For people with type 2 diabetes, understanding blood sugar levels—also called blood glucose levels—and the effect this has on the body is a key part of managing the condition. Glucose acts as an energy source, fuelling our cells so our bodies can move and function correctly. But for those with type 2 diabetes, glucose stays in the bloodstream and this much-needed fuel never reaches the cells.

When this happens our bodies look for another source of energy and start to burn fat instead, a process that releases ketones—an acid made in the liver—into the bloodstream. Ketones can be toxic and a high level of ketones in the blood is called diabetic ketoacidosis, a condition that if left untreated can result in a diabetic coma or even death.

Fortunately, there are lots of things you can do to manage, lower, and monitor your blood sugar levels, all of which we’ll explore below. 

What is a healthy blood sugar level?

As a general rule, a 'normal' blood sugar level is:[1]

• At home with a self-testing kit, a normal range is 4 to 7mmol/l before eating and under 8.5 to 9mmol/l 2 hours after a meal
• If your HbA1c level is tested every few months, a healthy range is below 48mmol/mol (or 6.5% on an older measurement scale).

Your doctor is a good place to start if you have any questions about blood sugar levels. 

How do you know if your blood sugar levels are too high?

If blood glucose levels are too high you might experience some of the following symptoms:[2]

• Feeling thirsty, even though you’re drinking lots of fluids
• Needing to urinate more frequently than usual
• Feeling tired and lethargic even if you’re getting plenty of rest
• Blurred vision 
• Recurrent infections 
• Changes to your skin or cuts and bruises that take a long time to heal

If you experience any of these symptoms, make an appointment with your doctor who will test your blood sugar levels. If you have type 2 diabetes and are able to test your blood sugar levels yourself, you’ll be able to see if any of these symptoms mean your levels are elevated. If they’re too high then you will need to lower them back down to a healthy level. It’s important to try and have a steady blood sugar level at all times.

How to lower blood sugar

Here are five things you can do to manage and keep your blood sugar levels in a healthy range.

1. Make changes to your diet

One of the easiest and most effective ways to keep your blood glucose levels stable is through your diet. Carbohydrates, sugar, and fat can all raise your blood glucose levels so you’ll need to pay close attention to how much of these you’re eating throughout the day.

Try and favour a diet rich in fresh vegetables, protein, and unsaturated fats. Foods like nuts, avocados, and fish are great for keeping your blood glucose levels low while making sure your body gets the essential nutrients it needs to function. While carbohydrates are a great source of energy, you may find it helpful to limit the amount of starchy carbohydrates you eat in a day; these are foods like pasta, potatoes, white bread, and white rice. Instead, opt for complex carbohydrates, like wholemeal bread, pasta, and rice; these take longer to break down and so raise your blood glucose levels at a much slower rate.

As well as keeping an eye on your carbohydrate intake you should also be aware of how much sugar you’re consuming, particularly when it comes to hidden sugars. While things like fruit juices or dried fruit might seem healthy, they contain high levels of fructose, which can convert into fat that's then stored in the liver… further impacting insulin resistance.

There are plenty of different eating approaches to explore when it comes to managing blood sugar levels with diet, so try them out and see what suits you—and by that, we mean what makes you feel well but also what suits your lifestyle, budget, and health goals. Before making major changes to your diet, please consult with your doctor first. 

2. Think about your eating habits 

We know that adopting new eating habits can sometimes feel overwhelming, especially when it comes to changing habits of a lifetime. 

As well as making changes to your diet, try and understand how and when your blood sugar levels spike. By tracking your eating habits you can then make any adjustments to your behaviour so you can be sure you’re eating the right foods at the right times. 

Consider starting a food diary; by recording everything you eat in a day (make sure you don’t cheat!) you’ll have a clear understanding of your eating habits, some of which might come as a surprise to you! For example, you might think you’re only having the odd biscuit here and there but your food diary might reveal you’re actually eating much more than you initially thought. Similarly, you might notice you tend to snack more in the afternoons, which is when your blood sugar starts to spike. Once you gain these insights into your behaviours, you can then build a plan that slowly replaces them with healthier choices.

3. Embrace physical activity

There are many reasons why staying active is important to our health. As well as reducing the risk of certain diseases it’s great for keeping our hearts healthy, lowering our blood pressure, and helping us get a good night’s sleep. And it’s not just the physical benefits either; keeping active is a great way to boost your mood and improve memory and brain function.

Exercise can also keep our blood sugar levels at a healthy level. When we exercise our bodies use sugar reserves that are stored in the muscles and liver.[3] After exercise, our bodies then replenish these stores with sugar from the bloodstream, meaning the more you exercise the lower your blood sugar levels will be. 

Alongside eating well, exercise is a key factor in losing weight. Losing a substantial amount of weight—around 15kg or 2 stone 5lbs—increases the chance of type 2 diabetes going into remission.[4] Not to mention losing weight comes with lots of other significant health benefits such as better mobility, decreased joint pain, and reduced chances of suffering from a heart attack or a stroke.

Exercise also affects our metabolism, also referred to as our basal metabolic rate (BMR). Exercise increases muscle mass which results in a higher BMR; this helps to burn calories but without exerting any extra effort. 

4. Build new habits

No one is perfect and we understand that life still happens while you’re making healthy choices. Making small changes to your daily routine to help build new habits can make a huge difference in managing type 2 diabetes and sending it into remission.

Smoking, as well as causing cancer, heart disease, and lung disease, also has negative implications if you suffer from type 2 diabetes. High levels of nicotine can lessen the effects of insulin meaning smokers with type 2 diabetes often struggle to manage their blood sugar levels more so than non-smokers.[5] 

Earlier, we looked at why you should pay attention to what you eat but you should also pay attention to when you eat. Introducing regular set meal times can help maintain healthy blood sugar levels, especially if you eat similar amounts of foods (particularly carbs) at the same time each day. 

Don’t forget to stay hydrated by drinking plenty of water throughout the day. Plain water contains no carbohydrates, calories, or sugars, so it won’t affect your blood sugar. A recent study found that not drinking enough water can result in hyperglycaemia (the name given when blood sugar levels are too high).[6] Similarly, if you’re looking at how to lower blood sugar levels, drinking water can help flush excess sugar from the blood via the kidneys and bladder through urination.

5. Monitor blood glucose levels

You can maintain healthy blood glucose levels through regular monitoring. If you’re taking insulin or other blood sugar-lowering medications you’re probably already familiar with blood sugar monitoring; for many people living with type 2 diabetes the use of a blood glucose monitor isn't common, but that’s not to say it can’t help. 

By using a blood glucose monitor you can check to see if your blood glucose levels fall within a healthy range and understand how these are impacted by things such as food, exercise, illness, and stress. It’s also a great way to check in to see if your treatment plan is working correctly.

You may also have heard about continuous glucose monitoring (CGM). This refers to a small device that is worn under the skin and monitors the amount of glucose in the blood at any given time; this information can then be accessed easily on a patient’s mobile phone. There’s plenty of research [7] to suggest that having access to your blood glucose levels encourages users to stick to healthy habits like an eating plan or exercising regularly. As each individual will react differently to food and exercise, a CGM can offer a unique insight as to why blood glucose might be different for a specific individual.

Consistency is key to managing blood sugar levels

So there you have it, five simple steps you can take to help manage, maintain, and lower your blood sugar levels. Creating and following new habits will not only help you manage your condition but it’s the start of sending type 2 diabetes into remission. As with anything, results won’t happen overnight but with hard work and determination, you can start regaining control of your health and future.