Diabetes Diet No-No: 6 Things That Happen When You Skip Meals

Skipping meals isn’t the best diet plan for anyone, but for people with diabetes, skipping a meal can lead to immediately dangerous blood sugar swings, as well as potential complications down the road.

“An eating approach that involves consuming a consistent amount of carbohydrates — which break down into glucose or blood sugar at regular intervals throughout the day — can help prevent blood glucose spikes and improve the effectiveness of prescribed medication in people with diabetes,” says Andrea Goergen, RD, a health coach at Cultivate Healthy, a nutrition consultancy practice in Washington, DC.

To better manage your blood sugar and help avoid complications, be sure to eat regularly. If you don’t, one of the following six issues may arise.

At some time or another, we’ve all been too busy, too stressed, or too tired, and ended up skipping a meal. But skipping meals may increase your chances of binging on food that aren't good for diabetes. “If you skip meals, you'll be hungrier and more vulnerable to eating foods that are particularly calorie-dense, and you'll be in a hurry to get food, so anything that requires cooking or extra effort won't be very appealing,” says Adina Pearson, RD, who specializes in diabetes at Walla Walla Clinic in Washington state.

Resist skipping meals even if you have to eat something small, like a non-meal “meal” pieced together when time is tight. “My go-to choice for keeping blood sugar down is a Greek, whole-milk, plain yogurt in the large container,” says Julie Stefanski, RDN, CDE, at Leg Up Farm, a nonprofit therapy center in Mount Wolf, Pennsylvania. Scoop a cup of yogurt on top of fruit, such as berries, and give it a squirt of vanilla-flavored liquid Stevia. Pair with another protein, such as a hard-boiled egg, lean turkey stick, or 20 almonds. To keep cravings down later, skip any yogurt mix-ins, especially if they contain candy pieces.

We all know the feeling of being angry due to hunger — sometimes called “hangry” — that can lead us to feel irritated, make impulsive food choices, and even isolate ourselves from our loved ones. But being hungry can also make us feel tired, Goergen says.

When we don’t nourish our bodies appropriately, our cells don’t get the energy they need to function, thereby zapping our energy stores, she explains. 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, Pearson says. Managing blood sugar is key for avoiding diabetes-related complications down the road.

To fight off fatigue, don’t skip meals, and fuel up with a healthy snack when needed. “Having a meal based on lean protein, such as grilled skinless chicken breast, salmon, or a lean cut of steak, paired with two different kinds of nonstarchy vegetables, like asparagus and zucchini, or sautéed broccoli and cauliflower, is a good way to feel full without indulging in too many carbohydrates,” says Stefanski. Carbohydrate-heavy foods with refined grains and sugars raise blood sugar quicker and higher than protein or oils, she says.

Regardless of whether you have diabetes, the brain uses glucose as fuel, so skipping meals means depriving the organ of the food it needs to concentrate and perform mental tasks, explains Goergen. 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 people with diabetes also need a clear head to best manage their disease effectively.

Breakfast is especially important because at this time of the day the body is “breaking the fast” from the night before, so eating not only fuels thinking and mental acuity in the morning, but also helps with blood sugar management. Stefanski recommends an omelet with spinach, salsa, or peppers as a diabetes-friendly breakfast. A few small nitrate-free turkey sausages with a half-cup of whole fruit works well, too. But skip the juices, recommends Dr. Youdim, explaining that fruit juice is packed with sugar but devoid of the fiber that can help regulate blood sugar.

An animal study published in July 2015 in the Journal of Nutritional Biochemistry found the practice of skipping meals to save calories sets the body up for fluctuations in insulin and glucose that ultimately puts weight on rather than takes it off. “Maintaining a healthy weight is essential for managing diabetes,” says Adrienne Youdim, MD, associate clinical professor of medicine at the David Geffen School of Medicine at UCLA in Los Angeles.

The National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) similarly warns that being overweight or obese has significant detrimental effects on managing blood sugar levels, and may lead to complications, like high blood pressure, heart disease, and stroke. If you skip meals often enough, your body may become less adept at regulating your feelings of hunger and fullness, Pearson warns.

Also, just because you don’t feel hungry doesn’t mean your body doesn’t need food at regular intervals. The appetite that is on pause often comes back with a vengeance later in the day, leading to overeating and subsequent high blood sugar.

Pearson explains that it’s not enough to practice portion control after skipping a meal, as your body literally fights for what it has 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.

“Bonking,” or experiencing reduced energy due to low blood sugar, is another potential effect of skipping meals that can be particularly dangerous for people with diabetes. Signs of bonking include dizziness, nausea, and shakiness, says Goergen.

Glucose feeds your cells while you're exercising, 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,” says Goergen, explaining that this process is called ketosis.

More important, 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. Hypoglycemia, or low blood sugar, can lead to dizziness, shaking, blurred vision, headache, confusion, and nausea during your workout. If left untreated, hypoglycemia can be life-threatening, Goergen says.

Prevent low blood sugar by eating a little something before your workout, such as a small banana or pressed fruit bar, recommends Stefanski. “Sometimes planning a workout about 60 minutes after a meal can be a good way to keep blood sugar stable, have good energy, and not have to add extra food into the day just for the workout,” she says.

“When it comes to skipping meals, people with diabetes face many of the same challenges as everyone else,” except when it comes to medication, says Pearson. A skipped meal alters the balance between food intake and insulin production, and can cause your blood sugar levels to eventually drop. “For diabetic people dependent on insulin or blood sugar–lowering medication, skipping meals can be more dangerous because it can lead to low blood sugar,” says Pearson.

What’s more, an article published in July 2013 in The Pharmaceutical Journal found that people may be at risk of hypoglycemia when they take certain diabetes medications without food. The paper notes there’s also a risk of gastrointestinal side effects, like nausea and diarrhea, when medication isn’t taken with meals.

Diabetes dosing is typically 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 do not neglect to accompany it with food when instructed. Keeping snacks in the car, at your desk, and in your purse is also important in case you find yourself away from food when it’s time to take your medication.