Living under the specter of blood sugar
I have lived under the specter of diabetes for most of my life; my dad lived with it for more than 60 years. I saw how it affected his daily life and ours too to a certain extent. Blood sugar spikes were a daily occurrence for him and I remember my parents saying that the main thing was to avoid all sugar (to this day I don’t like the taste of mangoes, which my dad rarely had). So he continued to have our daily Gujrati lunches of rotli, daal, bhaat, shaak and evening dinners of bhakri-kadhi or pav bhaji, pani puri, dhokla, or thepla.
For years I too followed a similar diet. I’m healthy, vegetarian, prioritize exercise and lots of daily movement, get regular blood work, and have excellent cholesterol, vitamin levels, thyroid health, and glucose numbers. So, all good, right? Not so fast! We know that what we eat has a big impact on blood sugar and that blood sugar levels can affect mood, ability to focus, and physical energy levels. But how do we know the granular details and what exactly do we change within our diets?
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CGM: Catching those glucose spikes
My husband recently heard that biosensors that measure glucose are now available with a prescription to healthy, non-diabetic, or non-pre-diabetic folks willing to pay out of pocket, so we decided to try it. It is the newest trend among our circle of friends who want real-time data to help motivate them to make positive changes in their health. Diabetic patients already have the ability to measure blood glucose through lab testing, as well as standard home kits using a drop of blood. But a Continuous Glucose Monitor (CGM) is a game-changer for people like us to manage our wellness.
A CGM is a small wearable sensor that you can wear on your body painlessly at home for easy and accurate blood glucose monitoring. You place it on the back of the upper arm, where a small transmitter inserted into the skin collects glucose levels from the interstitial fluid beneath the skin. Each sensor lasts for 14 days. With the CGM you can empower yourself with far more data. You can see your daily averages, when and for how long your blood sugar spikes, which types of foods have the greatest effects, and how things like exercise, sleep, and stress affect your numbers.
My numbers looked good when…
A fiber-rich green smoothie mid-morning elicits a flat line, while my daily afternoon snack of bhel led to an immediate rapid spike and a slow drop. At a celebratory Italian dinner with friends, I noticed that my glucose readings were fairly stable, even after a lemon drop martini, bread, gnocchi in a cream sauce, pasta with veggies, and dessert. However, this was because I was armed with information and now know that it’s not what I eat, but the order in which I eat it that makes all the difference.
The numbers you’ll want to be looking at are:
- Average glucose value over a 24-hour window: Ideal glucose range is 70-140
- Glycemic variability: This describes the “spikiness” of your glucose curve. Ideally, we want glucose to remain stable and rise only slightly after meals. If you have high glycemic variability, your blood sugar is frequently spiking and crashing. Not only can this impact your mood and energy, but it can also have long-term impacts. Studies show that these big spikes and dips in glucose can damage tissues more than elevated but stable glucose levels. Extreme glucose variability has been linked to heart disease, diabetes, and metabolic dysfunction. High levels of variability can also indicate that you’re becoming insulin resistant—your body is unable to use insulin efficiently to control glucose.
- After your meal: Maximum glucose level (140 or below, ideally). If you’re shooting above that by a lot, you might look at the foods you’re eating before that spike, both
what the foods are and how much of them you’re eating. - How quickly your levels return to your pre-meal number: You want your glucose levels to recover within 2-3 hours of eating.
Tweaks that helped flatten my sugar curve
Here are some diet tweaks I found improved my glucose data. Please note that I am not a doctor. This is my personal journey and things that have worked for me. Your mileage may be different.
Eat foods in the right order
- Veggies and plants first, then proteins and fat, and lastly carbs
- Add a salad as a starter to all your meals. It flattens the glucose curve. Your stomach will feel full longer and avoid the glucose dip that leads to cravings
Flatten your breakfast curve
- Breakfast is the wrong time to eat sugar and starches
- Choose a savory breakfast over a sweet one
- Avoid cereal, toast, jam, pastries, fruit juice, fruit smoothies, banana bread. Choose steel-cut oats
- Avoid fruit juices. Have the full fruit instead.
- Pick dessert over a sweet snack. If you want something sweet, have it as a dessert rather than a snack on an empty stomach.
Reach for vinegar before you eat sweets
Simply drink a tablespoon of apple cider vinegar in a tall glass of water a few minutes before eating something sweet. It flattens sugar and insulin spikes
After you eat, move
Within 70 minutes of a meal, take a walk or do sit-ups in order to curb a glucose spike
If you have to snack, go savory
Replace sweet snacks with carrots, cucumber, cheese, a slice of ham, or peanut butter. These savory snacks will give you steady energy.
Put some clothes on your carbs
- When you eat carbs, add fiber, protein, or fat to them.
- Combine with fruits – nut butter, full-fat yogurt, eggs, cheddar cheese
Wearing the CGM has had a positive impact on my behavior, what I eat, and my general sense of well-being. My habits have exponentially changed by the readings that provide a more granular, real-time look at your blood glucose levels. It offers an easy data-driven approach to better healthcare.
