Happy Saturday! With the weekend comes your chance to Ask D'Mine! — through our weekly advice column, hosted by veteran type 1, diabetes author and community educator Wil Dubois. This week, Wil responds to reader questions about lowering your @#$! blood sugar without insulin, and about the real value of the Glycemic Index.

{Got your own questions? Email us at AskDMine@diabetesmine.com}


Bill from Indiana, type 2, asks:  Is there a fast way to lower your blood sugar without insulin? I have type 2 and take pills, but at times my blood sugar gets real high.

Wil@Ask D'Mine answers: Fast? Yes. Reliable? Not so much. First, ask your doctor if more pills are right for you. No kidding. Depending on what kind and amount of pills you take, you might be able to safely take an extra one to lower an every-now-and-again high blood sugar.

For instance, the sulfonylurea class of meds stimulate the pancreas to produce more insulin. If you don't already take the maximum dosage, and if you use one of the shorter-acting varieties, you might be able to pop an extra one to cover a dietary indiscretion. On the other hand, pills like metformin, which act mainly on the liver's production of glucose, are unlikely to be of any help at all for a post-banana-split slip up.

Failing pills, there's always the good ol' fashioned last resort — not cod liver oil — but exercise. Anatomical fact: muscles in action require more glucose than muscles lounging on the couch in front of the TV. Exercise can actually vacuum up extra glucose from your blood stream. Yep, moving those muscles burns it off. No kidding.

So move your body in any direction to move the numbers on your meter downward.

But why so quick to rule out insulin?

Did you know that you don't have to be "on" insulin to use it? I noticed you said that "at times" your blood sugar gets "real high." I'll take that to mean the rest of the time it's OK. If extra pills and extra exercise don't cut the mustard, you could talk to your doc about PRN use of insulin. PRN is nursing and doc shorthand for the Latin phrase pro re nata, which translates roughly to "as the circumstance arises." It's used in modern medicine to mean, "take this med only when you need it." Common PRN meds would be painkillers, which you would only presumably take when you're in pain; and allergy meds, which you only take when your nose is running, your eyes are watering or you're sneezing your head off.

So you can always talk to your doc about keeping a pen of fast-acting insulin around to use PRN. You could view it as your break glass in case of emergency therapy. Pens are pre-filled, portable, discrete, and ever-so-easy to use. Oh, and the needle? About the size of a human eyelash nowadays. I promise you, an insulin shot doesn't hurt at all.

Don't you think an every-now-and-again shot of insulin is better for your health than an every-now-and-again high blood sugar?


Nancy from Utah, type 1, asks: What can you tell me about the Glycemic Index?  

Wil@Ask D'Mine answers: To hear some people tell it, the Glycemic Index (GI) is indeed the Holy Grail of diabetes control.  The theory states that every food on God's green Earth affects blood sugar in a different and unique way, independent of its simple carb count. (Amy wrote about the GI here.) Any of you who have painstakingly counted your carbs and "properly" bolused insulin for the food, only to watch your blood sugar crash and burn, have long suspected this to be true.

The idea behind not all carbs are created equal was initially postulated by Dr. David Jenkins and his colleagues in Toronto in the early '80s, during his team's research into what the best "diabetes diet" might be.

Since then dozens of researchers have set out to map the glycemic impact of everything on the grocery shelves and in gardens of the world. So the "science" of glycemic indexing seeks to discover exactly how much of a blood sugar impact various foods really have; and to create master a list, or "glycemic genome" of the food chain.

Sugar itself has a GI value of 100. Presumably, water has a GI value of zero. All other foods fall in between. Generally speaking, foods that break down quickly in your digestive system have higher GI values, as they'll raise your blood sugar more rapidly than foods that break down more slowly. So the higher the GI number, the more the food will kick your ass, blood sugar wise; and therefore should be avoided, moderated, or more highly medicated — according to the proponents of the glycemic index.

For instance, macaroni and cheese has a GI value of 64, and carrots have a GI value of 39.

Or do they?

Because just whose mac and cheese are we talking about? The Blue Box stuff or Stouffers? What if you make it from scratch? And the carrots? Guess what? Not all carrots are created equal. Different varieties have different GI values. How they are prepared changes the number. How they are stored changes number too. Hell, where they are grown can change the GI number. Oh. And did I mention that the glycemic response to any one food varies from person to person?

Is this system frickin' hopeless? In a word: Yes.

But that hasn't prevented South Beach, NutriSystem, and a host of others from building fad diets on this shaky foundation.

If we could have GI meters that could sniff a food, and magically give us the value of the food on our plate, we could use the numbers to guide us in how to match our foods to our medicines. But frankly, with today's technology, the carb count of a food is just as useful, and more readily available, than its GI value.

Personally, I wouldn't waste my time.



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.