By Michelle May, MD and Megrette Fletcher, M.Ed., RD., CDCES authors of Eat What You Love, Love What You Eat with Diabetes
Do you know what your blood sugar range should be? If you are not sure, ask your health care provider to establish a target range for your blood sugar. One size does not fit all, however the American Diabetes Association has established a target blood sugar of 70-130 mg/dL before meals and 180mg/dL or below after 
eating. As you know, having elevated blood-sugar levels increases your risk for kidney disease, retinopathy, and neuropathy, and plays a role in heart disease, delayed healing, and infection. It can also cause you to feel fatigued.
How Mindful Eating Can Help
Be curious, not critical, if your blood sugar is above this target. The causes of high blood sugar can often be traced back to changes in eating, physical activity, and medication. In addition, an injury, illness, infection, or stress can cause a sudden increase in blood sugar. More gradual changes may be from increasing insulin resistance, decreasing insulin production, and age-related changes.
Changes in eating. When your blood sugar is too high, the mindful eating cycle provides clues to possible causes, as you learned in “Don’t Miss the Lesson” in chapter 17.
Over treatment of hypoglycemia. Hypoglycemia can be an unpleasant experience, so you might be tempted to over treat it by eating until you feel better. But overeating doesn’t raise your blood sugar faster than eating 15 grams of carbohydrates or taking four glucose tabs, and it can raise your blood sugar higher than it needs to go.
Changes in physical activity. Less physical activity than normal can lead to a higher blood sugar than normal, as Mac discovered:
“My blood sugar was high when I woke up this morning. Then I remembered that I’d skipped my walk after work because it was raining. I looked through my blood sugar log and realized what a difference exercise makes.”
Changes in medication. Another possible cause of high blood sugar to consider is a missed dose or other changes to your medication.
Illness. Having a cold or flu is a stress on the body that can cause the blood sugar to rise. Additionally, being sick can change activity and eating patterns.
Medication side effects. Some over-the-counter and prescribed medications are known to raise your blood sugar, including cough syrup, certain antidepressants, inhalers, steroids (such as those taken for a flare-up of asthma or injections in your joints), and others. Make sure that all of your health care providers (including your pharmacist) are aware that you have diabetes.
Progression of diabetes. Diabetes is not a static disease; in other words, you can expect it to change over time. Keeping track of your blood sugar can help you notice these changes, giving you the information you need to make the necessary adjustments to your diabetes plan, so you can experience optimal health.