The Importance of Glycaemic Control for People With Diabetes

For people living with diabetes, understanding how to maintain stable blood sugar levels is critical. Poor glycaemic control can lead to a range of different health conditions, such as fatigue, foot ulcers, and recurring hospital visits.

Because blood sugar levels are affected by lifestyle factors like diet, what you eat and drink is one of the easiest starting points for diabetes management. Keep reading to find out how you can optimise your diet for glycaemic control and what other lifestyle changes you should consider.

 

Diabetes: Causes and Outlook

Diabetes is a chronic condition where a person has high blood glucose levels (blood sugar). This occurs when you don’t have enough insulin to convert glucose into energy.

Diabetes has two main forms: type 1 and type 2. Around 5–10% of people with diabetes have type 1 diabetes, which usually develops in childhood or adolescence [ADA]. It’s caused by an autoimmune reaction where the immune system mistakenly kills beta cells in the pancreas that are responsible for insulin. Few or no beta cells means less insulin and a build-up of glucose in the blood.

Type 2 diabetes, on the other hand, affects 90–95% of people with diabetes, and is normally caused by lifestyle factors [ADA]. It’s especially common in older adults, particularly men and people with chronic diseases such as hypertension [petrie]. Being overweight or obese is the greatest risk factor for type 2 diabetes [barnes]. Physical activity, like walking, is associated with a lower likelihood of type 2 diabetes [hu].

Although diabetes is a chronic health condition, it can be managed with multidisciplinary health treatment, blood glucose monitoring, and the right lifestyle choices. Traditionally, diabetes has been viewed as a progressive disease, which means it gets worse over time. As such, management strategies have focused on reducing complications through lifestyle modifications and complication-specific interventions [draznin, melmer].

Recent research, though, has shown that diabetes progression can slow, stop, or even reverse [riddle]. This is known as ‘remission’. Diabetes is classed as being in remission when your HbA1C levels (which is a type of haemoglobin in your blood) fall below 6.5% at least three months after you stop taking glucose-lowering medication [riddle].

 

Understanding Blood Glucose Levels

Blood glucose levels (BGL) refers to the amount of sugar present in the bloodstream. BGL monitoring helps people with diabetes make informed decisions about diet, medication, stress, and physical activity – all of which can impact your glucose levels. The BGL for a person without diabetes is typically 4.0–7.8 millimoles of glucose per litre of blood (mmols/L).

People with diabetes often find it difficult to keep their BGL within a healthy range. While optimal BGLs vary between individuals, the Royal Australian College of General Practitioners (RACGP) does provide general recommendations for target blood glucose levels before (pre-prandial) and after (post-postprandial) eating.

 

Glucose Level Targets

Talk to your GP, dietitian, or diabetes educator about blood glucose targets that are ideal for you. You can check your BGLs using a finger-prick test or a continuous glucose monitor (CGM). Keep in mind that a CGM can’t be used on its own – you still need to do daily finger-prick tests to calibrate it.

  Type 1 diabetes Type 2 diabetes
Before meals 4.0–6.0 mmol/L 4.0–7.0 mmol/L
Two hours after starting meals 4.0–8.0 mmol/L 5.0–10 mmol/L

 

HbA1C: Long-Term Glycaemic Control

A blood test used to access long-term glycaemic control is HbA1c, which represents ‘the big picture’. Your HbA1c (or glycated haemoglobin) is used to monitor your average BGL over the past three months [schnell].

A goal for many people is a HBA1C under 7% [Melmer]. A HbA1c blood test every three to six months, combined with self-monitoring at home, helps your healthcare team understand your risk of complications and make decisions about medications, diet and exercise. Ask your healthcare team what your HbA1c goal should be.

 

Why Self-Monitoring Your BGLs Matters

Self-monitoring your BGLs is an important part of diabetes management. Without regular BGL data, you and your healthcare team won’t be able to make the right decisions about diet, physical activity, and medication [kirk]. There’s also a correlation between a lack of self-monitoring and diabetes-related hospitalisation [kirk].

You can use the finger-prick test or continuous glucose monitoring (CGM) to check your BGLs. Finger-prick testing involves pricking your finger with a needle and applying a test strip. CGM, on the other hand, doesn’t draw blood – a CGM wearable device measures your interstitial fluid through your skin. CGM provides continuous data and is completely painless, but it isn’t as accurate as a finger-prick test – you’ll still need to calibrate your CGM device through regular finger-pricking.  

 

Risks Associated With Poor Glycaemic Control

The main goal of diabetes management is to achieve and maintain good glycaemic control, blood pressure, and cholesterol. Over time, unstable blood glucose levels can cause long-term damage to blood vessels, nerves, and other tissues, including those behind your eyes and on the bottoms of your feet [nemer]. People with type 2 diabetes are also at higher risk of conditions like cardiovascular disease and foot ulcers [nemer].

Those conditions may sound frightening, but it’s important to realise that they’re preventable. With the right healthcare team and lifestyle interventions, the progression of diabetes can be halted or even reversed. People with diabetes can and do live long, healthy and fulfilling lives – often without significant pharmaceutical or surgical interventions.

 

How to Use Food to Control Blood Sugar

Food and drinks have a big impact on blood sugar, so understanding the relationship between carbs and your BGLs is important.

 

Low-Gl Carbohydrates

When you eat foods that contain carbohydrates, your body breaks down those carbohydrates into glucose (a type of sugar). Glucose is absorbed into your blood and used as a source of energy for your body [alberts]. 

The glycaemic index (GI) is a ranking of carbohydrates (0 to 100) based on how quickly they affect blood glucose (blood sugar) levels. The higher the GI, the faster your blood sugar will rise, and the higher the peaks and troughs in your BGLs will be after eating the food. High-GI foods (a GI of 70 or more) include foods with refined sugars, like soft drinks, fruit juice, pastries, lollies, white bread, and white rice. 

Medium-GI foods and drinks have a GI value of 56 to 69. Low-GI carbohydrates (GI of 55 or less) are characterised by a smaller rise and fall in blood glucose. These carbohydrates break down more slowly, which means glucose is released into your blood at a slower rate. Examples of low-GI foods include whole fruits, starchy vegetables (potatoes and corn), dairy foods, whole grains like oats and brown rice, and nutritional supplements like AdVital Powder.

 

Tips for Lowering the GI of Foods

Some tips for lowering the GI of your meals, snacks, and drinks include:

     

      • Replace the high-GI foods in your diet with low-GI ones.

      • Don’t overload on low-GI foods; too much of a good thing will increase your BGLs. Keep carb-rich portions to a moderate size (that is, about a quarter of your dinner plate or a third of a cup of cooked low-GI rice or pasta).

      • Never skip meals. Include three main meals and zero to two snacks per day (depending on your management plan).

      • Balance meals with some carbs, lean protein, and plenty of salad or vegetables.

      • Combine your carbohydrate-based meals and snacks with protein, such as eating an apple with nuts or adding a scoop of AdVital Powder to a carb-based meal.

      • Use acidic dressings and sauces, such as lemon juice or vinegar.

      • Choose higher-fibre, less processed breads and cereals, such as dense, grainy bread and rolled or steel-cut oats.

      • Combine your carbohydrates with healthy fats (such as olive oil, nuts, avocado, or fish) and limit saturated fats.

      • Eat more non-starchy vegetables, such as dark leafy greens, carrots, and salad vegetables.

      • Use carbohydrate exchanges to manage carbohydrate portion sizes (see carb counting below).

    Lean proteins, healthy fats, fibre, and acidic foods help slow digestion and glucose release, preventing rises and falls in blood glucose levels.

     

    The Five Food Groups

    Because high-GI foods are typically processed foods, people with diabetes can benefit from eating meals made up of the five food groups. These are:

       

        • vegetables and legumes/beans 

        • fruit 

        • wholegrain foods such as breads, cereals, rice and pasta 

        • lean meat, fish, poultry, tofu, tempeh, and nuts 

        • milk, yoghurt, cheese, or non-dairy, calcium-fortified plant alternatives.

      Together, the five food groups represent a balanced diet. If you can, aim to meaningfully incorporate all five into your daily eating plan.

      Keep in mind that every diabetes diagnosis is unique. Make sure you talk to your dietitian about a diet that matches your individual needs.

       

      High-Fibre Foods

      While it’s important to keep your blood glucose levels steady, which involves avoiding meals with a high glycaemic load, you still need to make sure you’re getting enough fibre. A high-fibre diet can help control BGL, support weight loss, and improve overall health [Reynolds].

      The average adult following a Western diet should aim to consume around 35 grams of fibre each day [Reynolds]. For context, a banana has around 3.5 grams of fibre – you can try increasing your fibre intake with supplements like psyllium husk or Pear Juice enriched with AdVital Powder.

      Keep in mind that the two types of fibres – soluble and insoluble – have different impacts on blood glucose. Soluble fibre is broken down by your body and slows digestion, which has positive effects on BGLs [yu kang]. Insoluble fibre passes through your body mostly intact, which means it typically doesn’t affect BGLs (although it’s important for GI health) [ting]. If possible, aim to combine sources of both soluble and insoluble fibre in your meals.

      Consult your GP or dietitian before making significant diet changes, especially if you have chronic health conditions.

       

      Carb Counting

      Another strategy you can use to manage your blood sugar is carb counting. Even if you’re limiting high-GI foods and eating meals comprising the five food groups, you can still spike your blood sugar by eating oversized portions.

      Carb counting means keeping track of the amount of carbohydrates you eat in your meals, snacks, and drinks, and making sure that those carbohydrates are spread out evenly across the day.

      Using carbohydrate exchanges is an easy way to plan meals and snacks. A single exchange is an amount of food that contains 15 grams of carbohydrates (one exchange = 15 grams of carbohydrates).

      Examples of food with 15 grams of carbs that are equivalent to one exchange include:

          • one regular slice of wholegrain bread

          • one medium apple, one small banana, or three small fruits (such as apricots)

          • one cup of milk

          • half a cup of mashed potato

          • a third of a cup of cooked pasta or rice

          • six squares of plain milk chocolate

          • one scoop of AdVital Powder.

        When you’re eating packaged foods, always make sure you read the nutritional information on the label; check ‘serve size’ and ‘total carbohydrates per serve’. You can then use carb exchanges to work out how much you can have (and whether a whole food might be a better option).

        Talk to your dietitian about the number of carbohydrate exchanges per meal or snack that are right for you.

         

        Sample Meal Plan

        This is a sample meal plan for a busy female. It uses a general guide of two to three carb exchanges per main meal and zero to one carb exchanges per snack. The carbohydrate-containing foods are bolded.

        Meal Food Carbohydrates (g) Carb exchanges
        Breakfast 1 AdVital Banana Smoothie (AdVital Powder, banana, and milk) 30 2
        Snack  latte coffee (250 millilitres milk) with no sugar 15 1
        Lunch 1 sandwich (2 slices of wholegrain bread with cheese, lemon-pepper tuna, and 1 cup mixed salad vegetables) 30 2
        Snack 1 apple and ¼ cup raw nuts 15 1
        Dinner Chicken stir-fry (100 grams lean chicken, beef, tofu or AdVital Powder, 1 cup low-GI rice, and 2 cups non-starchy vegetables) 30–45 2–3
        Snack    

        Other Lifestyle Changes to Manage Diabetes

        Making lifestyle changes is essential for managing diabetes effectively. These changes can impact blood sugar levels and overall health.

        Regular Exercise: Regular physical activity is vital. Engaging in aerobic exercises, such as brisk walking, cycling, or swimming, can help lower blood sugar levels, improve your body’s sensitivity to insulin, and maintain a healthy weight [Harvard health].

        Healthy Weight Loss: Losing excess weight can improve insulin sensitivity and glycaemic control. Work with a healthcare professional or a registered dietitian to develop a personalised weight management plan [hood].

        Stress Management: Stress can affect blood sugar levels, so managing it is crucial. Adopting stress management techniques such as mindfulness, deep breathing exercises, and engaging in relaxing activities can contribute to better symptom management.

        Support Systems: It is also essential to establish a strong support system, which could include regular consults with healthcare professionals, attending diabetes education programs, and seeking support from loved ones [qi]. These people can provide encouragement on the journey to better glycaemic control.

        Final Thoughts

        Understanding blood glucose levels – and how they can be managed through interdisciplinary healthcare, lifestyle changes, and self-monitoring – is a crucial part of glycaemic control.

        By regularly monitoring blood sugar levels, you and your healthcare team can make informed decisions about your diet, exercise, and medication, leading to better long-term outcomes. Specific dietary tactics, like carb exchanges, maintaining a low glycaemic index, and eating more soluble fibre, can be especially useful under a dietician’s direction.

        Having diabetes doesn’t determine the quality of your life. The right healthcare and the right lifestyle interventions can reduce the risk of complications – and even lead to remission. If you’re grappling with diabetes, talk to your healthcare provider about how a holistic, interdisciplinary approach can benefit you.  

        Medical information on FlavourCreations.com.au is merely informational and is not the advice of a medical practitioner. This information is general in nature and was accurate at the time of publication. For more information about nutrition and your individual needs, see a GP or an Accredited Practising Dietitian.

        Information presented in this blog is merely informational and is not the advice of a medical practitioner. This information is general in nature and was accurate at the time of publication.

        While this guide provides valuable information on kids’ nutrition and essential vitamins, it is important to consult with a qualified healthcare professional, such as a pediatrician or registered dietitian, regarding any specific health or dietary concerns related to your child. Individual needs may vary, and professional medical advice is essential for personalised recommendations tailored to your child’s unique circumstances.

         

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