Over the years, I have had many exercisers with diabetes ask me why they’re gaining weight instead of losing it. There are two possible answers to that question. One answer, which is more applicable to new exercisers, is that muscle weighs more than fat (for an equivalent amount). Consequently, if you are gaining muscle while losing some fat weight due to your new exercise regimen, then your scale weight is likely not reflective of the positive changes in your body composition (i.e., less fat, more muscle).
The second possible answer is more applicable to people who are not new to exercise, especially anyone who may have recently changed the amount or intensity of training that they’re doing. I first ask them, “Have you been treating a lot of low blood sugars recently?” When they invariably reply, “Yes,” then I know to tell them that they have simply been taking in too many extra calories while treating hypoglycemia.
Of course, you have to treat a low if you have one! However, every calorie counts, even the ones that boost your blood sugar back to normal (and beyond). People with diabetes often reach for candy, cola, juice—or other high calorie, high fat, and high sodium foods—to correct lows, which can lead to rebound high blood sugars, unhealthy eating, and weight gain. What you use to correct a low is often just extra calories not accounted for in your daily meal plan.
What can you do to avoid gaining weight when you have to treat frequent lows? The best advice is to treat them with something low in calories, but with enough glucose to bring your sugars back to normal. When you have a hypoglycemic reaction, do not binge on candy bars, cookies, and other high calorie, high fat foods. These “treats” take longer to raise your blood sugar than pure glucose and usually contain calories (like ones from fat) that do not raise blood sugar levels effectively. You are almost certain to eat too much of them waiting for your blood sugar to rise and consume unnecessary extra calories that will cause weight gain—and excess weight gain can lower the ability of your insulin to keep blood sugars in check. You can also end up with rebound hyperglycemia, which may increase your insulin needs and promote fat storage.
I’m going to sound like a walking advertisement for glucose products from here on out, but I fully understand from both professional and personal experience how critical making smart choices is when you want to keep exercising regularly and avoid weight gain. Using fast-acting glucose to raise your blood sugars is likely to contribute the fewest extra calories. Why? Pure glucose contains only 4 calories per gram, so a 15-20 gram treatment has 60-80 calories, and every single calorie goes directly to rapidly correcting your blood sugar levels.
Hypothetically speaking, if you’re correcting just two lows per week with 15 grams of carbs, you will take in an extra 6,240 calories a year, or the equivalent of almost 2 pounds of body fat (one pound of fat is 3,500 calories). By way of comparison, getting 15 grams of carbs from other foods usually results in your consumption of way more calories, especially if any of the foods contain calories coming from fat (9 calories per gram) or protein (4 calories per gram), neither of which will rapidly correct a low blood sugar.
Here are just a few other food comparisons:
- A 2-ounce bag of Skittles candy contains almost 60 grams of carbohydrate and four times the calories of a 15-gram glucose dose. Likewise, just one ounce of Smarties contain 25 grams, which if you consumed them all would probably raise your blood sugar too much and cause you to take in extra calories.
- A candy bar like Snickers contains about 100 extra calories for every 15 grams of carbs. Correcting lows with Snickers or other candy bars adds another 3-pound weight gain a year.
- A regular soda that contains high-fructose corn syrup may take longer to correct a low (fructose has to be converted into glucose first), and it’s easy to consume more than 15 grams—which is the amount in only 4 ounces of a soda (one third of a 12-ounce can).
- Even choosing orange juice or a banana to correct a low is less effective because the fructose (fruit sugar) is much more slowly converted into glucose. You probably won’t be able to stick to only 4 ounces of juice or half of a medium banana (15 grams of carbs) while you wait for your low to be corrected, and end up consuming more calories than necessary.
Check out some calorie intake comparisons using Dex4’s new Hypo Smart Choice Calculator, at http://dex4.com/smartchoice. You’ll likely be surprised how many extra calories you may be consuming just treating low blood sugars with the usual things like orange juice and soda!
There is nothing worse than exercising and trying to lose weight, but ending up gaining some instead due to all the extra calories you eat to correct low blood sugars. If you can prevent lows with diet and medication changes before, during, and after exercise and avoid taking in those extra calories in the first place, certainly do that! But when you do have to treat an occasional low, keep in mind that using food rather than pure glucose can add a lot of calories to your total yearly intake and your lows may take longer to correct.
In short, pure glucose is always best for rapid treatment of lows, although pure sucrose (table sugar, as found in hard candies) is second best. For prevention of lows during longer bouts of exercise or overnight, however, consider taking in a low-calorie bedtime snack with a balance of carbs, protein, and fat that will keep your blood sugars stable for longer. Some examples are Balance bars, low-fat and reduced sugar yogurt, or low-calorie ice cream. An ounce of prevention is always worth a pound of cure, especially if a hypoglycemic episode leads you to eat everything in sight!