Hitting the Reset Button on your In-Range Goal

Five occasions when you must look out for changes.

By Susan B. Sloane, BS, RPh, CDE

Because diabetes control involves so many variables such as eating, stress, illness, exercise, and more, getting blood sugars in one’s target range can be challenging, I have found from my own experience with my two sons that you cannot beat yourself up when you lose control. You just need to re-evaluate and start with a fresh perspective. Life is not lived in a controlled environment, which is why with diabetes care, you can start with a suggested treatment regime and then begin to tailor it with your healthcare team so that it fits your individual needs. When might we need to hit a reset button in regards to regaining control of our diabetes?

1. When you are prescribed new medications that may alter diabetes control. Several medications can alter glucose metabolism including certain anti-psychotic medications, and more.^1,2  In addition, some antibiotics can cause changes in blood glucose which can cause low blood sugars in some cases.³
2. When you start a new exercise program.
3. When you have recently been hospitalized or have been through a medical trauma. Even pain can induce stress hormones and cause blood sugars to rise.⁴
4. When you have had recent weight gain/loss.
5. When going through stressful times, such as the loss of a loved one or losing a job.

The good news is that when you identify the cause of your diabetes getting out of control, you can begin the process that brings you back to good health. Some people may not realize at first that their diabetes is out of control. I have some patients who check their blood glucose only in the morning or fasting state. This may not allow a person to get the entire picture of how they are doing with regards to diabetes control. Type 2 Diabetes is a progressive disease. This means that although your body may have the ability to produce some insulin initially, that ability to sustain some insulin production may decrease over time. This can happen even without an apparent cause, like some of those listed above. One of the first signs that your diabetes may be out of control are an observation of higher than normal after meal blood glucose readings. If you have any symptoms of high blood glucose such at fatigue, excessive thirst, increased hunger or increased urination, you may want to check your blood sugars more frequently to see if this is a result of rising blood sugars. Other potential signs of high blood glucose might be tingling in the hands and feet or blurred vision. Hitting reset on your diabetes will require patience and diligence, with a probable emphasis on checking blood sugars more frequently. You can track the times of these blood sugar values, chart them, and send them to your health care team to evaluate using the Dario App. With shared information, your healthcare team can come up with a new plan to keep your diabetes in check. It may come in the form of a new diet plan, weight loss if applicable, and/or medication/therapy adjustments. With the proper tools and a little knowledge, we can work together to hit reset and continue on the path to good health! Remember that your pharmacist is also a member of your health care team. Ask questions, especially if you are starting a new medication.