When you're first diagnosed with diabetes, your doctor will likely recommend diet and lifestyle changes to help you manage your blood sugar. While interventions such as insulin prescriptions may be required, diet and exercise alone can result in significant progress.
Many people worry that these changes will be too drastic and hard to stick with. When done correctly, the diet and exercise required to manage blood sugar don't need to be an inconvenience. Though, as with all lifestyle changes, some discipline will be required.
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When a healthy body has a blood sugar level that's too high, the pancreas produces a hormone called insulin. This hormone is what tells your body that it needs to use or store excess blood sugar.
Depending on the type of diabetes, a diabetic's body either doesn't produce enough insulin or doesn't respond to the insulin well enough. With the insulin not working as effectively as it should, changes in the diet become necessary to help to regulate those levels.
Exercise helps people with diabetes in several ways and, specifically, helps to control blood sugar by two mechanisms. First, exercise itself increases glucose uptake. Second, exercise improves the body's sensitivity to insulin, allowing the hormone to do its job more effectively.
Exercise also helps to manage risk factors. Being overweight is a risk factor for type 2 diabetes, which can be improved by exercising and losing weight. Diabetes is a risk factor for many heart-related problems, and exercise helps to reduce those risks.
While simply reducing blood sugar is one goal of a healthy diabetic diet, it isn't the only one. The way you eat also plays a big role in how at-risk you are for complications of diabetes, such as heart disease.
A well-rounded diet that focuses on proper nutrition across the board will help reduce blood sugar and the risk of complications from diabetes as well. Eating properly means eating the right foods in adequate amounts while avoiding unhealthy foods.
Let's take a look at what that means in practice.
Your body needs many vitamins, minerals, electrolytes, and other nutrients to effectively regulate its various systems. Certain nutrients are beneficial to your cardiovascular system, some for the immune system, and so on.
While everyone should strive to eat a balanced meal that includes the recommended amount of all these vital nutrients, diabetes increases the risk factors for many other conditions, making proper nutrition even more important for those who have it. A well-rounded diet will include foods from each of the food groups:
While there are plenty of nutrients you should maintain in your diet, there are some foods that should be avoided. Not everything in food is healthy for you, and some of the ingredients in our food are actively bad. That doesn't mean that you can never have a treat, but it does mean that you need to be mindful of how many of these foods you're eating.
It's also important to understand which of these foods are necessary for small amounts but harmful when consumed in large amounts and how many are best avoided altogether.
There are plenty of foods with heart-healthy fats such as Omega 3 and Omega 6. But there are also foods with unhealthy fats, such as saturated fat and trans fat. Limiting your intake of the latter can keep your cholesterol in check and your arteries healthy.
Sodium, found in salt, is a necessary electrolyte. But most people get far more of it than needed. When you get too much salt, your blood pressure can elevate, leading to other heart-health side effects.
As a diabetic, we've already seen how keeping sugar intake under control is important. Added sugars, such as those in most sweets and sugary drinks, provide little to no nutritional value and can have detrimental health effects.
While it's okay to have a little alcohol, drinking too much can affect your blood sugar levels. Experts recommend no more than one drink per day for women and two drinks per day for men.
The timing of your meals may be important to managing your diabetes. Whether this is true depends on the treatment plan you're on.
For example, someone on insulin or other diabetes medication may experience a drop in blood sugar after taking it. While this is the purpose of the medicine, you don't want your blood sugar to drop too low. Your doctor may tell you to plan your meals according to your medicine timing to properly regulate blood sugar.
Your treatment plan may even be more specific. Your health care team may recommend you eat a certain amount of carbohydrates at a certain time of the day. To make most of your diet changes, be sure to discuss the specifics of how you should change it with your doctor.
There are many different goals for exercise. Some people want to gain muscle, lose weight, improve cardiovascular function, and so on. For diabetes, you don't need to focus on any of those specific goals.
Although we've seen how losing weight can help remove one of your risk factors for type 2 diabetes, the primary concern is just getting active. The National Institute of Health recommends 30 minutes of exercise at a moderate or greater intensity five days a week. Moderate intensity means that it's challenging but sustainable.
Almost any type of exercise you choose can get you into the moderate-intensity zone or above. Find an activity that you really enjoy doing, decide which days you want to exercise, and try to build an exercise program around that.
By working out at around the same time every day and planning what your workouts will be ahead of time, it'll be easier for you to develop the habit of exercising and turn it into a permanent yet enjoyable new lifestyle.
Whichever type of exercise you decide to do, remember that you don't have to start at full intensity. While you should work out up to 30 minutes per day, five days a week, that might be too much activity for you in the beginning. You can try 20 minutes a day, three times a week, or even less, and add to it as you acclimate.
Remember that a little exercise is better than no exercise. Do what feels comfortable while challenging yourself to do just a bit more day after day or week after week until you hit the target activity level.
Doing the same workout routine every week for the rest of your life is enough to make anyone tire of exercise and give up. That's why it's a good idea to swap out your routines every few months and try something new. This can mean a new weightlifting routine, a different type of cardio, or whatever you want it to be.
Any new change in lifestyle is easier if you create a plan and develop a habit. Taking the time to develop a meal plan will give you a better idea of the types of changes you need to make, but will also make it easier to stick to the changes day by day than trying to just figure it out on the fly.
By planning your meals ahead, you can take the time to ensure each meal will have the nutrients your body needs and also help keep you within your blood sugar targets. There are two major methods recommended to people with diabetes for controlling their blood sugar levels: counting carbohydrates and the plate method.
Before we talk about either of the two methods, let's first take the time to understand portion size. If you buy a bottle of soda from the store, you'll probably drink all of it. The bottle is a portion.
But the bottle might not be a single serving. When comparing the nutrient content of foods, it's always important to look at the serving size to ensure that you're comparing apples to apples.
Beyond its usefulness for making comparisons, understanding the concept of portion size can also be the first step in making serious changes to your diet. Portion sizes have gotten larger over time. People eat more servings in one sitting. By reducing portion size, you can still have some of your old favorites while lowering the blood sugar you're consuming.
With this method, understanding serving size versus portion size is especially important. For each meal, you need to look at the nutritional information for the food you're eating and keep track of the total number of carbohydrates you consume with each meal.
The amount of carbohydrates you can have per meal varies depending on several factors, including age, weight, and activity level. As a general guideline, the CDC¹ recommends that people with diabetes get about half of their daily calories from carbohydrates.
When counting carbs, it's important to understand which ones can increase your blood sugar. Your nutritional label will probably break the carbohydrates section into three categories: fiber, sugar, and added sugar.
As we've seen, starch is also a carbohydrate, but that often isn't included on nutritional labels. Sugar (added or natural) and starch both raise your blood sugar, fiber does not. Therefore, simply subtracting the grams of fiber from the grams of total carbohydrates will give you the carbohydrate count that can increase blood sugar.
As long as you're careful with serving sizes and accurately record all the carbohydrates you consume, counting carbs is an excellent method to calculate carbs consumed. But it isn't the most convenient. This is especially true for those who are just beginning to make changes to their lifestyle to help manage diabetes.
The plate method is an easier way of managing carbs that may work well enough for you, at least to get started on the path to developing healthier eating habits. For the plate method, you start with a 9-inch dinner plate.
When making yourself a plate of food, fill half of it with nonstarchy vegetables. These have little to no sugar. On another quarter of the plate, put your protein.
This is typically meat but could also be beans, eggs, tofu, or other vegetable-based protein. On the final quarter of the plate, put the foods that are higher in complex carbs. This is, in effect, a variation on the portion control method we've already discussed.
Getting a diabetes diagnosis means that you'll need to make some lifestyle changes. For many people, the thought of making those lifestyle changes, combined with the increased stress of worrying about their health can seem overwhelming. But the good news is that you can still enjoy many of the same foods you always did, just in greater moderation than before.
For those who need to increase their daily activity, doing so slowly and building up to the recommended activity level can make it more manageable. Your diabetes care team will be with you to provide advice during every step of the process and help make the transition to your new lifestyle less challenging for you.
Carb counting | Centers for Disease Control and Prevention
Diabetes risk factors | Centers for Disease Control and Prevention
Prevent diabetes complications | Centers for Disease Control and Prevention
Diabetes diet, eating, & physical activity | NIH: National Institute of Diabetes and Digestive and Kidney Institute
Diabetes diet, eating, & physical activity: What foods and drinks should I limit if I have diabetes? | NIH: National Institute of Diabetes and Digestive and Kidney Institute
Diabetes diet, eating, & physical activity: When should I eat if I have diabetes? | NIH: National Institute of Diabetes and Digestive and Kidney Institute
Diabetes meal planning | Centers for Disease Control and Prevention