These tips can be used safely alongside prescription drugs that control blood sugar (such as Metformin and supplemental insulin) and may help reduce or eliminate the need for prescriptions over time.
1. Eat Balanced Meals
The simplest way to manage blood sugar is to consume less glucose. “If you eat a lot of glucose — and that’s not just sugary foods but starchy carbohydrates like bread, rice, and potatoes — then your blood glucose goes up,” says nephrologist Jason Fung, MD, author of The Diabetes Code.
The glycemic index (GI) ranks carbohydrates based on their impact on blood-sugar levels. Foods with a low GI tend to be absorbed more slowly, causing a more gradual, modest rise in glucose.
Still, the GI can only serve as a general guide because responses to glucose are highly individual. Genetics, the microbiome, body composition, and portion size all affect that response, which is why two people can have completely different reactions to the same food. (This is why a continuous glucose monitor can come in handy; more on that in a bit.)
Restrictive eating can lead to problems of its own, however, so rather than focusing exclusively on cutting down on carbohydrates, Jill Weisenberger, MS, RDN, author of Prediabetes: A Complete Guide, advocates for taking a broader view of a healthy diet. “Too often, people focus only on calories for weight, carbs for blood glucose, sodium for blood pressure, or fat for cholesterol,” she notes. “This myopic view of health and diet rarely leads to good outcomes.”
Make sure every meal contains combinations of different nutrients. This can naturally curb an over-emphasis on carbs.
Instead, emphasize variety. Make sure every meal contains combinations of different nutrients. This can naturally curb an over-emphasis on carbs. “Having a balanced meal tends to lead to better blood-sugar control than a carbohydrate-heavy meal without some protein or fiber,” Weisenberger says.
Protein is typically more filling than carbohydrates, so it can help reduce overeating and snacking. It also slows the absorption of carbohydrates, moderating their effect on blood sugar. Healthy fats (think nuts, seeds, avocados, and olive oil) produce a similar moderating effect on carbohydrates.
Fiber — both soluble and insoluble — is crucial here too. “Having a couple of foods at every meal with different types of fiber is going to be beneficial,” Weisenberger explains. “Some fibers slow down the release of glucose into the blood, and some are food for the good bacteria that produce helpful compounds that reduce insulin resistance.” (Wondering how much protein you actually need? Learn more about this macronutrient and how to get it from healthy sources.)
Finally, try eating your carbohydrates after some fiber, fat, and protein. “When you go to a restaurant, they start by bringing you bread, which is the worst thing to eat first,” says Elizabeth Boham, MD, MS, RD, a functional-medicine physician in Lenox, Mass. “Instead, start with salad with some olive oil. Starting with fiber, protein, and fat really helps with balancing blood sugar.”
2. Move More
When we exercise, we increase our body’s sensitivity to insulin, which decreases insulin resistance. And anything that decreases insulin resistance is going to help manage blood glucose.
Both cardio and strength training offer benefits here — and a combination of the two is best. “The increased insulin sensitivity following exercise could last for a couple of hours or a couple of days, depending on the duration and intensity of the exercise,” Weisenberger says.
Boham recommends two strength-training sessions and at least 150 minutes of cardiovascular exercise per week — and not all the cardio needs to be intense. “Going for a walk after you eat dinner is a wonderful activity that can help improve blood sugar after a meal,” she says.
The very act of exercising helps remove glucose from the blood, even if you’re insulin resistant.
Strength training helps build lean muscle mass, which is crucial for absorbing glucose. “The preferred place for blood sugar to go after eating is to the muscle, but if we don’t have a big muscle, we don’t have a big repository for that sugar to enter,” Weisenberger explains. (For more, see “Why Strength Training Is Essential.”)
She compares muscles to small and large buckets in a rainstorm — the big ones are going to hold a lot more rain. “That’s why we don’t want to lose muscle mass as we age; we want to build as much muscle as we possibly can.”
The very act of exercising helps remove glucose from the blood, even if you’re insulin resistant. “If you’re actively using your muscles, they don’t need those messages from insulin in order to take up sugar,” Weisenberger says.
Though longer bouts of exercise are most effective, simply moving around throughout the day also counts. Research shows that breaking up long periods of inactivity helps improve insulin sensitivity. The American Diabetes Association recommends three minutes of movement for every 30 minutes of extended sitting.
“That could just be walking to the bathroom, moving the laundry from the washer to the dryer, or getting up and doing some squats and stretches,” Weisenberger notes.
3. Try Time-Restricted Eating
Time-restricted eating (TRE) is a moderate form of intermittent fasting in which you eat only during a specific window of time each day. Usually that window is between four and 10 hours long. Studies indicate that TRE can lead to a reduction in fasting insulin levels, improved insulin sensitivity, and better glucose tolerance.
“If the underlying problem in prediabetes is too much glucose, you can either put less glucose into the system or let your body burn off the excess, which is what intermittent fasting does,” Fung says. “It’s the most powerful natural therapy for type 2 diabetes.”
Fung compares a body with too much glucose to an overflowing sink. “The strategy we have right now is that when the sink overflows, we get mops,” he says, referring to the medications used to manage type 2 diabetes. “But the best strategy is to turn off the tap and let the water drain out. Let your body burn off the glucose.”
During fasting, the body uses stored glucose, which is primarily glycogen from the liver, to meet its energy needs. As glycogen stores diminish, the body starts to burn fat for energy. This may help improve insulin sensitivity.
If you decide to try TRE, keep in mind that the body becomes more insulin resistant as the day goes on. “If you eat the same meal at noon or at 8 p.m., you’ll produce a higher amount of insulin after the later meal,” Boham notes. “[Eating] earlier is better when it comes to insulin resistance and prediabetes.” (To learn if you’re a good candidate for TRE, see “Everything You Need to Know About Intermittent Fasting.”)
4. Consider a Continuous Glucose Monitor
If you’re curious about your individual response to carbohydrates, a continuous glucose monitor (CGM) can be a useful tool. This device measures blood-sugar levels in real time with a sensor placed under the skin. A CGM may be prescribed by a doctor if you have type 1 or type 2 diabetes, but you can also find over-the-counter brands.
“CGMs give you information that you couldn’t get otherwise,” Fung says. “We know what the average response to any given food is, but we don’t know what your personal response is going to be. The CGM gives us personalized information about what foods are doing to us.”
A CGM may also offer insight into how sleep, stress, and meal timing are affecting your blood sugar, Boham adds. Still, she cautions that a CGM is best used for a short time, to avoid focusing too much on one kind of metric, and with the support of a provider who can help you interpret the information.
5. Reduce Inflammation
“Prediabetes is an inflammatory disorder,” Boham says, so training your focus on reducing inflammation can yield big benefits.
The simplest way to cool inflammation is by eating fewer inflammatory foods, especially hyperprocessed fare and known allergens like dairy and gluten. Increasing inflammation-fighting compounds from fresh, whole plant foods also helps. (Our bodies need inflammation to fight off infection, but too much of it for too long can spur a wide range of illnesses. Learning to manage it effectively is key. See “How Chronic Inflammation Affects Your Health” for a deep dive on this subject.)
“There’s been great research on phytonutrients and how they can help decrease inflammation after a meal,” Boham explains. “So, in addition to protein, fats, and fiber at each meal, think about including colorful plant foods. Just adding more spices to your meals can be really helpful.”
Regular relaxation also helps calm the system. “When we’re in a state of stress, our blood sugar goes up,” she says. “It makes sense. If you’re running from a tiger, the body wants more glucose in the blood so it can use it to run away.”
The reverse is true as well. “If we activate the parasympathetic, calming nervous system, we can actually bring down our blood sugar.”
Weisenberger adds that poor sleep is a type of physical stress on the body. “One night of poor sleep will increase insulin resistance even in healthy people. But if somebody habitually gets bad sleep, then we can see a big difference in insulin sensitivity.”
6. Experiment With Cold Therapy
A small body of research suggests that cold therapy — such as cryotherapy, polar plunges, ice baths, and cold showers — can lower fasting glucose and insulin levels and improve insulin sensitivity.
It may confer some of these benefits by creating what’s known as brown fat. “When we think of fat, we usually think of white fat, which stores calories. But there’s also brown fat,” Fung explains.
Brown fat stores energy in a smaller space than white fat; it also generates body heat and burns caloric energy.
Regular cold exposure helps generate more brown fat. “If it’s burning energy, that’s going to be useful in the treatment of prediabetes because it’s using up glucose,” Fung says, adding that more research is needed.
As always, the most sustainable way to manage your blood glucose is a personalized, holistic approach that suits your individual needs. If your A1C is running high, it’s worth the time to learn what works for you. Building supportive diet and lifestyle habits can mean the difference between managing a progressive metabolic disease or turning the tide for good.
Learn More About A1C
High blood glucose and prediabetes diagnoses are becoming increasingly common, even among people who are otherwise in good health. Discover the factors that contribute to a concerning A1C reading, along with diet and lifestyle strategies that can help you regulate your blood- glucose levels, by reading “Here’s What You Need to Know About A1C,” from which this article was excerpted.
