Tips for lowering fasting blood sugar? Pre-diabetes advice

[kokotg]

Last appointment my A1C was pre diabetic, and I have a VERY strong family history of diabetes (mother, grandmother, I think 4 out of 7 aunts and uncles on that side all diabetic; my mother was in her mid 40s when diagnosed, so younger than I am now), so...I'd sure love to stave off diabetes as long as possible. I test at home pretty regularly, and my post meal levels are generally fine as long as I don't eat anything super carby. But my fasting blood sugars have been stubbornly high, and are pretty much always at the high end of pre-diabetic range these days. And then it seems like it's tricky to get my numbers back in range early in the day because I'm starting from a higher baseline. I know from google that this is pretty common, but all the advice I can find it targeted at actual diabetics ("adjust how much medication you take at night!") Anyone had this issue and been able to deal with it without medication? It doesn't seem to matter much what I eat the night before; perhaps wine before bed helps some? But I haven't tried everything yet of course. I have been taking cinnamon right before bed. I have another A1C coming up in a few weeks, so I figure I still have a chance to help myself out some with that if I can fix this fast! 

[prairiewindmomma]

Move for 30-60 minutes a day. Walking for 30 min after each meal seems to be the best bang for your buck. 
 

Don’t eat at all after 7 pm if you can help it. 

 

[kokotg]

2 minutes ago, prairiewindmomma said:

Move for 30-60 minutes a day. Walking for 30 min after each meal seems to be the best bang for your buck. 
 

Don’t eat at all after 7 pm if you can help it. 

 

I aim for 10,000 steps a day--sometimes fall short but usually end up with 65,000 or so for the week, and I've added in 20-30 minutes of yoga 5ish days a week. Walking right after a meal works well for post-meal numbers, and I need to get more consistent about that (which is tricky, with kid schedules and all) but that fasting number is the stubborn one. It doesn't seem like stopping eating earlier in the evening helps with it, either, although I need to experiment more and actually track that. I wonder if a walk right before bed would be useful. 

[Toocrazy!!]

I’ve been wearing a CGM off and on for the last year - not diabetic or prediabetic though. But I found that if I walked after dinner and got my numbers down and didn’t eat anything else, they were pretty stable overnight. Never alcohol. For me, wine would artificially lower my number at first, but then cause a roller coaster all night. Bad sleep also equals a higher number. 
Sometimes mine is higher right when I wake up, but getting out of bed and getting some movement in usually gets it down quickly. My health coach recommended jumping jacks right when I get out of bed. Get the heart rate up and use up leftover glucose. 
Also - steps throughout the day, directly after meals is more effective for me than one long walk a day. You can get your numbers down once, but then keep them elevated all day with food if you’re not moving. Since an A1C is just an average over time, that wouldn’t help your numbers. 
I’ve also had luck keeping my numbers steadier with the order I eat my foods. Salad and fiber always first, then protein and fat. Any carbs I do eat that can be separated, go last in the meal. It makes a big difference in my numbers. Although I am pretty low carb. There’s a person who goes by glucose goddess that has some tips like this. I’ve found they mostly work for me. 
of course, YMMV:) That’s just what I have found to work for me. 

[Jean in Newcastle]

My fasting numbers have been the trickiest to control because of the “dawn effect “. Ie - your blood sugars can drop too low overnight, causing your liver to pump out glycogen, raising your fasting blood sugars. I have had the best luck with eating some protein (two eggs in my case) before bed. (An hour or so before). It keeps my sugars steady. 

Edited May 3, 2023 by Jean in Newcastle
Typo

[ScoutTN]

6 minutes ago, Toocrazy!! said:

I’ve been wearing a CGM off and on for the last year - not diabetic or prediabetic though. But I found that if I walked after dinner and got my numbers down and didn’t eat anything else, they were pretty stable overnight. Never alcohol. For me, wine would artificially lower my number at first, but then cause a roller coaster all night. Bad sleep also equals a higher number. 
Sometimes mine is higher right when I wake up, but getting out of bed and getting some movement in usually gets it down quickly. My health coach recommended jumping jacks right when I get out of bed. Get the heart rate up and use up leftover glucose. 
Also - steps throughout the day, directly after meals is more effective for me than one long walk a day. You can get your numbers down once, but then keep them elevated all day with food if you’re not moving. Since an A1C is just an average over time, that wouldn’t help your numbers. 
I’ve also had luck keeping my numbers steadier with the order I eat my foods. Salad and fiber always first, then protein and fat. Any carbs I do eat that can be separated, go last in the meal. It makes a big difference in my numbers. Although I am pretty low carb. There’s a person who goes by glucose goddess that has some tips like this. I’ve found they mostly work for me. 
of course, YMMV:) That’s just what I have found to work for me. 

I am type 1.5 and would LOVE a CGM, but most insurance, including ours, will not pay for one unless I am insulin dependent. They are $$$. 
 

I have yet to conquer the dawn effect, even though I have tried multiple strategies. Sometimes I just schedule the blood draw for later in the morning, when some activity will take it down some. I end up super hungry and with a headache, though.

Edited May 3, 2023 by ScoutTN

[Toocrazy!!]

Yes, I agree completely on the CGM. I paid for it out of pocket privately. It made all the difference for me. I don’t understand why they don’t cover them for insurance. Purely financially, it would save the insurance companies a lot of future money allowing people this information even for a few months. 

[Carol in Cal.]

“Reversing Diabetes” by Whitaker is what I used to help DH with this.  I got it 22 years ago, and DH made some diet and exercise changes and has not progressed to actual diabetes, despite a tendency toward it and strong family history of it.

10 minute walk after every meal is recommended.

Aerobic exercise 4-6X weekly for an hour.

High protein low carb/slow carb eating.  In his case, crazy big salads with protein for at least one meal per day.  No rice.  No soda.  (Those hurt!). The slow carb thing varies from one person to another, and to figure out your own patterns you do need a glucose monitor.  You check right after a meal, 1/2 hour later, 1 hour later, and 2 hours later to see how YOUR body metabolizes that food.  

[ScoutTN]

Diabetes caused by autoimmune issues is not reversible. Diet and exercise do not stop antibodies attacking the pancreas. Blood work can distinguish this, what my doc calls type 1.5, from typical type 2. 

[thatfirstsip]

I'm not sure about repairing insulin resistance itself (i.e. reversing prediabetes), but you can probably lower blood sugar by eating minimal carbs. One slice of low carb bread, if any at all. No added sugar, no noodles, no rice, no potatoes, nada. I eat peanut butter, low carb bread (again, one slice, once a day), all varieties of cheese, avocados, baby carrots, broccoli, any animal protein I feel like, the occasional single clementine. No drink with any calories (except straight cream on occasion). 

I lowered a prediabetic fasting (105-115) to a fasting of 80-90 within a couple of weeks. I don't think I can go back to carbs and keep the low fasting, so I just continue to not eat carbs unless it's the above foods.

It's pretty easy; once I told myself I could have all the brie I wanted at any time of day, I didn't care much about not eating cookies. Brie is good.

[73349]

The PhD who runs masteringdiabetes.org (himself a T1D) says he found that contrary to the dietary advice he'd received from his doctor (e.g., avoid fruit), lowering the fat in his liver and muscles improved his insulin sensitivity and his overall health, and it works on other people, too. His book is endorsed my Michael Greger (whose nutrition motto is basically "Prove it") and some other MDs. https://www.masteringdiabetes.org/book/

Edited May 3, 2023 by 73349

[kbutton]

Exercising five times per week, eating veggies (lots) before a meal, and moving carbs to later in the day all helped me. I also eat pretty low carb.

I think the biggest difference was from eating between noon and 8 PM. I have messed up cortisol, and I theorize it makes my AM higher blood sugars last longer than most people’s do. 

[kokotg]

Thanks everyone! I already do eat pretty low carb and have for years (I vacillate between super low carb and just lowish carb), and I know how to eat /exercise to keep numbers in range during the day. I also know that I'll never be able to just eat what I want and keep my blood sugar okay; that has been true for a very long time (I had gestational diabetes with my first, so between that and family history I've kept an eye on my blood sugar for forever now). But my fasting numbers keep creeping up no matter how well I control things during the day...like my fasting blood sugar will usually be the highest number I see all day, with the possible exception of maybe an hour after eating, depending on what I eat. And then it doesn't go down in the morning--like I've done intermittent fasting, but I'll take it first thing in the morning and it will be 120 or whatever and then 4 hours later, no eating, exactly the same. I'm not really sure if I CAN do anything about it, but I'd love to try. I've now got eggs before bed, exercise later at night, and exercise first thing in the morning on my list of things to try! I know I've read that the liver controls glucose overnight and the pancreas after meals--not sure where or if that's accurate--but it would make sense that the things I do during the day wrt to food aren't going to help with whatever's happening overnight. Sometimes I think giving up and going on meds and eating a slice of pizza every once in awhile would be lovely...but I know that not having diabetes is better than having even well-managed diabetes, so I'm trying! 

[Selkie]

1 hour ago, 73349 said:

The PhD who runs masteringdiabetes.org (himself a T1D) says he found that contrary to the dietary advice he'd received from his doctor (e.g., avoid fruit), lowering the fat in his liver and muscles improved his insulin sensitivity and his overall health, and it works on other people, too. His book is endorsed my Michael Greger (whose nutrition motto is basically "Prove it") and some other MDs. https://www.masteringdiabetes.org/book/

My online plant based groups are full of people who reversed their Type 2 by following his advice, and Type 1's who have been able to greatly reduce their meds.

[Grace Hopper]

My functional med doc recommended berberine as a supplement. But I think the jury is out on how effective it truly is. 

[kokotg]

1 hour ago, Grace Hopper said:

My functional med doc recommended berberine as a supplement. But I think the jury is out on how effective it truly is. 

The number of supplements that might or might not help is dizzying! Right now I'm taking cinnamon, garlic, vitamin d, magnesium, vitamin c (I don't think that one has anything to do with blood sugar, though), and a multivitamin with ginseng. 

 

[Jean in Newcastle]

I just want to say- blood sugars can make no sense sometimes. Today I have worked my body harder than ever, not eaten any different than usual, taken my usual meds and my sugars are uncharacteristically high. 

[ScoutTN]

48 minutes ago, Jean in Newcastle said:

I just want to say- blood sugars can make no sense sometimes. Today I have worked my body harder than ever, not eaten any different than usual, taken my usual meds and my sugars are uncharacteristically high. 

This! 
 

[kokotg]

47 minutes ago, Jean in Newcastle said:

I just want to say- blood sugars can make no sense sometimes. Today I have worked my body harder than ever, not eaten any different than usual, taken my usual meds and my sugars are uncharacteristically high. 

I know my mother's sugar goes absolutely bonkers when she has any kind of illness or sometimes in response to medication changes for things totally unrelated to diabetes. 

I guess I should also say that it may not even matter much that my fasting numbers aren't great as long as I'm keeping things under control during the day. It will be interesting to see how the A1C is this year. I've been careful about what I eat, testing sugar regularly, exercising more, I weigh 10 pounds less than a year ago, plus all the supplements of dubious value....at least I can say I've done what I can if I do need meds. Also, I looked back through my records and the A1C had crept into pre-diabetic range one other time several years ago and then has been normal since until last year...so we'll see! (last year I had it done in early March, I think, whereas it's usually been at different times of year...I wonder if the difference was just having the holidays in the time period it was measuring).

[Jean in Newcastle]

2 minutes ago, kokotg said:

I know my mother's sugar goes absolutely bonkers when she has any kind of illness or sometimes in response to medication changes for things totally unrelated to diabetes. 

I guess I should also say that it may not even matter much that my fasting numbers aren't great as long as I'm keeping things under control during the day. It will be interesting to see how the A1C is this year. I've been careful about what I eat, testing sugar regularly, exercising more, I weigh 10 pounds less than a year ago, plus all the supplements of dubious value....at least I can say I've done what I can if I do need meds. Also, I looked back through my records and the A1C had crept into pre-diabetic range one other time several years ago and then has been normal since until last year...so we'll see! (last year I had it done in early March, I think, whereas it's usually been at different times of year...I wonder if the difference was just having the holidays in the time period it was measuring).

It’s just a theory (based on some scientific studies) but I assume that my sugars are high today due to stress. That includes the stress on my body caused by a hard workout. (With my fibromyalgia I don’t handle exercise the way that “normal “ people do). I also had my second dental appointment in two days and even though it went very well, it’s still a bit stressful on my body. 

[kokotg]

7 minutes ago, Jean in Newcastle said:

It’s just a theory (based on some scientific studies) but I assume that my sugars are high today due to stress. That includes the stress on my body caused by a hard workout. (With my fibromyalgia I don’t handle exercise the way that “normal “ people do). I also had my second dental appointment in two days and even though it went very well, it’s still a bit stressful on my body. 

I had a major bout of anxiety over the winter, and I definitely wonder if that had something to do with it. I also had covid for the first time, and there's a pretty undeniable connection between covid and new diabetes diagnoses, so...

[ScoutTN]

Stress definitely makes my numbers go up. Same with “minor” illnesses. Emotional ups and downs absolutely have an effect. 

[Toocrazy!!]

Stress for sure! I was playing in a pickleball tournament last fall- and I am not normally competitive. I was so nervous and stressed. Before that match started was the highest my numbers have ever been while wearing my CGM. It was crazy! 
I have also had a UTI while wearing it, and even fasting my numbers would not go down. It’s pretty much how I was sure I had an infection even before testing. 
I think A1C is just the last 90 days average, so it could definitely be affected by holidays, stress, anxiety, a sickness, etc. 

One additional test I have seen recommended is a fasting insulin test. Many functional drs think this is more indicative of future issues than fasting glucose. In very simple terms I understand it to mean that your body will do everything it can to keep glucose numbers steady by releasing insulin. So for years your fasting glucose and A1c can be relatively normal, but if your body is working extra hard to keep those numbers in line, the fasting insulin will show that. 
and yes to muscle! That’s what I’m trying to do now. Build some muscle to use up glucose as I eat it. 

[kokotg]

Just updating in case anyone from the future is reading this...just got my labs back and my A1C is 5.8, so still pre-diabetic, but on the lower end of pre-diabetic (and down a smidge from last year). So the high fasting numbers are annoying, but were not a sign that things were about to go off the rails at least. I will keep experimenting with different things! I'm about to be gone on an RV trip for most of the summer, so I'm relieved that I'm not going to have to mess around with trying to adjust to metformin or something while I'm traveling.