Chances are, you know someone who is diabetic—after all, the chronic condition affects an estimated 38.4 million Americans of all ages (that’s 11.6 percent of the population), according to the CDC. But did you know that one in three Americans qualifies as “pre-diabetic,” a condition in which blood sugar levels are higher than normal but not quite high enough to be officially diagnosed as type 2 diabetes.
What makes this last statistic particularly alarming is that many people with pre-diabetes are unaware of their condition. Without intervention, it can easily progress to type 2 diabetes, increasing the risk for serious complications like heart disease, nerve damage, and kidney problems, according to registered dietitian nutritionist Vandana Sheth, R.D.N., a certified diabetes care specialist and author of My Indian Table. The good news: Early detection and lifestyle changes can prevent this progression, which is why tuning into changes in your blood sugar balance is key.
- ABOUT OUR EXPERTS: Vandana Sheth, R.D.N., is a registered dietitian nutritionist, certified diabetes care specialist, and author of My Indian Table. Jerry Bailey, D.C., LA.c., is a certified nutritionist, acupuncturist, chiropractor, and functional medicine physician at Lakeside Holistic Health.
How does someone become pre-diabetic?
You don’t just wake up one day pre-diabetic. Rather, it’s a gradual process that results from a combination of genetic, lifestyle, and environmental factors. “Primarily, it starts with insulin resistance, in which the body’s cells become less responsive to insulin, leading to elevated blood sugar levels,” explains Jerry Bailey, D.C., LA.c., certified nutritionist, acupuncturist, chiropractor, and functional medicine physician at Lakeside Holistic Health. “A lot of factors can come into play, including a diet high in refined carbohydrates and sugars, lack of physical activity, obesity, and lifestyle choices like stress and inadequate sleep.”
It all centers around blood sugar, the regulation of which is crucial for overall health. “In individuals without diabetes, blood sugar levels are maintained within a narrow range through the balanced action of insulin, a hormone produced by the pancreas that facilitates the uptake of glucose into cells,” explains Bailey. “In prediabetes and diabetes, this delicate balance is disrupted. The body’s cells begin to resist insulin (meaning insulin can not attach to the cell to open the channels to let glucose in), causing blood sugar levels to rise above normal levels.”
Read More: 7 Things That Throw Off Your Blood Sugar Balance
If untreated, this insulin resistance can lead to pre-diabetes and then type 2 diabetes, in which the pancreas loses its ability (you might say it gets burnt out) to produce sufficient insulin to keep blood sugar levels in check, he says. As a result, elevated blood sugar not only becomes persistent but can also precipitate a cascade of serious health complications.
Signs that may indicate your blood sugar needs regulating
Some of the following signs may seem minor, but they could be clues that your blood sugar isn’t quite as healthy as you think and needs tending to.
1. Low energy levels
While fatigue is a common symptom of many conditions, it can be a red flag for high blood sugar when accompanied by other warning signs. “In prediabetes, having higher-than-normal blood sugar levels means some or many of the carbohydrates being consumed are not metabolized and converted into energy by our mitochondria inside the cells,” explains functional dietitian Jenna Volpe, R.D.N., L.D., C.L.T. “As a result, we may feel tired and depleted and we may even crave more carbohydrates or feel insatiably hungry.”
2. Frequent urination
If you’re taking more frequent bathroom breaks, elevated blood sugar could be to blame. “When blood sugar levels are high, the kidneys work overtime to filter and absorb the excess glucose, ultimately leading to increased urine production,” explains Bailey. “This frequent urination can result in dehydration, leading to an additional cycle of increased thirst and further urination, indicating that your body is struggling to maintain balance.”
3. Increased thirst
As mentioned, intense and persistent thirst alongside frequent urination can alert you to blood sugar issues. When the body loses water because of increased urination, it triggers a reflex to hydrate more, making you thirsty. “While this may seem like a straightforward call for fluids, it’s essential to consider that this sensation might point toward an underlying issue with how your body is processing sugar, and thus warrants further investigation,” he says.
4. Blurry vision
Blurry vision is a less obvious but significant symptom of blood sugar imbalances. “High glucose levels can cause fluid to shift in and out of the lenses of your eyes, affecting your ability to focus clearly,” Bailey says. “If blurry vision is a recurring issue, it may be a warning sign from your body that your blood sugar levels are not adequately regulated, necessitating a closer examination of your health.”
5. Mood Imbalance
Emotional symptoms such as mood swings, irritability, or even anxiety can also stem from unstable blood sugar levels. “Rapid changes in blood glucose can affect your brain’s ability to function optimally, leading to feelings of agitation or low mood,” Bailey explains. In understanding that mood disturbances can be linked to blood sugar regulation challenges, you might be more likely to look out for other warning signs and check in with a healthcare provider about what you need to do to promote more stable physical and emotional health.
6. urine That Smells Like Acetone
When your body doesn’t get enough glucose (as occurs when sugar gets stuck in the blood instead of shuttling into cells), it thinks you’re starving. So, it essentially switches into survival mode and starts producing its own glucose from fat and protein, explains Volpe. This process, called gluconeogenesis, also produces ketones, which can be dangerous in high amounts. Since the body flushes out excess ketones via urine, you might notice your pee smells like nail polish remover if blood sugar issues are driving significant gluconeogenesis, she says. Unless you’re on a keto diet, this is not a good thing and indicates your metabolic health needs tending to.
How to support healthy blood sugar
If any of the above signs sound familiar, don’t panic. A number of lifestyle changes you can make daily can help keep your blood sugar in check. Here are the experts’ top recommendations.
1. Stick To whole-food carbohydrates
Examples of “whole-food carbohydrates” include fruits, starchy vegetables, and whole grains. These foods are higher in fiber, which is essential for healthy blood sugar. “When it comes to blood sugar regulation, fiber makes a great buffer because it helps to reduce the glycemic index (the rate at which a food raises blood sugar) of any food,” Volpe explains. “Fiber is indigestible, so it acts like a net, slowing down the rate at which the sugars and starches from the food break down and get absorbed into the bloodstream.” Getting your carbohydrates and sugars from these whole foods ensures you’ll have the assistance of fiber in keeping your blood sugar stable.
2. Limit ultra-processed foods
When you hear the word “ultra-processed,” your mind might jump to lab-made eats like cheese puffs, but many highly-processed foods can actually be masked as “healthy,” like canned fruits and vegetables, flavored yogurts, and breakfast cereals. That’s why Volpe recommends carefully reading ingredient lists and avoiding ultra-processed products as much as possible.
Read More: Your 2-Week Guide To Cutting Out Highly-Processed Foods
“Any food made with refined flour that’s been stripped of fiber and nutrients, and any food containing large quantities of added refined sugars, like cane sugar, corn syrup, or high-fructose corn syrup, is a quintessential ‘ultra-processed food,’” she explains. “ These foods can spike blood sugar levels rapidly, leading to insulin resistance and potential type 2 diabetes.”
3. Pair carbs with fat and protein
Similar to fiber, fats and proteins slow down the digestion and absorption of sugars and starches, helping prevent rapid fluctuations in blood sugar levels. “While fats and proteins do get broken down and digested, they take longer—about two to four hours, versus 30 to 90 minutes, which is the amount of time it takes the digestive system to break down sugars and starches (the two types of carbohydrates we get from food),” says Volpe.
Examples of foods high in fats and proteins include but aren’t limited to: cheese, chicken, fish, eggs, nuts, seeds, peanut butter, and oils. Pairing these foods with higher-carb eats makes for more balanced snacks and meals—and more balanced blood sugar, Volpe explains. She recommends adding a scoop of protein powder and a spoonful of peanut butter to fruit smoothies or eating an apple, banana, or piece of toast with peanut butter.
4. Engage in regular physical activity
Physical inactivity (a.k.a. a sedentary lifestyle) increases the risk of developing prediabetes and diabetes. While many people shy away from exercise because they think it involves a rigorous dedicated workout routine and a significant amount of time, you don’t even need to break a sweat to benefit your blood sugar! In fact, even just walking for two minutes after eating can help improve blood sugar levels, according to a 2022 study published in Sports Medicine.
Consistency is key here. “I find the best way to stay consistent with a physical activity regimen is to choose activities that are compatible with your schedule, financial budget, the time of year, and, of course, personal preferences,” says Volpe. “For example, if it’s wintertime and there’s a foot of snow on the ground (or it’s summertime and triple-digits outside), going outside to walk three times a week may not be the most feasible or practical way to try and be physically active.” Instead, you might try dance cardio videos in your living room or a few cycles of kettlebell swings in your basement.
Aim for a minimum of 20 to 30 minutes of physical activity three to four times per week, as recommended by the current Physical Activity Guidelines for Americans.
5. Stay hydrated
Even if you think you’re getting enough H2O each day, you might not be—and proper hydration is essential for maintaining healthy blood sugar levels. “Drinking sufficient water helps the kidneys flush out excess sugar through urine and prevents dehydration caused by frequent urination linked to elevated glucose levels,” says Bailey. “Additionally, staying hydrated can help curb excessive thirst, which is a common symptom of blood sugar imbalances.”
Read More: How To Choose A Top-Notch Hydration Supplement
How much H2O you need depends on factors like your age, activity level, and health status, but a general baseline to get started with is an average of 15.5 cups of water per day for men and about 11.5 cups for women.
6. Manage stress effectively
It might surprise you to learn that chronic stress can harm your blood sugar levels, but it’s true! You see, increases in stress hormones like cortisol can increase glucose production in the liver, explains Bailey. “Incorporating stress-reduction techniques, such as mindfulness meditation, yoga, or even simple breathing exercises can help mitigate these effects,” he says. “By addressing your mental and emotional well-being, you lay the groundwork for a healthier body better equipped to regulate blood sugar levels.”
7. Consider supplements
While lifestyle changes are most important when you’re looking to promote healthy blood sugar levels, some supplements may also have potential benefits for blood sugar balance.
Alpha-lipoic acid (ALA), known for its antioxidant properties, has been shown to support insulin sensitivity and support glucose uptake by the cells. “It helps to reduce oxidative stress, thereby promoting overall metabolic health,” says Bailey.
Berberine is another supplement those with blood sugar concerns should be aware of. “Derived from various plants, berberine has demonstrated significant effects on glucose metabolism and lipid regulation,” says Bailey. “Research indicates that berberine can promote healthy fasting blood sugar and enhance insulin sensitivity.”
When should you talk to your doctor about Your blood sugar levels?
If you notice any of the aforementioned subtle signs—like fatigue, increased thirst, or mood changes—mentioned above, it’s a good idea to schedule an appointment with your healthcare provider, notes Sheth. Additionally, if you have risk factors such as being overweight, leading a sedentary lifestyle, or having a family history of diabetes, consider having regular blood sugar screenings to catch any potential issues early. “Once identified, a healthcare provider may recommend lifestyle changes, regular monitoring, and potentially medication to prevent prediabetes from progressing to Type 2 diabetes,” says Sheth.