What Goes Up, Must Come Down – Or Not

What Goes Up, Must Come Down – Or Not

I’m a big believer that anyone with diabetes needs to understand diabetes. When we really understand what’s going on, everything about diabetes management makes more sense. And, when something makes sense it’s easier to motivate yourself.

Take high blood glucose levels as an example. You may think that having diabetes means carbohydrate foods have a different effect on your blood glucose level than the same food would have on someone without diabetes – your blood glucose goes high but their’s stays “normal.” But, while that may seem logical based on the result (high versus normal blood glucose levels after eating), the real story is slightly different. The real story is that carbohydrate food sends everyone’s blood glucose higher, with or without diabetes. It’s not the “going up” that defines diabetes, it’s the coming down, or to be more accurate, not coming down.

Having diabetes actually means your blood glucose levels are not coming back down in a normal way after eating carbohydrate foods, and that’s because the hormone that bring blood glucose levels down – insulin – is either in short supply or your body is not responding to insulin in a normal way (called insulin resistance). It’s not that food affects us differently — it’s our response to food. That’s a subtle difference, but an important one.

So, what does this “real story” tell us about managing diabetes? In simple terms, do everything you can to improve your response to rising blood glucose levels. Take your medication as directed. Get more exercise, and include “resistance” exercises like weights – exercise increases insulin sensitivity. And, give your body time to react to food by managing what, when and how much you eat. Spread carbohydrates throughout your day, for instance, and focus on carbohydrates with a low “glycemic index.” Foods with a low glycemic index digest more slowly, and release glucose into your blood at a slower rate. Beans, apples and pears, barley, winter squashes, brown rice, and oats are a few “carbohydrate foods” with a low glycemic index.

Medication, exercise and eating habits can work to improve insulin sensitivity and slow the absorption of glucose into your bloodstream after eating.

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