The diabetes advice I give ALL my clients

You might think that the guiding behavioral principles change radically when someone is diagnosed with diabetes. But I highlight the following seven practices for every one of my clients (depending on their readiness), regardless of whether or not they have diabetes.

1. Eat regularly throughout the day - our bodies do possess compensatory mechanisms to supply our cells with glucose if we go for long periods of time without eating. This capacity is compromised in people with diabetes, making it especially important to not go too long without eating. But eating every 4 or so hours is good for all of us to avoid extreme hunger (which can lead to fatigue, [h]anger, brain fog, anxiety, and overeating), to maintain relatively stable blood sugar levels without taxing the body unnecessarily, and to sharpen our powers of interoception, meaning the sensing and interpretation of our body's needs over the course of the day. 

2. Eat a balance of protein, carb, and fat at meals and snacks - carbs are burned up first, then protein, and finally fat. If you were to eat just carbs, they would get burned up quickly and then you'd feel hungry again quite soon. If you were to combine carbs with protein and fat, however, not only would you slow down the influx of glucose into the blood stream, but you'd add to your satisfaction - staying sated for longer - and nutritional intake and likely your enjoyment. This doesn't have to be perfect. When you're putting together meals and snacks, just have a think about where your carb, protein, and fat are coming from.

3. Find your sources of fiber - just like the presence of protein and fat in a meal, fiber slows the absorption of carbohydrates, maintaining more stable blood sugar levels and allowing you to feel satisfied for longer. This is true whether or not you have diabetes. Fiber-containing foods also have other benefits - they help prevent constipation, manage cholesterol levels, and add texture and substance to what we're eating. 

4. Accumulate veggie intake little by little - vegetables can feel like a dirty word when you're ditching dieting and reconnecting with your inner Intuitive Eater. Take your time with reclaiming them, and when you do, consider approaching vegetables in a way that prioritizes accumulation little by little. What I mean by this is tossing a handful of baby spinach in your breakfast smoothie, adding leftover roasted broccoli to your lunchtime wrap, dipping some carrots along with pretzels in your hummus snack, and adding frozen mixed veggies to your dinner stir fry. It doesn't have to be all of the above. The point is that veggie intake can be small and cumulative for big benefits - taste, texture, and nutrition. 

5. Regular movement matters - moving your body in ways that are enjoyable and functional has many benefits for people with diabetes, including improved insulin sensitivity and regulation of glucose uptake. But these effects are beneficial for all of us, as are improved mobility and flexibility, mood elevation, and improved sleep. I'm a big fan of moving more regularly for shorter periods of time. Don't let the idea of a 45- or 60-minute workout prevent you from moving in ways your body enjoys. 15, 20, or 30 minutes more days of the week is way more valuable to your whole self.

6. Prioritize sleep - not getting adequate quality or quantity of sleep can impact blood sugar levels in those with diabetes. But getting enough is essential to all human beings in order to thrive. Adequate rest and sleep improve immunity, mood, and cognition. Could you survive on 5 hours of sleep? Maybe. But don't you want to do more than survive?

7. Manage changing stress levels - stress is a moving target for all of us, and it is not doled out equitably across populations and across time for the same individual. Increased stress can mess with blood sugar control in those with diabetes, but it needs to be managed in any body. Stress, to some degree, is a normal part of life. This makes it important to manage in an ongoing way. During times of increased stress, in particular, we might need to switch gears to meet ourselves where we are.