By Shahzadi Devje – an award winning media Dietitian, writer, speaker, recipe creator and Resident Nutritionist for ReverseD – the first diabetes TV reality show. Check out her blog, and follow her on Facebook, Instagram, and Twitter for more.

Diabetes: The 10 Most Important Steps You Can Take to Better Manage Blood Sugar

Diabetes is a complex and serious disease – a pandemic unfolding before our very eyes. Its prevalence has reached alarming proportions, posing an overwhelming threat to both the developed and developing world. According to a new report, by the Centers for Disease Control and Prevention (CDC), more than 100 million U.S. adults are now living with diabetes or pre-diabetes. This is consistent with previous trends, highlighting that cases of diabetes continue to rise. The World Health Organization (WHO) projects that diabetes will be the 7th leading cause of death in 2030.

As a certified diabetes educator, I’ve never encountered an individual with ‘diabetes only.’ Patients present with an array of health issues, exacerbated by uncontrolled blood sugar levels. But, by managing diabetes better, you can delay and prevent health problems such as heart disease, stroke, nerve and kidney diseases, and vision loss.

Having lived with a parent struggling with diabetes, I’ve experienced the anguish that accompanies this disease; as a result of lack of education. For our family, education was the map we needed to navigate through this journey. I witness the same with patients; the more they know, the better their management. It’s a poignant occasion – to witness how increased knowledge heightens one’s confidence to participate in the self-management of their condition. It also provides the motivation to take back control and strive for better health.

Insulin resistance: Metabolic mayhem!

Labeled as a chronic disease, diabetes develops when the pancreas fails to produce the hormone insulin, or when the body cannot make good use of the insulin it produces, known as insulin resistance. This causes glucose (sugar) to build up in your blood (hyperglycemia), instead of being used by your cells (liver and muscle) for energy.

Insulin acts like a key; to unlock the doors to your cells. This allows blood sugar or glucose (from the food you eat) to pass from your blood into your cells – to give you energy. In insulin resistance, the muscles and the liver ‘resist’ the action of insulin, so your body has to produce higher amounts of insulin (hyperinsulinaemia) to keep the blood sugar levels within a normal range. This may continue to develop for a long time. The cells become increasingly insulin resistant, and both insulin and blood sugar levels rise. The increased stress on the pancreas – to secrete more and more insulin, eventually leads to a damaged pancreas; resulting in decreased insulin secretion. Lower amounts of insulin, coupled with insulin resistant cells leads to metabolic mayhem; resulting in blood sugar levels to shoot up.

The impact of chronically high blood sugar levels

In the short- and long-term, exposure to high blood sugar levels is associated with unpleasant symptoms and serious damage to various organs and tissues. When blood sugar levels go beyond a specific threshold, type 2 diabetes is diagnosed.

In insulin resistance, your body tries to get rid of excess glucose in your blood  by converting it into fat. This fat tends to be deposited around the abdominal area; a familiar indicator of insulin resistance. Weight gain increases your risk of insulin resistance, and insulin resistance can also lead to weight gain – creating a vicious cycle. Additionally, insulin resistance also increases your risk of heart disease.

Take control: How to manage blood sugar levels

The good news is that you have the power to prevent or reverse insulin resistance. The many complications of diabetes are also preventable, through better food choices and regular exercise.

For people with diabetes, medications may be prescribed as a method of regulating blood sugar levels. Numerous classes of oral diabetes medications exist, that can can be used with insulin or in combination with one another. But let’s be honest, exclusive reliance on medications to manage type 2 diabetes is a band aid solution; covering the wound, and hoping for the best. You may find yourself relying on medications in the early stages of type 2 diabetes, to mitigate the risks of certain complications.

However, there is decisive scientific evidence that changes in habitual eating patterns and exercise habits are effective strategies in diabetes management. Studies such as the Lyon-Diet Heart Study highlights that a Mediterranean type diet, lowers the risk of heart attack in high-risk individuals by 70 percent. Additionally, The Dietary Approaches to Stop Hypertension (DASH) research supports the notion that a predominantly plant-based diet can be as effective and safer, in the reduction of blood pressure than medication. When comparing the effectiveness of metformin versus lifestyle modification, The Diabetes Prevention Program showed that lifestyle changes were twice as effective than metformin, in reducing the occurrence of diabetes in high risk people.

Discover the 10 most important steps you can take to better manage your blood sugar levels:

Diet

1. Reduce your portions

The amount of food you eat is closely linked to your blood sugar control. Eating large amounts of food, particularly rich in carbohydrates can lead to blood sugar spikes. Drinking a big glass of water before meals is one strategy to help you to eat less at meal times. Another simple way to control your portions and cut calories, is to use smaller plates and bowls. It’s always a good idea to portion food out and avoid eating from a bag or packet. Eating fewer calories has consistently shown to increase insulin sensitivity in overweight and obese individuals.

2.Eat more fiber

It is well accepted that that a diet high in fiber is linked to a decreased risk of cardiovascular disease; a major complication of diabetes.  Soluble fiber, found in eggplant, okra, oat products, beans, psyllium, barley delays the absorption of glucose in the small intestine; thereby improving post-meal blood sugars. Soluble fiber also helps feed the friendly bacteria that live in your colon, which may improve gut health and reduce insulin resistance.

Some simple ways to increase fiber intake are: eat the skins and seeds of fruits and vegetables, choose whole grains, add beans and lentils to soups and salads, sprinkle seeds to cereals, yogurts and in baking and enjoy nuts as a quick and healthy snack or throw them in salads.  

3. Choose carbs with a low glycemic index

Not all carbs are created equal. Refined carbs are absorbed quickly in your bloodstream and cause a spike in your blood sugar levels. Refined carbs include sugars (like table sugar and syrup) and refined grains, such as white flour; stripped of all nutritional goodness. Due to their low fiber content, eating refined carbs will not keep you full for very long and have shown to contribute to overeating.

Foods with a low glycemic index (GI) are absorbed more slowly in our blood stream, and have shown to improve blood sugar control.  Low GI foods include legumes (like beans and lentils), non-starchy vegetables, some starchy vegetables like sweet potatoes, many fruit, and most whole grain breads and cereals (like barley and rye)..

4. Choose more plant-based proteins

Adopting a predominantly plant-based diet, such as the Mediterranean diet, is widely regarded to be an effective option for the management of diabetes. Key features of this diet include a high consumption of fruits, vegetables, legumes, nuts, seeds, and whole grains, with a low intake of red meat and dairy. A mediterranean style eating pattern has been shown to improve blood sugar control, reduce cardiovascular risk factors, such as blood pressure, and cholesterol levels in type 2 diabetes.

5. Avoid added sugar (as much as possible)

Added sugars offer no nutritional benefit and impact blood sugars control and weight adversely. It’s important to cut down on all kinds of sugary drinks: regular soda, fruit drinks, sports drinks, etc., flavored hot and iced coffees and teas, pastries, candy, cereal bars and desserts. An occasional treat can be enjoyed on special occasions in a small portion.

Lifestyle

6.Do regular exercise  

Exercise not only helps to make your body’s cells more sensitive to the action of insulin, but also the exercising muscles use the glucose in your blood as energy. Both of these mechanisms help to reduce your blood sugars. With long term regular exercise, you can lower your A1C (your 3 month average of blood sugar levels) and reduce the risk of diabetes related complications.

7.Prepare for better sleep

Those with diabetes who struggle with sleep, tend to have higher insulin resistance and find it more difficult to manage their diabetes. High blood sugars can also make it tough to fall asleep and stay asleep. High blood sugars may cause you to feel uncomfortable, and unsettled and result in interruptions in sleep, due to frequent urination. It’s important to schedule sleep as you would any other activity and get to bed around the same time every night. Try to relax before bedtime and set the mood; dim the lights, play mellow music or have a warm bath. Avoid any types of stimulants, such as tea or coffee as the effects of caffeine can last up to 8 hours or more.

8.Learn to manage stress

We all experience stress at some time in our lives. However, living with a chronic disease causes an added burden. During times of stress, the adrenal glands secrete hormones in response to stress, which triggers the release of glucose from our tissues into the bloodstream. This can impact blood glucose management adversely. It’s important to not ignore the signs of stress, but rather, accept that it exists and decide whether you can do something about it. Opening up and talking to those close to you can help. Identify and participate in activities that bring you joy and help you unwind.

Supplementation

9.Consider a vitamin D supplement

Vitamin D has numerous important roles in the body, including maintaining the healthy bones, joints, and teeth as well as supporting your immune system. Those with diabetes over the age of 50 years are encouraged to take 400 IU of vitamin D daily. Circumstantial research evidence shows that vitamin D supplementation may help to overcome insulin resistance and may prevent type 2 diabetes. Some scientists believe that vitamin D may actually regulate the production of insulin from the pancreas.

10.Experiment with apple cider vinegar

Apple cider vinegar has shown some promise in helping to lower blood sugar, particularly impressive in those with prediabetes. A study from Arizona State University has shown that ingesting about 4 tablespoons of apple cider vinegar, diluted in water blunts the post-meal blood sugar levels in those with pre-diabetes, with a lesser effect in those with diabetes.

You can check out Shahzadi on ReverseD: The first docu-series tackling diabetes on Discovery Life Channel, at 7 pm on Tuesdays.

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