Pictured recipe: Mushroom Scrambled Eggs
It's tempting -- and even sounds logical -- to skip meals: You're busy, you're not hungry, you're trying to lose weight, or your blood sugar is too high. Skipping meals, however, may actually increase your blood sugar and cause you to gain weight. Here are seven rewards of eating regularly scheduled meals when you live with diabetes.
During sleep, when you're not eating, the liver sends more glucose into the blood to fuel the body. For many people during the early years of having type 2 diabetes, the liver doesn't realize there is already more than enough glucose present. "Your morning (fasting) blood sugars have much more to do with your liver and hormonal functions than what you ate for dinner last night," says Kathaleen Briggs Early, Ph.D., RD, CDE, assistant professor of biochemistry and nutrition at Pacific Northwest University of Health Sciences in Yakima, Washington
Real-life example: Until recently, if Cheryl Simpson's blood glucose meter flashed a high reading before breakfast, she might delay eating until midafternoon in an attempt to lower that number. Now Cheryl, PWD type 2, won't leave home without eating breakfast. Her blood glucose numbers have improved. "Plus, eating breakfast makes it a whole lot easier to make good food choices later on," she says.
Irregular eating can have you "bouncing back and forth between normal blood sugars and high blood sugars," Early says. A meager meal can give you a meager rise in blood sugar. If you take one or more blood glucose-lowering medications that can cause low blood glucose (hypoglycemia), skipping meals or eating too little can increase the risk. Spreading out foods, especially carb-containing foods, over three meals each day (and snacks if you want them) can help maintain steady blood sugar levels.
Real-life example: Cheryl, PWD type 2, would make her way through the meat, the vegetables, and each of the rice and noodle dishes at a Chinese buffet before topping off the meal with ice cream. She thought a big meal wouldn't hurt as long as she held back at other meals that day. Cheryl now understands the damage done by a big glucose spike after a big meal and that splurging won’t prevent hypoglycemia if she skimps at another meal.
Tip: If your meal is delayed and you’re worried about low blood sugar due to the medication you take, choose a snack with about 15 grams of carb, such as a small box of raisins or handful of pretzels. If you’re at risk of experiencing hypoglycemia frequently, always try to carry one or two portions of 15 grams of carb.
Eating meals spaced throughout the day provides a consistent fuel source and can help combat the feeling of fatigue. For people who want to snack, a small amount of carbohydrate can help keep energy levels up, and including protein will help you feel full.
Snacks that contain some carbohydrate and protein are:
• 1/2 cup carrot sticks and 2 tablespoons hummus
• 1/2 cup cantaloupe and 1/2 cup cottage cheese
• 1 small apple and 12 almonds
• 1 small apple and 1 string cheese
• 1/2 cup banana slices and 1 tablespoon peanut butter
Real-life example: Cheryl, PWD type 2, has a little more kick in her step now that she doesn't skip meals. She didn't realize how drained she felt every day until she started feeling better. Along with other eating changes, spreading out her foods has helped her accomplish more throughout the day.
Tip: Tired or thirsty? A glass of water and a bit of exercise may help you beat fatigue (with no added calories).
It takes a bit of detective work to sort out the causes of high and low blood sugar and to determine the best eating, exercise, and medication strategies for you. If your blood glucose numbers are unpredictable, eating similar amounts of foods at similar times each day and keeping accurate records will help you and your health care provider identify trends and guide adjustments to your treatment plan. Eating randomly makes spotting trends and controlling blood glucose levels much more difficult.
To learn how a meal affects your blood sugar, do a blood glucose check with your meter just before you start to eat and about two hours after the first bite.
Tip: Set up a simple experiment with the following steps.
1. Wash and dry your hands, then check your blood sugar before your meal.
2. If you take blood glucose-lowering medication with meals, take your dose as usual.
3. As you take your first bite of the meal, set a timer for 2 hours.
4. Check your blood sugar again 2 hours after the first bite.
5. In a journal or on a notepad, record the date, times of checks, blood glucose results, foods and drinks you consume, and portions.
6. Repeat the experiment on another day to compare information and check for trends. If results are off-target, talk to your provider about meal, exercise, and medication options.
Skipping meals is like skipping your medications. It causes erratic blood sugar levels, making weight control difficult. Well-controlled blood glucose helps manage appetite, and when blood sugar is high, the pancreas kicks out extra insulin (if it's still producing insulin) to compensate. Because one of insulin's jobs is to store fat, it's telling your body to pack on the pounds from any excess calories, not get rid of them. Last but not least, skipping meals can lead to overeating later, especially at your evening meals.
Tip: If you find it’s healthiest to bring food with you to work or daily activities, plan what you’ll need and pack it the night before.
Insulin and some blood glucose-lowering pills "don't halt their action if you decide to skip a meal," says Kathleen Stanley, dietitian and author of 50 Things You Need to Know About Diabetes (American Diabetes Association, 2009).
Instead, the medications that stimulate insulin production can continue to lower blood glucose even if levels are not elevated. The common pills that can cause this include: glimepiride, glipizide, glyburide, nateglinide (Starlix), and repaglinide (Prandin). These medications may increase the risk of low blood sugar (hypoglycemia).
Having frequent low blood glucose reactions can make weight control more challenging due to the need to eat or drink carb-containing foods or treatments to quickly bring blood sugar levels back into a healthy range. Because having a low blood sugar may make you feel panicky, it's easy to overeat. You may easily consume more calories than you need to treat the low. Ask your provider whether the glucose-lowering medication you take can cause hypoglycemia and what you can do to prevent it. If you’re experiencing low blood glucose reactions frequently, talk to your health care provider about making medication changes or adjustments.
Regular meals can provide structure and a framework for organizing your day and scheduling time for exercise, fun, and relaxation, says dietitian and diabetes educator Kathleen Stanley. Both exercise and leisure time help you manage stress, which helps you control diabetes.
Structured meals tend to be more nutritious, too, adds Kathaleen Briggs Early, Ph.D., RD, CDE. If you're skipping meals or grabbing food on the go, you may choose less-healthy foods that lack vitamins, minerals, antioxidants, fiber, and other nutrients.
Consider that most of us need at least 5 cups of fruits and vegetables daily. That's pretty hard to accomplish if you skip meals or eat on the run.
Tip: Plan to eat three meals daily, each with at least three food groups, such as protein, starch, and veggies.