Contributor: Kelly Schmidt, RD, LDN

Blood sugar management is key to overall health, regardless of a diabetes diagnosis. You may have seen non-pharmaceutical companies advertising continuous glucose monitors to the average consumer. One helpful tool in blood sugar management is the power of a routine.

Routine can help us understand how our blood sugar will behave with certain meals, activities, foods, and days of the week. Does anyone else take the most insulin on Mondays? I liken this to being a parent - to understand blood sugar needs and our unique diabetes, we need to step back and adjust our perspective, similar to understanding the needs of a newborn baby. Yes, there are a lot of variables to think through, but once we understand our diabetes needs more thoroughly, we may be able to spend less time on our diabetes and more time on things we love.

Weight Loss and Calories
Weight loss is far more than just eating fewer calories. In fact, a calorie deficit diet is only successful short-term. Our bodies are smarter than weight loss apps. Additionally, did you know weight loss is said to be three times harder for women with diabetes? According to a study from The American Journal of Clinical Nutrition, we have different hormonal responses to different types of food¹. Sustainable weight loss and health come down to working with our hormones, including insulin, and learning to eat in a way that makes us individually feel good. Sure, calories are fuel, but the foods we tolerate and prefer are as unique as our fingerprints.

Some Healthy Eating Challenges
When we highlight a challenge we face in blood sugar management, health, and weight loss, we can shine a light on the hurdle and create solutions to work through it. Some common challenges are:

• Too busy to grocery shop and cook
• Not planning ahead
• Eating out
• Lost directions due to varying advice
• Ignoring our hunger/fullness signals to hit blood sugar targets
• Manipulated relationship with food (Having diabetes can increase the risk of developing eating disorders)

My biggest piece of advice is NOT to overhaul your food or lifestyle, but try to improve by only 1% each week. Small changes lead to big results.

My 5 Pillars of Glucose Management
During my ten years of private practice, I have organized specific pillars that I see as foundational to practice daily to move towards better health throughout our life.

• Gut health - Our gut aids in digestion, absorbing nutrients, and having a more robust immune system. A healthy gut with a diverse, beneficial microbiome is essential for our health. An imbalance of microbes with reduced diversity may contribute to weight gain, above-target blood sugar and cholesterol, and other disorders. People with type 1 diabetes are more likely to have a gut characterized by decreased microbial diversity². It is important to nourish your gut with appropriate nutrition to restore its healthy gut flora.
• Rest - Studies have found that glucose levels are elevated after a short night’s sleep³. Hormones that control stress and satiety are also affected, which can lead to increased food consumption and weight gain. I always credit sleep as "the secret sauce to health.”
• Activity - Walking for ten minutes after a meal can be an effective way to aid in blood sugar management in people with diabetes. A study collected health information on a representative sample of adults over 18 years old. Out of nearly 6,000 people who responded, over 25% of American adults sit for more than 8 hours every day, and 44% of those people get little to no exercise⁴. Simply moving your body can help blood sugar management and aid insulin absorption.
• Carbohydrates - Food and drinks with carbohydrates affect your blood sugar the most. The American Diabetes Association (ADA) suggests that there is no magic number of ideal carbs to eat for each meal. The amount of carbohydrates you need is primarily determined by your body size, activity level, dietary preferences, concurrent medical therapies, etc. However, a low carbohydrate diet (<130g/day) may improve glycemic management and metabolic health in people with type 1⁵.
• Eating with the sun - When we eat is as important as what we eat. Our metabolism, blood sugar, digestion, and hormones may benefit when we choose to eat with the sun. Circadian rhythm is our body’s internal clock that reacts to changes in light. It helps us determine when to sleep, wake up, eat, digest, release hormones, and regulate body temperature and other bodily functions. Irregular mealtimes and eating late can disrupt our circadian rhythm and result in lower insulin sensitivity and more inflammation in our body.

Life is short but also not perfect. Add more grace to your day, your goals, and your expectations. Chase results, not rules.

References

1. Ludwig, D. S., Aronne, L. J., Astrup, A., Cabo, R., Cantley, L. C., Friedman, M. I., Heymsfield, S. B., Johnson, J. D., King, J. C., Krauss, R. M., Lieberman, D. E., Taubes, G., Volek, J. S., Westman, E. C., Willett, W. C., Yancy, W. S., & Ebbeling, C. B. The carbohydrate-insulin model: a physiological perspective on the obesity pandemic (2021). The American Journal of Clinical Nutrition 114 (6), 1873–1885. https://doi.org/10.1093/ajcn/nqab270
2. Jamshidi, P., Hasanzadeh, S., Tahvildari, A. Farsi, Y., Arbabi, Mahta., Mota, J. F., Sechi, L. A., & Nasiri, M. J. (2019). Is there any association between gut microbiota and type 1 diabetes? Gut Pathogens. 11 (49). https://doi.org/10.1186/s13099-019-0332-7
3. Tsereteli, N., Vallat, R., Fernandez-Tajes, J., Delahanty, L. M., Ordovas, J. M., Drew, D. A., Valdes, A. M., Segata, N., Chan, A. T., Wolf, J., Berry, S. E., Walker, M. P., Spector, T. D., & Franks, P. W. (2022). Impact of insufficient sleep on dysregulated blood glucose control under standardized meal conditions. Diabetologia. 65(2), 356–365. https://doi.org/10.1007/s00125-021-05608-y
4. Ussery, E. N., Fulton, J. E., Galuska, D. A., Katzmarzyk, P. T., & Carlson, S. A. Joint prevalence of sitting time and leisure-time physical activity among US adults. (2018). Journal of the American Medical Association. 320(19),2036–2038. https://doi.org/10.1001/jama.2018.17797
5. Turton, J.L., Raab, R., &Rooney, K.B. (2018). Low-carbohydrate diets for type 1 diabetes mellitus: A systematic review. PLoS ONE. 13(3), e0194987. https://doi.org/10.1371/journal.pone.0194987

Kelly Schmidt, RD, LDN is the founder of Kelly Schmidt Wellness, a wellness business changing the landscape of blood sugar management with holistic nutrition strategies for busy women with diabetes. While eating is a necessity, knowing how to eat well is an art. Kelly can guide you on how to craft your healthiest recipe for life. Follow her on Instagram @diabeticdietitian or reach her by email: kelly@kellyschmidtwellness.com.