Got questions about navigating life with diabetes? Ask D'Mine! Our weekly advice column, that is — hosted by veteran type 1, diabetes author and educator Wil Dubois. This week, we're talking about the importance of following a blood test routine and what different nut butters might do to your blood sugars. You know we love y'all, so go on, keep reading... we're not just buttering you up!

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Debbie, type 2 from Arkansas, writes: How important is it to test and eat at the same times every day? Especially my fasting test, I never seem to get to it at the same time. I babysit my grandson 5 days a week and homeschool the 2 grandkids I'm raising, so I get to it when I get to it.

Wil@Ask D'Mine answers: It depends... on your therapy, meds and what you're trying to accomplish by testing. Let's start with that fasting test, as that's where you start your day. This is low tide for most people, the foundation on which everything else is built. In theory, it should stay stable until you start eating, so it really doesn't matter if you check it when the sun rises or three hours later.

I say in theory because the real world has the nasty habit of getting in the way. Even if you don't eat, activity lowers blood sugar. If you're up and active chasing that little grandson of yours, it'll lower your blood sugar. Does it matter? Maybe. Maybe not. At a minimum, it'll give you a false sense of what your true fasting blood sugar is — which may or may not matter anyway. If you're treating your diabetes with diet and exercise, it probably doesn't make that big a difference. If you're on an insulin pump and trying to nail down your overnight basal rates, checking at a different time every morning will make your task impossible.

What about the meals? Well, if you take a pill like Glipizide that squeezes your pancreas like a sponge to ring out as much insulin as possible, and you skip a meal, you could go low. So in that case, erratic meals could be an issue for you. But if you take a med like Victoza, which is time-released, doesn't cause lows, and works whenever meals happen—there's no risk. So in that case, erratic mealtimes really wouldn't be an issue for you.

But all of that misses the point, in my book. Uh, my metaphorical book that is. I don't think I've written a book about this subject yet. Let me share my personal philosophy of diabetes treatment with you. (Warning! Radical approach to medicine alert: The following is an anti-establishment viewpoint.) I believe that a person's diabetes therapy should fit the lifestyle of that person, and that the he or she shouldn't have to change their lifestyle to suit the therapy. And that's the philosophy I use when designing treatment plans for patients at our clinic.

We've got lots of ways to treat diabetes, especially type 2 diabetes like yours. If you live La Vida Loca with a crazy-ass, unpredictable schedule, then you need a therapy designed to accommodate that.

In short, the therapy should serve the grandma; the grandma shouldn't have to serve the therapy.


Ben, type 2, from Pennsylvania, writes: I love nut butters, but they seem to be bad for my sugar levels. I asked my doc if I needed to eliminate them completely. His suggestion was that I try eating them with whole grain bread, to slow the absorption of sugars into my bloodstream. I'm also looking into cashew butter instead of peanut butter, for more nutritional value. Do you have any suggestions there?

Wil@Ask D'Mine answers: Personally, my favorite butter is a Butterfinger, but they really frack up my blood sugar big-time. The type of nut butters you're talking about really don't have that much sugar in them and are packed with fat as it is, so there's plenty already goin' on to slow down the absorption of sugar.

According to my Calorie King App, an average peanut butter (chunky or smooth) has 3.5 carbs per tablespoon and 8 grams of fat. That should give it a pretty low glycemic index. But to double-check, I looked it up and found that peanut butter ranks well in most people's lists of low-impact foods. That means it's unlikely to kick you in your glucometer.

In the interest of good science, I double-checked both almond butter and cashew butter for you. On paper, they're both very similar to peanut butter in terms of nutrition and blood sugar impact. Almond butter has 3.4 carbs with 9.5 grams of fat and cashew butter clocks in with 4.4 carbs and 7.9 grams of fat.  All three are around 100 calories, more or less, per tablespoon. Frankly, the only real difference that I can see would be the taste.

I think your doc is on the right path. The problem isn't the nut butter, unless you're eating an entire jar in one sitting, and changing to another nut isn't going to help you. I think the problem is what you are putting the nut butter on, and I don't think whole grain bread is going to help. Whole grain is "better" for you than Wonder Bread, for sure, but bread made from wheat is on the other end of the glycemic index from your beloved nut butters. I think it's the bread, not the butter, that's giving you problems.

You need to find something else to put your nut butter on that will have less of an impact on your diabetes.

Ben, meet celery. Celery, meet Ben.

No, really. I'm serious. Celery is highly under-rated. I 'll admit, by itself it's none too exciting. But it's firm, crunchy, has a nice little trough running down the middle that's perfect for holding any kind of nut butter, and has a mild flavor that doesn't compete with anything. As an added bonus, it's so low in calories you can actually lose weight eating it, as it takes more calories to chew it than it contains. Of course, slathering it with a 100-caloire per tablespoon nut butter eliminates that effect.

But the benefit of using celery over bread is that, calorie-wise, you can eat more of what you love (the nut butter), without getting fat, because you've dropped the bread calories.

There are other options you can look at, too. For many people, a growing range of gluten-free products has significantly lower real-world impact on blood sugars. Black rice bread is popular with my health-nut peers at the clinic. (But you have to read the labels, because some of this stuff is made with potato flour, which is NOT low-carb.)

When I visited my sister recently, she made me a sandwich... come to think of it... it was almond butter and jelly... on gluten-free bread. It tasted great and my blood sugar flat-lined. And I'm the guy who gets a 150-point excursion from a single Zesta cracker.

And one last thing, Ben. You can double your nuts, so to speak, by putting your butter on an almond cracker.

And that's all this nut has to say about butters and blood sugars.

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.