For American Diabetes Month this November, we’re following up on some of the latest research. The more we know about how to better manage blood sugar and its impact on the human body the better we will all be able to manage our health.
Managing diabetes with lifestyle has been linked more and more to overall health, such as in this new research on how dementia is linked to blood sugar control. Researchers don’t know the biochemical link yet between blood sugar and increased risk of dementia, but there seems to be a strong correlation, with people who have metabolic syndrome or type 2 diabetes twice as likely to develop dementia as others. Alzheimer’s disease in particular may be caused in part by how the brain metabolizes sugar. Recent studies have also linked type 2 diabetes to an increased risk of skeletal complications including vertebral fracture.
This year’s official theme for American Diabetes Month is the connection between type 2 diabetes and cardiovascular health. These two conditions are strongly linked to each other, and making healthy choices for your heart also means making healthy choices for your blood sugar, most of the time.
What’s the best way to track blood sugar?
For a long time, it’s been known that the best way to track blood sugar is to do regular checks upon waking, before and after meals, before and after exercise and at different times of day. This gives the fullest picture of how blood sugar fluctuates naturally throughout the day and allows an individual to customize diet and exercise choices to what works personally. The more precise one gets with times eaten, what was eaten, and how much activity they did, the better the results. But this can get draining, which is why advances in continuous blood glucose monitoring (CGM) may be good news for diabetics.
Tracking one’s blood sugar nowadays is usually achieved with a combination of a fingerstick and the once-every-three-months test for overall blood glucose average known as the HbA1c. The HbA1c test gives a good overall snapshot of one’s current health for that three month period, but isn’t very granular as far as what caused spikes and dips in blood sugar.
New technology for blood sugar monitoring
A relatively new technology known as continuous glucose monitoring (CGM) is a device inserted under the skin that keeps measuring blood sugar throughout the day. Fingersticks can help track what factors actually cause individual spikes, but they have to be done very regularly and diligently to be useful. CGM, on the other hand, has both precision of knowing exactly when sugar spikes and falls, and averages out results for a big-picture snapshot of metabolic health. It also measures the equivalent of 300 fingerstick tests per day, which makes for more accurate averages.
CGM devices can be purchased on the internet at a variety of prices depending on the precision of the device and extra features like whether it alerts you to spikes. CGM is sometimes covered by Medicare plans and other insurance, but it is more costly than standard glucose monitoring so check with your insurance to see if these devices can be covered. CGM devices generally last a certain amount of time such as 90 days before they need to be purchased again.
CGM can be used for a new emerging metric, as well—time in range. Time in range refers to the amount of time one is within the healthy boundaries of high and low blood glucose as established by the health care providers. It creates a fuller picture since there’s a big difference between spiking out of healthy range for a few minutes following an indulgent meal and staying above healthy range for days on end, for example.
Why blood sugar stability matters for everyone
Research shows blood sugar spikes are common for a lot of people, not just diabetics. CGM studies of mostly-healthy people find that it’s not uncommon to go through life seemingly metabolically healthy but with occasional spikes of blood sugar that look like those seen in diabetics.
The 2019 American Diabetes Month’s theme—the link between type 2 diabetes and cardiovascular disease—reminds us that risk factors are often the same for these two conditions. The good news is, so are the behaviors that can lower risk. For example, exercise is a key way to reduce the likelihood of metabolic syndrome, heart attack, stroke and type 2 diabetes. Healthy sleep patterns and stress management are strongly linked to lowering these risks as well.
A high-fat low-carb breakfast is one way to keep blood sugar stable in the day, as is eating meals rich in fiber, which also have the added benefit of keeping you full longer. This is especially true for people with type 2 diabetes, and a new study on blood sugar all day following a high-fat, low-carb breakfast shows how important it is for self-management. In general, foods that spike blood sugar lead to a drop and increased hunger, so eating filling meals from high on the satiety index is one way to keep blood sugar stable for everyone.
Aside from eating filling meals without too many carbohydrates, exercise, stress management and a healthy sleep schedule can be the best ways to manage both blood sugar spikes and risk factors for cardiovascular disease.
This American Diabetes Month, take our quiz on type 2 diabetes self-management for more tips on monitoring and managing your own blood sugar.