Good blood sugar control is vital to staying healthy in the short and long term with diabetes. Accomplishing this goal requires eating healthier, being physically active, managing stress, and taking blood glucose-lowering and related medications as prescribed. Here are doable steps you can put into action to help you reach your goals.

How to Take Control Now

Healthy blood glucose (or blood sugar) control includes steps like following a balanced meal plan, engaging in an active lifestyle with sufficient physical activity, and taking blood glucose-lowering medications as you need them over the years. You might also need other medications to control your blood pressure and lipids (cholesterol). Consider some additional lifestyle tips that can also help control blood sugar and improve overall health. Find out what works and which ones you should avoid.

Keep Eating Habits Consistent

Skipping meals, especially breakfast, could push your blood sugar higher, and depending which blood glucose-lowering medications you take, could cause hypoglycemia (low blood sugar). When you don't eat for several hours because of sleep or other reasons, your body fuels itself on glucose released from the liver. For many people with type 2 diabetes (PWDs type 2), the liver doesn't properly sense that the blood has ample glucose already, so it continues to pour out more. Eating something with a little carbohydrate signals the liver to stop sending glucose into the bloodstream and can tamp down high numbers.

Skipping meals also may lead to overeating, which can cause weight gain. And if you take certain glucose-lowering medications, such as sulfonylureas (generic name glimiperide, glipizide, or glyburide), that cause your pancreas to release more insulin into your blood stream, or if you take insulin with injections, a pump or inhaler, you risk having your blood sugar drop too low if you skip or delay meals.


Include and Enjoy Healthy Sources of Carbs

An eating plan that is too low in carbohydrate "is not balanced and may deprive the body of important fiber, vitamins, and minerals," says Constance Brown-Riggs, M.S.Ed., RD, CDE, author of The African American Guide to Living Well with Diabetes (Career Press, 2010).

Recently, Brown-Riggs counseled a PWD type 1 who cut her carbohydrate intake to 90 grams per day. The result: constant hunger and no improvement in blood glucose or lipids. Brown-Riggs helped the woman balance her meal plan with additional carbohydrate-containing foods. "When she increased her carb intake, her hunger subsided. Additionally, she was able to improve her A1C, triglycerides and HDL cholesterol levels. Meal planning for diabetes is not one-size-fits-all,” explains Brown-Riggs.

Cook Pasta Al Dente and Measure Servings

It is best to eat your spaghetti al dente, says David J. A. Jenkins, M.D., Ph.D., Canada research chair in nutrition and metabolism at the University of Toronto and St. Michael's Hospital. Overcooked pasta and other starches become soft, lose their form, and give up their glucose more readily, likely giving you a slightly bigger rise in blood sugar, he says.

"The real problem with pasta is that it's so palatable," and you may eat more than you intend, says Jenkins. A cupful of pasta provides as many calories and carb grams as three slices of bread, and the pasta goes down faster. Jenkins' advice: Cook starchy foods adequately, but avoid overcooking. Enjoy your pasta with plenty of low-calorie vegetables or beans, as in pasta fagioli. Finally, he says: Control portions and count the calories and carb grams.

In a Pinch, Eat Diabetes Bars and Shakes as Meal Replacements

Bars or shakes made specifically for people with diabetes can help you control blood sugar levels when you're on the go, says dietitian Constance Brown-Riggs. "When used as a meal replacement or snack, they can take the guesswork out of carbohydrate counting," she says.

Toss them in your purse, suitcase, or desk drawer so you'll always have a suitable choice when you're stuck in traffic or can't break for lunch. But if you fall into the trap of eating them in addition to your usual meals or snacks, both your weight and your blood sugar levels may climb. You have to swap them for other foods, or your calorie and carb intake will likely be too high.

And don’t forget to read the labels for calories, saturated fats, and any other nutrient of particular concern. Just because a bar or shake is labeled suitable for diabetes doesn’t mean that it’s truly a wholesome food choice or ideal for the health of your heart.

Enjoy Cinnamon as a Natural Flavor Booster (But It Might Not Lower Blood Sugar)

Cinnamon contains a number of compounds that could improve insulin sensitivity and insulin action, says Laura Shane-McWhorter, PharmD, BCPS, BC-ADM, CDE, FASCP, FAADE, a professor at the University of Utah College of Pharmacy and author of The American Diabetes Association Guide to Herbs and Nutritional Supplements: What You Need to Know from Aloe to Zinc (2009).

Though studies are mixed, a 2013 meta-analysis[i] found that among people with type 2 diabetes, the consumption of cinnamon led to lower fasting blood glucose, LDL cholesterol and triglyceride levels, as well as a beneficial increase in HDL cholesterol levels. Unfortunately, explains, Shane-McWhorter, the ideal dose and form of cinnamon has not been determined, and cinnamon may even cause liver toxicity. Before taking a cinnamon supplement, have a talk with your healthcare provider.

However, you can still enjoy this versatile, fragrant spice to delight your taste buds without extra calories or sodium. Cinnamon brings out the natural sweetness of tomatoes in a sauce and adds an interesting complexity to beef and poultry. Sprinkle it on oatmeal, yogurt, and fruit to boost sweetness without adding sugar.




Talk to Your Doctor About Drinking Alcohol

Alcohol may lower blood sugar, but it can do so erratically and therefore isn't considered a safe or effective method of glucose control.

Alcohol interferes with the liver's ability to raise blood glucose and can cause low blood glucose (hypoglycemia). This is especially important to note if a person takes a blood glucose-lowering medication that can cause hypoglycemia, such as a sulfonylurea or insulin. In fact, it's hard to predict just when alcohol might cause hypoglycemia. Sometimes the effects can occur the following day. And when alcohol is mixed with high-sugar drinks, such as sodas and juices, or eaten with carb-containing foods, your blood sugar may initially rise but drop later.

However, most PWDs can drink alcohol in moderation (up to one drink a day for women, up to two drinks a day for men), depending on individual factors and diabetes management. And research shows it doesn’t matter what type of alcohol is consumed. Alcohol also seems to serve as an anti-inflammatory, which is one reason moderate and regular consumption has been studied for its heart-healthy benefits.

If you take a blood glucose-lowering medication that can cause hypoglycemia or if you have high triglycerides, talk to your health care provider about what's best for you.

Have a Cup of Green Tea

Replacing sugary drinks with green tea is a great way to cut calories, save carbs, and get a good dose of disease-fighting polyphenols. But don't bank on it to lower your blood sugar. A few studies suggest that green tea may help prevent type 2 diabetes and improve insulin sensitivity, but the evidence isn't strong enough to make firm recommendations.

Green tea extracts—but not the beverage—in high doses have been associated with several cases of liver toxicity, says Laura Shane-McWhorter, Pharm.D., CDE, a professor at the University of Utah College of Pharmacy and author of The American Diabetes Association Guide to Herbs and Nutritional Supplements: What You Need to Know from Aloe to Zinc (2009). Shane-McWhorter recommends people with diabetes use supplements with caution.

Drink Water to Save Calories and Stay Hydrated

It's a smart idea to drink plenty of calorie-free beverages, especially water, every day. This is especially true when your blood sugar levels are elevated. Because high blood sugar can cause excessive urination, drinking plenty of water helps prevent dehydration, says dietitian Constance Brown-Riggs.

Splash a Little Vinegar

Can a spoonful of vinegar help the blood sugar go down? Yes, says Carol S. Johnston, Ph.D., RD, professor and director of the nutrition program at Arizona State University's College of Health Solutions. Consuming 1-2 tablespoons of vinegar diluted in a cup of water or consumed as part of a salad before a meal may help slow the “postmeal surge in blood glucose by as much as 40 percent,” she says. But that's not a license to go carb crazy.

Vinegar may inhibit starch digestion and hold food in the stomach a little longer, Johnston says. By partially blocking the digestion of starch, vinegar may help to blunt the rise of blood sugar in response to eating. The problem is the vinegar itself. It just isn't fun to drink a couple tablespoons before a meal. Take advantage of vinegar's benefits by splashing some on a salad and adding it to cooked vegetables. Johnston recommends whisking your own vinaigrette with two parts vinegar to one part olive oil.

Use caution, especially if you use insulin; reports have shown a higher frequency of hypoglycemic episodes in individuals with type 1 diabetes who consume vinegar, Johnston says.

Talk to Your Health Care Provider Before Adjusting Medication

If your blood glucose consistently runs high, work with your health care provider to increase one or more of your glucose-lowering medications and/or add a new one. It’s well known that type 2 diabetes progresses over time—that means your pancreas has a dwindling supply of insulin being made. If your blood sugar is high because of simply eating too much, learn from your slip-up and move on. Don’t adjust your medications without first discussing it with your diabetes health care provider.

Set Aside Time for Quality Sleep

Too little sleep or poor sleep can disrupt your hormones, leading to increased appetite, higher blood sugar, and a thicker waistline. In fact, researchers from the Netherlands found that a single night of sleep deprivation can decrease insulin sensitivity by almost 25 percent.

Find a sleep routine that works for you. If you have trouble sleeping, talk to your health care provider about your sleep patterns to see if they warrant an assessment for sleep apnea, a potentially serious sleep disorder. The Look AHEAD study, a large multi-center study of people with type 2 diabetes, found that at the beginning of the study more than 80% of participants had sleep apnea. A small amount of weight loss dramatically decreased sleep apnea.

Waking frequently to use the bathroom may be a sign of high blood glucose. And a fitful night with bad dreams might indicate low blood glucose. Either way, measure your blood sugar more often and talk to your healthcare provider right away.


Exercise to Boost Energy & Improve Sleep

It's not a good idea to skimp on sleep to get more exercise or to trade in exercise to get more sleep.

"If you're giving up exercise for sleep," says Jennifer Hyman RD, CDE, a registered dietitian and diabetes educator in Long Island, New York, "chances are you are not active enough during the day." It becomes a vicious cycle, because inactivity can reduce the quality of sleep, and poor sleep leaves you too lethargic to exercise.

Sneak in at least a few minutes of daily exercise by walking on your lunch break and taking the stairs instead of the elevator, Hyman says. Don't fall for the common trap of skipping exercise when time is tight. If all you have is a few minutes, take it. And remember that every single time you exercise, you're improving insulin sensitivity.

Do Your Research Before Taking Supplements

Research results for several popular diabetes supplements have been mixed. Claims abound that bitter gourd, or bitter melon, which is eaten as a vegetable in India and other parts of Asia, lowers blood sugar. Some studies suggest that the fruit, juice, or extract improve glucose tolerance. Unfortunately, "most of the studies have not had good study design, and the results have been variable," says pharmacist Laura Shane-McWhorter.

Chromium picolinate may work as an insulin sensitizer and improve blood glucose levels in people with type 1 or type 2 diabetes, Shane-McWhorter says. Again, studies are mixed, she adds. A 2014 systematic review and meta-analysis[i] found that chromium supplements improve blood glucose control and may even improve HDL cholesterol and triglyceride levels.

"The biggest controversy with supplements is the issue of a reliable manufacturer and whether the product contains what it actually states on the label," Shane-McWhorter says. In fact, the FDA has found products illegally marketed as all-natural diabetes treatments to contain undeclared active ingredients of medications.[i]

So how can you know if a supplement is safe? Shane-McWhorter suggests checking the United States Pharmacopeia website (usp.org) and ConsumerLab.com. Most importantly: Be sure to always talk to your health care provider before you start to take any nutritional supplements.