Balancing blood sugar: Diet & Lifestyle Modifications for pre-diabetes, diabetes, and insulin resistance

What is pre-diabetes?

Pre-diabetes is a condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as diabetes. It's often a precursor to type 2 diabetes. Without intervention, pre-diabetes is likely to become type 2 diabetes in 10 years or less. It's possible to prevent the progression of pre-diabetes to type 2 diabetes through diet and lifestyle modifications.

What is Insulin Resistance?

Insulin resistance is a condition where the body's cells become resistant to the effects of insulin, a hormone that regulates the movement of sugar into cells. This results in the body needing more insulin to keep blood sugar levels normal, and can eventually lead to the development of type 2 diabetes and other health problems.

If they both affect my blood sugar, are they the same thing?

No, pre-diabetes and insulin resistance are not the same, but they are closely related. Insulin resistance is a condition where the body's cells become resistant to the effects of insulin, a hormone that regulates the movement of sugar into cells. This can lead to higher blood sugar levels. Pre-diabetes is a condition characterized by higher than normal blood sugar levels, often as a result of insulin resistance, but not high enough to be diagnosed as diabetes. It's often a precursor to type 2 diabetes.

1. Balance your plate

You may have seen something like this before- a 9” sized plate with an emphasis on 1/2 plate non-starchy vegetables, 1/4 plate protein, and 1/4 plate carbohydrate foods.

Portioning your plate in this way for most, if not all meals can make sure that you have a good amount of protein and fiber at meals, which can help s l o w the breakdown and release of consumed carbohydrates into the bloodstream, resulting in more stable blood sugar levels and less spikes, highs or lows. Stable glucose = stable energy, which helps you and your metabolism function at their best.

2. Eat with your rhythm

Adopting a Circadian Rhythm Eating pattern can also play an important role in controlling blood glucose levels. This approach aligns eating patterns with your body's natural circadian rhythm, typically involving eating larger meals earlier in the day, and enjoying smaller meals and snacks toward the afternoon/evening.

Research suggests that this pattern can help regulate blood glucose levels and improve overall metabolic health, and may also improve sleep in some individuals as well. Note that this style of eating may not be possible for some due to lifestyle, work, or exercise schedules, any may need to be modified to optimize nutritional needs.

3. Get moving - preferably after a meal

After consuming a meal, the carbohydrates present in the food are broken down into sugars, such as glucose, which are then absorbed into the bloodstream. This causes a rise in blood glucose levels. The increase signals the pancreas to release insulin, a hormone that helps cells take in the glucose for energy or storage. However, in certain conditions like pre-diabetes and insulin resistance, this regulation process can be impaired, leading to persistently high blood glucose levels after meals.

We can help this process of lowering our blood glucose levels and improve our insulin sensitivity (how efficient insulin is at bringing glucose inside of our cells) by taking a short walk or doing some kind of activity within 30-45 minutes of eating a meal. This allows our muscles to take glucose from our bloodstream to replace what they used while being active.

Whether it is a walk with the family, dog, running up and down the stairs, or doing chores around the house, aim to get in about 10-15 minutes of movement. Bonus points if it is after your last meal of the day!

4. Choose foods & food pairings that support good glucose control

The Glycemic Index (GI) and Glycemic Load (GL) are tools that can help you choose foods that promote stable blood sugar. The GI measures how quickly a food raises your blood sugar levels, while the GL takes into account both the GI and the amount of carbohydrates in a serving of food. Foods with a low GI and GL are digested and absorbed at a slower rate, leading to a slower rise in blood sugar levels, which can be beneficial for people with pre-diabetes or insulin resistance. Again, this is why plate balance plays such a big part in blood sugar management.

Ways that we can reduce the overall Glycemic Load of a meal or snack:

1. Choosing less refined grains and snacks and opting for those that contain fiber
2. Opting for a smaller portion of higher GI/GL foods like white rice, potatoes and bread
3. Pairing carbohydrate foods with protein and fiber to help slow digestion/glucose release into the bloodstream

Glycemic Index/Load Chart of Common Foods

While portions and pairing foods will have the biggest impact on blood glucose levels, choosing foods of a lower/moderate to incorporate into your diet may be a way to “fine tune” your meals in terms of impact on your blood glucose levels.

Glycemic load will determine the final impact on blood glucose - while it does not mean that you always have to stick to “low” foods, it does mean that when choosing higher GL foods, pairing them with protein, fiber, and/or fat can lower the impact it has on blood glucose.