How to eat to lower blood sugar

When you have type 2 diabetes, life can often feel like a juggling act: You have to balance how much you eat, and when you eat it, with the right amount of exercise — all while taking your medications consistently. Strike a good balance and your blood glucose (sugar) can remain stable. If you don't make it work, your risk of diabetes complications rises.

Food makes your blood sugar levels rise soon after eating. The particular food you eat, how much you eat, and the timing of your medication around the time you eat make a difference in your levels, too.

Damage to your body from high blood sugar can happen pretty quickly, and the higher the level, the greater your risk of complications, according to a 2015 review in the Diabetes & Metabolism Journal. The higher (and lower) the blood sugar levels reach, the more likelihood for damage to vessels and other parts of the body.

And problems can develop when the numbers stay high for just a few days, according to the Joslin Diabetes Center in Boston. The specialty medical center advises making changes to your treatment plan if blood glucose levels stay over 180 mg/dl for three days in a row.

If you have trouble keeping blood sugar in a healthy range after eating, you’re not alone. What foods can you eat and what other steps can you take to keep blood sugar under control? Try these tips and tricks.

Additional reporting by Andrea Peirce

Choose the Healthiest Carbohydrates

Of the major nutrients found in food — carbs, protein, and fat — carbs have the biggest effect on your blood sugar. That’s because carbs are the most quickly broken down into glucose for energy. Having too many carbs, or the wrong type of carbs, can lead to spikes in your blood sugar.

The best way to figure out how the carbs you eat affect your blood sugar is to test your levels before and after meals. The American Diabetes Association (ADA) recommends keeping track of the number of carbs you have per meal. The amount you should eat may vary depending on what it looks like to successfully manage your diabetes. Choose healthy, complex carbs such as whole fruits and vegetables, whole grains, beans, and lentils. Because they contain fiber and are less processed, these foods don’t lead to as many swings in your blood sugar levels. Stay away from refined carbs such as soda, candy, white pasta, white rice, white bread, and other processed foods — they can cause blood sugar to rise quickly.

Offset Carbs With Fat and Protein

When carbs are consumed as part of a meal that includes protein and fat, they affect blood sugar more slowly. For this reason, planning ahead for healthy, balanced meals is fundamental to good diabetes management, says Jenny Champion, RD, a diabetes educator, personal trainer, and editor of Posh Paleo Magazine.

To make sure your meals are well-balanced, the ADA suggests this method of filling your plate:

• Half your plate: non-starchy vegetables, such as spinach, carrots, tomatoes, or greens
• A quarter of your plate: grains and starchy foods, such as whole grain noodles, rice, or potatoes
• A quarter of your plate: lean protein, such as beef, fish, chicken, or tofu
• Add an 8-ounce glass of low-fat milk and a piece of fruit or half a cup of fruit salad on the side.

Remember that even if you eat the right foods, eating too much can cause your blood sugar to rise. “Keeping track of what you’re eating — and how much you’re eating — and then how it affects blood sugar is the best way to stay on top of your diabetes,” Champion says.

Get a Head Start on Protein

Breakfast seems to be a particularly good time to load up on protein. In a study published in April 2015 in the Journal of Nutrition, people with diabetes who ate 25 to 30 grams of protein at breakfast had lower blood sugar spikes after both breakfast and lunch than those who ate less. Reduced-fat cheese and egg whites are excellent sources of protein, according to the ADA. Other protein-rich ideas for breakfast when you have diabetes include a breakfast burrito, for example. But because people respond differently to different foods, says Champion, it’s important to keep tracking your blood sugar to see how various breakfast foods affect you specifically.

Eat More Fiber

Fiber is a special type of carbohydrate that's not broken down by the body, so eating it doesn’t have any effect on blood glucose levels. It also promotes digestive health and keeps you feeling fuller longer after a meal. Also, says Champion, because it slows the surge in blood sugar after a meal, it’s especially beneficial for people with diabetes.

Research has shown that people with diabetes who get enough fiber each day are able to control their blood sugar better than those who don’t. The Joslin Diabetes Center, the ADA, and other organizations recommend that the average person aim to eat between 20 and 35 grams each day.

One of the best ways to hit this goal is to eat more whole grains, beans, vegetables, and fruits with the skin left on. If you need help in finding out how to incorporate enough fiber into your diet, consider working with a diabetes educator or a registered dietitian — a professional can give you more ideas and advice.

Go Nuts for Snacks

Aside from what you eat, the amount of food you eat at each meal affects your blood sugar. In general, the bigger your portions, the more your blood sugar levels will rise. Snacks are a great way to lessen hunger so you don’t end up overeating at meals. But be smart about your choices. Focus on snacks that combine carbs, proteins, and fats to help stabilize blood sugar.

Nuts, in particular, are a great snack choice for people with diabetes: A major review and analysis of studies published in the journal PLOS One in July 2014 found that tree nuts, including pecans, cashews, and almonds, may help with weight management and blood sugar control. In another study, published in June 2014 in the Journal of the American Heart Association, adults who ate two servings of pistachios a day eased their body’s response to the stresses of everyday life, which lessened the load on their heart. That’s an added benefit for people with diabetes, a condition that can be stressful to manage.

Beware of the Label “Sugar-Free”

Grocery shopping can be confusing, since at first glance, many foods may seem healthier than they are. Smart food choices can be hard to make. Watch out for sugar-free alternatives, which are better than the real-sugar versions, but hardly healthy.

In addition, says Champion, “just because a food is labeled ‘sugar free,’ ‘reduced sugar,’ or ‘no sugar added’ doesn’t mean it’s carbohydrate free, too.” This means the food can still cause your blood sugar to rise. Your best bet is to look at the Nutrition Facts panel and ingredient label on the back of the package, she says. Don’t rely on advertising claims on the front of the package.

The ADA suggests that rather than just looking at the sugar content, always check the total amount of carbohydrates in a product — which includes the amounts of starch, fiber, sugar, and sugar alcohols. This total will give you a more accurate idea of how a food may actually affect your blood sugar levels.

Drink More Water

What you eat makes a difference in your blood sugar levels with diabetes, but so does what you drink. The ADA recommends calorie-free options to stay hydrated: water and unsweetened teas are great choices. Diet soda is not a healthy substitute for sugary sodas, but if you're faced with a choice between regular soda and diet there’s no question that the diet version is better. The most natural and healthy choice is water. Another benefit of water is that drinking it before a meal can make you feel fuller — and that can help you avoid overeating.

Drink Less Alcohol

While alcohol isn’t completely off-limits for people with diabetes, it can cause low blood sugar (hypoglycemia) for up to 24 hours after you drink. “Alcohol makes blood sugar drop,” says Champion, “which can cause cravings for sugar that may cause you to eat too much sugar.”

So if you do drink, at least control how much. “Pace yourself and have a full glass of water after every alcoholic drink,” says Champion. The same guidelines on drinking apply to people who have diabetes and those who don't: Women should have no more than one alcoholic drink a day, and men no more than two a day.

The ADA says that if you drink, check your blood sugar before you do and again before bed. If the level’s too low, eat something to raise it. Never drink alcohol on an empty stomach. And if you’re counting carbs, don’t count alcohol in your plan as a carbohydrate choice.

Time It Right

Because your blood sugar levels are affected by when you eat your meals and snacks, sticking to the same schedule from day to day will help keep your levels steady and consistent. Timing your medication and managing your insulin therapy around your meal schedule is also important. Insulin shots are most effective when you take them in such a way that the insulin goes to work when the glucose from your food starts to enter your blood, according to the ADA.

For example, regular insulin works best if you take it 30 minutes before you eat. “If you take insulin, talk to your diabetes educator to get help in calculating exactly how much insulin you’ll need (and when you’ll need it) throughout the day,” advises Champion. “Timing and dosage are very important for effective blood sugar control.”

Simplify Your Tracking

Keeping a diary that tracks what foods you eat, and what your blood sugar levels are, is one of the best ways to learn how different foods affect you, says Champion. They’re also good for figuring out the effects of daily stress and your exercise routine on your body. But keeping a handwritten diary can seem complicated, time-consuming, and inconvenient. Instead, download one of the latest diabetes data tracking apps that make the job a cinch. You can explore phone app and other trackers to download on the National Institute of Health’s website.