Ask the Expert: What can my mom do when her blood sugar readings have been very unstable?

“My mom is also a diabetic type 2 for over 30 years. Recently her sugar has been OK in the morning but out of control after noon—being over 200 or as low as 45 (once) even if she only eats vegetables. She takes medications for hypertension and water retention, plus vitamins, and calcium. My concern is the instability of the readings and how sick she has gotten from this. She lives in the Dominican Republic and comes to NY to see her doctors every 6 months. Anything you think we should know or do to help her with this problem?”

Without knowing the “diabetes medications” your mom is taking, I would say that your mom may need an adjustment in diabetes medication or possibly an adjustment in what she is eating for breakfast, or perhaps a change in exercise schedule for greater consistency in blood glucose levels. Certainly vegetables can raise blood sugar, but generally veggies don’t drastically increase a person’s blood sugar, unless they are eating “starchy” vegetables. The only vegetables with a significant amount of carbohydrate in them are winter squash, corn, peas and potatoes, each of which contains 15 grams of carbs per ½ cup cooked. Lima beans have 15 grams of carb in 2/3 cup. For the most part the rest of the vegetables (the “nonstarchy” veggies) have 5 grams of carb per ½ cup cooked or whole cup raw. This would include leafy greens, green beans, broccoli, carrots, cauliflower, cucumber, spinach, zucchini, and tomatoes.

Again, knowing the diabetes medications she takes would be helpful, but in general, it always helps for a diabetic person to have a schedule. Eating breakfast at the same time, exercising at the same time each day, avoiding really stressful incidents and eating the same amount of carb each day at each meal can be helpful. So can getting enough rest. If a person is ill their blood sugars generally get higher than they usually run. There will always be some variety in the blood glucose levels that we see, but it isn’t good for us to bounce from very low to very high. If she isn’t doing it already, see if you can talk your mom into writing down the carbs she is eating and the blood sugars she is seeing and then fax them to the educator she sees in New York. Perhaps they can make some adjustments in her medication or carb budget.