regular insulin with a rapid-acting one which can take effect within five minutes, peak around in an hour and stop lowering the blood sugar after two to four hours unlike the Regular which continues to work for three to six hours.

4. Keep a regular and consistent bedtime and sleep schedule. Sticking to a routine as much as possible can help avoid low blood sugar overnight. Some people find that a change in the bedtime routine affects their blood sugar level, plunging down low during the night and so have to watch more carefully.

5. Mind you, it is the same way with changes in food consumption and activity. Exercising so close to bedtime could also make the blood sugar go low at night so planning ahead is key. Try to follow regular meal schedule to make sure the blood sugar goes up slowly. How do you do that?

Upon waking up, eat a healthy breakfast with low-glycemic foods that will not make the blood sugar go up quickly and to get the metabolism going. Ideas for the breakfast meal could include oatmeal, eggs and whole wheat bread. Have a snack of nuts, raw vegetables with hummus, whole grain crackers and peanut butter, low-fat string cheese or a small cup of vegetable soup, three hours after breakfast.

How about lunch? Well, it could be a black bean burrito, a chicken salad, brown rice and tofu or hummus sandwich on wheat bread and goat cheese. Have a snack three hours after lunch of almond butter on whole grain crackers, or an apple with low-fat cheese or popcorn with parmesan cheese. Any of the above mid-morning snacks will also do.

At this point it is good to review the causes of hypoglycemia:

1. A sugary meal at dinner time

2. Too much exercise

3. Alcohol consumption

4. Excess insulin at bedtime

5. No bedtime snack

6. Release of growth hormone during the night may interfere with insulin.

Avoiding the first five and eating consistently during the day including the snacks between meals and having a sleep routine can prevent the rise and fall of the blood sugar level which may cause overnight hypoglycemia. Just missing one meal at the start of the day could cause blood sugar low overnight. You will see the blood sugar level improve with regular meal and sleep routine. For some whose insulin is fine-tuned, there may not be any need for snacks.


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2.Must-Reads from Around the Web

Heath Matters International Plays Key Role in Diabetes Medication Affordability

Diabetes and Intimacy

Dance Out Diabetes Hip Hop Dance Class

Fraud alert: Phone scammers offer free diabetes supplies

Eating White Rice Daily Ups Diabetes Risk, Study Shows

3. The ABCs of Diabetes Management and Blood Sugar

To do the blood sugar management right, it is wise to know and understand the ABCs of diabetes management. A is for A1c or haemoglobin test which goal should be less than 7% according to the American Diabetes Association while the AACE’s goal is 6.5%

B stands for blood pressure, the goal of which is less than 130/80 mmHg for adults who are not pregnant. As for C for cholesterol, we have to pay attention to the good HDL cholesterol which should be greater than 50 mg/dl (1.3 mmol/1) in women and should be greater than 40 mg/dl (1.0 mmol/1) in men.

We also have to watch the bad LDL cholesterol which should be less than 100 mg/dl (less than 70 mg/dl in the population at the highest rate) with Triglycerides as less than 150 mg/dl. Your doctor may also give your own personalized goals in A1c, blood pressure and cholesterol levels.

Blood sugar management just means to keep them as close to normal or the target levels. To do that, you will have to employ healthy eating, exercising and perhaps taking medication and insulin therapy. It is important to manage the blood sugar not only because you will feel better but also you can avoid the complications.

To be sure to keep the blood sugar level as normal as possible, one must test frequently and to regularly do the A1c test. Every point that lowers the A1c level will reduce the risk for kidney disease by 50%, eye disease by 76%, nerve disease by 60% and the cardiovascular disease by 42%.

Testing the blood sugar level frequently will show how the foods you eat, exercise you do, medications you take affect the blood sugar. Knowing that something makes it high will enable you to make the necessary change as to what is effective in keeping the blood sugar level within the normal range.

Testing the blood sugar in pairs for seven days will help reveal the effect of certain foods or exercise on the blood sugar level. Insulin can be injected or supplied by insulin pump as the continuous flow of insulin to meet what the body needs can help with the blood sugar control.

Keep in touch regularly with your doctor so you can keep track of your progress to fine-tune the treatment plan to avoid complications. There are alternative treatments that have been shown to lower the blood sugar level but other studies have not been successful in finding their benefit.

Some have shown promise like alpha lipoic acid, caffeine and cinnamon but don’t stop taking your medication unless directed by the doctor. Also manage the stress level and find a group support that can share with you all the pros and cons of blood sugar control.

4. A Success Quotation of the Month

"It's your aptitude, not just your attitude that determines your ultimate altitude." Zig Ziglar

Let’s show Mr. Ziglar we’re up to his challenge. By golly, we will have the right aptitude and attitude to get to the top just like the woman in this news:

Banting Diabetes Patient Dies at 81 Sheila Thorn lived with diabetes from birth. She was born in British Columbia, Canada and was treated for diabetes as an infant by the discoverer of insulin, Dr. Frederick Banting. She was a very sick baby so her father rode her in a kayak to see the doctor up the river.

She said just last January that she benefited greatly from close attention to her diet, medication and the support of her husband. She was described as "the longest surviving insulin-dependent person with diabetes in the world." Her story is inspirational and touched the hearts of many diabetics.

5. And here’s the dessert recipe we promised you.

Orange Dream

6. Let's laugh together at this joke even if it's not funny. Laughing will help get us healthy.

Here Are Some Jokes

1. The handle on your recliner does not make it an exercise machine

2. My physician recommended that I start my exercise program slowly so today I walked past a store that sells exercise clothes.

3. Do you know why I do not exercise? It is because exercise makes my coffee spill.

4. I was going to get up from sleep to go walking but my toes voted against me 10 - 1.

7. Do you have a question or comment for the team?

Confused by glucosamine?

Drop us a line at our contact form and write your questions or comment there.

You may see your question answered in an upcoming issue of Diabetes Positive Approach like this one below.

7. Question: "Should I stop taking Glucosamine because my blood sugar has gone up?"

Answer: There may be a link between taking Glucosamine and blood glucose if the blood sugar has gone up since taking it. Glucosamine is a compound that is found naturally in the body. It is needed to produce glycosaminoglycan which is a molecule used to form and repair cartilage and other body tissues.

Production of glucosamine slows with age and it can make one resistant to insulin so if your blood sugar has gone up since taking it, talk to your health care team to see if there are adjustments to make or whether it is right for you to manage diabetes and arthritis.

8. Got something to say? Please write down your questions and comments in the contact form in our website.

Just go to the contact form and write your questions there. Also go to the disclaimer.

Thank you for being a subscriber of Diabetes Positive Approach, ! We are not perfect and neither is everyone else. No one is expected to be right all the time so accept that and take one day at a time. There is no need to beat yourself up when something goes wrong. Just get up and start over.

This way we will not subscribe to the notion that the biggest tragedy is the waste of human resources and not as Oliver Wendell Holmes said that the biggest tragedy in America is the waste natural resources but the waste of human resources. No sir, that’s not us because we will always keep trying!

Warm Regards,

Roger and Evelyn Guzman

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Go to Symptoms-of-Diabetes Home Page for the Disclaimer.

Did you miss the following back issues of this newsletter? Here are two of them:
Diabetes Positive Approach Newsletter 805

Diabetes Positive Approach Newsletter 806

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