If you’re among the 100 million-plus Americans who have diabetes or prediabetes, you may be eager to do all you can to keep your blood sugar (glucose) levels in check.
Good news: While insulin injections and oral diabetes mediations often are central to that effort, there are other strategies to help control blood sugar levels generally and prevent spikes. To learn about them, Bottom Line Personal interviewed George L. King, MD, director of research at Joslin Diabetes Center and a professor of medicine and ophthalmology at Harvard Medical School.
Plan your meals
For people with diabetes or prediabetes, meal planning is critical for maintaining blood sugar and keeping hemoglobin A1C levels in a healthy range (an A1C test indicates the average amount of glucose in your blood over the past three months). For most adults, that means usually eating three regular meals that deliver a total of 1,500 to 1,800 calories a day without exercise…and eating the right mix of proteins, fats and carbohydrates. For the days with exercise, an additional 200 to 300 calories can be added.
Ideal: A fiber-rich diet made up of 70% carbohydrates, 15% lean protein (mostly from plant sources) and 15% fat-containing food such as salmon, sardines (fatty fish), shrimp, avocados, nuts and yogurt.
People with diabetes and prediabetes sometimes worry that eating carbohydrates will cause spikes in blood sugar, a condition doctors call hyperglycemia. In fact, only simple (refined) carbohydrate foods will do that, including foods that contain sugar, sugary drinks, candy, juices, white rice, pasta and cakes, pies and pastries. Complex carbohydrate foods, including high-fiber food, whole grains, legumes, fruits, brown rice and starchy vegetables—whose molecular structure causes them to break down slowly in the body—limit blood sugar spikes.
Helpful: The American Diabetes Association’s Diabetes Plate method. Fill half your plate with non-starchy vegetables, such as leafy greens, carrots, broccoli and the like. Fill one-quarter with lean protein, such as fish, chicken and soy foods. Fill the last quarter with starchy vegetables, whole grains, beans and lentils. Use a nine-inch plate to keep portion sizes under control. Fruit and dairy foods are also part of a diabetes-friendly diet—fruits are wonderful desserts, and dairy products can be placed in a cup on the side.
Get moving
Exercise helps your muscles remove glucose from the bloodstream. While vigorous exercise is great, going for a stroll can help, too. In a small study conducted at University of Bedfordshire in England, participants who interrupted prolonged periods of sitting with brief walks experienced better blood sugar levels than those who remained sitting or who simply stood up. Aim to walk for a total of roughly an hour a day, or at least 5,000 steps. Helpful: Walk to nearby destinations instead of driving. If you must drive, pick a parking space a bit farther away from your destination. Skip elevators and escalators, and use the stairs when you can. Walk around the block after eating lunch either at home or work.
Exercise, including strength-training and aerobic workouts in addition to walking, boosts your body’s sensitivity to insulin—a blood sugar–controlling effect that lasts 48 hours. So try to get a good workout at least every other day. Caution: Older people and those with diabetes can lose muscle around the hips and upper legs, which may cause them to be unstable and increase the risk of falling, so it is very important to protect those muscles. Simple exercise such as standing up from a chair or sofa 10 to 20 times over a few minutes both in morning and evening are great ways to preserve those muscle for stability.
Research also has shown that taking a stroll after a sit-down meal can help keep blood sugar levels from rising to unhealthful levels.
Don’t skimp on sleep
Getting enough shut-eye helps reduce risk for a range of ailments including heart disease, obesity, depression…and diabetes. A 2021 review of randomized clinical trials by researchers at Tribhuvan University, Drexel University College of Medicine, Hiroshima University and other institutions showed that limited or poor-quality sleep interferes with the body’s ability to control blood sugar levels.
As we age, our changing circadian rhythms can cause us to awaken earlier than we would like. No worries—you can compensate just by setting an earlier bedtime. Brief naps during the day can be helpful, too—just limit your snooze to an hour or less.
Consider a wearable glucose monitor
Glucose monitoring can be helpful not only for people with diabetes but also those with prediabetes. Prediabetes is indicated when fasting blood sugar levels run abnormally high (between 100 and 125 milligrams per deciliter) but not high enough to indicate a diagnosis of diabetes. Continuous glucose monitors can make that easy to do, providing a real-time readout of your blood sugar level throughout the day.
The readings also can help you and your doctor pinpoint the foods and eating patterns that cause your blood sugar to rise. Typically affixed to the arm, these disposable devices are available without a prescription and cost about $100 a month. Not all insurance plans cover glucose monitors for people without diabetes. People with diabetes typically should aim to maintain a blood glucose reading of 80 milligrams per deciliter to 180 milligrams per deciliter for at least 17 hours out of each day—though your doctor may recommend a different target depending upon your specific needs.
Maybe some melon?
Melon is no substitute for conventional diabetes treatment, but limited research from Tajen University in Taiwan suggests that an edible gourd commonly known as bitter melon contains insulin-like compounds that can bring modest improvements in the body’s ability to regulate blood sugar levels. Known scientifically as Momordica charantia L., bitter melon is available in some specialty grocery stores.
