What You'll Learn:
- Blood sugar is primarily managed by the hormone insulin. When insulin is dysregulated (as in type 1 and type 2 diabetes), it can create blood sugar spikes and dips that disrupt your metabolic processes.
- Uncontrolled blood sugar can lead to a range of serious complications, including heart disease, stroke, and damage to vital organs.
- A blood glucose monitor is a helpful way to track your blood sugar levels and ensure that your current treatment plan works. You'll also want to get your hemoglobin A1C checked at least once a year to track changes in insulin sensitivity and glucose clearance.
- A diet rich in protein, fat, and fiber is the best option for blood-sugar control. Each of these macronutrients has a unique impact on blood sugar that helps to stabilize levels and keep you within a healthy range.
- As part of a well-rounded lifestyle, physical activity can significantly influence blood sugar regulation by improving insulin sensitivity and increasing glucose clearance from circulation.
- Low-carb, low-sugar snacks are a fail-safe for anyone trying to regulate blood sugar throughout the day. Having some healthy snacks on hand can help you avoid going for high-carb options while helping to keep your blood sugar levels stable.
This comprehensive guide will teach you all you need to know about the ins and outs of regulation. We'll discuss what is, why it's important to keep it regulated, how it can be managed, your ideal levels, and the key signs to look out for when is off-balance.
We'll also go over the best ways to stay on top of your , including glucose testing, foods that regulate blood glucose, and the importance of exercise for maintenance.
So without further ado, let's dive into the world of .
Before we jump into the nitty gritty of , let's first review what is and why maintaining is so crucial to overall health and physical balance.
Your naturally fluctuates throughout the day, depending on what foods you eat. While glucose from significantly impacts , protein has a more moderate effect, and fat doesn't increase at all. Therefore, are the most crucial to keep an eye on if you want to ensure that your stays within a healthy range.
That said, your body does have a system for managing as it rises, and that responsibility falls under the hormone insulin. As glucose (sugar) from your meal enters your circulation, insulin is released from your to help shuttle glucose into your cells, where it can be used as fuel, or stored for later. Therefore, maintaining steady highly depends on your body's ability to release and respond to insulin which can become impaired if you are .
In the case of , your body may be making enough insulin to control , but your cells have lost their ability to sense insulin signals. As a result, you'll end up with spikes in both and insulin without any way to get the out of circulation and into your cells.
Small to moderate increases in throughout the day is not a problem for most people, but for those with diabetes, can accumulate rapidly and cause downstream issues such as:
- Damage to
- Vision problems
- Increased risk of and stroke
- Neuropathy (nerve damage)
- Kidney damage
- Skin infections
- Bone and joint problems
Understanding Normal and Dangerous
So, what does normal look like? While everyone's body is unique and will respond to glucose a little differently, there are parameters for the healthy range in which your can fluctuate.
In the fasted state, where you've had nothing to eat or drink in at least eight hours, should be below 100 milligrams per . If your levels are above 100 milligrams per but below 126 milligrams per , you're in the range. Anything above 126 milligrams per is considered diabetes:
- Normal: less than 100 mg/dl
- 100 mg/dl to 125 mg/dl
- Diabetes: 126 mg/dl or higher
But what about after your meal? What's a safe level of postprandial ?
According to the ADA (), postprandial (post-meal) should stay at or below 180 milligrams per . If your produces insulin efficiently, and your cells are sensitized to insulin signals, then your will likely never reach these numbers. However, in the case of diabetes, may rise to 180 milligrams per or higher, which would put you into a state of (high ).
Symptoms of typically emerge slowly after several days or even weeks of elevated blood glucose. Early symptoms may include:
- Increased thirst
- Blurred vision
- Feeling weak or unusually tired
If goes on for a while, you may begin to notice:
- Fruity-smelling breath
- Dry mouth
- Abdominal pain
- Nausea and vomiting
- Shortness of breath
- Loss of consciousness
Over time if are not normalized, it can lead to serious damage throughout your body. As mentioned previously, chronically high due to untreated diabetes may lead to organ damage, damage to and increases your risk for and stroke.
Another complication of diabetes is ( ). Although people without diabetes can experience low blood glucose, in most cases, happens when your diabetes medication is not properly regulated, causing an imbalance in your insulin/glucose ratio.
Some early signs of 4]: include[
- Looking pale
- Feeling shaky or off-balance
- Dizziness or lightheadedness
- Hunger or nausea
- An irregular or fast heartbeat
- Difficulty concentrating
- Feeling weak and fatigued
- Irritability or anxiety
In more severe , you may experience:
- Loss of coordination
- Difficulty speaking or slurred speech
- Blurry or tunnel vision
- Muscle weakness
If left untreated, could eventually lead to seizures or unconsciousness, although these symptoms are very rare.
Monitoring : Glucometer, A1C Test, and
Keeping an eye on your is crucial for managing diabetes and avoiding potential complications. Your doctor will likely provide you with instructions on how often to test and which testing method is best for you, depending on the type of diabetes as well as any medications you may be taking.
Generally speaking, if you're taking insulin, it's a good idea to test several times per day to ensure that you aren't taking too much or too little medication. This type of testing is usually recommended before meals or at bedtime. However, you can also use glucometers to check your postprandial to see how well you're clearing glucose from your blood.
Blood Glucose Monitor
Blood glucose monitors (also known as glucometers) require a small blood sample (just a pinprick) to measure your current . Blood glucose monitors are particularly useful for helping you understand how your body responds to and any glucose-lowering medications you may be taking. Ideally, your glucose monitor will be connected to an App that allows you to track your over time and gain insight into your unique responses.
If you're managing diabetes without medication, you may not need daily monitoring, but it's still good to have a blood glucose monitor around to keep an eye on things. Blood glucose monitors can also be helpful if you start to feel symptoms of hyper or .
How to use a blood glucose monitor:
- Begin by washing your hands with soap and water, and then dry your hands well.
- Open the test strip container and take one strip out, handling carefully so as not to contaminate it.
- Gently massage whichever fingertip you plan to use for the blood draw to allow the blood to come to the surface.
- Using a lancet, prick your finger and squeeze from the base of the finger to encourage blood flow.
- Place a small amount of blood onto your test strip, allowing it to absorb completely, and then immediately place the strip into the .
- After a few seconds, your meter will display your . If you have an App connected to your meter, it will likely track this number for you. Otherwise, jot down your number in a journal.
While your will assist you with your target ranges, below are generally accepted guidelines for people with diabetes:
- ranges before meals: 80 milligrams per to 130 milligrams per .
- One to two hours after meals: below 180 milligrams per .
A measures your average A1C (HgA1C) test over the past three months. This type of can help to diagnose diabetes and is recommended at least twice a year for people already diagnosed to get an idea of how well your body is managing .
HgA1C measures the percentage of (proteins) that are chemically linked to glucose (a process called glycation). The higher your HgA1C levels, the poorer your ability to manage and the more susceptible you are to .
is essential for helping your red blood cells carry around oxygen, but when glucose attaches to this protein, it can impair its function and reduce oxygenation to cells and tissues.
Checking your HgA1C can help you determine how well your current treatment plan is working and give you insight into what your glucose has been up to over the last several months.
Since this test assesses the percentage of bound to glucose, your results will appear as a percentage:
- A reading below 5.7% is normal
- 5.7% to 6.4% is diagnosed as
- 6.5% or higher on two separate tests indicates diabetes.
For people with diabetes, a target of less than 7% is associated with a lower risk of diabetes-related complications.
Traditionally an HgA1C test would have to be carried out by your doctor. However, today there are at-home A1C tests that allow you to measure in the comfort of your own home.
Similar to a blood glucose monitor, at-home A1C tests require a simple finger prick for a small blood sample. At-home testing is a great option if you want to avoid a doctor's visit and a long wait for lab results.
Continuous Glucose Monitor ()
are typically used for people with that require insulin. These devices measure your every few minutes using a sensor that's inserted under your skin (usually your stomach or arm). The sensor specifically measures the glucose found in the fluid between the cells, also known as interstitial fluid.
Your doctor will let you know if your treatment plan requires .
Foods That Help Balance : A Comprehensive Guide
Many people diagnosed with diabetes find that they don't need to take medication to manage as long as they keep their diet in check. As you learned, each one of the three macronutrients has a different impact on blood glucose:
- directly increase most rapidly
- Protein has a moderate impact on
- Fat does not influence
Planning your diet to minimize can make or break your long-term prognosis with diabetes.
Below are three food groups to focus on to help keep stable throughout the day.
Of all the macronutrients, protein is well-known to be the most satiating due to its slow digestion and absorption. While can be broken down readily in your digestive tract, protein requires a concerted effort by your stomach acid and digestive enzymes.
Due to the time and energy-intensive process of breaking down protein, its absorption into circulation happens slowly over several hours. This leads to prolonged satiety as your blood receives a slow and steady supply of nutrients.
Furthermore, in the case of protein, the end result of digestion is amino acids. Unlike glucose, which can directly spike , amino acids have to go through a process known as gluconeogenesis (GNG) before they can be turned into glucose. And only a certain percentage of amino acids will even make it to the GNG pathway, as amino acids play a range of crucial roles in your body that often take precedence before their utilization as fuel.
Some examples include renewing and repairing cells and tissues and synthesizing enzymes, DNA, and hormones.
When protein is combined with in your meal, it slows the entire digestive process as your enzymes have to tackle both protein and breakdown simultaneously. For this reason, it's a good idea to always include some protein in your meals – especially if you're eating .
When choosing protein sources, quality matters big time.
First, you want to ensure that your protein is highly digestible and that the amino acids in your protein form a complete amino acids profile. Without getting too into the weeds, a complete protein must contain a specific ratio of each essential amino acid. Luckily, any animal-sourced protein will naturally represent a complete protein which can make things easy if you're a meat eater. Animal-based proteins are also low in , which is helpful when you want to keep your low.
Second, choosing high-quality animal proteins means that as often as possible, you're going for grass-fed, pasture-raised, organic, non-GMO, antibiotic-free, and hormone-free. It may sound like a tall order, but most farmers that raise their animals organic will already have the rest of the list covered.
Some high-quality protein choices include:
- Red meat like beef, lamb, and pork
- White meat like chicken and turkey
- Eggs (all kinds)
- Seafood like fish, scallops, shrimp, and shellfish
- Dairy — particularly full-fat Greek yogurt and cottage cheese (low-fat versions often add more , and you miss out on the healthy fats naturally contained in these foods)
Another nutrient that's particularly helpful for blood glucose control is fiber. While fiber is technically considered a , it's not absorbed into circulation and, therefore, won't instigate an increase in blood glucose.
In fact, studies in people with show that fiber can help to control and reduce insulin levels.
Similarly to protein, fiber helps to slow digestion and therefore reduces your uptake of nutrients into circulation. That said, fiber goes about this process in a very different way than protein. Instead of slowing digestion due to an intensive breakdown process, fiber can influence enzyme accessibility to your fat, protein, and within your digestive tract.
When fiber is present, it creates a more complex food matrix, which means that your digestive enzymes must work harder to access and dismantle the other macronutrients present. As a result, digestion is slowed down, and glucose levels rise much more steadily.
In addition to its direct impact on digestion, fiber also acts as a food source for the beneficial bacteria in your gut. When your bacteria consume fiber, they produce short-chain fatty acids (SCFA), which studies show may improve A1c, glucose levels, and elevated levels of glucagon-like peptide-1, which regulates insulin.
While most foods that contain fiber tend to be higher in than protein or fat, there are plenty of low- fiber options. For example:
- Seeds – flax seeds, chia seeds, pumpkin seeds
- Coconut (unsweetened)
- Berries – raspberries, blackberries
- Nuts – pistachios, almonds,
- Vegetables – broccoli, asparagus, cabbage, spinach, collard greens, okra, artichoke, brussels sprouts
Many people are adding more fat to their diets today for a variety of reasons; it's crucial for cellular health and function, it makes up around 60% of brain tissue, it insulates vital organs, and it adds a delicious mouthfeel to your meals.
For those with diabetes, however, fat has another significant benefit; it doesn't increase . While protein may moderately raise blood glucose, fat won't directly influence at all. What makes fat particularly helpful for people with issues is that this macronutrient assists in the production of ketones which your body can use in place of glucose. This is one of the reasons that so many people with conditions are turning to a ketogenic diet that focuses primarily on fat and protein.
Some high-quality sources of fat that you can add to your -regulating diet include:
- Coconut oil
- Avocado oil
- Olive oil
- Nuts and seeds
The Importance of Exercise for Management
While it goes without saying that exercise is an important aspect of overall health and well-being, regular activity can directly improve management in a variety of ways, namely:
- Improved non-insulin-dependent glucose utilization
- Improved glucose clearance
Improved non-insulin-dependent glucose utilization
One of the fantastic benefits of exercise is that it improves your body's ability to use glucose, independent of the hormone insulin. During , glucose uptake into active muscles increases significantly as your hungry muscle cells need to maximize their fuel resources.
To keep things running smoothly, research shows that when your muscles contract during exercise, it enhances your cells' ability to take up glucose from the blood, and this process takes place whether insulin is present or not.
Studies show again and again that can improve . This is at least in part due to the role of a glucose transporter called GLUT-4. GLUT-4 is a protein that works with insulin to assist glucose uptake into your cells. Studies show that when you exercise, it increases GLUT-4 expression on your cell membrane, thereby amplifying your body's sensitivity to insulin signals and enhancing your ability to move glucose out of your blood.
Amazingly, studies show that just one bout of can increase up to 16 hours post-exercise.
Improved glucose clearance
Aside from its direct impact on , when you exercise, it draws on reserve glucose stored in your muscles and liver. As these stores become depleted, your body starts to pull glucose from your blood to rebuild its stores. The longer and more strenuous your exercise, the more your will be affected.
Which Type Of Exercise Is Best?
Any regular movement should help to increase and glucose clearance. That said, the best exercise routine is one that you'll stick with. If you're new to working out, you may want to start with walking and then move up to more strenuous exercise like:
- Aerobics (jogging, hiking, cycling)
- Resistance training (weights, body weight, resistance bands)
- Interval training (HIIT, run-walk, or Tabata)
- Group classes
- Vinyasa or hatha yoga classes
Healthy Snacks for Diabetics: Low- and Low-Sugar Options
Many people get tripped up when it comes to snacking for regulation. Having low- and low-sugar options around can be a lifesaver if you're someone who tends to get hungry and snack mindlessly. A couple of intentional snack breaks throughout the day can also help you keep your stable, so you don't feel inclined to grab the first thing you see to satisfy your hunger.
Below is a list of low- and low-sugar snack options to have around as your fail-safe:
- Nuts and seeds (almonds, macadamia nuts, Brazil nuts, sunflower seeds, pumpkin seeds, etc.)
- ½ avocado with salt and lime
- Cottage cheese or Greek yogurt
- Turkey and cheese roll-ups
- Hard-boiled eggs
- Celery with nut butter
- Beef or salmon jerky
- Veggies and guacamole
- Chia seed pudding
Conclusion: Maintaining for a Better Life
Maintaining is a cornerstone of health. Aside from conditions like and diabetes, regulation plays a role in overall nutrient utilization and physiologic homeostasis.
When becomes dysregulated, it can set the stage for serious complications, including , syndrome, and damage to vital organs.
Furthermore, control plays a direct role in weight management and maintenance, which itself can contribute to, or worsen, a wide range of health conditions.
Once is under control, you'll feel significant shifts in your daily energy levels, moods, cravings, and general well-being. By understanding what is and how it works, you've armed yourself with the tools necessary to manage and maintain healthy levels for years to come.
- Pu, Li Jin, et al. "Increased blood glycohemoglobin A1c levels lead to overestimation of arterial oxygen saturation by pulse oximetry in patients with type 2 diabetes." Cardiovascular diabetology 11.1 (2012): 1-6.
- Smith, Ann. "Nucleic acids to amino acids: DNA specifies protein." Nature Education 1.1 (2008): 126.
- Walsh, Gary. Proteins: biochemistry and biotechnology. John Wiley & Sons, 2014.
- Chandalia, Manisha, et al. "Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus." New England Journal of Medicine 342.19 (2000): 1392-1398.
- Riccardi, Gabriele, and Angela A. Rivellese. "Effects of dietary fiber and carbohydrate on glucose and lipoprotein metabolism in diabetic patients." Diabetes care 14.12 (1991): 1115-1125.
- Zhao, Liping, et al. "Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes." Science 359.6380 (2018): 1151-1156.
- Chang, Chia-Yu, Der-Shin Ke, and Jen-Yin Chen. "Essential fatty acids and human brain." Acta Neurol Taiwan 18.4 (2009): 231-41.
- De Carvalho, Carla CCR, and Maria José Caramujo. "The various roles of fatty acids." Molecules 23.10 (2018): 2583.
- Nguyen, Thanh-Tin P., et al. "Separating insulin-mediated and non-insulin-mediated glucose uptake during and after aerobic exercise in type 1 diabetes." American Journal of Physiology-Endocrinology and Metabolism 320.3 (2021): E425-E437.
- Venkatasamy, Vighnesh Vetrivel, et al. "Effect of Physical activity on Insulin Resistance, Inflammation and Oxidative Stress in Diabetes Mellitus." Journal of Clinical & Diagnostic Research 7.8 (2013).
- Bollinger, Lance, and Tom LaFontaine. "Exercise programming for insulin resistance." Strength & Conditioning Journal 33.5 (2011): 44-47.
- Leguisamo, Natalia M., et al. "GLUT4 content decreases along with insulin resistance and high levels of inflammatory markers in rats with metabolic syndrome." Cardiovascular diabetology 11.1 (2012): 1-10.
- Borghouts, L. B., and H. A. Keizer. "Exercise and insulin sensitivity: a review." International journal of sports medicine 21.01 (2000): 1-12.