Did you know that having good blood sugar control is not only achieved by watching what you eat?
When you’re living with diabetes, having well-controlled blood sugar levels is key. It is the link between whether your condition is well managed or not and can lead to fewer complications.
Maintaining good blood sugar control remains a challenge for many people living with diabetes (1). What’s more, many different factors can control how well you do this.
Eating a diet high in added sugars or refined carbohydrates is amongst the more obvious causes of high blood sugar levels. There are also several factors related to your lifestyle that can cause those spikes in blood sugar.
In this article, we look at the importance of good blood sugar control when you have diabetes, and what results you should be aiming for. We will then take a look at fifteen ways that you can effectively control your blood sugar levels.
Blood sugar and Diabetes
When you are living with diabetes, knowing how to manage your blood sugar levels is essential. It can help to reduce your risk of complications and can make you feel healthier. It can also empower you in the knowledge that you are doing what you can to manage your condition.
While the two main types of diabetes (type 1 and type 2) vary, they do share this common factor – too much sugar in the blood.
When you don’t have diabetes, the sugar level in your blood is controlled by the hormone insulin, which is released by the pancreas. For people with type 2 diabetes, this system is faulty.
Either not enough insulin is being produced, or the insulin that is produced is not working. This causes the sugar in your blood to begin to build up, and can lead to lots of problems, often called diabetes complications.
The following are common complications of poorly controlled diabetes:
- Nerve and kidney problems (microvascular)
- Heart problems (macrovascular) (5).
In a scientific statement released by The American Diabetes Association (ADA), up to 80% of people with diabetes developed heart problems.
Better glycemic control may reduce the long-term risk of these problems occurring (5).
The impact of better glycemic control on microvascular problems is also well established. Extensive prospective studies are supporting the benefit of tight blood sugar control. These studies show that tight blood sugar control can lead to a delay in the progression of complications for people living with type 2 diabetes and how often they occur (6) (7).
What causes changes in blood sugar?
It won’t come as a surprise to you that the food you eat has the most significant impact on your blood sugar levels.
Eating a diet high in refined carbohydrates, that includes lots of added sugars and foods with a high glycaemic index (GI) are all things to avoid. The ADA breaks down the different types of diets that can help you to manage your diabetes.
Yet, it is not only about the food that you eat!
Diabetes UK and The American Diabetes Association both list several lifestyle factors that can also impact your blood sugar levels.
Stress, dehydration, pain, and low levels of exercise are all extra factors to consider when it comes to how you manage your blood sugar levels (4).
Read on to find out what you should be aiming for when you’re testing your blood sugar levels.
Normal blood sugar levels
If you are living with diabetes, your dedicated healthcare team will work with you to tell you what your targets for blood sugar control are.
This will look different for everyone and will depend on individual factors such as medications you take and how active you are. Yet, some targets are safe to follow to help get you started with your management (2).
- Before meals: 4-7 mmol/l (72-126mg/dl)
- Two hours after meals: less than 8.5mmol/l (less than 153 mg/dl)
The only reliable way to measure your long-term blood sugar control when you have diabetes is with a test called hemoglobin A1c, or HbA1c.
Your specialist diabetes team should be keeping an eye on this for you, with a blood test at least once per year. It will help them to look at your average blood sugar levels, and also see if any trends are emerging.
Your HbA1c levels are essential to track if you have diabetes – try and aim to get your HbA1c within the recommended limits to avoid increasing your risk of serious complications (3):
• Equal to or below 48mmol/mol (equal to or below 6.5%).
We will now take a look at fifteen things you can consider that can help you to lower your blood sugar naturally and with the use of medicines.
15 Ways to Manage Blood Sugar Levels
1) Watch your alcohol intake
Let’s kick off with this one, as it’s different from most other ways to manage your blood sugar.
While alcohol can cause your blood sugar levels to rise (due to the carbohydrate content of some drinks), it can also increase your risk of having low blood sugar (also called a hypo).
This is a risk if you take insulin or other blood sugar-lowering medications. Usually, your body can help itself to recover when you have a hypo, as the liver stores extra glucose and releases it back into the blood as needed.
Alcohol prevents the liver from doing this, meaning there is a higher risk of hypo’s when you’re drinking (8).
It’s essential that if you choose to drink with diabetes, you speak to your dedicated healthcare team to help yourself safely do this.
2) Prevent or manage stress
Being stressed can make you feel tired, irritable, and exhausted. It can also lead to problems with high blood sugar. Stress releases hormones cortisol and adrenaline, which can cause your blood sugar levels to go up. This is as a result of increasing your level of insulin resistance.
Looking after yourself, talking, and getting out in nature are all great ways to help prevent or manage stress.
You may also wish to try some mindfulness or meditation or yoga. One randomized controlled trial found regularly doing yogic exercises led to reduced stress and improved blood sugar levels among students.
3) Consider cutting back on carbs
As it’s the carbs that we eat that have the biggest impact on our blood sugar levels, it makes sense that cutting back a bit will lead to better control. When we eat carbohydrates, the body breaks them down into sugar (mainly glucose). The body then uses this glucose as an energy source.
For someone with diabetes, the body is unable to carry out this process effectively. Without medication or dietary changes, the level of glucose in the blood can rise sharply with a high carb diet.
Eating a low-carbohydrate diet can help to maintain better blood sugar levels. There are, of course, things to consider for making sure a low carb diet is healthy, but it is possible!
There’s generally no need to go the whole hog and start following a ketogenic diet. There is evidence that it is effective for weight loss and good diabetes control in the short term, although there is not much evidence on sustainability, as found in this recent study.
Foods like white bread, pasta, rice, and added sugars should be kept to a minimum. You can read more about following a low carb diet when you have diabetes in this article.
4) Eat more foods with a low glycemic index (GI)
You might think that this is the same as going low carb, but that isn’t true. A low carb diet encourages reducing the total amount of carbohydrates that you eat, whereas a low glycemic index diet is to do with the quality of the carbohydrate.
The GI ranking of foods links to the impact that it has on your blood sugar levels. The more of an impact it has, the higher the GI will be.
It makes sense then, to focus on eating more foods with a medium or low GI and choose foods with a high GI less often. Foods with a low GI include porridge made with rolled oats, carrots, broccoli, sweet potato, beans, quinoa, buckwheat, and barley.
5) Get plenty of sleep
Evidence suggests that inadequate or disturbed sleep can lead to poorer glycaemic control.
Short sleep duration leads to several changes that can all play a role in your blood sugar levels. It leads to the body producing more cortisol, changes in appetite-regulating hormones, and more inflammation.
One large study found that HbA1c was significantly higher for people who had diabetes and slept for less time. The general recommendation is that adults prioritize sleep and get between seven and nine hours per night (9).
6) Exercise regularly
Exercise is great for your health. It can help to improve your cardiovascular fitness, muscle tone, and the strength of your bones. Regular exercise can also help you to maintain a healthy weight.
Being active can also help to improve insulin sensitivity. If you exercise regularly, the cells in your body can use the available sugar in your bloodstream more effectively (13).
If you’re able to, it’s a good idea to aim for the government-recommended amount of physical activity per week. In the UK, this is at least 150 minutes of moderate-intensity activity a week, or 75 minutes of vigorous-intensity activity per week.
7) Consider losing weight, if you need to
Weight management remains to be a cornerstone of treatment for people with type 2 diabetes. Many studies support losing weight as a way to prevent developing type 2 diabetes. Losing weight (if necessary) can also help to improve blood glucose levels.
When you carry excess weight (particularly around your middle), it puts more pressure on your organs. This increases your level of insulin resistance. When you lose excess weight, the insulin that you produce or inject can work more effectively, and your blood sugar levels will be better (14).
There is no one size fits all when it comes to weight loss. Be sure to work with your healthcare team to find an approach that works for you and is sustainable.
8) Eat more fiber
Having a diet high in fiber can help with good blood sugar control. As such, it’s recommended that people with diabetes include plenty of fiber-rich foods in their diets.
Soluble fiber is a particularly beneficial form. It works to lower blood sugar levels by slowing the absorption of sugars into the blood. Although fiber is a type of carbohydrate, it is not digested or absorbed by the body, so it does not raise blood sugar levels.
Research supports the benefits of including more fiber when you have diabetes. To increase your fiber intake, enjoy a diet rich in nutritious foods, including whole grains, oats, and fruit and vegetables.
9) Cut back on added sugars
There has been a lot of hype around ‘natural’ sources of sugar, and there is no shortage of recipes online, claiming to be ‘free from refined sugars.’ These recipes are often loaded with sweeteners such as honey and maple syrup.
The truth is, these sugar substitutes often impact your blood sugar levels in a similar, if not the same, way as regular table sugar. It’s best to limit all sources of added sugars to improve your blood sugar levels, and for general health.
10) Drink plenty of water
If you’re drinking enough water (at least 6-8 glasses per day is a good aim), then your kidneys can do their job, helping you to flush out toxins.
This is key when you have diabetes, as your body deals with hyperglycemia by producing more urine to try and flush out some of the excess sugar. If you’re not replenishing this lost fluid, your body will struggle to remove this sugar, and your blood glucose levels can stay high.
A 2017 study found that when people had a low water intake for three days, it led to high blood sugar levels. Try carrying a water bottle around with you or setting alarms on your phone to remind you to drink plenty.
11) Stay cool in the heat
There are many ways in which we can enjoy hot weather safely. For people with diabetes, they need to take extra care, as relaxing in the sun can mess up blood sugar readings.
For people with diabetes, if you are inactive for long periods in hot weather, it can lead to high blood glucose levels.
You should also be careful not to get burnt – sunburn is a cause of stress to the body, which triggers the release of cortisol. This results in temporary insulin resistance and higher blood sugar levels (10).
12) Consider supplementing with magnesium
Magnesium deficiency is common among people with diabetes (11). This is thought to be due to the losses from urine as a result of frequent urination caused by high glucose levels.
Low levels of magnesium in the blood can also worsen insulin resistance (12), so you may want to keep an eye on your levels when you have diabetes.
Supplementation may not be recommended routinely, although studies have shown that if you are magnesium deficient, topping up your levels can lead to better blood sugar control.
You can also increase the magnesium in your diet by including more magnesium-rich foods. Always consult a doctor or registered nutrition professional before taking a supplement.
13) Look after yourself!
Just like your body releases the stress hormone cortisol when you get sunburnt, the same happens when you’re unwell. Your body also releases more glucose (sugar) into your bloodstream as part of its defense to help it fight off infections and illnesses (even if you’re not eating much).
For people with diabetes, as they cannot release more insulin to help cope with this, blood sugar levels can become dangerously high.
Illness cannot always be prevented, although a nutritious diet, rest, and regular exercise can help to maintain good health.
14) Take your medication
Your specialist diabetes team will advise you on whether you need medication and/or insulin to manage your diabetes, and the best ones to take.
Aim to attend all of your appointments and maintain a good relationship with them – if you’re not sure about something, ask! It could be the difference between gaining good control and not.
Studies have found diabetes education to be important for people living with the condition. More education can lead to better outcomes, improved quality of life, and feelings of empowerment.
15) Don’t smoke
This one should be a given when it comes to living a healthy life, although aside from the well-known health risks of smoking, it can also harm your blood sugar levels.
Amongst smokers with type 2 diabetes, more insulin is needed to control blood sugar levels, and their insulin production is less effective. Numerous studies support this.
The Centres for Disease Control and Prevention recommend that all people with diabetes who smoke should quit immediately.
Good glycemic control is essential when you are living with diabetes. There are several diet and lifestyle changes you can make to help yourself manage your blood sugar levels better.
Carbohydrate intake, sleep, supplements, stress, diet, and exercise, can all play a role. Paying attention to some of the changes mentioned in this article can help you to improve diabetes management.