Your blood sugar, or blood glucose, is an important measure of your health. Too much or too little is unhealthy. Normally, your body can control your blood glucose so that it stays within healthy levels, but your blood sugar goes awry in diabetes. It is often too high (hyperglycemia), and sometimes too low (hypoglycemia).

Blood glucose monitoring lets you know your blood glucose levels. You can get the most from it if you do it as many times a day as your doctor recommends, you use a high-quality glucose meter (glucometer), and you know how to interpret and respond to your blood glucose values.

Who Should Check Blood Glucose?

The American Diabetes Association (ADA) recommends self-monitoring of blood glucose, also known as SMBG, for many people with diabetes. Your doctor may ask you to check your blood sugar at home if:

• You have type 1 diabetes
• You have type 2 diabetes and are on insulin.
• You have been unable to meet your blood sugar targets when you go to the doctor for a fasting blood sugar test or A1C test.
• You are or have been experiencing low blood glucose levels, with or without symptoms.

Why Should You Monitor Blood Glucose?

Monitoring your blood glucose can provide you with important information that you cannot get without the test. If you are on basal insulin, SMBG can guide you on dose or timing changes that may be necessary. According to Harvard-affiliated Joslin Diabetes Research Center, patients with diabetes can use blood glucose testing to find out:

• Whether you may need changes in medication prescriptions.
• How your exercise and diet affect blood sugar levels.
• If you need to change your routine when you are sick.
• When you have hypoglycemia or hyperglycemia that requires action.

How to Check Your Blood Glucose

You can check your blood glucose with a simple home blood glucose meter, which also called a glucometer. There are a couple of main types of blood glucose monitoring devices: traditional and continuous. 

Diabetes-Friendly Exercises 

Can you have chocolate if you have diabetes?

For many people, chocolate ranges from being a pleasant-tasting treat to being necessary for survival. Can chocolate be part of life if you have diabetes? Read on for questions and answers to your burning chocolate questions and to learn how you can make chocolate a healthy part of your routine.

What are the different types of chocolate?

What exactly is chocolate? Chocolate comes from the seed of the cocoa tree. Cocoa liquor includes cocoa solids and cocoa butter, and it is the percent cacao that you may see on a food label. Cocoa powder includes cocoa liquor minus some of cocoa butter, leaving solids.

• Chocolate has cocoa liquor, cocoa butter, and often sugar.
• Dark or semisweet chocolate has at least 35% cocoa liquor.
• Milk chocolate has condensed or powdered milk in the chocolate mixture has usually contains 10%-12% cocoa liquor.
• White chocolate has cocoa butter, milk, and sugar.

Then, of course, there are chocolate-flavored products or products made with a little bit of chocolate and a lot of other ingredients. Brownies and chocolate cake and cookies have flour, sugar, and eggs. Chocolate ice cream has sugar and cream. Chocolate syrup has water and sugar.

How does chocolate affect blood sugar?

As you wonder whether cocoa is good for diabetes, the first question may be how chocolate affects blood sugar. Happily, chocolate has a low glycemic index (GI), which means it does not lead to sharp spikes in blood sugar when you eat it. This is likely because of its high amount of fat and fiber, both of which slow digestion. Milk chocolate and sugar-sweetened dark chocolate have a higher GI than unsweetened chocolate, but are still lower-GI than high-sugar, high-starch, low-fiber treats such as cake and syrup.

There is more good news about chocolate and your blood sugar. It may improve the very problems that lead to type 2 diabetes. Eating chocolate may increase insulin sensitivity. It may also stimulate the beta cells in your pancreas to release insulin. Both of these actions can lead to lower blood sugar. In fact, eating chocolate with a meal may lead to a lower blood sugar spike.

How else does chocolate affect your health?

A lot of research has looked at chocolate consumption and health, especially heart health. Most of the findings are positive. That is especially good news if you have diabetes, since diabetes is a risk factor for heart disease and related conditions. Various studies have linked chocolate consumption to lower blood pressure, triglycerides, and total cholesterol levels, and lower levels of unhealthy inflammation. Many studies have included people with diabetes.

It is however of note that women who are pregnant should avoid chocolate, particularly if you have gestational diabetes.

What about weight gain?

Chocolate is high-fat and delicious. It is also high-calorie, with about 140 calories per ounce. In comparison, an ounce of bread has 60 calories and an ounce of cheese has 110 calories. To get 140 calories, you would have to eat 2 large apples, ¾ cup of pasta, or 1 pound of cauliflower.

Don't high-fat, great-tasting, and high-calorie add up to a formula for weight gain? Actually no! 

Tips and diabetes-friendly options at your favorite fast-food chains

Breakfast has the reputation of being the most important meal of the day. Breakfast supporters argue that it helps with weight control because it keeps you from being too hungry and wolfing down high-calorie foods later in the day. They also point to research linking breakfast consumption to a more nutritious overall diet.

With diabetes, there are even more reasons to eat breakfast. Skipping it can lead to hypoglycemia. In addition, skipping breakfast can reduce your body's insulin response. Both of these effects lead to overall higher blood sugar the opposite of what you want!

But what if fast food is your only choice? 

Eating Fast Food with Diabetes

Just because you have diabetes doesn't mean you can't eat fast food if you make smart choices!

What you eat is one of the most important factors in controlling diabetes, so avoiding fast food may be a priority. Still, fast food is almost sure to be an occasional or regular part of life since it is so convenient and great-tasting. The good news is that eating fast food with diabetes can be healthy if you make better choices.

With some planning, you can choose meals that are:

• Low or moderate in carbohydrates and calories.
• High in protein.
• Low in unhealthy fats.
• Sources of fiber, essential vitamins and minerals.
• These are some fast food choices that can fit into your diabetes diet.

Burger and Chicken Joints

Small burgers and grilled chicken can keep you on track, while double or triple cheeseburgers and fried chicken sandwiches and nuggets can set you back. Look for small or kid-sized burgers and hold the mayo and fatty dipping sauces. When you can, order extra lettuce and tomatoes.

Follow your instincts when it comes to sides and desserts. French fries, onion rings, and mashed potatoes and gravy are as bad as you may think, while carrot sticks and side salads with dressing on the side can be the answer. Similar, choose fresh fruit or yogurt instead of cookies, apple pie, and ice cream.

Try:

• Small burger or cheeseburger hold the bun if you are low-carbing it with apple slices or baby carrots.
• Grilled chicken salad with vinaigrette or light dressing and without croutons or noodles.
Grilled chicken with a fresh fruit cup.

Sandwich Shops and Cafes

You usually have quite the range of choices here, and can walk away with a diabetic disaster or a healthful meal. Sandwich shops and cafes often give you complete control over what goes into your meal, so take advantage. You have the right to ask for your order to exclude certain ingredients, even if they are listed on the item’s description on the menu. But do be careful with the amount of carbs per serving if you are following a low-carb diet.

Go for a salad or eat only half the bread in your sandwich, try for mustard instead of mayo, and look for more healthful proteins such as chicken or cheese instead of processed meats or meatballs. You may also have the chance to load up on vegetables to help you create a filling, low-calorie meal, and you can finish with some sweet but guilt-free fresh fruit.

Consider:

• A sandwich with vegetables and cheese or grilled chicken on whole-grain bread.
• A large salad with grilled chicken and dressing on the side, and with limited add-ons such as croutons, chow mein noodles, dried fruit, and bacon bits.
• Lentil or bean soup or a broth-based soup with vegetables instead of broccoli cheese or another creamy or cheesy soup.

Pass up the syrupy coffee beverages and sweet tea, and opt instead for unsweetened tea.

There may be more good news about pizza than you knew. Although it can be over-the-top in calories, saturated fat, and carbs if you get thick or stuffed-crust pizza, it can be a low-glycemic manageable treat if you stick to 1 or 2 slices of thin-crust pizza.

As for toppings, keep the cheese light – it adds calories and fat, but lowers the glycemic index. Skip the processed fatty meats such as pepperoni and sausage, and instead look for vegetables. You are also sure not to find a good dessert option for diabetes, since dessert pizza and cinnamon sticks are a combo of refined starches and sugars plus excess fats.

Good fast food choices for diabetes when eating pizza may include:

• Thin crust.
• Extra sauce.
• Extra tomatoes, bell peppers, mushrooms, onions, and any other vegetable toppings.
• Anchovies or chicken instead of pepperoni or sausage.

Skip the breadsticks, pasta, and chicken wings as sides, and opt for green salad instead.

Tips for Eating Fast Food with Diabetes

• Check the nutrition information before you go or while you are there – most chains are great at making their info available, especially if you ask for it.
• Plan your order ahead of time when you can. Even if you cannot, look for a lean protein such as grilled chicken plus a vegetable such as a salad.
• Go easy on the bread or skip it entirely, and ask for whole-grain when you can.
• Check for green salads and steamed or raw vegetables for your side dishes.
• Limit fried or starchy sides such as French fries, mashed potatoes, noodles and pasta, onion rings, and rice.
• Get dressing and sauces on the side, and look for lower-calorie condiments such as mustard, hot sauce, and salsa.
• The small size can easily have less than one-third the calories as the “large” size.
• Get baked, roasted, or grilled, and not fried, battered, or breaded.
• Keep your eyes open for opportunities to add vegetables as sides, as toppings on burgers, tacos, sandwiches, and pizza, and in stir-fry and entree salads.

Mexican

Eating fast food with diabetes can be disastrous if you choose wrong at a Mexican restaurant, but it can also be nutritious if you are careful. Grilled chicken and lean steak are rich in protein and low in fat, pinto and black beans are high in fiber and protein, and avocados (think: guacamole!) are among the healthiest possible sources of fat. Tacos can be good choices because they tend to be smaller than burritos and tostadas.

Just keep in mind that too much of anything can be bad for diabetes, blood sugar, and weight, and that Mexican fare tends to include plenty of problem ingredients, such as fried tortilla chips and tostada shells, oversized starchy tortillas, and overly generous amounts of unhealthy cooking fats.

Any of these options may help you come out ahead.

• Naked burrito or burrito bowl with grilled or salad vegetables, pinto beans, and chicken, and with no tortilla.
• Taco salad with lettuce, tomato, light cheese, pinto or black beans, avocado, and olives, with no sour cream or chips, and with salsa or pico de gallo instead of creamy dressing.
• Chicken or fish taco with lettuce, tomatoes, salsa, and avocado.
• Chicken shrimp, or steak fajitas without the tortillas.

Chinese and Other Asian Cuisines

Chinese and other Asian fast food choices for diabetes can be really good, or really bad. You are sure to spike your blood sugar and put a damper on weight loss if you have mounds of white rice, fried rice, or chow mein or pad thai noodles. The same is true if you get fried or breaded chicken, fish, or shrimp dishes.

On the other hand, you can almost always find dishes with plenty of vegetables and lean protein, such as skinless chicken, shrimp, tofu, or fish. Oyster sauce and wine sauce are lower in sugar than sweet and sour sauce. Teriyaki salmon and chicken are good options at Japanese restaurants. For dessert at a Chinese fast food joint, enjoy a fortune cookie for 30 worthwhile calories.

• Clear soup, such as hot and sour, egg drop, or tom yum, plus stir-fried vegetables and tofu or chicken.
• Stir-fry with chicken and vegetables, plus a fortune cookie.
• Fish in black bean sauce plus mixed vegetables.
• Teriyaki salmon, seaweed salad, and edamame.

When possible, ask for vegetables or brown rice instead of white or fried rice.

Beverages

Wherever you eat, your choice of beverage can make or break your meal. Water is always a great choice, since it is naturally calorie-free. Decaffeinated tea and coffee are also good options. While diet drinks are calorie-free, they can throw your body's blood sugar regulation further out of whack.

Steer clear of sugary beverages, such as regular soft drinks or other sugary fountain drinks such as sports drinks or lemonade. A large soda can have 400 or more calories and 100 or more grams of sugar – more than the daily recommended limit for four days! Blended coffee beverages and sweet tea are just as bad.

Most fast food places these days do have healthy choices. You may just need to look for them or special-order the regular menu items to make them healthier. With diabetes, you can eat convenient and great-tasting fast food while managing blood sugar and weight.

Separating the myths and facts of diabetes

Do you have diabetes or prediabetes?
If so, you may be getting a lot of messages about it. Some of those messages may be conflicting, and some may be difficult to believe. Which information is true, and which should you ignore? These are 7 myths about diabetes, and the truths behind them.

Myth 1: I will get diabetes if I am overweight.

ruth: Not everyone who is overweight gets diabetes, and not everyone who gets diabetes is overweight. Some people who are overweight are metabolically healthy. Physical activity levels, genetics, and whether or not you smoke affect diabetes risk, too. Age is also an important factor, since insulin sensitivity naturally decreases when you get older.

That said, extra weight is the most common risk factor for diabetes. Your risk of developing type 2 diabetes may be 7 times higher if your BMI is 25 to 29.9 (overweight) and by 20 times higher if your BMI falls into the class 1 obese (BMI 30 to 34.9) category compared to if your BMI is under 25 (normal weight).

Weight gain is another risk factor, with each extra kilogram (2.2 lbs.) you gain raising risk for diabetes by 49% over the next 10 years. As bad as that may sound, take heart: losing a kilogram lowers your risk by 33%!

Myth 2: Eating sugar causes diabetes.

Truth: Eating sugar does not cause diabetes, but it certainly increases your risk. Study after study links sugar consumption to diabetes, particularly added sugars, which have recently been called out on nutrition labels. The biggest culprits are sugar-sweetened beverages, such as fruit drinks, sodas, flavored coffees, and sports drinks. The reason why sugar leads to diabetes is because it tends to cause weight gain. Sugar may also lead to diabetes by impairing insulin sensitivity, but that is still debatable.

Note that added sugars, not natural sugars, cause these negative effects. The natural sugars in dairy products, such as milk and yogurt, are not linked to diabetes. Neither are the sugars in fruit. In fact, people who eat more fruit may have a lower chance of developing diabetes.

Myth 3: People with diabetes cannot eat carbohydrates.

Truth: Carbohydrates can be a healthy part of your diabetes diet. A few carbohydrates are actually necessary for life. Beyond that, you can choose a carb approach that works for you. Some people with diabetes follow a very low-carb ketogenic diet or a nearly-as-restrictive low-carb diet.

These diets exclude grains, most legumes, most fruits, sugary foods, and starchy vegetables. Low and very low-carb diets can lower A1C, but they have questionable long-term benefits. They are difficult to follow for long because they can get boring and do not allow for treats and special occasions. They may also pose threats to heart or kidney health.

A moderate carb approach that focuses on healthy carb sources can also work to control blood sugar. By including 1 to 3 small servings of high-carb foods, such as beans, fruit, or starches, at each meal and snack, you can keep your blood sugar levels more stable. Along with keeping portion sizes down, you can help by choosing nutritious sources of carbs, or sugars and starches.

So, a healthier diet for diabetes limits carbohydrates from added sugars and refined starches, but it should include whole grains and fruit. These are not only linked to weight loss and heart health, but also to better blood sugar control.

Myth 4: People with diabetes need to eat special foods.

Truth: A healthy diet can help people with diabetes control blood sugar better, but the foods do not need to be special. The same types of healthy eating plans that can help improve heart health and control weight can help lower blood sugar. You might choose to follow a Mediterranean-style diet, a DASH (Dietary Approaches to Stop Hypertension) eating pattern, or a general healthy diet based on increasing whole foods and limiting processed foods.

Most people do not need to use special diabetes diet products. Bars, shakes, and other meal replacement and snack options can be expensive and may not offer any benefits over healthy food choices. They can contain highly processed ingredients. Also, eating a bar or drinking a shake may not be as satisfying as eating an entire food-based meal, so these products can get in the way of weight loss in prediabetes or diabetes.

Myth 5: I would start to feel symptoms if I got prediabetes or diabetes.

Truth: Most people with prediabetes do not get symptoms. In fact, 90% of those with an A1C in the prediabetes range do not know that they have prediabetes. Symptoms of prediabetes could include a softening and darkening of the skin at the back of the neck and under the armpits.

If you have diabetes, you might not have any symptoms, or you may notice one or more of the following symptoms.

• Excessive thirst and urination.
• Increased hunger.
• Unexplained weight loss.
• Fatigue.
• Tingling or numbness in hands and feet.

Since it is impossible to know whether you have diabetes or prediabetes without a blood test, you are best off asking your doctor if you should get tested if you are concerned or if you are overweight, over age 45, or have a family history of diabetes or you had gestational diabetes when you were pregnant.

Myth 6: Everyone with prediabetes will get diabetes. Truth: About two out of three people with prediabetes develop type 2 diabetes eventually, but there is a good chance that you do not need to be among them! Research shows that while prediabetes develops into diabetes if you do nothing, you can dramatically lower your risk for developing diabetes with simple lifestyle changes.

Losing as little as 7 percent of your body weight – about 12 to 18 pounds for many people – can cut your risk of diabetes by over half, and each of the following changes can add to that effect.

• Increasing physical activity.
• Eating more leafy greens and whole grains.
• Eating less fried food and sugar.
• Drinking water instead of sugar-sweetened beverages.
• Avoiding tobacco.
• Getting adequate sleep.

Myth 7: Diabetes is no big deal.

Truth: Diabetes is a huge deal. The only thing about diabetes that is no big deal is that a lot of people have it. Other than that, diabetes takes a lot of time to manage, it is expensive, and it can lead to serious health problems.

Diabetes management requires a lot of time and effort on your part. People with diabetes may need to measure blood sugar one or more times every day. You may be on one or more prescription medications, including insulin that may need to be injected one or more times per day. You will need to attend medical checkups with a regular doctor and specialists such as a kidney and food doctor. Insulin is also expensive, and you can't skip doses.

Aside from the nuisance, and the cost of paying for medications and medical care, diabetes causes health concerns. Complications can include blindness, kidney disease, foot problems, and neuropathy. Diabetes also increases the risk for heart disease, kidney disease, stroke, and hypertension.

Bottom Line

You can do a lot to manage prediabetes and diabetes, but you may need some help. Lark DPP for diabetes prevention and Lark Diabetes for diabetes management, and is Fully CDC Recognized. Lark can make it easier to eat healthy, increase physical activity, and do what your doctor says if you need to take medications or monitor blood sugar. You can be in charge of your health with a personal 24/7 health coach in your pocket.