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Ask Dana: What extra tips do you have for keeping my blood sugars in range after I eat a morning meal with carbs?

QUESTION:

Dear Dana,

I was diagnosed with type 1 diabetes 5 years ago and have really limited my intake of carbs since.  Through the urging of my health care team, I have begun to include carbohydrates back into my diet.  But I am frustrated and (if I’m being honest, anxious) by the inevitable spike I have in my blood sugars after I eat – but especially after breakfast.  What extra tips do you have for keeping my blood sugars in range after I eat a morning meal with carbs?

– Betty Sloan
Atlanta, Georgia

ANSWER:

Dear Betty,

When people are first diagnosed with diabetes, it is sometimes a knee-jerk reaction to stop eating carbohydrates. However, that is not always the best and healthiest approach to your nutrition or your diabetes.

The trick is learning to take mealtime insulin at the right time, which if done correctly, will reduce the spike from eating carbs and prevent your blood glucose from rising after eating.

To begin, test your carb ratio for the various mealtimes during the day.

Be aware that it is not uncommon to have a more robust carb ratio for breakfast compared to other times of the day. Not only are you exiting a fasting state, but morning-time hormonal changes can also make your insulin less effective.  People also tend to consume more processed carbs in the morning with less of a timed pre-bolus; glucose spikes tend to be higher with both of those habits.

When you are testing your carb ratio, your goal is for your blood glucose to be back at a baseline level 3 to 4 hours after eating. If there is a spike despite the correct carb ratio that you test, you can then start working on the pre-bolus timing of the insulin for that meal and other strategies.

carb heavy breakfast

One simple tip to help slow down the glucose spike from carbs at mealtime is to start your meals by eating proteins, fats and vegetables first.

Starting with these items will slow the absorption of glucose and decrease the rise from carbohydrates. You can also focus on eating carbohydrates that are low on the glycemic index; these will be higher in fiber, lower in added sugar, and often have more protein and fat to help prevent a blood glucose spike.

Be mindful, though, that not all low glycemic foods are “healthy foods” as ice cream and pizza can be categorized as low glycemic. However, lower glycemic foods like whole grains, high-fiber lentils, or beans can work better with your insulin timing and help lower a post-meal blood sugar rise.

Additionally, a short walk or light exercise after a high-carb meal will also help absorb the glucose in your bloodstream after eating and it will increase the insulin sensitivity that comes with physical activity.

Even through moderate exercise, your body is more efficient in absorbing glucose into the body’s cells. This simple habit can significantly lower post-meal blood sugar levels.

Finally, there are several medications that can also help reduce a blood glucose rise after a meal.

These medications, like GLP-1 agonists or SGLT-2 inhibitors, can be a helpful addition to your diabetes management. Talk to your healthcare team or an IDS provider to see if any of these would be right for you.

If you need more individualized guidance, connect with our team here at IDS!

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