Eating a healthful diet to keep your blood sugar levels stable throughout the day is one of the cornerstones of diabetes management — but what if you aren't hungry or lose your appetite? Is it OK to skip a meal?
The Risks of Not Eating
"Skipping meals is not safe if you have diabetes," cautions Audrey Koltun, RDN, CDCES, a dietitian in the Division of Pediatric Endocrinology at Cohen Children's Medical Center in Lake Success, New York.
Diabetes occurs when your body either uses insulin improperly or no longer produces it. Insulin allows your body to use blood sugar (glucose) from carbs for energy. When insulin can't do its job, blood sugar can build up in your bloodstream and set the stage for diabetes and its related complications, the American Diabetes Association explains. In the U.S., diabetes statistics show that 34 million adults have the condition, according to the Centers for Disease Control and Prevention.
If you skip meals, you can develop low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia), both of which can be dangerous or even deadly, according to the Cleveland Clinic. When severe and untreated, hypoglycemia can cause seizures or loss of consciousness, Mayo Clinic says. Over time, hyperglycemia can lead to diabetes-related damage to your nerves, blood vessels and other organs, the Cleveland Clinic explains.
Loss of appetite or meal skipping could also lead to overeating, Koltun says. "If someone with type 2 diabetes does not eat all day and then binge-eats later on, one will have an elevated blood sugar," she explains. "Weight gain can also result from overeating."
That's why it's important to eat three small meals a day and to not go more than four or five waking hours without eating, Koltun says.
Lack of Appetite: Possible Causes
As a general rule, diabetes does not cause loss of appetite, but people with diabetes may lose their appetite for many reasons, some of which are related to diabetes and others that are not. These can include:
Gastroparesis. "This occurs when food sits in the stomach for a long time due to damaged nerves that help contract the muscles used to move food further down the gastrointestinal tract," Koltun says. Gastroparesis can diminish your appetite. The American Diabetes Association notes this as a potential complication of diabetes.
Depression. The Mayo Clinic points out that people with diabetes are at an increased risk for depression, and depression may cause loss of appetite. Managing diabetes is stressful and may cause some people to feel depressed.
Medication side effects. Metformin is a diabetes drug that controls the amount of blood sugar or glucose in your blood, but it may cause loss of appetite, according to the Mayo Clinic. Other drugs for conditions that travel with diabetes also could be responsible for loss of appetite.
If you're experiencing a loss of appetite, discuss your medications with your doctor to see if there is a connection, says Ajaykumar D. Rao, MD, an associate professor of medicine at Temple University's Lewis Katz School of Medicine and an associate professor in the Center for Metabolic Disease Research at Temple University Hospital in Philadelphia.
Feeling sick. People with diabetes also get colds, flus and stomach bugs, all of which can affect appetite. If you're eating less due to an illness, talk to your doctor because your diabetes medications may need to be adjusted, Dr. Rao says.
Diabetic ketoacidosis. This potentially fatal condition occurs when your blood sugar is high and your insulin level is low, according to the American Academy of Family Physicians. As a result, your body starts to burn fat, which causes a buildup of acid in your body that, if left untreated, can lead to coma and death.
Poor diabetes control. If your blood sugar levels run consistently high, you may lose your appetite, Koltun says.
Certain cancers. Some cancers may cause loss of appetite. "This has to be coupled with weight loss and last for more than four to six weeks," says Dr. Rao.
Is This an Emergency?
- Audrey Koltun, RDN, CDCES, CDN, registered dietitian/nutritionist and certified diabetes care & education specialist, Division of Pediatric Endocrinology, Cohen Children’s Medical Center, Lake Success, New York
- American Diabetes Association: “Blood Sugar and Insulin at Work”
- Cleveland Clinic: “Missing Meals? Avoid Dangerous Blood Sugar If You Have Diabetes”
- Cleveland Clinic: “Hyperglycemia (High Blood Sugar)”
- American Diabetes Association: “Autonomic Neuropathy”
- Mayo Clinic: “Diabetes and Depression: Coping With the Two Conditions”
- Mayo Clinic: “Metformin (Oral Route)”
- Ajaykumar D. Rao, MD, associate professor, Lewis Katz School of Medicine, Temple University, and Center for Metabolic Disease Research, Temple University Hospital, Philadelphia
- American Academy of Family Physicians: “Diabetic Ketoacidosis: What It Is and How to Prevent It”
- Mayo Clinic: "Diabetic Hypoglycemia"
- CDC: "National Diabetes Statistics Report 2020"