For about 5 years I saw patients at an Internal Medicine office. The majority of patients I saw had been diagnosed with Type 2 Diabetes. While each patient was unique in their experiences, concerns and goals, during that time I found a lot of commonalities. I want to share some observations with you and suggest some gentle nutrition principles that could have a big impact on managing Type 2 Diabetes.
It may take some time for your blood glucose levels to stabilize.
High blood glucose readings (high fasting blood glucose, an elevated A1C, or both) would indicate a diagnosis of Type 2 Diabetes. Even with medication, nutrition and physical activity interventions, it will take time for your levels to adjust. That’s a good thing! You’ll want a steady downward trajectory rather than a sudden fall in blood glucose. Because your body has adapted to a high level of circulating blood glucose, it needs time to adjust to a new lower level. Otherwise you would experience drastic swings that bring drastic physiological symptoms (related to blood glucose swings).
Food isn’t the only thing that affects your blood glucose.
It’s easy to assume that food is the only factor in abnormal blood glucose levels, but there are quite a few other things that effect it. Sleep, stress, exercise, mental health concerns, medications, meal/snack timing, eating patterns and digestive function are other contributors. While clearly food will be a factor, it’s important not to overemphasize its effect while losing sight of other physiological functions and lifestyle factors. There are a lot of layers to your overall self-care!
Your body thrives on rhythm
We are cyclical, rhythmic creatures. We have sleep rhythms, digestive rhythms, hormonal rhythms, etc. Your body likes predictability and rhythm. While you don’t need anything militant or rigid (which actually doesn’t have a positive impact on your physical or mental health), having a certain amount of flexible structure will help your blood sugar levels find their natural rhythm (instead of drastic, extreme changes during the day).
Here are some basic suggestions for establishing a flexible structure:
- Include 3-5 food groups at meals and 1-3 food groups at snacks.
- A snack will likely keep you going for 1-2 hours while a meal would keep you full and satisfied closer to 3-4 hours.
- Honor your hunger cues and respect your fullness cues to identify how much to eat at meals and snacks.
So, if you eat breakfast at 8:00 am, you’ll likely need something to eat around 11 or 12. If lunch isn’t going to be until 1:00 pm, you’ll want to plan a snack… and so on throughout the day. This flexible structure can help you anticipate your needs and plan accordingly, which will go far in stabilizing your blood sugar levels.
You can eat carbohydrates
Those diagnosed with diabetes often believe they can’t eat carbohydrates, which isn’t true. Your body and brain still need carbohydrates and energy, that doesn’t change! I would encourage you to spread carbohydrates out evenly over the day and include them at meals and snacks with other food groups. Balance and variety are important nutrition principles for everyone.
You need to eat enough food, often enough
Because of the stigma associated with Type 2 Diabetes, it’s easy to internalize the idea that you caused this disease by eating too much food. However, that’s a dangerous association to make for a few reasons. First, it’s untrue. We actually don’t know exactly what causes Type 2 Diabetes, or at least can’t say weight or food intake directly causes it. Second, this assumption leads you to eat less food than you need. In some cases, that restriction can lead to intermittent overeating or bingeing. Swinging between those extremes in eating is incredibly harmful to managing blood sugar levels, and is far more problematic than eating carbs or sugar in and of themselves (the foods you may be in a restriction/chaos cycle with).
In order to normalize blood sugar levels, you need to be eating consistently, regularly and adequately. Try to reject the idea that you need less food because of this diagnosis. In fact, living with Type 2 Diabetes will necessitate being even more intentional about eating enough food, often enough. If your blood sugar readings are unpredictable with swings between high levels and low levels, this would be the place to start.
Diabetes, or any health concern, can be scary, confusing and frustrating. I hope these observations have been helpful in better understanding diabetes management.