Recently, I was talking with a 45-year-old friend who was feeling tired and sluggish. He had some concerns about his blood sugar. I have a daughter who is diabetic so I gave him a meter and test strips and told him to check his blood sugar fasting in the morning. After the first several tests, his numbers presented high, 120 mg/dl [6.7 mmol/L] to 136 mg/dl [7.6 mmol/L]. He immediately changed his diet and went on a Phase 1 Atkins Induction diet and has maintained a No/Low carbohydrate diet for approximately six weeks. He has at least one drink at night consisting of a clear alcohol such as vodka mixed with diet soda or tonic. Although he has had one good number (100 mg/dl [5.6 mmol/L]), his overall numbers continue to remain 100 mg/dl [5.6 mmol/L] to 118 mg/dl [6.6 mmol/L] fasting, with an average of 113 mg/dl [6.3 mmol/L] over the last 14 days. He travels often and gets little exercise. He does enjoy swimming and will go as often as possible. Would alcoholic drinks contribute to the high numbers? What can he do to bring down these numbers? Why, after eating little to no carbohydrates, won’t the numbers come down further?

It is important to realize that the capillary blood sugar measurements, although good for following blood sugars with therapy, are not a substitute for having a blood draw fasting glucose level from a clinical laboratory under the supervision of a physician. Remember that fasting glucose values between 100 mg/dl [5.6 mmol/L] and 125 mg/dl [6.9 mmol/L] are consistent with what is referred to as impaired fasting glucose and represent a form of pre-diabetes. When a person falls in this range, it is time to take action to prevent diabetes. In addition to having these values confirmed in the clinical laboratory, it is important that your friend understand the benefits and implement lifestyle changes. These include additional exercise, weight loss, and alcohol moderation. Alcohol, when it is limited to one drink per day may not have much of an impact to directly cause glucose elevations. However, there is a slippery slope there. One sometimes becomes more than one and that is not necessarily good. There is an indirect effect of the alcohol intake in that it contributes nutritionally empty calories to a person’s daily calorie load and me be a source for eliminating calories as part of a more generalized attempt to lose weight.

With regard to the post-meal blood sugar, please note that everyone, whether they have diabetes or not, has a rise in blood sugars after meals. People with diabetes have higher glucose excursions and remain higher longer than those without diabetes. Make sure that the glucose levels being experienced are indeed higher than desired. If they are extremely high, I would recommend an oral glucose tolerance test for the diagnosis of type 2 diabetes.

JTL