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Kos Diabetes Group: Skipping Meals [1]

['This Content Is Not Subject To Review Daily Kos Staff Prior To Publication.']

Date: 2023-06-23

For most people skipping a meal is typically no big deal. But if you’re a person with diabetes, skipping meals could lead to dangerous blood sugar swings, as well as potential complications down the road. Even an occasional missed meal can throw off the balance between food intake and certain diabetes medications resulting in blood sugars that are too low (hypoglycemia) or too high (hyperglycemia) — and that can be dangerous.

Do you know how many pictures I looked at trying to find a breakfast that wasn’t all carbs?

It is especially important not to skip breakfast because the body is “breaking the fast” from the night before. When your body is in the fasting mode, maybe due to sleep, or because you are skipping a meal, the body looks for a source of energy, since you are not consuming any food. Your liver will go into action and start releasing glucose into your bloodstream. However, when people who suffer from Type 2 diabetes skip meals, the liver does not realize that there is already a significant amount of sugar in the blood and keeps releasing more of it, to provide for the energy requirements of the body causing your glucose level to go up even though you didn’t eat so don't skip a meal in an attempt to lower high blood sugar.

Skipping a meal entirely definitely does not work to reduce blood sugar levels, but eating a meal including foods with a small carbohydrate content can trick the body into believing that you are providing a source of energy to it, and the liver does not need to send glucose into the bloodstream.

Fueling our body with at least three meals a day is beneficial not only for diabetes management, but also for weight management. An eating approach that involves consuming a consistent amount of carbohydrates — which break down into glucose at regular intervals throughout the day — can help prevent blood glucose spikes and improve the effectiveness of prescribed medication in people with diabetes. Skipping meals can result in poorly controlled blood glucose. Eating at regular intervals ensures that carbohydrates are spaced throughout the day, which translates to better overall blood glucose control.

I’ve had days where I felt just like this. Everything took energy I just didn’t have

When we don’t nourish our bodies appropriately, our cells don’t get the energy they need to function, thereby zapping our energy stores. Although anybody can experience a feeling of crashing after skipping meals, people with diabetes — especially those on insulin or blood sugar–lowering medication — can suffer dangerous dips in blood sugar during these crashes.

The brain uses glucose as fuel, so skipping meals means depriving your brain of the food it needs to concentrate and perform mental tasks. Eating breakfast not only fuels thinking and mental acuity in the morning, but also helps with blood sugar management. In a study published in January 2017 in the journal BMC Public Health, researchers found that white-collar workers without diabetes who ate a quality breakfast significantly improved their short-term cognitive functioning compared with those who didn’t eat breakfast or ate a poor-quality one. Nobody wants to feel foggy, but this is especially important to people with diabetes who need a clear head to manage their disease effectively.

Skipping breakfast—going without that morning meal can increase blood sugar after both lunch and dinner. Daniela Jakubowicz, M.D. a professor in the diabetes unit at the E. Wolfson Medical Center, Tel Aviv University and Tel Aviv Medical Center, Israel, conducted a study of the effects of breakfast on Type 2 diabetics. In that study, the omission of breakfast was associated with a significant increase in all-day blood sugar spikes. Put another way, on a day when the men and women in the study skipped breakfast, lunchtime blood sugar levels were 37% higher than on the days they ate breakfast, and they were 27% higher at dinner time. Reducing the amount of starch and sugars in lunch and dinner in attempts to better control blood sugar seemed to have no effect on reducing elevated glucose levels if diabetic individuals skipped breakfast.

In another study of individuals with Type 2 diabetes, skipping breakfast was associated with an almost 11% increase in HbA1c. Scheduling higher energy intake in the mornings, as compared with evenings, led to overall reduced glucose excursions throughout the day in Type 2 diabetes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6934661/ .

We’ve all had the feeling of being angry due to hunger — sometimes called “hangry” — that can lead us to feeling irritated, making impulsive food choices, and even isolating ourselves from our loved ones. But being hungry because of a skipped meal can also make us feel tired. To fight off fatigue, eat meals based on lean protein, such as grilled skinless chicken breast, salmon, or a lean cut of steak, paired with two different kinds of non-starchy vegetables, like asparagus and zucchini, or sautéed broccoli and cauliflower. It will help you to feel full without indulging in too many carbohydrates.

Not enough time or not hungry enough for a full meal? Eat something small, like a non-meal “meal” if time is tight or you’re not feeling that hungry. Try some Greek yogurt with fresh berries or other fresh fruit paired with another protein like a hard-boiled egg, lean turkey, or about 20 almonds. Skip any yogurt mix-ins, especially if they contain candy pieces because they may lead to cravings later.

Skipping a meal early in the day because you don’t feel hungry often means that hunger appears with vengeance later in the day, leading to overeating and a subsequent blood sugar spike because your body is literally fighting for what it missed. In fact, a study published in October 2009 in the European Journal of Neuroscience showed that your brain is primed to seek out high-calorie foods when it’s been starved.

Maintaining a healthy weight is essential for managing diabetes. Skipping meals is one of the worst things you can do when it comes to weight management, especially if you have diabetes. Skipping meals can lead to poor food choices at the next meal. Oftentimes, when we skip a meal, we become so hungry that at the next opportunity to eat we eat the wrong foods and too much of them.

Skipping meals to save calories sets the body up for fluctuations in insulin and glucose levels that ultimately puts weight on instead of helping you take it off. If you skip meals often enough, your body may become less adept at regulating your feelings of hunger and fullness and can also lead to nutritional deficiencies, muscle loss and worst of all, hormonal imbalances. The body perceives the lack of food as a sign of stress and so it releases stored energy to help you go on with the day. But if that energy does not match up to the physical activity that your body requires, that released energy, gets stored back as fat along with the added food that has been consumed throughout the day. This back and forth of energy going up and down due to stress and skipping meals leads to insulin resistance among other hormonal imbalances. It causes stubborn weight gain around the abdomen and lower abdomen area, energy fluctuations and mood swings.

Dysregulation of the stress hormone cortisol is another common hormonal side effect. Ideally, it should be at its highest level when you wake up in the morning and should gradually go down by the time you hit the bed. But, when a person has imbalanced cortisol levels, these timings go haywire and it leads to people waking up groggy; having a burst of energy in the evenings and struggling to fall asleep.

Skipping meals is not the solution to weight loss or blood sugar control. If you have diabetes and are trying to lose weight, the key to successful weight loss and blood sugar control is to eat regular meals rich in fruits, vegetables, healthy carbohydrates, fiber, and lean protein. Aim to eat breakfast, lunch, dinner, and nourishing snacks daily, and spread your carbohydrate servings throughout the day.

When you don’t eat regularly, your metabolic rate will slow down as your body conserves energy and stores fat. Skipping meals and binge eating afterwards will disrupt your insulin response. If you cannot avoid skipping meals because of your work or other responsibilities, keep snacks handy in the car, your desk or purse to avoid hunger that can raise blood sugar levels.

Regular exercise is a big part of maintaining good glucose levels. Glucose feeds your cells when you exercise, but without fuel from food, the body begins burning fats to create glucose, causing acids called ketones to accumulate in the body. Your muscles may experience fatigue during physical activity simply because your body has run out of energy from its usual energy source. You can avoid this by having a small snack before exercising like a banana or you can plan your workout for about 60 minutes after a meal to help keep your blood sugar stable, have good energy, and not have to add extra food into the day just for the workout.

Diabetes medication is typically dosed twice a day, and not eating a meal when taking medication can cause an imbalance of its effects. To ensure your medication works as intended, follow the directions on the label closely, and make sure to take it with food when instructed.

If you take diabetes medication that is meant to help lower your blood glucose levels, but you don't fuel your body with carbohydrates to provide that glucose, you may become hypoglycemic which can cause dizziness, shaking, blurred vision, headache, confusion, and nausea. If left untreated, hypoglycemia can be life-threatening, Hypoglycemia (blood sugar levels below 70mg/dL) must be treated with 15g of a fast-acting carbohydrate to bring blood sugars to a safe level. Frequent bouts of low blood sugar are dangerous and can cause weight gain as you consume foods to correct the hypoglycemia.

How an individual with diabetes should time their meals will vary and depend on their body’s needs, their blood glucose patterns, the type of medication they’re taking, and other factors.

Meal timing needs to be customized based on an individual’s age, their stage in life, their occupation, their living situation, their work hours, their medication, activity level and so on. All of those will impact how a person should best optimize their nutritional intake. Skipping meals and lack of meal structure can throw off the balance between food intake and medication. Talk to your doctor or another member of your diabetes care team if you feel you need help with the timing of meals and snacks.

Please be aware that we are currently dealing with an issue that is causing our basement to flood. I will stop in when I’m able to check comments.

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[1] Url: https://www.dailykos.com/stories/2023/6/23/2176806/-Kos-Diabetes-Group-Skipping-Meals

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