To optimize the control of type 2 diabetes (T2D) or prevent its progression, it is necessary to focus on diet and physical activity, but also on sleep and stress management. Here is a summary of the key points to consider.
A short duration of sleep (less than seven hours per night) is associated with an increased prevalence of T2D as well as poorer glycemic control in people with diabetes. Limited evidence also suggests a potential link between the circadian rhythm and the prevalence and control of T2D.
A recent study looked at the link between sleep and glycemic control. The authors wanted to verify whether the quality, duration, and timing of sleep had an impact on the glycemic response to breakfast the next morning. A total of 195 healthy adults consumed standardized meals containing the same amount of calories for two weeks. Continuous glucose monitors were used to measure glycemic variation. The results suggest that poor sleep quality and later bedtime routines are associated with a more pronounced glycemic responses to breakfast the next morning. A person’s deviation from their usual sleep pattern was also associated with poorer glycemic control. Although the study was done in people without diabetes, it highlights the importance of sleep duration and quality for blood sugar control.
Proper stress management can also help improve glycemic control in people with diabetes. When the body experiences stress, it reacts by releasing hormones such as cortisol into the bloodstream. Studies suggest that over time, an excess of cortisol in the blood causes an increase in blood sugar. In healthy individuals, cortisol levels fluctuate, leading to a gradual increase and decrease in blood sugar levels throughout the day. On the other hand, in people with T2D, cortisol levels do not fluctuate, resulting in consistently high blood sugar levels, making it more difficult to manage diabetes. Although it is normal to feel occasional stress, a regular relaxation activity is important in order to optimize long-term stress management and thus glycemic control in people with T2D.
Studies indicate that very low-carb and low-carb diets may be effective in improving blood sugar control in people with diabetes. Studies also indicate that a whole food plant-based diet, which is by default high in carbohydrates since it mainly includes fruits, vegetables, whole grains, and legumes, may also be effective in improving blood sugar control in people with diabetes. Therefore, it can be concluded that there is no ideal distribution of macronutrients for diabetes. What these two types of diets have in common is that they exclude ultra-processed foods that are rich in carbohydrates (sweet and savory treats, sugary drinks, refined grain products, etc.).
However, there is no need to make drastic changes to one’s diet (such as following a ketogenic or vegan diet) to improve one’s blood sugar control. Studies also indicate that a Mediterranean diet is effective for diabetes. Since this type of diet is not very restrictive, it may be easier more sustainable in the long term. This is a good choice for people who don’t know where to start to change their eating habits. Of course, it may also be useful to consult with a Registered Dietitian to obtain more personalized recommendations.