Expert diabetes advice: How to keep blood sugar in check
If you have type 2 diabetes, you will understand that managing your blood sugar levels is vital. Endocrinologist Dr Richard Siegel’s six-point plan makes it easy.
Every five minutes, one person is diagnosed with diabetes in Australia. The good news is there are plenty of ways to help manage blood sugar levels to lower the risk of future problems.
These include maintaining a healthy body weight, exercising regularly and eating a balanced diet that’s low in saturated fat, high in fibre and which includes a variety of fruit and vegetables.
It’s also important that we eat in a way that helps to reduce the impact of blood sugar spikes after meals and snacks, according to UK-based endocrinologist Dr Richard Siegel.
“Blood sugars tend to be highest after meals,” says Dr Siegel. “Compared with high fasting blood sugar readings, high post-meal blood sugar has been associated with the fluctuations in blood sugar that’s damaging to the lining of blood vessels.” This, he says, can then affect your cardiovascular health.
Dr Siegel explains that to achieve a three-month average blood sugar level (HbA1c) of less than 7 per cent — which is the general target that has been recommended for non-pregnant adults with diabetes— blood sugar has to stay under 5.5mmol/L most of the time, including after meals.
Achieving this isn’t as daunting as it sounds. With a few easy strategies, you’ll be able to improve your post-meal blood sugar levels. Here’s how …
1 Balance your plate
Try incorporating different foods to see their impact on your post-meal readings. For example, if you always stick with baked potatoes, rice and couscous, experiment with the effect of low-Glycaemic Index (GI) carbohydrates, such as lentils, quinoa and wholemeal pasta, and also tinker with serving sizes.
Always balance the carbs with protein — fish, lean meat, chicken, eggs or tofu — and serve with lots of colourful vegetables such as carrot, zucchini, eggplant and spinach. If you usually eat a big bowl of pasta with tomato sauce, reduce the pasta serving, switch to a wholegrain version and add some lean protein, such as beef mince, to balance blood sugars.
2 Take a walk after meals
Research suggests a short walk after each meal may be better for blood sugar levels than one single walk during the day.
A recent study from New Zealand supports this. Scientists randomly assigned 41 adults with type 2 diabetes to walk for either 30 minutes continuously each day at any time, or for 10 minutes after each of their three main meals (within five minutes of finishing eating). Walking after each meal resulted in post-meal blood sugar levels 12 per cent lower overall compared to the single walk.
Try getting off the bus a stop earlier in the morning, and step outside after lunch for a 10–minute walk around the block. An after-dinner stroll with your partner or kids is a great way to catch up on the day.
3 Tuck into veg first
Early research suggests that eating the vegies on your plate first, followed by the protein, and leaving carbs until last, helps improve after-meal readings. So eat your broccoli first, then the grilled salmon, then the potatoes. Finish each part before moving on to the next.
In trials of people with type 2 diabetes, these eating sequences improved post-meal blood sugar levels and HbA1c compared with eating carb-rich foods first, or eating in any other order.
4 Lower your carbs at breakfast
For many, breakfast is a carb-rich meal, but you may want to rethink this. “You tend to get the highest blood sugars of the day after breakfast, so it may help to make breakfast your lowest carb meal,“ says Dr Siegel. “In the morning, your body tends to be more insulin resistant, which is related to some of the stress hormones, including growth hormones and cortisol, which increase during the very early hours of the morning.“
Replacing some of the carbs with protein improves post-meal blood sugar levels. For example, swap jam on toast with eggs and grilled mushrooms, and cut back to one slice of wholegrain toast. There’s no need to drastically restrict your carbs, but reducing portions makes a big difference.
5 Establish your own facts
Take your blood sugar readings immediately before eating, then two hours after starting. The difference in these numbers shows the effect of what you ate on your blood sugar levels.
Experiment by repeating the meal on another day, altering the serving size or slightly reducing the amount of carbs, to see which foods can help close the gap in your blood sugar readings. This ‘paired’ testing can help you understand the impact of a new meal on your blood sugar.
Keep in mind that when you should test blood glucose levels and how often you should test varies depending on each individual, the type of diabetes you have and the tablets and/or insulin being used. Always speak to your doctor or to a Credentialled Diabetes Educator to help you decide how many tests are needed and the levels to aim for.
6 Alter blood sugar testing times
Blood glucose monitoring helps you balance your food with your lifestyle and with any diabetes medication that you might be talking.
Do a bit of short-term detective work to help out with long-term blood sugar control. If your readings appear fine two hours after starting your meals, and yet your overall HbA1c readings remain high, vary the times you take the readings.
“Different meals may be causing blood sugar to peak at different times,“ says Dr Siegel. “A high-carb meal may raise blood sugar early on after eating, while a high-fat meal may delay the peak. If you always test at the same time after meals, you may not be registering the highest readings.“
If you can measure it, you can manage it!
What is ‘diabesity’
‘Diabesity’ is the term used to explain the strong link between diabetes and obesity. A 2005 Australian study found that participants who were obese were four times more likely to develop type 2 diabetes than those with a BMI between 19 and 24.
Type 2 diabetes
The numbers you need to know
Blood glucose levels
6–10mmol/L after a meal or snack
Less than or equal to 7%
Women less than 80cm
Men less than 94cm
Why you should test blood sugar often If you have diabetes
1 Develop confidence in managing your diabetes
2 Better understand the relationship between your blood sugars and the food you eat
3 Know whether medications, if used, are making a difference
4 Find out immediately if your blood sugars are too high (hyperglycaemia) or too low (hypogylacemia)
5 Know when to seek advice from your doctor about your diabetes management
The number of Aussies who have diabetes
Speak to a professional diabetes educator about when & how often you should test