Diabetic Nerve Pain
Diabetic nerve pain is symptom of diabetic neuropathy, which is a common complication of diabetes. It can limit your activities and interfere with quality of life, and diabetic neuropathy can lead to permanent damage to the areas of your body that are affected. This is what you should know about diabetic nerve pain, who gets it, how to lower your risk, and how to treat it if you get it.
Diabetic Nerve Pain and Other Symptoms of Diabetic Neuropathy
What is diabetic neuropathy, anyway?
Peripheral neuropathy is the most common type of neuropathy. It can occur in your feet, legs, arms, and hands. Classic symptoms are numbness, tingling, weakness, and pain in the affected areas. You may have trouble walking or with your balance, and symptoms can be more severe at night.
When talking about diabetic nerve pain, peripheral neuropathy might be the most likely cause. You could have severe pain when your arms, hands, legs, or feet are touched lightly. You can also have chronic pain that can get in the way of diabetes management or cause depression or anxiety.
Since your circulation is poor, your feet can develop wounds such as blisters and sores that are slow to heal. You may not notice them because of the poor feeling in your feet. If the wounds progress, they could get infected and eventually a toe, foot, or even leg could need amputation.
Autonomic neuropathy is nerve damage related to controlling your internal organs. These can be the areas affected and the signs and symptoms that you may notice.
- Digestive tract: diarrhea, constipation, upset stomach, vomiting, excessive feeling of fullness.
- Heart and blood vessels: light-headedness upon standing or starting an activity, changes in heart rate.
- Bladder: incontinence, infections.
- Sex organs: erectile dysfunction (men), difficulty with orgasms (women).
- Sweat glands: excessive or inadequate function.
Proximal neuropathies : These are diabetic neuropathies in your hips, thighs, or buttocks, and they can be extremely painful. You are more likely to get proximal neuropathy if you are an older adult or a man. Symptoms can include:
- Severe pain in the area.
- Loss of strength and muscle tone.
- Unintentional weight loss.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains that diabetic neuropathy results from high levels of blood sugar (blood glucose) and high levels of blood triglycerides, or a type of fat or lipid. There are two main ways that glucose and triglycerides cause diabetic neuropathy and the resulting pain.
Damage to your nerves from high levels of glucose and triglycerides.
Damage to your small blood vessels when extra glucose in your blood attaches to them. This restricts blood flow throughout your body and reduces the oxygen and nutrient supply to your cells so they do not heal properly.
Who Gets Diabetic neuropathy?
Over half of people with diabetes will eventually get some type of diabetic neuropathy, according to the NIDDK. About half will get peripheral neuropathy, and about 3 in 10 will get autonomic neuropathy. Up to 1 in 4 have some type of nerve compression at the wrist, which is a type of focal neuropathy.
You are more likely to get nerve damage and experience some type of diabetic nerve pain if you do not keep your blood glucose levels within target ranges. Your chances of developing neuropathy also increase if you:
Have had diabetes for a longer time.
Are an older adult.
Are overweight or obese.
Have hypertension or high cholesterol.
Smoke.
Consume alcohol in excess.
Have kidney disease.
How to Prevent Diabetic Nerve Pain
Prevent diabetes
Manage diabetes
Treatment for Diabetic Nerve Pain
Treatment for diabetic neuropathy can include remedies to provide pain relief, and medications and lifestyle changes to lower blood sugar and prevent progression of diabetic neuropathy in the longer term. You and your medical team can also manage your diabetic nerve pain and neuropathy regularly.
Treatment of Diabetic Neuropathy: Pain Management
When pain strikes, you need relief. The relief strategies listed here may not heal your diabetic neuropathy, but they can help you get through the day.
Physical Activity
Physical activity is among the safest strategies for reducing nerve pain, although the effects are only temporary and exercise does not heal nerves. Exercise also has benefits for diabetes management, since it increases insulin sensitivity and can help with weight loss and lowering triglycerides. Of course, exercise has all kinds of other benefits such as improving mood.
Choose a low-impact activity, such as swimming. Pounding from high-impact activities can make nerves go numb and increase pain.
Get your doctor's approval before starting any exercise, and specifically ask about safe exercises with diabetic neuropathy.
Ask about a referral to a physical therapist who can help you exercise safely.
Dietary Supplements and Alternative Therapies
Some nutritional supplements and other alternative therapies can help reduce diabetic nerve pain symptoms, but always be sure to check with your doctor first.
Vitamin D: your body can make it with sunlight exposure and it is in some foods, such as fatty fish and fortified milk, but many people have suboptimal levels.
B vitamins: deficiency of vitamins B12 and B6 can increase feelings of pain and make nerve damage worse.
Alpha-lipoic acid: this antioxidant may reduce pain.
Relaxation: yoga, biofeedback, meditation, and massage can help you respond better to pain so that it does not affect you as much.
Capsaicin: cream, lotion, jelly, and patches can all block pain signals, but have not definitively been proven effective for diabetic nerve pain, and can make you more sensitive to the sun.
Pain Medications
Various types of medications can relieve pain, but all medications can have side effects. These solutions are best only for short-term use, and under your doctor's supervision.
Over-the-counter (OTC) pain relievers ibuprofen, acetaminophen, and asprin can work, but ask your doctor how long they are safe to use.
Anti-depressants and anti-seizure drugs these can reduce pain, but can have serious side effects.
Opioids – these are effective for bad pain, but are quite strong and addictive.
The best way to reduce diabetic nerve pain is prevent it or slow the rate of progression of diabetic neuropathy. You can do this by lowering your blood glucose to target ranges if your glucose has been high. Joslin Diabetes Research Center at Harvard Medical School recommends keeping A1C under 7% if you can.
The cornerstones of lowering blood sugar and controlling diabetes are:
- Adopting healthy lifestyle behaviors: weight loss if you are overweight, increasing physical activity, eating well, and getting enough sleep. Did you know that quitting smoking can improve blood flow and reduce diabetic neuropathy symptoms?
- Taking all of your diabetes and other medications as prescribed.
- Measuring blood glucose levels if your doctor recommends it so you can stay motivated to lower them and start to understand what affects your levels.
Stay on top of your signs and symptoms so you can recognize any changes quickly and prevent more serious problems from developing. Daily self-care that you can do at home involves checking your feet if you have peripheral neuropathy.
- Inspect your feet every day for any blisters, cuts, corns, or other signs of a wound or infection.
- Protect your feet by wearing shoes and socks and making sure they are neither hot nor cold.
- Trim your toenails straight across to prevent ingrown nails.
With all that it takes to manage diabetes and with the burden that diabetic nerve pain can place on you, any help that you get can be welcome. Lark for diabetes is a supportive health app that provides empathetic coaching around diabetes management and living a healthy life.
Blood Sugar Chart
What is the normal range for blood sugar – your guide to blood glucose levels.
What is Blood Sugar?
Blood sugar, or blood glucose, needs to be in the right range for you to be healthy. At least some glucose is necessary for your muscle, liver, and some other cells to use as fuel so they can function. A blood sugar chart can help you remember which levels you should opt for.
Too much or too little glucose, though, is dangerous. Too little sugar, or hypoglycemia, can make you weak or even lead to loss of consciousness. On the other hand, hyperglycemia, or too much glucose in your blood, can also become an emergency or lead to diabetes complications.
Different Levels and What They Mean
The ranges of safe levels of blood glucose depend on factors such as what time of day it is and when you last ate. Safe levels of blood sugar are high enough to supply your organs with the sugar they need, but low enough to prevent symptoms of hyperglycemia or complications of diabetes. Dangerous levels of blood glucose are outside of this range.
The target levels can also vary if you have diabetes. For example, if you are diabetic and are monitoring your blood sugar, you might get a reading of 65 mg/dl. That is considered to be mild hypoglycemia, and you would be wise to eat 15 grams of fast-acting carbohydrates and retest your blood sugar in 15 minutes.
If you were not diabetic, you probably would not know that your sugar was low because you would not test and because you would not symptoms, and you would not act. That is fine because your body is capable, under normal circumstances, of raising your blood glucose to healthy levels when needed, even if you have not eaten.
What is the Normal Range for Blood Sugar?
You might want to measure your blood sugar before meals to get a baseline, and then two hours after your meal to measure your normal blood sugar level. Your doctor might also suggest measuring blood sugar before bed to be sure you have been eating well throughout the day and can go to sleep with peace of mind.
These are considered within the range of normal:
- Less than 140 mg/dl if you do not have diabetes.
- Less than 180 mg/dl if you have diabetes.
Blood Sugar Levels in the Morning
The best time to check blood sugar levels in the morning is right when you wake up and before you eat anything. This gives you a glimpse of what may be happening overnight, and it gives you a baseline for the day.
These are goal levels, according to Joslin.
- Under 70 mg/dl if you do not have diabetes.
- 70 to 130 mg/dl if you have diabetes.
The dawn effect can often lead to a high morning measurement in diabetes. This is your body's tendency to get ready for the day by raising blood sugar by increasing levels of counter-regulatory hormones the ones that counteract insulin. With diabetes, you do not have the capacity to counterbalance this rise in blood sugar, so levels can be dangerously high.
Ways to lower your morning blood sugar value include:
- Eating dinner earlier.
- Checking your medications making sure you are taking them properly and asking your doctor if they are correct.
- Going for a walk after dinner.
- Including protein with your dinner.
Blood Sugar Levels after Eating
Many foods have types of carbohydrates called starches and sugars. When you eat foods with these types of carbohydrates, your body breaks them down into glucose, which is a type of simple sugar, and releases the glucose into your bloodstream. Aside from glucose produced by your liver, food is the main source of blood glucose.
After eating, your blood sugar levels rise. They rise more when you eat more carbohydrates, when you do not eat fiber, fat, or protein with your carbs, and when you eat certain types of carbohydrates, such as refined sugars and starches.
These are target values.
| When Measured | Goals for Healthy Adults | Goals with Diabetes |
| Before lunch, dinner, or a snack | Less than 110 mg/dl | 70-130 mg/dl |
| 2 hours after you eat | Less than 140 mg/dl | Less than 180 mg/dl |
| Before bedtime | Less than 120 mg/dl | 90-150 mg/dl |
Hemoglobin Chart
Hemoglobin is the oxygen-carrying protein in your red blood cells, but it is highly relevant to blood sugar levels. Sugar in your blood attaches to hemoglobin, creating what is called glycated hemoglobin, or A1C. High blood glucose levels lead to more hemoglobin being glycated.
Measuring your A1C is an alternative to measuring fasting blood glucose. Measuring blood glucose directly with a finger prick or a blood draw at your doctor's office lets you know your blood sugar at that moment, while the A1C value you get provides an estimate of your average blood sugar levels over the past 3 months.
For example, if your A1c value is 7.8 (a reading between 140-199 mg/dl) would be considered high.
| Glycated Hemoglobin (A1C) Value | Estimated Average Glucose (EAG) |
| 5.6% (Highest normal value) | 114 mg/dl |
| 5.7% (Prediabetes) | 117 mg/dl |
| 6% | 126 mg/dl |
| 6.4% (Diabetes) | 137 mg/dl |
| 7% (Goal in diabetes) | 154 mg/dl |
| 8% | 183 mg/dl |
| 9% | 212 mg/dl |
| 10% | 240 mg/dl |
Printable Blood Sugar Chart
A blood sugar chart showing goal values can help you quickly gauge how you are doing with your monitoring. This chart shows what to aim for throughout the day if you have diabetes or not.
Blood Sugar Level Chart by Age
Blood sugar levels tend to rise with age due to an increase in insulin resistance and decrease in insulin sensitivity. In one study, each extra decade of age was linked to a 2.7 mg/dl increase in fasting glucose, and a 4.5 mg/dl increase in 2-hour post-prandial (post-meal) glucose levels.
How to Reduce Blood Sugar
You can take steps to reduce blood sugar as soon as you find out that it is high. This is how to reduce blood sugar if you have a single high reading that may be dangerous:
Ask your doctor what to do if you missed a dose of insulin or another diabetes medication.
Ask your doctor if your medication type(s) and dose(s) are still appropriate for you.
Drink water to dilute the sugar.
Exercise (if safe) for 15 minutes.
Eat a small protein snack, such as a hard-boiled egg, ½ ounce of peanuts or pistachios or other nuts, ½ cup of beans, or ½ cup of plain yogurt or cottage cheese.
If you have chronically high blood sugar in prediabetes or diabetes:
Exercise regularly, assuming your doctor approves it.
Lose weight if you are overweight or obese.
Eat a higher proportion of vegetables, whole grains, lean proteins, healthy fats, and fruit.
Limit sugary foods and beverages, fried foods, refined starches, and processed and fatty red meats.
Beware of starchy vegetables such as sweet potatoes, which can spike your blood sugar. Check out our guide of which veggies to avoid!
| Time and Situation | 117 mg/dlGoal for Non-Diabetics | Goal for Diabetics |
| First thing in the morning (fasting before breakfast) | < 100 mg/dl | 70 - 130 mg/dl |
| Before lunch, dinner, and snacks | < 110 mg/dl | 70 - 130 mg/dl |
| Two hours after starting to eat a meal or snack | < 140 mg/dl | < 180 mg/dl |
| Before going to bed | < 120 mg/dl | 90- 150 mg/dl |
How to Reduce Blood Sugar
How to Reduce Blood Sugar
High blood sugar (blood glucose) can be dangerous. It can happen if you have a high reading when you test your blood glucose, if you get a high value on your glucose test during pregnancy, or if you have prediabetes or diabetes.
Some complications of high blood sugar develop over time, with months or years of high blood sugar. However, it is important to treat high blood sugar immediately because of other complications, such as hyperglycemic hyperosmolar nonketotic syndrome (HHNS), that can happen quickly and be emergency situations. In any case, you can take steps to reduce your blood sugar to prevent harm or further health risks.
Signs of High Blood Sugar
| Time and Situation | Goal for Non-Diabetics | Goal for Diabetics |
| First thing in the morning (fasting before breakfast) |
< 100 mg/dl | 70 - 130 mg/dl |
| Before lunch, dinner, and snacks | < 110 mg/dl | 70 - 130 mg/dl |
| Two hours after starting to eat a meal or snack | < 140 mg/dl | < 180 mg/dl |
| Before going to bed | < 120 mg/dl | 90- 150 mg/dl |
You may or may not notice signs of high blood sugar. They can include:
Increased thirst, due to the extra sugar in your blood.
Increased urination, due to the extra water you may drink.
Blurred vision.
Fatigue, weight loss, and hunger
Infections, foot numbness, and slow wound healing due to sugar damaging your blood vessels and reducing oxygen delivery to parts of your body.
Kidney damage, chronic gastrointestinal distress, and heart disease due to sugar damaging these parts of your body.
The only way to know for sure if your blood sugar is high is to test it. Your doctor might order a fasting blood glucose, A1C, or oral glucose tolerance test (OGTT) as a routine test or if she suspects that you have diabetes or prediabetes. If you have diabetes, you are probably already testing your blood glucose at home, and you can test an extra time if you think that you may be having a hyperglycemic episode.
How to Reduce Blood Sugar Fast
Say you have diabetes and are testing your blood glucose at home as your doctor recommended. You find that your glucometer gives you a high blood sugar reading. You know that you need to get your blood sugar down to stay safe. What can you do?
Take your medications. Did you skip a dose? If so, your next step depends on which medications you are on. For some medications, you should take a dose as soon as possible. For others, you may need to try another approach. Ask your doctor beforehand so that if you do ever miss a dose, you know what to do.
Drink water. Sometimes, lowering blood sugar levels can be as simple as diluting the sugar. You can do that by drinking water. Of course, be sure to choose water or another low-calorie beverage, and not a sugary beverage!
Exercise. Physical activity is one of the most effective ways to increase insulin sensitivity so your blood glucose can decrease. If your doctor has cleared you to work out, walk, cycle, or do another heart-pumping activity for 15 minutes, and be sure to check your blood sugar after exercising.
Have some protein. Protein helps lower blood sugar and slow digestion. As a bonus, protein can help reduce hunger and satisfy cravings that can be a sign of hyperglycemia. A small snack, such as an ounce of low-fat cheese, ½ cup of cottage cheese, a hard-boiled egg, or an ounce of almonds, is enough.
Foods to Avoid with High Blood Sugar
Foods to avoid with high blood sugar are those which drive up your blood sugar or increase your insulin sensitivity. If you have high blood sugar, limit the times you choose the following.
Foods with added sugars: candy, cookies, pies, muffins, ice cream, sugar-sweetened yogurt, sugary cereal.
Sugar-sweetened beverages: soft drinks, energy and sports drinks, sweetened or flavored coffee and tea.
White flour-containing products: white bread, bagels, pita, English muffins, rolls, crackers, and pretzels.
Refined grains and grain products: white rice and pasta, and refined breakfast cereal.
Fried foods: fried potatoes (French fries and hash browns), fried chicken and fish, doughnuts, onion rings, cheese sticks.
Processed meat and fatty red meat: Ribs, fatty steak, pepperoni, salami, sausage, ham and other luncheon meats, hot dogs.
Boiled potatoes.
Dried fruit and fruit juice.
Another tip is to never eat refined carbohydrates sugars and starches on their own. If you do have refined carbs, be sure you have them with one or more of the following so that their effect on your blood sugar is lower.
Fiber: add a veggie and choose whole instead of refined grains.
Lean protein: beans, lentils, nuts, low-fat dairy, fish, egg whites, tofu, and chicken.
Healthy fat: nuts and peanuts, nut and peanut butters, or avocado.
Foods That Reduce High Blood Sugar Instantly
Actually no food will reduce high blood sugar instantly, since it takes at least 10 to 20 minutes from the time you start eating until the time the digested food gets released into your bloodstream and can affect your blood sugar levels. Still, there are some foods to keep in mind for when you have high blood sugar and you want to lower it.
These are some foods that can help lower blood sugar, along with serving sizes. Remember, you do not need to have too much to have an effect.
½ to 1 oz. of nuts or peanuts, or 1 tablespoon of peanut or nut butter.
3 oz. of salmon or tuna.
1 hard-boiled egg or 2 egg whites.
½ small avocado.
1 cup of plain or regular Greek yogurt.
½ to 1 oz. of unsweetened chocolate.
½ cup of cooked beans or lentils.
Diet and Exercise to Reduce Blood Sugar
Aside from taking any medications that you may be prescribed, losing extra weight, getting active, and eating right can be the best ways to reduce blood sugar.
Losing weight: Any pounds that you lose if your body mass index is over 30 can lower your blood sugar dramatically. These strategies are simple and effective.
Eating more vegetables.
Cutting portion sizes of high-calorie foods.
Eating less often at restaurants, or eating half of the amount you are served.
Swapping sugary beverages for water and fruit for dessert.
Steaming, grilled, and baking instead of frying with added fats.
You can check your BMI here. Overweight is over 25, and obese is over 30.
Getting active: Getting moving increases insulin sensitivity, lowers blood sugar, and also helps you lose weight. This includes dedicated workouts, activity throughout the day, and breaking up sedentary time.
Dedicated workouts: At home, at the gym, or outside, the goal is to get 30 minutes, most days of the week. Find something you love, whether it is to walk, cycle, or swim, dance, kickbox, or do pilates, or train for and play tennis, basketball, or golf.
Activity throughout the day: Take the stairs, park further away, and pace your office while you are on the phone. It all adds up or subtracts to lower blood sugar.
Breaking up sedentary time: Sitting for too long, even if you went to the gym in the morning, can lead to higher blood sugar. Lower your levels by breaking up your sitting time at least once every 30 to 60 minutes. As little as 1 to 3 minutes of stretching, marching in place, or swinging your arms can help.
Eating right: While weight loss is a significant factor in blood sugar control, eating right also helps reduce blood sugar. What does eating right include?
Carb control: Spread evenly throughout the day a moderate amount of healthy carbohydrates, such as small servings of beans, starchy vegetables, fruit, whole grains and low-fat dairy.
Fiber consumption: To slow digestion and reduce blood sugar spikes, think about unprocessed plant foods: whole grains, vegetables, fruit, nuts and peanuts, soybeans, beans, and lentils.
Healthier fats: avocados, olive oil, nuts and peanuts, and especially omega-3 fats from fatty fish and flaxseed.
Lean proteins: Seafood, chicken, eggs, tofu, low-fat dairy, and beans.
Some research suggests that a low-glycemic diet can be helpful. You can choose one by limiting sugar and refined starches, having fiber, protein, and fat with your carbohydrate sources, and choosing less processed foods, such as whole grains instead of refined.
Home Remedies to Reduce High Blood Sugar
What else can you do in your daily life to reduce high blood sugar?
You have opportunities all day, and even all night!
Sleep: Sleep deprivation drives up blood sugar by causing cravings and poor food choices and getting hormones out of whack. Get adequate sleep, and your insulin and other hormones will realign to reduce blood sugar. Remember: sleep is not for lazy people. It is for healthy people who want to be at their best, so make it a priority.
Vinegar: Old wives tale? Maybe not. Apple cider and other types of vinegar may help lower blood sugar by slowing gastric emptying to reduce the post-prandial (post-meal) blood sugar spike, and suppressing glucose production by the liver if you take it at bedtime. According to research in the Journal of Diabetes Research, vinegar also increases insulin sensitivity and glucose uptake by muscles.
Chromium: Chromium is necessary for the proper use of insulin, and deficiency can lead to high blood sugar. Good sources include broccoli, spinach, bran cereal, oysters, and cheese. Chromium picolinate is a common form of chromium supplement, but you should ask your doctor before taking any nutritional supplement.
Stress: Too much stress gets your hormones out of balance and increases blood sugar. While you cannot eliminate stress, you can learn to manage it better. Exercise, deep breathing, aromatherapy, and letting go of what you cannot change can all reduce the burden of stress on your body.
Immunity: Catching a cold or getting another illness drives up blood sugar, so do what you can to strengthen your immune system. Besides getting adequate vitamin C from healthy foods such as bell peppers, oranges, and leafy greens, you can reduce infections by washing your hands frequently.
Staying aware: Monitor your blood sugar levels so that you know what is normal for you, how different foods and patterns affect your blood sugar, and when your blood sugar is high. Then you know when and how to react.
The best way to reduce blood sugar may be to use a diabetes app, such as Lark. It can coach you on making the behavior changes that can reduce blood sugar, and alert you to high blood sugar levels that may need attention.
Depression and Diabetes
Diabetes is enough to manage on its own. So is depression. What happens if you have both diabetes and depression? You are certainly in good company if you do. Depression is about twice as common in people with diabetes as it is in the general population.
Diabetes is a condition with high blood sugar levels due to lack of insulin production (type 1 diabetes) or insulin resistance (type 2 diabetes). Depression is a mood disorder. Why are these two chronic conditions related?
Researchers are still unraveling the tangled relationship between diabetes and depression. It appears that diabetes can cause depression and depression can cause diabetes, and that the two are related in additional ways. With all the attention to these two conditions comes good news: there are many ways to manage depression and diabetes.
Facts and Figures on Diabetes and Depression
Both diabetes and depression are common. The Centers for Disease Control and Prevention (CDC) report that 1 in 8 adults have diabetes, while 1 in 15 adults have major depressive disorder, according to the National Institutes of Mental Health (NIMH).
That is just the surface, though. The two conditions are clearly related, as your risk for depression is twice as high if you have diabetes than if you do not.
What Is Depression, and Whom Does It Affect?
Depression is more than feeling down every so often. Depression is also called depressive disorder or clinical depression. It is a mood disorder that includes having negative feelings, such as sadness or hopelessness, for most of the day for at least two weeks. According to the NIMH, major depression is among the most common types of depression.
Many factors can contribute to depression. Genetic, environmental, lifestyle, and psychological factors all affect your risk for depression. You are more likely to be diagnosed with major depressive disorder if:
You are female.
You identify with two or more races/ethnicities.
You have a chronic illness, such as cancer, heart disease, or diabetes.
You experience a major negative or even positive life event, such as losing or starting a job, having a baby, getting married or divorced, retiring, or moving.
You are on certain blood pressure medications, sleeping pills, painkillers, or other medications.
Depression Signs and Symptoms
How do you know if you have depression? The NIMH lists the following signs and symptoms.
Feelings of hopelessness, emptiness, sadness, or worthlessness.
Loss of interest in and excitement for usually fun activities.
Anxiety, trouble concentrating, or irritability without apparent causes.
Feeling tired or having no energy.
Trouble sleeping, or sleeping more than usual.
Changes in weight or appetite.
Muscle pain, headaches, or upset stomach for no real reason.
Thoughts of death or suicide.
Contact your healthcare provider or seek help immediately if you have signs or symptoms of depression, or think you may have depression. Depression is not always easy to identify. Help is available, and there are ways to treat it so that you feel more like yourself again.
Link between Depression and Diabetes: Chicken and Egg?
Does diabetes cause depression? Probably. Does depression cause diabetes? Probably. Do underlying factors cause both conditions? Probably.
Research published in JAMA Internal Medicine found that there is a bidirectional relationship between depression and diabetes. Over 10 years,
Participants with depression had a 17% higher risk of developing diabetes.
Participants on antidepressant medications had a 25% higher risk of developing diabetes.
Participants with diabetes had a 44% higher risk of developing depression.
In addition, a higher body mass index (overweight or obese) and lower physical activity levels were linked both to depression and diabetes.
Depression can increase your risk for diabetes for a number of reasons.
Certain antidepressants increase insulin resistance, which leads to prediabetes and type 2 diabetes.
People with depression are more likely to be overweight and physically inactive.
Both of these are risk factors for prediabetes and diabetes.
Depression is linked to higher levels of stress hormones such as cortisol, which raises blood sugar.
Some antidepressant medications increase cravings for high-carbohydrate foods, which can spike blood sugar and lead to weight gain.
Depression can interfere with your blood sugar management and raise your risk for complications of diabetes.
Type 2 Diabetes and Depression
On the other hand, why might type 2 diabetes lead to depression? The American Diabetes Association (ADA) offers several possible reasons.
A diagnosis of type 2 diabetes can be a trigger for depression.
Managing diabetes is stressful and time-consuming.
You might feel as though you do not have control over your condition, especially if you do not hit your goal A1C or blood glucose levels.
Complications, such as neuropathy, can be painful on a daily basis.
You can feel pressure from your doctor or family to control your diabetes, or even guilt about your blood sugar levels
Type 1 Diabetes and Depression
Many of the factors that lead to depression in type 2 diabetes are also present in type 1 diabetes and the risk for depression is similar. Another factor in type 1 diabetes is the use of insulin. In the 10-year study on the relationship between diabetes and depression, participants on insulin medications were 53% more likely to get depression.
Help for Diabetes and Depression
The first thing to know about diabetes and depression is that effective help is available. There are strategies to improve diabetes control and to treat depression. Controlling these conditions often goes hand in hand, so when you get a handle on one of them, you can often manage the other one better, too.
Physical Activity: Exercise is so simple and so effective. You may know that exercising can help with weight loss and heart health, but physical activity also directly helps with diabetes and depression by:
Improving mood.
Increasing insulin sensitivity.
Lowering blood sugar.
Reducing anxiety.
Helping manage stress.
Giving you more confidence in your ability to manage diabetes.
Any activity is good, and more is usually better, as long as it is safe. The general recommendation is to work up to at least 30 minutes, at least 5 days per week. You can walk, jog, bike, hike, swim, do zumba, play a sport, or do anything you love that gets your heart pumping.
Diabetes Self-Management Programs: Self-management is a cornerstone of diabetes management. Better diabetes management can reduce symptoms of depression, and many of the actions that go into diabetes self-management directly help with depression. Diabetes self-management includes:
Taking your medications as prescribed.
Checking blood glucose in the mornings or as your doctor recommends.
Losing weight if you have extra pounds.
Increasing physical activity.
Eating healthy.
A diabetes self-management coaching app can help with all of these on a daily basis.
The Healthcare System:
Take advantage of the medical care you can get. The healthcare system can help with diabetes control and diagnosis and treatment for depression. Work with your doctor to get the right types and amounts of medications if you need them, and be sure to take them as prescribed. Psychotherapy and counseling are options that can also help. When possible, a collaborative care model, with a nurse in charge of all of your care, can be more effective than having two separate teams managing both conditions.
Diabetes and depression are common comorbidities, but you do not have to succumb to them. Help is available in the form of lifestyle changes, medical care, and self-management programs. A digital health coaching app may be worth considering to support you as you work to maintain your physical and mental health.
Best Multivitamins for Diabetes
Supplements to help lower blood sugar
Managing your diabetes takes a range of strategies, from taking your medications and monitoring your blood sugar, to eating well and getting active. As you commit to your health, you might be wondering if there is anything else you can do to improve your health.
The best multivitamins for diabetes have the nutrients you need and are safe and easy to take. These are some considerations when deciding on a multivitamin.
What Do Vitamins and Minerals Do?
For starters, vitamins and minerals keep you alive. They are involved in all of your body functions and your body needs the right ones available at the right times to function properly. Here is a taste of what you need vitamins and minerals for.
Metabolizing fat, protein, and carbohydrates in food so you have energy for movement and processes such as breathing and having your heart beat.
Regulating blood sugar and insulin sensitivity.
Replicating genetic material and producing new cells.
Keeping a strong immune system.
Maintaining healthy skin, eyes, teeth, bones, muscles, brain, and everything else.
A deficiency of a single nutrient can have noticeable and sometimes intense or permanent consequences. The best multivitamin for diabetes keeps you nourished as your body works to control blood sugar.
Multivitamin or Nutritious Diet?
Why Consider a Multivitamin?
Prevent nutrient deficiencies and associated symptoms.
Consistently supply a range of nutrients on a daily basis.
Avoid worrying about getting each of more than 29 essential vitamins and minerals.
Insure intake of nutrients required for blood glucose control.
Some people wonder whether a nutritious diet can take the place of a multivitamin. If I eat well, won't I be sure to get the vitamins and minerals I need?
Other people wonder whether a multivitamin can take the place of nutritious foods. As long as I get my vitamins and minerals from a supplement, can't I eat whatever I want?
No, and no!
A perfect diet could get you all the vitamins and minerals that you need, but it does not always. You might not get as much of each nutrient that you need, every single day. Or, you might miss out on some vitamins or minerals that are only in a few select foods. Taking a multivitamin is like an insurance policy so that if you miss out on a few vitamins or minerals from your diet, you will still get them from your supplement.
On the other hand, your multivitamin does not give you license to ignore nutritional content of your food. Low-nutrient foods tend to be pretty junky. If you choose them, you are almost sure to get more added sugars, refined carbohydrates, and unhealthy fats in your diet than you really should. That's a sure way to raise blood sugar!
Some nutrients are hard to come by for various reasons. You might be short on vitamin B12 if you follow a vegan (plant-only) diet, or may need extra vitamin D if you are an older adult and do not drink milk or eat fatty fish.
Which Multivitamin and Mineral?
Make the Most of Your Multivitamin
Use a high-potency multivitamin and mineral supplement.
Look for USP certification.
Choose high-nutrient foods.
Ask your doctor which supplement is best for you.
Take your supplement every day or as directed.
Consider taking a separate calcium supplement.
When choosing a multivitamin, be sure to keep in mind that you want both your vitamins and your minerals. There are 13 vitamins and more than 16 essential minerals (more than because there a lot, but some of them are in such tiny amounts that you do not need to worry about them).
Do not assume that a multivitamin also has the minerals. It often does, but some multivitamins, could be just that: a bunch of vitamins. Read the supplement facts panel to make sure your multivitamin has all of the vitamins and several minerals.
Top Nutrients for Everyone
Multivitamins could have benefits such as preventing common deficiency diseases, such as anemia. The best multivitamin has all the vitamins and many minerals. It provides 100% of the daily value (DV) or reference daily intake (RDI) for most vitamins and many minerals. Note that you will not get extra benefits from taking excessive amounts of nutrients, so there is no need to pay extra for a supplement with megadoses.
These are a couple common items to consider when checking the nutrients in your supplement.
Calcium is such a big nutrient that it does not usually fit into a regular multivitamin. Ask your doctor if you should take a separate calcium supplement.
Iron deficiency is the world's most common mineral deficiency, but too much can be toxic. Men and post-menopausal women may need a multivitamin without much iron.
Potassium is critical for blood sugar control and a healthy heart, but it is tough to put into a pill. You will probably need to get your potassium from healthy foods such as vegetables, fish, yogurt, beans, and fruit.
Nutrients in Diabetes
A general multivitamin and mineral supplement probably has what you need if you have diabetes, but there are a few nutrients to look for specifically because they may relate to your blood glucose levels or insulin resistance.
There are a few nutrients that are known for their role in blood sugar control.
Chromium, especially in the form of chromium picolinate, may improve glucose intolerance.
Vitamin D: Suboptimal vitamin D levels are common, but insulin sensitivity can improve by 60% when Vitamin D is replenished.
Selenium deficiency is linked to diabetes risk.
There are also some nutrients that are known to be low in diabetes or can help lower the risk of comorbities.
Calcium and vitamin D: patients with diabetes may have higher risk for osteoporosis and risk for bone fractures, but calcium and vitamin D can help.
Vitamin B12: deficiency leads to neuropathy, which is already a risk in diabetes. Plus, the common diabetes drug metformin can increase risk for deficiency.
Folic acid is necessary for heart health.
Making It Work for You Taking a multivitamin is a lot like doing any other health behavior for your diabetes.
It becomes easier as you practice it,
Long-term strategy for health,
It makes your other efforts pay off more,
It works better when you make other healthy choices.
You can get more out of your multivitamin when you make other healthy choices. These are just a few
Exercising to strengthen bones and practicing balance to prevent bone-injuring falls to support the bone-strengthening effects of calcium and vitamin D in a multivitamin.
Limiting salty foods, such as pickles, salty sauces and other condiments, and processed and fast foods, to keep blood pressure down along with the vitamin C in your multivitamin.
Including plenty of high-fiber foods, such as vegetables, fruit, legumes, and whole grains, to support the heart-healthy benefits of the folic acid and vitamin B12 in your multivitamin.
USP Certification for Multivitamin Supplements
Taking a multivitamin can be healthy, but there are a few precautions to follow to stay safe. First, ask your doctor if you should take one and which nutrients to look for. Follow her suggestions to be sure you are getting what you need.
When you are choosing a brand, your doctor may have specific recommendations. If not, be aware that the Food and Drug Administration (FDA) is technically responsible for the oversight of vitamins and minerals, but in reality has little control due to the Dietary Supplement Health and Education Act of 1994 (DSHEA). The FDA does not guarantee that the label on the supplement is correct.
To protect yourself as much as possible, choose a supplement with US Pharmacopeia (USP) certification. USP-certified products have been tested to be sure they contain the nutrients they claim, and that they do not contain harmful contaminants.
The best multivitamins for diabetes can help give your body what it needs for improving blood glucose control and maintaining your health in other ways. They are best when you also make healthy diabetes management choices.
Reduced Insulin Sensitivity
Reduced Insulin Sensitivity – How to Increase it Naturally
Learning healthy behaviors can help you lower your risk of reduced insulin sensitivity
Lifestyle change is a large factor in reducing your risk of insulin sensitivity The topic of insulin sensitivity comes up frequently nowadays, and there is good reason. Reduced insulin sensitivity leads to high blood glucose levels and is the main cause of prediabetes and type 2 diabetes, which are increasingly common in the U.S., and can have serious consequences.
It is good to become aware of what reduced insulin sensitivity, or insulin resistance, means, and, better yet, what to do about it. Advanced insulin resistance, such as in the case of type 2 diabetes, can mean that you need medications to control blood sugar. It can also mean that you have a higher risk for certain health conditions.
Luckily, lifestyle changes can help you naturally increase insulin sensitivity, even if it has been decreased greatly. Healthy behaviors such as losing extra weight and getting active are usually effective at increasing insulin sensitivity. Lark can support your healthy lifestyle changes whether you have type 2 diabetes, prediabetes, or insulin resistance that is so minor that you may not even be aware of it.
What is Reduced Insulin Sensitivity?
Reduced insulin sensitivity is also called insulin resistance. Let's break it down!
- Insulin is a hormone produced by your pancreas. It helps your body regulate blood sugar, or blood glucose levels.
- Sensitivity describes how sensitive, or responsive, cells in your body are to insulin.
- Reduced insulin sensitivity happens when cells in your body are not as responsive to the effects of insulin and have trouble taking up glucose from your blood.
Normal Insulin Sensitivity
To make it clearer, here are some more details on what happens with normal insulin sensitivity. Many of the foods you eat contain types of carbohydrates called sugars and starches. Examples include bread, pasta, potatoes, cereal, sweets, and soft drinks. During digestion, your body breaks down the carbs into a type of sugar called glucose. The glucose goes into your bloodstream, which temporarily raises blood glucose, or blood sugar, levels.
The glucose in your blood is carried to certain cells that use glucose for energy. Some of your cells, such as muscle, liver, and fat cells, use insulin to take up the glucose. During normal insulin sensitivity, these cells need a normal amount of insulin to take up glucose, which lets the level of glucose in your blood go back down to normal levels.
Reduced Insulin Sensitivity
Various triggers can lead to reduced insulin sensitivity. When it happens, insulin is not as effective on cells such as your liver, muscle, and fat cells. They need more insulin just to take up the same amount of glucose. Insulin levels in your blood rise. Eventually, glucose levels may rise if your pancreas can no longer produce enough insulin to keep up with the demand.
Who Has Reduced Insulin Sensitivity?
Lots of people have reduced insulin sensitivity – maybe even you! You have reduced insulin sensitivity if you have prediabetes or type 2 diabetes. That already includes 45% of U.S. adults, but that is not all. The truth is that insulin resistance can start to develop years or a decade before you have signs of it.
You are more likely to have reduced insulin sensitivity if you:
Are overweight or obese
Are not physically active
Have a family history of type 2 diabetes
Are Hispanic American, Asian American, Native American, African American, or a Pacific Islander
Are an older adult
How Is Reduced Insulin Sensitivity a Problem?
Reduced insulin sensitivity can become a health problem. As it progresses, your cells are less and less able to respond to insulin; they need more insulin to clear glucose from your blood. At some point, your pancreas may not be able to keep up with demand. Insulin levels may not be high enough to let your muscles, fat, and liver cells get enough glucose out of your blood.
The result is that your blood sugar levels may rise above normal levels, leading first to prediabetes, and then to type 2 diabetes. The progression can take years; in fact, you are likely to have reduced insulin sensitivity for up to a decade before you actually develop prediabetes.
If this sounds far-fetched or as though it may be something for others to worry about, consider this: prediabetes and diabetes are common. Over 45% of adults, or nearly 1 in 2, have prediabetes or diabetes, according to the Centers for Disease Control and Prevention (CDC). The number jumps to nearly 3 in 4 for adults over 65 years.
Reduced insulin sensitivity is not just a problem because a lot of people have it. It is a problem because it can lead to serious health consequences. Prediabetes is not likely to cause many or any symptoms, but it does increase risk for diabetes, and diabetes has its own set of concerns.
Seventh-leading cause of death in the U.S.
Higher risk for heart disease, kidney disease, and stroke
Increased risk for Alzheimer's disease
Risk of complications such as blindness and diabetic neuropathy
Daily (or more) blood glucose testing and probably medications
Most cases of type 2 diabetes are preventable, and your chance of preventing diabetes is higher if you try to reverse reduced insulin sensitivity early on.
Reduced Insulin Sensitivity & Correlation with Early Signs of Prediabetes
Reduced insulin sensitivity means you have trouble processing glucose normally. Your blood glucose levels can be higher than normal. While prediabetes symptoms are rare, you could have signs of high blood sugar if your blood sugar levels are consistently too high. This is likely correlated with reduced insulin sensitivity.
Signs of high blood sugar and diabetes can include:
Increased thirst and urination
Unexplained, unintentional weight loss
Lack of energy
Increased hunger
Blurred vision
Numb or tingling hands or feet
Compared to having lower insulin sensitivity, having higher insulin sensitivity is linked to lower levels of insulin in your blood. The reason is that you do not need as much insulin to get your blood glucose back to baseline levels after meal. This is healthy, because it means that you can keep blood glucose levels normal when you eat carbohydrates without making your pancreas work so hard to produce and secrete extra insulin.
How to Increase Insulin Sensitivity Naturally
There are many ways to increase insulin sensitivity naturally. Unlike with medications, these strategies have no harmful side effects. Instead their side effects may include increased energy, better mood, and lower risk for other health conditions!
Diet for Increasing Insulin Sensitivity
What you eat, and how much, can have an immense impact on your insulin sensitivity. Losing extra pounds can increase insulin sensitivity and lower your risk for prediabetes and diabetes. In one study, overweight individuals with prediabetes who lost 5 to 7% of their body weight (that is 9 to 13 lb. for someone who weighs 180 lb.) lowered their diabetes risk by 32%. You can use this calculator to find out your body mass index (BMI) if you know your height and weight. A BMI over 25 is considered overweight, and a BMI over 30 is considered obese.
The healthiest and most sustainable way to lose weight is usually to do it gradually. Together, that means that you do not need to follow a fad diet or cut out all good-tasting foods. Instead, consider adding one or more doable steps, such as the following, into your regular routine.
Serve smaller portions of higher-calorie foods. That could mean ordering a small instead of regular fries or burger, or having only half a piece of cake.
Add more low-calorie foods. For example, stir broccoli into mac and cheese or pasta sauce so that the same size portion has fewer calories. Or, start dinner with a green salad so that you are less hungry for higher-calorie foods for the main course.
Choose water or decaffeinated tea or coffee instead of soft drinks, energy and sports drinks, and other sugar-sweetened beverages with calories.
Swap less processed foods for highly processed ones to limit added sugars and unhealthy fats. For example, choose fruit instead of desserts, or roast chicken and fish instead of fried and battered choices.
Healthy Eating for Increasing Insulin Sensitivity
Your diet is not just about weight loss. A lot of research has been done to check the effects of what you eat on your insulin sensitivity. Here is what the results suggest if you want to reduce insulin resistance.
Eat more
Whole grains , including oatmeal, popcorn, brown rice, whole wheat products, and wheat bran.
Fiber , which is in plant products such as whole grains, vegetables, nuts and seeds, fruit, and legumes (beans, peas, and lentils).
Healthy fats , including monounsaturated fats from olive oil, avocados, and peanuts, and omega-3 fats from fatty fish and flaxseed.
Vegetables and a variety of fruit and vegetables.
Limit:
Trans fats, which are in fried foods, plus processed foods such as some snack pies and cakes, doughnuts, and crackers. Added sugars from foods and beverages, such as soft drinks, desserts, sugar-sweetened cereal and yogurt, and other processed foods such as some baked beans, teriyaki and pasta sauces, and canned soup.
Saturated fats from animal foods, such as fatty meats and butter.
Processed meats.
What about a low-carb diet? Some people try to improve insulin sensitivity by turning to a low-carb diet, which restricts high-carb foods such as bread and other grains and grain products, starchy vegetables, sugary foods, and even fruits and legumes. However, the jury is still out. A low-carb diet could lower your body’s demand for insulin, but there could be long-term harm from having too much protein or fat to make up for the low amount of carbohydrates.
A smart-carb approach may be safest and healthiest.
. Spread your carb intake through the day, with one or two small servings per meal and snack. . Avoid excessive amounts of carbs at once, such as large plates of pasta, huge bagels or muffins, or meals with bread, a side of rice or potatoes, and a starchy and sugary dessert. . Look for high-fiber, less refined carbohydrate sources, such as whole grains, fruit, and starchy vegetables. . Limit refined grains and sugars. . Eat your carbohydrate with a source of fat and/or protein.
Exercise is one of the quickest and surest ways to increase insulin sensitivity naturally. The benefits last for 24 to 48 hours, so try to get in a workout at least every 1 to 2 days to keep getting the rewards.
Type of Exercise Examples How Much?
Another important way to increase insulin sensitivity is to stop sitting. At least, try not to sit for so long! Breaking up your sedentary time with a few minutes of light activity, such as walking or doing calf raises, can fight insulin resistance.
More Ways to Naturally Increase Insulin Sensitivity
You have opportunities all day to increase insulin sensitivity naturally, and side effects can include feeling better in so many ways.
Get enough sleep. A single night of sleep deprivation reduces insulin sensitivity. Being chronically low on sleep, as so many adults are, can harm your health even if you are doing everything else right. You can use Lark to get a handle on your sleep patterns and work on sleeping better if you are not yet getting enough.
Manage stress better. Some stress is good, and too much stress is unfortunately common. The effects are not just in your head; being overly stressed alters your hormones and increases insulin resistance. Learning how to manage stress can help normalize your metabolism. Meditation, exercise, and deep breathing are some ways to manage stress. Lark can help you recognize when you are feeling stressed and remind you of ways to try to handle it through digital therapeutics.
Medications and Natural Approaches to Increasing Insulin Sensitivity
Medications can be necessary to keep normal blood sugar levels in check if your insulin sensitivity decreases too much. Still, even if you have diabetes, these natural support strategies can increase insulin sensitivity. They may make your medications more effective or allow you to take lower doses (of course, never change your medication dose without talking to your doctor first).
Ready to Increase Insulin Sensitivity?
If you are worried about reduced insulin sensitivity and are ready to increase it naturally, Lark is ready to help. The friendly health coach is available through your smartphone 24/7 to guide you and support you as you make healthy lifestyle choices. You do not need to be alone on your health journey!