Four months ago, I could fit everything I knew about blood sugar into a 140-character Tweet. 

I knew that kids had sugar highs after cake and ice cream, followed by crashes that made them grumpy zombies. I’d experienced low blood sugar in a job that frequently required me to work through meals. Lightheaded and confused, I’d notice my hands shaking and be unable to put together the cause right away. 

“I’d notice my hands shaking and be unable to put together the cause right away.”

“Did you eat today?” my husband would ask when I got home. I often couldn’t remember. He’d hand me an apple or some nuts and in just a few minutes, I’d feel like I was coming back to life. Only after correcting the problem would I truly realize how weak I’d felt, or even notice how irregular my heart rate had been. “Wow,” I’d say to him. “I can’t believe I drove home like that.” 

I thought about blood sugar in the same vein as headaches or bloating — a thing my body would sometimes need attention for, but otherwise manageable enough. I started keeping protein bars in my office drawers, and considered the problem solved. 

“I thought about blood sugar in the same vein as headaches or bloating — a thing my body would sometimes need attention for, but otherwise manageable enough.”

And then just weeks before graduating preschool, my daughter was diagnosed with type 1 diabetes.

We spent two days in the hospital, getting a crash course in glucose, insulin, and the endocrine system from a diabetes educator named Gwen. My husband took notes, and I instantly forgot my squeamishness around needles. We practiced counting carbs in estimations based on what our kid actually ate, learning how to manage meals that would now include a lot of surprisingly complicated math and an insulin shot.

After less than 48 hours, our daughter was fitted with a continuous glucose monitor and we were discharged with a binder full of handouts and enough medical supplies to turn our linen closet into a full-on diabetic pharmacy. 

We didn’t feel ready. How could we ever be ready?

We checked and double-checked our math before calculating each dose of insulin, using the suggested carb-to-insulin ratio and a confusing chart that gave us additional units according to her blood sugar reading and the time of day. We learned that “diabetes math” is a nightmare of word problems that no school class had ever prepared us for. “It’s an art, not a science,” everyone kept telling us at the hospital, a phrase that would come to haunt my dreams. “You’ll have to figure out what works using trial and error.” In other words, we were having to guess at how to treat our only child with a drug she needed to keep her alive, but one that could also kill her.

“We were having to guess at how to treat our only child with a drug she needed to keep her alive, but one that could also kill her.”

Blood sugar sometimes feels like the only thing I think about now. And even though the stakes are different for people with diabetes, the care and maintenance of healthy levels of blood sugar (also called glucose) is essential for everybody. 

What is glucose and what happens when it fluctuates?

When we eat, our body breaks down the food into a simple sugar — glucose, from the Greek word for “sweet” — which travels through our bloodstream and gets converted into energy.

This process is aided by the pancreas — an organ I had never thought about before I had to learn how to behave like one. The pancreas releases insulin, which is a hormone that moves glucose from the bloodstream into our cells. (Hormones, by the way, are the body’s chemical messengers. They are extremely powerful, and having too much or too little of any one hormone can have major impacts on nearly every aspect of our health.) 

“When we eat, our body breaks down the food into a simple sugar — glucose, from the Greek word for “sweet” — which travels through our bloodstream and gets converted into energy.”

Everyone experiences blood sugar rises after eating. Without insulin, or if your body isn’t using insulin properly, glucose levels will rise to dangerous levels. Sustained high blood sugar is called hyperglycemia, and very high levels can cause life-threatening complications — like diabetic ketoacidosis (DKA) or hyperosmolar hyperglycaemic state (HHS). If left untreated over months or years, high blood sugar can lead to permanent damage to multiple parts of the body, including the eyes, kidneys, nerves, and blood vessels.  

Type 1 diabetes is an autoimmune disease where the body destroys insulin-producing cells; type 2 is when there isn’t enough insulin or the body is insulin-resistant. Both conditions require blood glucose monitoring to prevent a build-up and extreme fluctuations. Hyperglycemia (high levels) and hypoglycemia (low levels) are not only dangerous for our health, but they feel terrible, and can cause brain fog, fatigue, and generally disrupt day-to-day life.

Monitoring blood glucose in non-diabetics

With the recent FDA clearance for over-the-counter continuous glucose monitors (CGMs) for non-diabetics, some corners of the wellness industry are trying to convince us that we should all be tracking our glucose levels along with our steps, weight, blood pressure, heart rate, and sleep score. Which is a lot!

There are some real benefits to knowing this personal data. Having clear measures of how your body responds to all the elements of your lifestyle can help you make better decisions to support your health and wellbeing. And while blood sugar rises are expected after eating, some studies suggest that a spike (when your glucose increases at a rapid rate, and then falls just as fast) can be worse for the body than a higher but steady glucose level. 

“Having clear measures of how your body responds to all the elements of your lifestyle can help you make better decisions to support your health and wellbeing.”

But if your pancreas is responding with the right amount of insulin, and your body follows orders to process glucose into energy, then well, smooth sailing, right? Why would someone without diabetes need to know much else about their blood sugar?

“A revelatory 2018 Stanford study using CGMs on people considered “healthy” showed glucose dysregulation with spikes that reached diabetic levels.”

A revelatory 2018 Stanford study using CGMs on people considered “healthy” showed glucose dysregulation with spikes that reached diabetic levels. The study revealed what finger-stick measures can’t show, which is the actual fluctuations of blood glucose throughout the day occurring in people without diabetes.

A finger stick, the old standard method of checking glucose levels, only gives you the reading in that single drop of blood (think of it as a snapshot rather than a video). So by monitoring blood sugar levels only a few times a day, people were missing the ebbs and flows of their glucose levels, including the spikes that were much higher than anyone expected for nondiabetics.

Since blood sugar spikes increase a number of health risks, including the development of cardiovascular disease and prediabetes (a precursor to type 2 diabetes), this study indicates that perhaps even people without diabetes could benefit from monitoring their levels with a CGM (the authors of this study recommend once a year). 

The challenges of “flattening the curve”

If this study revealed anything, it’s that many people are walking around experiencing major fluctuations and spikes in their glucose levels without even knowing it. This can be dangerous, leading to conditions like prediabetes (a precursor to type 2), or just miserable, contributing to low energy, constant hunger, poor sleep quality, and more. But even with a CGM, trying to get glucose levels to remain in a steady, healthy range is not exactly straightforward.

“Even with a CGM, trying to get glucose levels to remain in a steady, healthy range is not exactly straightforward.”

Remember how the hospital team told us that diabetes management was “an art not a science”? I will admit that I chafed at this — weren’t they scientists? Hadn’t they just given us a formula and a set of rules to follow? We just had to count the carbs, calculate the ratio, make adjustments according to her glucose levels, and *boom*! Diabetes managed! 

Lol. 

It turns out that there are dozens of variables that affect the curve: stress, poor sleep quality, adrenaline, heat, and cold could all throw a wrench into a carefully designed plan, and not always the same way! Most of the time, for example, exercise lowers blood sugar. Except for when it raises it.

Growth hormones at night interfere with insulin too, causing highs we can accidentally overcorrect with too much insulin, which starts acting about 20 minutes after administered, but peaks more than an hour after that. And then the type of foods eaten are all processed differently as well, depending on what order they’re consumed and what they’re paired with. Fat and protein also affect the curve, sometimes leading to a second rise. And second-day carbs have a lower glycemic index, meaning they’re easy to overcorrect if we dose using the usual ratio. 

“There are dozens of variables that affect the curve: stress, poor sleep quality, adrenaline, heat, and cold could all throw a wrench into any carefully designed plan, and not always the same way!”

We had to learn all of this in real-time, toggling back and forth between apps and Reddit threads and messages with our endo team after every insulin shot, heart in our throats as we watched the app charting her levels to find out if we’d gotten it right.

It took me spending a full summer with my daughter to get to a point where I could start to predict and account for how her individual body might respond to each circumstance. Even then, I still felt like what I was doing was barely a treatment plan at all. I wouldn’t call it an “art,” but something more like “vibes.” No matter what we did, even if we repeated the same carb count, treatment, and activities on an identical schedule every day, her glucose levels would do something absolutely Looney Tunes and we’d be back to the Reddit boards, trying to figure out what happened.

Basically, everyone is different, and it’s almost impossible to design a one-size-fits-all approach to glucose regulation.

Glucose management for non-diabetics

There is much debate about the necessity for non-diabetics to use CGMs. If you have a family history of diabetes, or you have been experiencing hyperglycemia symptoms, a CGM could help you gain insight into what your body is experiencing. If you are interested in optimizing your mental or physical performance by having a stronger grasp of your glucose levels, or you are simply curious, you could absolutely try a CGM, though I agree with the Stanford study authors who recommended monitoring only on an annual basis.

“If you have a family history of diabetes, or you have been experiencing hyperglycemia symptoms, a CGM could help you gain insight into what your body is experiencing.”

CGMs are not cheap. And they also aren’t foolproof. Lying on one can produce something called a “compression low,” which is a very unfun false alarm that can lead to overcorrecting and ending up with a spike. Inserting one can hit a blood vessel, making the readings inaccurate (and also produce a rather alarming amount of blood). Removing the medical-grade adhesive hurts, and can leave your skin extremely irritated, even if you use special wipes or oils or any of the other methods recommended.

I’m sharing all this because I begged for a CGM before we left the hospital, and I had no idea about the downsides. But for type 1 diabetes care, it’s an absolutely essential and lifesaving tool; we live with these drawbacks because we have to.

“If a CGM isn’t in your budget or you are wary of adding yet another monitoring metric to your mental load, there are cheaper, more practical ways to manage your glucose levels.”

If a CGM isn’t in your budget or you are wary of adding yet another monitoring metric to your mental load, there are cheaper, more practical ways to manage your glucose levels. After all, flattening the curve has tons of benefits, from better energy to a stronger immune system, reduced menopause symptoms and migraines, plus a lower risk of Alzheimer’s, heart disease, and type 2 diabetes, among others. So let me introduce you to my favorite (and totally free) resource: The Glucose Goddess.

Jessie Inchauspé, biochemist and author of “Glucose Revolution” and “The Glucose Goddess Method” has been a crucial resource as I try to understand the complex and individualized world of glucose regulation. She produces content on Instagram, Youtube, and her website to make cutting-edge and rapidly evolving science publicly accessible and easy to understand.

“Flattening the curve has tons of benefits, from better energy to a stronger immune system, reduced menopause symptoms and migraines, plus a lower risk of Alzheimer’s, heart disease, and type 2 diabetes, and more.”

It was after finding Inchauspé’s Instagram that I felt like I was able to finally get some clarity on what was happening with certain carbs. These graphs very clearly illustrate studies showing how food order, food pairing, and other factors contribute to the inevitable blood sugar spike we all experience after meals. Tips like pairing a fast-acting carb with a protein is something we’d been told to do, but seeing how it actually affects the curve is rather striking. These graphs have been illuminating, helping to debunk some commonly believed myths about “better” carbs like sweet potatoes fries vs. regular potato french fries (from a blood sugar perspective, they are nearly identical!).

One of my favorite tools she offers is her simple hacks to improve blood sugar levels. These are tips that are easy, free, and only require small changes in your daily habits. They include:

  • Eat a savory breakfast, not a sweet one.
  • Incorporate vinegar into your daily routine.
  • Have a veggie starter before the rest of the meal.
  • Eat carbs last.
  • Eat sugar as dessert, not on an empty stomach.
  • Eat fruit whole, not transformed.
  • Move your body for ten minutes after eating.
  • Dress up your carbs in protein or fat.

These hacks use science-backed studies proving their effectiveness. And they make sense! Slowing the post-meal glucose rise is sometimes as straightforward as starting digestion with foods that don’t typically cause spikes, like vegetables. Eating the carbs last means that the “spikier” foods get processed after insulin is already working, keeping the blood level steadier overall. Practical, smart, and easy to follow, Inchauspé makes it easy for anyone trying to steady their blood sugars and keep them in a healthy range.

“Eating the carbs last means that the ‘spikier’ foods get processed after insulin is already working, keeping the blood level steadier overall.”

I’ll be honest: I do not recommend that CGM life if you don’t strictly need it. The data fatigue is real, and if you’re anything like many of us who have to manage it, the impact on your mental health is not a joke. It can be hard not to moralize the outcomes of your decisions, and the truth is that you just aren’t entirely in control all the time. You can’t be. There are so many invisible variables, from genetics to hormones, that can show up and wreck all of your careful work. But even knowing this won’t negate a feeling of failure when you get an inexplicable spike, or when you have to force feed yourself a snack in the middle of the night because you got an alert that you’re low.

It’s worth it to support your health, and to look into tools that can help you reach your goals. But it’s important to keep an eye on your mental and emotional health too. The most important thing I’ve learned at the beginning of my journey into medical motherhood is to treat the person first, diabetes second. Stress and anxiety can otherwise wreck whatever progress we were making elsewhere.

So go slow and remain curious and gentle with yourself. It’s an art not a science, after all.

Stephanie H. Fallon is a Contributing Editor at The Good Trade. She is a writer originally from Houston, Texas and holds an MFA from the Jackson Center of Creative Writing at Hollins University. She lives with her family in the Blue Ridge Mountains of Virginia, where she writes about motherhood, artmaking, and work culture. Since 2022, she has been reviewing sustainable home and lifestyle brands, fact-checking sustainability claims, and bringing her sharp editorial skills to every product review. Say hi on Instagram or on her website.