My patient changed his diet to low-carb, gave up junk and sugar: Why was his blood sugar still high?

Managing stress through relaxation techniques, walking, yoga, breathing exercises (pranayama), prayer, meditation, or even short breaks during the day can help bring sugar levels down.

Are you really eating right?

My patient was eating clean, making a conscious habit to do so. But he was also having many small meals throughout the day. This is known as grazing. Although you may think you are avoiding the consequences of three big meals a day, grazing results in overall higher calorie consumption, which leads to higher blood glucose levels. Also, low-carb and low-sugar foods make you forget portion control, thinking you can eat more healthy food. Foods may be low-calorie, but too much of them can still affect your blood sugar levels. Be it millets, oats, whole grains, these will still break down into glucose when you have large portions or their refined versions in store-bought packets. Dried fruits and legumes should be had in moderation too.

What kind of exercise are you doing?

My patient admitted that he did some walking but not regularly. Just eating healthy without enough physical activity may not be sufficient. The muscles need to use glucose for energy. For example, a 30–45-minute brisk walk most days of the week can significantly improve blood sugar control. Irregular or very light activity may not give the desired effect. Most importantly, you need to do strength training at least thrice a week to build muscle mass. When you lift weights or do other resistance exercises, you increase muscle size, which allows your body to process glucose more efficiently and decreases its need for insulin. The beneficial effects tend to last longer than aerobic exercises.

Are you sleeping enough?

My patient’s sleep was another factor. “I sleep late and wake up tired,” he told me. Poor or insufficient sleep increases insulin resistance, which means your body does not use insulin effectively. This can raise fasting and post-meal blood sugar levels. Ideally, you should aim for six to eight hours of quality sleep every night. It’s also important that you get to bed early, preferably before 11 pm.

Think of blood sugar control as a combination of a healthy diet, regular exercise, stress management, good sleep, and proper medication adherence. We need to address all these areas together. With consistency, you will definitely see improvement.

(Dr Mohan is Chairman, Dr Mohan’s Diabetes Specialities Centre, Chennai)