Diabetes is one of the biggest challenges of our generation, and I’m at heightened risk for developing it. As some MedShadow readers might already know, I am one of the many women with polycystic ovary syndrome (PCOS.) That condition puts me at a substantially higher risk than the average woman for developing diabetes.
According to the Centers for Disease Control and Prevention (CDC), 4.8% of people between the ages of 18 and 40 (with or without PCOS), and 18.9% of those aged 45 to 64, in the U.S. have diabetes. But by the time they’re 40 years old, more than half of women with PCOS also have diabetes. I’m now 35.
I’m glad that there have been some new breakthroughs in understanding and treating diabetes in the past few years, but I’d still rather avoid any medications that I can, especially those that have only been on the market a short period of time, such as semaglutide because we’re still learning about its side effects. One of my primary health goals these days is doing what I can now to prevent diabetes later. So far, I’ve managed to do so. Here’s how.
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Insulin Resistance, PCOS, and Diabetes
About a year ago, I did a few sessions with a nutritionist. The main reason was that I had some vitamin deficiencies—iron and B12. They were likely a result of excessive sweating and long outdoor workouts in Florida, as opposed to my PCOS, but during the sessions, she calculated my “HOMA-IR score.” HOMA-IR is an indirect measure of insulin resistance. You can learn more about it in our article on insulin resistance.
An “optimal” score is 1.0 or lower. Experts don’t agree on the exact cutoff for insulin resistance (diabetes is associated with insulin resistance, but is diagnosed based on the sugar in your blood as opposed to your HOMA IR score). Most agree that if your HOMA IR is over 2.5 you likely do have insulin resistance, but in between 1.0 and 2.5, there’s a bit of a gray area. Plus, the range of healthy values is likely different for people of different ethnicities, genders, and ages.
My score was a 1.4. My nutritionist said this didn’t necessarily mean I have insulin resistance, but that it might be helpful to consider how my diet and exercise affect my blood sugar to lower the likelihood that my score might go up in the future. She also mentioned that almost none of her PCOS patients ever had an “optimal” score of less than 1.0.
Exercise and Blood Sugar
Regular MedShadow readers may also already know that I am an avid exerciser. I do a ton of cardiovascular exercise, because I love to train for half marathons and triathlons. (I’m working on trying to fit in more resistance training like weights and yoga.) Exercise plays a big role in making your body more sensitive to insulin and preventing diabetes—even if it doesn’t cause you to lose any weight.
But, as mentioned, I already regularly exceed the typical recommendations of 150 minutes of weekly exercise. So how else might exercise help?
The Two-Minute After-Meal Walk
All exercise is good exercise, but if you’re looking to control your blood sugar, consider the timing of your physical activity. Yes, I exercise a lot, but it tends to be in one- to three-hour-long blocks of time, set apart from my otherwise very sedentary lifestyle.
Unfortunately, journalism doesn’t require a lot of heavy lifting, and I’ve never been the type of person who could write an article while walking on the treadmill. That means that despite my long workouts, I end up sitting a lot of the day, but I recently learned that I don’t need to go for a 30-minute-long break every hour or two in order to reduce my risk for diabetes.
After you eat any meal or snack, your blood sugar rises (more on that below.) The main goal in fighting insulin resistance and preventing diabetes is making those rises slow, gradual inclines and declines, rather than steep spikes and plummets. And in 2022, researchers found that going for a walk as short as two minutes long within an hour or so of eating helped smooth the expected blood sugar spikes.
More power to those of you who can fit a midday workout in during lunch, but I struggle to get a good workout, shower, and a meal in, then get right back to work! What I can easily do is fit in a brief walk down the hallway and back before I settle back into my reporting. And that’s something I regularly do now.
After dinner, my fiance and I like to watch television, but since I know that flopping onto the couch right away isn’t good for my blood sugar, sometimes I’ll spend five to ten minutes marching in place, doing bodyweight squats, or stretching. I don’t do enough to break a sweat, but just enough to get my blood moving around and hopefully smooth out the blood sugar spike of the meal. As an added bonus, the activity also helps me manage my post-meal acid reflux!
Diet and Blood Sugar
Your diet is arguably the most important factor when it comes to controlling your blood sugar. We all probably know by now that too many sugary foods can lead to too much sugar in your blood. Simple carbohydrates like white breads, pasta, and rice can have the same effect. That’s why many experts recommend low-carb diets for people with diabetes.
But there’s another option, and that’s a huge comfort to me since carbs are definitely my favorite food group. Rather than avoiding carbohydrates altogether, we can make sure that when we do eat carbs, we eat them alongside fiber and protein, two nutrients well known to lessen that blood sugar spike. For example, rather than eating 30 small pretzels as a snack, eat 15 pretzels dipped in hummus. Hummus is made from chickpeas, which are rich in both fiber and protein.
A Few of My Favorite Lunches and Snacks
I find that having two small lunches each day, rather than one larger one, keeps me fuller for longer, reduces my acid reflux, and makes it easier to make healthy choices. Here are some of my favorites.
Greek Yogurt with Fixings
Most days, one of those midday meals is a bowl of nonfat greek yogurt with berries, granola, honey, and chia seeds. The granola is high in carbohydrates, but their effect on my blood sugar is diminished by the protein-heavy yogurt and fiber-rich berries. A few pinches of chia seeds give an extra boost to both the fiber and protein content of the snack, while also adding some extra healthy omega-3 fatty acids.
Farro with Roasted Vegetables and Sauces
For my second lunch, I’m often craving carbs. I satisfy this craving with a bowl of farro. Farro is a carb, but it’s a whole grain that’s also full of fiber and protein. I don’t always see it on the shelves of my local grocery store, so sometimes I order it in bulk online (you can find farro and other grains on Amazon). It’s chewy and satisfying with a complex, nutty flavor. If that doesn’t sound like you, other whole grains like bulgur and quinoa can make up the basics of the healthy bowl!
On Sundays, I boil a week’s worth of farro. Then, I scour my fridge and find any vegetables about to go bad, such as brussels sprouts, sweet potatoes, and asparagus. I roast them with a little olive oil and salt and mix them into the farro. Then I look for a protein to add. Sometimes I have some leftover chicken or shrimp, but often, I find a can of chickpeas or hard boiled eggs can go a long way if I’m busy. I mix these in. Then I think about flavor! I love to mix in pesto or harissa paste for flavor. Other times I’ll make a traditional vinaigrette with olive oil, lemon, and lots of herbs.
One fun trick I learned from TikTok to add protein and texture to the bowl is to put chickpeas in the food processor for a few pulses, then mix with a little olive oil and salt and roast until they’re crunchy like toasted breadcrumbs. It’s a great way to add more nutritional value, too! Lastly, I’ll also usually add a hefty serving of parmesan on top before eating. Maybe that adds a little protein and calcium, but I mainly do it because parmesan makes everything taste better.
Banana and Almond Butter
I’m a big banana fan, but they don’t keep me full for long, so when a hunger pang strikes, and I don’t have time to cook, I eat a banana with a few spoonfuls of almond butter. (Personally, I don’t like peanut butter, but that’s also a great option to use here). The protein and fat in the almonds makes it a much more filling snack, and helps control any blood sugar spike associated with the fruit.
Treats
I love to bake and eat indulgent sweets. Sometimes food needs to be more than fuel for our bodies, but also for our souls! I don’t deprive myself of the occasional cookie, ice cream, or extravagant slice of birthday cake. (This year it was dark chocolate with caramel-banana whipped cream!)
What I will do is balance that treat with other healthy foods and activities. For example, one small study of Chinese adults showed that blood sugar spikes following a meal were smallest if the individuals ate the vegetables first, then the protein, and finally the rice (fiber, protein then carbs), as opposed to eating them all together or in a different order. So, if I am going to have an indulgent dessert, I make sure I get plenty of fiber and protein first! Plus, if you’re already full, you’re more likely to keep the sweet serving small.
I also use the short walks to my benefit. I live in a small city, and there’s an ice cream shop about a half a mile from my apartment. If I’m craving ice cream, I don’t grab a bowl, and scoop it out of a tub buried in my freezer. Instead, I walk to the local shop, order a scoop of raspberry chocolate chunk ice cream and eat it while walking around town. When I’m done, I head back home. Is that walk enough to cancel out any sugar, calories, and fat I’ve just consumed? No, which is why I don’t get ice cream every day. But, it is enough to help balance out my blood sugar temporarily so that my occasional treat doesn’t push me closer to diabetes.
