Managing Diabetes: Tips for Blood Sugar Control and Digestive Health - Internal Medicine

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Managing diabetes effectively requires a comprehensive approach that includes dietary modifications, regular physical activity, and consistent monitoring of blood sugar levels. Based on your current practices and questions, let's delve into your situation and provide some insights.

1. Blood Sugar Control: You mentioned that your post-meal blood sugar levels range from 150 to 170 mg/dL, which is commendable as you are keeping them below the 180 mg/dL threshold set by your doctor. This indicates that you are managing your blood sugar relatively well, especially considering your initial diagnosis of diabetes with a blood sugar level over 300 mg/dL. However, it is essential to understand that blood sugar levels can be influenced by various factors, including the type and amount of food consumed, physical activity, stress levels, and even hormonal changes.
The reason your blood sugar might still be high despite eating what seems to be a healthy diet could be due to the carbohydrate content in the foods you are consuming. Even healthy foods can contribute to blood sugar spikes if consumed in large quantities or if they are high in carbohydrates. For instance, oats and certain fruits, while nutritious, contain carbohydrates that can raise blood sugar levels. It might be beneficial to monitor the carbohydrate content of your meals more closely and consider portion sizes.

2. Evening Routine and Blood Sugar Levels: You mentioned consuming a quarter bowl of brown rice, two bowls of stir-fried vegetables, and a fruit serving for dinner, followed by a 40-minute walk. If your blood sugar is around 110 mg/dL after dinner, that is a good sign, indicating that your body is processing the food well. Regarding your concern about drinking low-fat milk before bed, if your blood sugar is stable at 110 mg/dL, you may not need to consume additional calories from milk unless you feel hungry. It’s important to listen to your body; if you feel satisfied and your blood sugar is stable, you can skip the milk. However, if you experience symptoms of low blood sugar (like dizziness or shakiness), it might be wise to have a small snack.

3. Digestive Health and Fiber Intake: You are consuming a high-fiber diet and drinking plenty of water, which are both excellent for digestive health. However, if you are still experiencing constipation, it could be due to several factors. Sometimes, increasing fiber intake too quickly can lead to digestive discomfort. It’s also essential to ensure that you are getting a balance of soluble and insoluble fiber. Foods like fruits, vegetables, and whole grains provide soluble fiber, which can help with digestion, while whole grains and nuts provide insoluble fiber, which adds bulk to stool.

The use of probiotics, like the "三X利" you mentioned, can also support gut health, but it’s crucial to find the right balance. If you feel that you are taking too many supplements or if they are causing discomfort, it might be worth consulting with a healthcare provider or a dietitian. They can help you determine the appropriate dosage and whether any adjustments are necessary.

In summary, you are on the right track with your dietary choices and lifestyle changes. Continue to monitor your blood sugar levels, adjust your carbohydrate intake as needed, and maintain your physical activity. If digestive issues persist, consider consulting a healthcare professional for personalized advice. Regular follow-ups with your healthcare provider will also help you stay on top of your diabetes management and make necessary adjustments to your treatment plan.