Diabetes Is A Balancing Act

By Joy Pape, RN, BSN, CDE, WOCN

Your blood glucose level can change because of many things, such as the foods you eat, your activity level and the diabetes medicines you take. It’s a balancing act you can master when you learn to juggle these three things.


Many foods cause blood glucose to rise. Some will cause your glucose level to rise more than others. For the most part, the foods you eat are made up of carbohydrates, proteins and fats.

➧ Carbs

Carbohydrate-based foods have the greatest effect on blood glucose levels. But many are good for you, so don’t stop eating carbohydrates altogether. Choose healthy ones, such as vegetables, fruits, beans, low-fat milk and yogurt and wholegrain products. Eat the amount that fits into your diabetes meal plan.

➧ Protein

Protein foods don’t cause blood glucose levels to rise as much as carbohydrates, but you need to balance your portions of these foods too. Some healthy protein foods are fish, lean meats, eggs, low-fat cheese and soy. How much should you eat? A good rule of thumb is for the protein part of your meal to be about the size of the palm of your hand.

➧ Fat

Fat alone won’t cause your blood glucose to rise, but fats have the most calories. Eating too much fat can cause you to gain weight and may raise your cholesterol (lipids). Also, there are healthy and less-healthy fats. Some healthy fats are nuts, oils (such as olive oil) and nut butters like peanut and almond butter. Fatty fish like salmon, sardines and mackerel are also good sources. For nuts, an ounce makes up a serving size. That is about 20 almonds or about 14 walnut halves.

To find out how many carbohydrates, proteins and fats are in a food, read the label, look in a food counter book or search the Internet. To see how eating a certain food or meal affects your blood glucose, check your blood right before you eat then two hours after you take your first bite.


The medicines you take to lower your blood glucose work in different ways. Some help your body use the insulin it makes. Some slow down the amount of sugar your liver produces. Some show how quickly your food is absorbed and others push the pancreas to produce more insulin (if the beta cells of your pancreas are still able to do so).

Insulin helps glucose enter the cells of the body. If your physical activity is not balanced with the insulin or medicines you take to push the pancreas to make more insulin, your blood glucose level may drop too low. This may happen if you eat less than normal, skip a meal or are more active than usual. Talk with your health care provider and your pharmacist about the medicine you use. Ask what it does, when and how to take it and if it can cause you to have low blood glucose. Check your blood glucose often to see how you respond to your medicine.


Physical activity or exercise can lower your blood glucose level. It may be as powerful as some diabetes medicines. You may notice that on the days you are more active, your blood glucose is lower. Physical activity can lower your glucose level right away or after you finish your activity. This effect can last up to 72 hours.

If you take medicines that lower your blood glucose, don’t exercise if your blood glucose is too low, as your activity may drop your glucose level even more. Find out how physical activity affects your blood glucose by checking it before you exercise, then several times during the next 24 hours.


To find out how all you do works together, keep records of what you do and when you do it, along with your blood glucose levels. Note the foods you eat, the physical activities you do and the medicines you take. This will help you get the information you need to become an expert diabetes juggler.


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Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and www.NutritionStarringYOU.com. Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded NutritionBabes.com, a popular Health and Wellness website in 2009. NutritionBabes.com was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

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Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

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Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of DiabetesDigest.com, does not provide medical advice, diagnosis or treatment. See additional information.