How lifestyle, daily routine affect blood sugar
The secret to managing type 2 diabetes isn’t found in a pill. In most cases, the best way to treat type 2 diabetes is by practicing healthy habits on a regular basis.
Eating foods good for diabetes, exercising regularly, and maintaining a healthy weight are all great ways to help treat diabetes naturally.
It’s no secret that type 2 diabetes is on the rise in the United States and around the world. But if you’ve been diagnosed with diabetes, there’s a lot you can do to improve your health — and the best place to start is likely by making some changes to your lifestyle.
“Basic principles of good health like eating right, exercising regularly, and maintaining a healthy weight can be as effective as medicine in the management of type 2 diabetes for most people,” says Sue McLaughlin, RD, CDE, lead medical nutrition therapist at Nebraska Medicine in Omaha. That’s backed up by the Look AHEAD study, a large clinical trial funded by the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). The researchers found that over a four-year period, changes like eating a healthier diet and getting more exercise led to weight loss and improved diabetes control in 5,000 overweight or obese participants with type 2 diabetes.
A December 2016 review in Diabetologia similarly found through 28 studies that participants who were able to achieve about 150 minutes per week of moderate activity lowered their risk of type 2 diabetes by 26 percent compared with nonactive participants.
If you’re ready to make positive changes to help control diabetes, here’s how to get started.
Keeping close tabs on your diet is a major way to help manage type 2 diabetes. A healthy diet for people with type 2 diabetes includes fresh or frozen fruit and vegetables, whole grains, beans, lean meats, and low-fat or fat-free dairy. Focus on eating fruit and non-starchy vegetables, like broccoli, carrots, and lettuce, and having smaller portions of starchy foods, meats, and dairy products. Be especially careful about loading up on foods that are high on the glycemic index (GI) and especially the glycemic load (GL), systems that rank foods according to how they affect glucose levels.
“High glycemic index foods are going to be primarily processed foods,” says Lori Chong, RD, CDE, at The Ohio State University Wexner Medical Center in Columbus. Those processed foods tend to have more white sugar and flour in them, which are higher on the GI, she says. Foods lower on the GI include vegetables, especially non-starchy vegetables, like broccoli, cauliflower, and leafy greens and whole-grain products, such as brown rice (as opposed to white rice), Chong says. She notes that even many fruits are low on the GI, with pineapple and dried fruit being some of the highest (Berries, apples, and pears tend to be fairly low.)
Limit fast food, too, as these eats contain trans fats, refined carbohydrates, and loads of sodium, which can be especially unhealthy for people with type 2 diabetes due to their effect on the heart and body weight.
To help you avoid or limit fast food, Chong recommends planning ahead by packing healthy meals or snacks. Diabetes-friendly snack ideas include a piece of fruit, a handful of nuts, and yogurt. Also, if you absolutely must stop at a fast-food restaurant, steer clear of anything that’s deep-fried — such as french fries, chicken nuggets, and breaded fish or chicken, Chong says.
Shedding pounds can improve blood sugar levels and help keep type 2 diabetes under control. And you don’t have to lose a lot of weight to make a difference. “If you already have type 2 diabetes, losing just 10 to 15 pounds can lower your glucose levels,” says McLaughlin.
In fact, the CDC notes that losing just 5 to 7 percent of your body weight can help lower your risk of developing type 2 diabetes. So, if you’re 200 pounds, aiming to lose about 10 to 14 pounds might help you prevent prediabetes from progressing to full-blown type 2 diabetes or help halt the advancement of type 2 diabetes if you’ve already been diagnosed.
Where your fat is distributed also affects your diabetes risk and management. People who carry most of their fat in their belly (referred to as having an apple-shaped body) are more prone to type 2 diabetes than those with fat mostly in the thighs, hips, and buttocks (having a pear-shaped body).
“The abdominal fat tends to increase insulin resistance,” Chong explains. “Insulin resistance is really the heart of the problem with type 2 diabetes.”
A woman whose waist measures more than 35 inches and a man with a 40-inch waist need to lose weight for good diabetes management regardless of what their body mass index (BMI) may be, says McLaughlin, adding that a healthy diet and regular aerobic exercise will whittle away weight in the stomach area.
Even without losing a pound, you can help keep type 2 diabetes under control with exercise.
“When you do physical activity, such as walking, your muscle contractions push glucose out of your blood into your cells,” explains McLaughlin. The result: better blood sugar levels.
The more intense the exercise, the better. According to the British diabetes association diabetes.co.uk, high-intensity interval training (HIIT) may be better for weight loss and glucose control than continuous aerobic activity like jogging. HIIT involves alternating between short bursts of increased intensity exercise and rest — for instance, running and then walking on and off throughout the workout.
Regular weightlifting sessions can also help keep blood sugar levels steady. McLaughlin recommends using hand weights or resistance bands for 30 minutes two or three times a week. The CDC recommends getting at least 150 minutes a week of brisk walking or a similar activity, which comes out to about 30 minutes a day, five times a week.
Many overweight people with type 2 diabetes also have sleep apnea, a condition in which a person stops breathing temporarily while sleeping. In fact, a study published in 2013 in Family Medicine suggests that as many as one in two people with type 2 diabetes may have or be at high risk for sleep apnea, many of whom are undiagnosed.
People with type 2 diabetes and sleep apnea are at higher risk of death from diabetes complications such as heart attack and stroke.
Chong points to previous research in Circulation that describes the underlying mechanisms of sleep apnea. In people with sleep apnea, activation of the sympathetic nervous system — including increased heart rate, increased blood pressure, and constriction of blood vessels — all led to a higher risk of heart attack and stroke, which can be compounded in people who have type 2 diabetes (and thus already have a higher risk of heart disease).
“It’s a whole cascade of events, and no one is really sure what comes first,” Chong says.
Severe cases of sleep apnea may need to be treated with surgery or by wearing a special device while sleeping, but less severe cases can be managed by losing weight. Talk to your doctor if you suspect you may have sleep apnea — loud snoring, a large neck, and being overweight are all risk factors.
Poorly managed stress can make blood sugar levels harder to control, says McLaughlin. Try using relaxation techniques to chase away stress. Top-notch stress busters for diabetes include yoga, tai chi, meditation, massage, and soothing music.
As a bonus, stress relief may help you sleep better, which is important because studies show that not getting enough sleep can worsen type 2 diabetes. Sleeping less than six hours a night has also been found to contribute to impaired glucose tolerance, a condition that often precedes type 2 diabetes. In fact, a review published in 2015 in Diabetes Care analyzed 10 studies that involved more than 18,000 participants combined and found the lowest risk of type 2 diabetes in the group of participants that slept seven to eight hours per day. That’s the minimum recommended amount of sleep for most adults, according to the National Sleep Foundation.
Here are some other tips for reducing stress and sleeping better while managing diabetes:
In addition to yoga, try deep breathing before bed. This practice can promote mindfulness, helping you relax and fall asleep.
Avoid alcohol, caffeine, and spicy foods at night. “When people are sleep-deprived, they crave high-energy or high-sugar foods, which can make weight gain more likely if it happens repeatedly,” Chong explains.
Maintain a slightly cool temperature in your sleep environment. The National Sleep Foundation points out that a cool room is easier to sleep in than a warm room.
Block out all light and noise. This will make it easier for you to sleep, and in turn help lower your stress levels, Chong says. Blue light, the kind emitted by cell phones, tablets, and TVs can make falling asleep particularly difficult. So turn your screens off an hour or two before hitting the hay.
Go to bed at the same time every night to establish a sleep schedule. “Our bodies like routine,” Chong says. By establishing a regular sleep routine, you can take advantage of — and not confuse — your body’s internal circadian rhythm.
These management strategies can have a dramatic impact on blood sugar levels and the progression of type 2 diabetes, says McLaughlin. Simple lifestyle changes will improve how you feel today and help ensure a healthier future.
“They’re foundational,” Chong says of these lifestyle changes. “Typically, when the diet, stress management, and exercise are all good and routine, then oftentimes medication requirements will be less, and that’s something we all agree on is a good thing.”
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