A dietitian’s guide to glucose control (plus five top tips on how to manage it)

Whether you have a family history of type 2 diabetes or you’re aware of the strong link between glucose control and whole-body health, it’s worth keeping an eye on your glucose levels.

The topic of glucose control has gained increasing attention in the public sphere over the past few years, and for good reason.

Glucose is one of the most powerful molecules that controls homeostatic balance in the body, influencing disease risk, ageing and energy regulation. Fortunately, there is much we can do from a diet perspective to optimise glucose control and long-term health as a result.

What is glucose?

Glucose is a simple sugar found in carbohydrate-based foods that is the primary source of fuel for the muscles and the brain. When carbohydrates are consumed, they are broken down into glucose molecules, and transported to the cells to be used as energy. Insulin, a hormone secreted by the pancreas, regulates glucose levels in the body.

Why are blood glucose levels important?

Whenever we consume foods that contain carbohydrate – bread, rice, grains, cereals, legumes, fruits, vegetables and sugars such as honey and table sugar – simple sugars are taken from the small intestine into the bloodstream before being transported to the liver where they are either utilised as energy or stored for later use. Glucose storage and utilisation are complex and the body is in homeostasis or balance when glucose levels are tightly regulated, as high glucose levels over time are damaging to the body’s cells. Weight gain over time, inactivity and genetics all affect how efficiently glucose is metabolised in the body.

What happens when we eat?

When carbohydrates are consumed, blood glucose levels will rise over a couple of hours as the body processes the glucose it has been exposed to. Carbohydrate-rich foods that have a high glycaemic index like soft drink, white bread and white rice, result in relatively high levels of glucose in the blood after consumption compared with foods like wholegrain bread and legumes, which have a lower glycaemic index. This is why diets that have a lower glycaemic load overall are better for the health of the cells long term.

What does it mean if you have diabetes?

Glucose regulation is different for different people. For those who have normal glucose function, glucose levels will return to normal an hour or two after eating. However, for individuals who have impaired glucose function or type 2 diabetes, the hormone insulin no longer regulates glucose levels well. As such, high glucose levels after eating are common as the body works overtime to reestablish glucose balance. For this reason, some individuals with insulin resistance, impaired glucose tolerance or type 2 diabetes may require medication to help keep glucose levels controlled. For this group, consuming diets that have a lower carbohydrate load is an easy way to help keep glucose levels as tightly regulated as possible.

Signs you may have issues with glucose regulation

If you have a family history of type 2 diabetes, or had gestational diabetes, it’s a good idea to speak to your doctor about keeping an eye on both your insulin and glucose levels and monitor for gradual increases over time. Storing weight centrally, with a waist measurement of 100cm or more could be suggestive of high insulin and glucose levels, as is unexplained weight gain, sugar cravings and an inability to lose weight. While health practitioners may check for type 2 diabetes, identifying and managing elevated glucose and insulin levels early will ultimately help prevent type 2 diabetes from developing.

How to optimise glucose control

Whether you’re at risk of developing diabetes, or simply want to optimise your overall health by keeping glucose levels controlled, there are a number of dietary strategies that support glucose control.

Always eat carbohydrates and protein together

There’s nothing wrong with enjoying good quality carbohydrates such as starchy vegetables, whole grains, fruit and legumes as part of a healthy, balanced diet. But consuming carbohydrates in isolation, for example plain toast, plain noodles and rice or even fruit, will result in a relatively high release of glucose into the bloodstream. Combining protein-rich foods with carbohydrates at each meal and snack will help to keep glucose levels more tightly controlled, aiding glucose regulation. Think fruit with protein yoghurt, grain bread with lean meat or fish or eggs, and a smaller portion of noodles or rice with lean protein and veggies.

Learn how to “food sequence”

For those who do have glucose regulation issues, there is evidence to show that food sequencing, or eating your foods in a particular order, will result in more tightly controlled glucose levels. To food sequence, start with the vegetable component of the meal, followed by protein and then any carbohydrate-rich foods such as potato, bread, crackers or legumes.

Know your carbohydrate loads

While you may have heard of the glycaemic index (GI) of particular foods, the carbohydrate load we consume is also relevant. For example, while sourdough bread may have a lower GI than regular bread, sourdough tends to come in large slices, with 30-40g of carbohydrate per slice, so the total amount of carbohydrate the cell is exposed to is still high. Aiming for controlled portions of carbohydrate or 20-30g in total per meal or snack is an easy way to help regulate glucose levels.

Create space between meals

One of the worst offenders in terms of glucose control is grazing throughout the day. This includes sips of milky coffee, pieces of fruit and biscuits, and regular snacks in between meals. Each and every time we eat, glucose levels will be affected, resulting in constant spikes throughout the day. Ideally, the body needs several hours in between eating to allow hormones to do their work and let glucose levels to return to baseline. One of the most powerful things we can do to support glucose and appetite control is to allow for at least 3 hours in between all eating occasions, even tea or coffee with milk added.

Move after meals

Muscle cells utilise glucose, so the more we move, the better glucose control will be, especially after eating. For this reason, walking, completing household chores or running errands is a better idea than sitting down at the desk or in front of the TV after our meals.