Diabetes Q&A #5: High Post-Meal Blood Sugar, Lowering Triglycerides & More

Dr Jedha, Host

Hello there, thanks so much for joining me for a Q&A episode, answering your questions. I love these episodes because they are questions directly from you, and of course, we’ll be having more Q&A episodes in future so if you have a question, please send it in to cover in a future Q&A episode. Head to Type2DiabetesTalk.com/message to leave a voice message or email and I look forward to covering your question. 

Of course, if you’re one of our members you can send in questions for the podcast, but you also have other ways to get your questions answered regularly. You can use the monthly member check ins to ask your questions and get personal feedback and support. Plus, when you receive the notifications about your quarterly health reviews, so do send them in, as either me or our nutritionists personally review these to provide you with extra support throughout the year – we’re very hands on with this stuff because our primary goal is to make sure you’re achieving the goals you want to achieve and to support you every step of the way. 

02:25

Before moving to our questions of the day, I also want to thank those who have taken the time to leave a review for the podcast, I really do appreciate that. 

On our website, Kathleen left a 5-star rating and said: “Clear honest truth about foods that hinder success of controlling health issues, with proven plans and scientific directions to control the habits formed over years of unhealthy choices.” Thanks so much for leaving that Kathleen, appreciate it. 

Jan left a 5-star rating and said: “Understandable and able to follow. First time listening and very impressed.” Thanks Jan, glad to know you’re enjoying the podcast. 

Lori also left a 5-star rating and said: “Dr Jedha and her team provide a great program. I’ve been a VIP member for the past 18 months and I’ve been able to learn about prediabetes as well as understand everything that impacts my health regarding diabetes. If you have been newly diagnosed or may have had it for years and you just don’t understand the disease, sign up for the program and start reading their library or check out their different programs. The podcasts are also very good and just part of what you could be learning.”

Thanks so much for leaving the rating and review Lori, it’s great to have you as one of our members and for pointing out that the podcast is just one small part of what we provide to our members and what people could be learning by joining us. 

I also want to thank DeacRipps on Apple and others who left a rating, along with those of you who have left a rating on Spotify. Thank you, I really appreciate you taking the time to do so. If you’re listening now and this podcast has helped you understand your diabetes or make some changes and improvements, please head to Type2DiabetesTalk.com/review to let me know by leaving your rating and review. 

Okay, so let’s dig into today’s Q&A with the first question of the day from Amanat. 

04:37

Amanat said: I have type2 diabetes since 2016. My fasting sugar is 250. After two hours meal sugar is 370. My sugar is not coming low. Please help.

Host: Before answering this question I’ll translate those numbers for our metric listeners. So 250 is a blood sugar level of 13.9, while 370 is 20.6. 

Host: Amanat, thank you for sharing your situation. A post-meal blood sugar of 370 (or 20.6) is dangerously high, and it’s vital to bring those levels down as soon as possible. The good news is that making targeted changes to your nutrition can have a big impact.

The first thing to focus on is identifying and reducing foods that cause your blood sugar to spike. The first things to consider are whether you’re eating a lot of sugar filled foods or processed foods, or are you eating lots of high-carbohydrate foods like bread, rice, potatoes, and sugary snacks. If the answer is yes, then these are likely contributing to these levels so you really need to start evaluating your eating plan to assess what you’re eating, because those high levels are telling you that your current nutrition plan isn’t right, it’s not working for you. You want to be eating whole foods like non-starchy vegetables—think broccoli, spinach, or zucchini—and pair these with healthy proteins like eggs, fish, or chicken and fats like olive oil, avocado nuts and seeds. These swaps can help stabilize your blood sugar after meals. If you haven’t already, listen to episode 6 on what to eat to treat diabetes. Also make sure you’re drinking plenty of water to assist your body in regulating glucose more effectively.

Finally, your fasting levels are high but don’t concern yourself with that right now. Focus on tracking your blood sugar two hours after meals because you really need to get those levels down under 140 mg/dL or 7.8 mmol/L ideally, although with levels up at 370, aim for 180 or 10 at first, then once you achieve that, aim for a lower level. Your fasting levels will regulate better once you get your post-meal levels under control. So again, you really need to start evaluating your eating plan to assess what you’re eating, and of course, if it could be something else, like medication or another illness, always consult with your medical doctor, because there could be some steps you need to take outside your nutrition plan as well.

08:31

Our next question is from Katie.

Katie said: My triglycerides are 300 which my Dr was not happy about so I can use all the information on foods I can eat to get this lower please.

Host: Katie, thank you for your question. A triglyceride level of 300 is elevated, so it’s good that you’re taking steps to address it. Let’s talk about how nutrition can play a significant role in lowering those numbers. 

First, it helps to understand a little science: triglycerides are fat molecules made up of three fatty acids attached to a sugar backbone, called glycerol. This means excess sugar and refined carbohydrates in your diet can drive triglyceride production, pushing triglyceride levels higher. Foods and drinks like sweets and soda, and even too many high carbohydrate foods break down into glucose, which can be converted into triglycerides if your body doesn’t use it for energy. The most significant contributors to high triglyceride levels are sugar, refined carbohydrates and excess carbohydrate intake. Essentially, the more sugar and carbohydrates you eat, the more building blocks your body has to create and store triglycerides. 

So if that’s the case, then it makes sense that to lower triglycerides you need to do the exact opposite, and that is, avoid or reduce foods and drinks like sweets and soda, and avoid or reduce your intake of refined carbohydrates and high carbohydrate foods as well. 

We’re talking about cutting out sugary foods like candy, cakes and sodas, cutting down or cutting out refined carbohydrates that we commonly find in many processed foods like pastries, breakfast cereals and crackers, and even cutting down on high carbohydrate foods like pasta, rice and noodles. In most cases, when people do this, they see their triglycerides come down to normal levels quite fast. 

Then there are a few targeted things we can do, such as increasing intake of omega-3-rich foods like salmon, mackerel, and sardines, which is especially beneficial since these fats can lower triglycerides and support heart health. Include more monounsaturated fat from olives, olive oil, avocados and nuts and seeds, which can help lower triglycerides and help support overall health improvements in diabetes as well. Listen to episode 14 on the benefits of olive oil. 

To lower your triglycerides, the first step is to focus on reducing those added sugars and refined carbs. Replace them with non-starchy vegetables, healthy proteins like fish, chicken, or eggs, and natural fats such as avocados or olive oil. Including omega-3-rich foods like salmon, mackerel, and sardines is especially beneficial since these fats can lower triglycerides and support heart health. Regular consumption of nuts can lead to a reduction in triglyceride levels, making them a beneficial addition to your eating routine. Foods rich in anthocyanins, such as berries, have been shown to reduce triglyceride levels and improve other lipid profiles in type 2 diabetes. Really, there is a wide range of things you can do and your nutrition plan is going to play a central role in reducing triglycerides, but hopefully you’ve picked up on a key theme here and that is to avoid and reduce sugars, refined carbs and assess how many carbohydrate foods you’re eating overall. And focus on healthy whole foods and you will start to see positive changes. You can also find more tips on lowering cholesterol in episode 44. And for our members listening to this, head to the Healthmaps inside the members site to find our Lowering Cholesterol Healthmap, which provides you with a very detailed step-by-step plan to help you lower cholesterol levels. 

Thanks for your question Katie and overall the point is you can change those high triglyceride levels so start working on a few things we mentioned and start to see those numbers coming down. 

14:11

Okay, next up a question from Kathleen. 

Kathleen asked: I have prediabetes and am wondering if the type 2 diet is the same for pre diabetes?

Host: Kathleen, that’s a great question. The short answer is yes—the principles of a type 2 diabetes diet are very similar for prediabetes because both conditions involve issues with blood sugar and insulin regulation. The goal is to stabilize blood sugar levels, lower insulin levels and improve insulin sensitivity, which can help prevent prediabetes from progressing to type 2 diabetes.

A key focus is modifying your carbohydrate intake, especially reducing refined carbs and sugars, as these cause the biggest spikes in blood sugar, but also looking at how many carbs you might be eating and the types of carbohydrate foods as well, as all of these can have an impact on your blood sugar and insulin levels. What you want to do with prediabetes is prioritize lower carbohydrate, nutrient-dense foods like non-starchy vegetables, healthy fats from avocados or nuts, and quality proteins like fish, chicken, or eggs. These choices help keep your blood sugar stable throughout the day.

Another benefit of this approach is that it can support weight management, and help improve other things like triglycerides  that we just spoke about with Katie, along with cholesterol and blood pressure. We are all individuals, so while the specifics may vary depending on your individual needs, the foundational diet for prediabetes and type 2 diabetes is nearly identical. And with prediabetes, using the right nutrition principles can help you reverse your prediabetes back to normal. 

16:08

Thanks for sending in your question Kathleen. Next up a question from Ben. 

Ben said: I have prediabetic numbers but I’m a healthy weight. I thought only overweight people got diabetes?

Host: Ben, thank you for your question—it’s a common misconception that only people who are overweight develop diabetes or prediabetes. While weight is a very common risk factor, it’s not the only one. Even people at a healthy weight can have insulin resistance or other metabolic issues that lead to elevated blood sugar levels.

This can happen for several reasons. Genetics can play a big role, so if you have a family history of diabetes, you may be more predisposed. Your diet, even if your weight is healthy, also matters. A diet high in refined carbs, sugars and processed foods can strain your body’s ability to regulate blood sugar over time. Additionally, factors like stress, poor sleep, and physical inactivity can contribute to insulin resistance, regardless of your weight.

The good news is that being proactive with your blood sugar now can make a big difference. You may not need to lose weight and that’s fine, but that doesn’t mean doing nothing. You still need to focus on a nutrient-rich eating plan and stay active to support stable blood sugar and to improve insulin sensitivity. By addressing the underlying causes, you can lower your blood sugar levels to normal and reduce your risk of developing type 2 diabetes, so for you, this is a great opportunity to get proactive. I’d also recommend listening to episode 67 where we talked about misconceptions of obesity and diabetes, episode 50 on risk factors, and episode 32 on Reversing Prediabetes Through Proactive Nutrition.

16:08

Rick asked:  I am 79 male recently diagnosed diabetic A1c 7.8. My Doc put me on Metformin 500 mg. Twice daily, my blood glucose is around 200 upon awakening. 140 or lower in the afternoon. Guess I don’t understand?

Host: Rick, thank you for your question. First, let me say it’s great that you’re monitoring your blood sugar closely—it’s an important step in managing diabetes. Let’s break this down to help you understand what might be happening.

Your blood sugar in the morning, known as fasting blood glucose, is influenced by several factors. One common reason it’s higher in the morning is something called the “dawn phenomenon.” This is when your liver releases glucose into your bloodstream early in the morning to give your body energy to start the day. In people with diabetes, this process can cause fasting blood sugar to be elevated because the body doesn’t regulate glucose effectively. 

In contrast, your blood sugar in the afternoon is lower because of the combined effects of your meals, activity levels, and the action of Metformin, which helps improve your body’s insulin sensitivity and reduces glucose production in the liver.

We covered the topic of morning levels in detail in episode 38, so please go back and listen to that, as it also includes lots of strategies to help lower morning levels. Also, listen to episode 11 on normal blood sugar levels, as this will help you understand what’s going on. 

Your A1c levels are a bit high and over time you want to work on getting these down to 7% first, then work toward a level under 6% as we know this is associated with the least risk for developing complications. If you listen to episode 11 you will understand how blood sugar and A1c are related so you can focus on getting these levels lower. 

You’re off to a strong start, Rick, and it’s normal to have questions as you adjust to this diagnosis. So keep asking questions and taking steps to track your numbers—it will become clearer as you go!

Well, that brings us to the end of today’s Q&A. A big thank you to Amanat, Katie, Kathleen, Ben and Rick for your questions. 

If you’ve found today’s episode helpful or any of our episodes in fact, I’d love for you to leave a review and share your feedback—it truly helps others discover this podcast. Head to Type2DiabetesTalk.com/review. And don’t forget to send in your questions for our next Q&A episode at Type2DiabetesTalk.com/message. 

Until next time, take it one step at a time to be proactive with your health. 

Dr Jedha, over and out.