Diabetes Q&A #8: Sugar-Free Cordial, Testing Fruit, Persistent Highs, Blood Sugar Targets, Fasting vs A1c, and More

Dr Jedha, Host

Hello wonderful people and welcome to another Q&A episode of Type 2 Diabetes Talk,  where we answer your real-life questions about managing blood sugar, food, insulin resistance, and natural alternatives.

Today, we’re diving into some important and often emotional questions. We’ll talk about whether sugar-free cordial is okay now and then, how to test blood sugar after fruit, and what it means when your numbers don’t come down even hours after eating. You’ll hear about constipation and intermittent fasting, fasting sugar versus A1c, what to do if you can’t tolerate Metformin, and how one listener is working through the fear that comes with a new diagnosis.

This episode is full of practical advice and clear direction, and if you’ve been feeling stuck or overwhelmed, I think it’s going to help you take a breath, feel more grounded, and see that there is always a path forward.

And remember, if you’ve got a question you’d like answered in a future episode, just head to Type2DiabetesTalk.com/message and leave me an email or a voice message, I’d love to hear from you.

So let’s get started on our first question, which comes from Gale, who said: I’m newly diagnosed & lots to learn. I love water but know I will need something different every now & again. Would low sugar cordial be ok to have here & there?

Great question, Gale, and welcome to your journey of learning. It’s completely normal to want a bit of variety from just plain water, especially when you’re adjusting to a new diagnosis. The answer is, yes, low sugar or sugar-free cordials can be an option every now and again, especially if they help you stay hydrated and avoid high-sugar drinks. 

Sugar free cordials generally don’t raise blood sugar, but the key thing to look at is the label and choose wisely. Sugar free cordials are still sweet and many use less desirable artificial sweeteners, like aspartame, ace-K or saccharin. While others use more suitable sweeteners such as stevia, monk fruit or allulose. We spoke about sweeteners in episode 49 for more about options. 

But the thing is, if you’re only having it occasionally and it doesn’t trigger cravings or bloating, it’s perfectly fine. Just keep it in moderation. You can also add variety with soda water or sparkling water and a splash of lemon, herbal teas, or infuse water with fresh mint or cucumber. These give flavor with zero impact. Plus, check out episode 83 for more ideas on what to drink besides water. 

Joe asked: What is best way to test blood sugar level after eating fruit?

Great question, Joe, and it’s fantastic that you’re thinking about testing strategically. The best way to check how fruit or any other foods affect your blood sugar is to use timed testing. 

Here’s how to do it:

• First, eat the fruit by itself 
• Then, set a timer for 2 hours from the first bite, and test your blood sugar at that 2-hour mark.

Why 2 hours? Because that’s the standard window to assess how your body handles glucose from food. Ideally, you want your reading to be under 140 mg/dL (7.8 mmol/L), though some people aim for even lower targets, especially if they’re living with prediabetes or trying to reverse insulin resistance.

Track what type of fruit, how much you had, and what else you ate with it. Some fruits may work better for you than others, and pairing fruit with protein or fat can help blunt the blood sugar response.

So the key is: eat, test at 2 hours, and look at your patterns over time. That’s how you figure out what works best for your body.

Sandra said: My blood sugar levels never go down to 140 after meals, I eat mostly coffee, two crackers n cheese or plain crackers, 4 hours after it doesn’t budge…even after meds.

Thanks for sharing that, Sandra, and I hear the frustration in your message. When blood sugar stays elevated for hours, even after small meals and medication, it’s a strong sign that you’re eating foods that are elevating blood sugar and that insulin resistance is playing a big role. 

Crackers, even plain or whole grain ones, are still high in refined carbohydrates, and unfortunately, they can cause prolonged spikes in people with insulin resistance. Even just two can be enough to keep blood sugar elevated for hours, especially if your body’s insulin isn’t working efficiently. Caffeine can affect blood sugar levels in some people causing blood sugar to rise or stay elevated, even without any sugar added. But also, people frequently have coffee sweetened or with high carb milks or syrups and creamers.

If I were you I’d change things up:

Swap out the crackers for a lower-carb option like sliced cucumber, a boiled egg, or even cheese with olives or nuts, foods that won’t cause a big glucose rise. 

Try eating more nutrient dense foods, quality protein and fiber-rich vegetables, then test to see what happens with your blood sugar.

Make sure the coffee isn’t sweetened for start and even milks like oat milk and others people think are healthy, can be loaded with sugar and carbs. And if it’s not, then cut out the coffee and drink water for a while to test what happens. 

And since it sounds like you’re on meds, it’s a good idea to track patterns over several days and bring those to your next doctor’s appointment. It may be time to reassess your medications. 

Start with those tips and see how you go. Your blood sugar certainly can improve but you will likely need to make some changes to see the numbers coming down.

Reena asked: If you have insulin resistance what should my blood sugar reading be? My A1c was 6.4 and my morning reading is 90-115 and 100-190 after meals. 

Thanks for your question, Reena. First, an A1c of 6.4% puts you right on the edge of type 2 diabetes, so now is a really important time to take action to bring that number down.

Let’s talk about blood sugar targets. For people with insulin resistance, most research and clinical guidelines suggest aiming for:

Fasting blood sugar between 70–99 mg/dL, which is 4–5.5 mmol/L, or up to 6 mmol/L in some locations – this is considered the normal range. 

For 2-hour post-meal blood sugar, ideally under 140 mg/dL or 7.8 mmol/L, and some people even aim for under 110-120 mg/dL (6.1-6.7 mmol/L) if they’re working on reversing insulin resistance or prediabetes, because those tighter post-meal ranges can help you get to the target A1c level. 

Based on what you shared:

Your morning readings of 90–115 mg/dL, which is 5.0–6.4 mmol/L are a bit above ideal some days, which may indicate some early morning insulin resistance (also known as the dawn effect, which we spoke about in episode 38. 

Your post-meal readings of 100–190 mg/dL, which is 5.6–10.6 mmol/L show a wide range, some are within target, others are well above.

This tells us your blood sugar response is likely tied to what and how much you’re eating, especially carbohydrates, so I’d suggest tracking meals alongside your readings for a week can give you valuable insights. You’ll start to see patterns, what raises your blood sugar, and what keeps it stable.

And just remember, insulin resistance is reversible. You’re not stuck with these numbers. With targeted food changes, activity, sleep, stress management and the right supplements, you can improve your A1c and daily blood sugar levels over time.

Habari asked: Can intermittent fasting cause or worsen constipation” 

Great question, Habari, and yes, intermittent fasting can cause or worsen constipation for some people. The reason for this is that when you’re eating less frequently, you’re also likely eating less food overall and less fiber, which means less bulk moving through the digestive system so this can really slow down digestion. Plus, some people unintentionally reduce their fluid intake, which can slow things down even more. And of course, changes to your eating rhythm can throw off your body’s natural digestive routine as well.

If you want to stay with the intermittent fasting, make sure you stay hydrated throughout the day, not just during your eating window. Include fiber-rich low-carb foods like chia seeds, leafy greens, and non-starchy veg.  And you could also consider a magnesium citrate or magnesium glycinate supplement if needed to gently support regularity. 

Helen said: “I was just recently diagnosed with type 2 diabetes. Since then, I’ve made big changes, cleaned up my diet and laced up my shoes. I’ve started running again. I’m 49, about to turn 50. But if I’m being honest… I’m scared. Really scared. The complications, the food restrictions, the fear.  it’s been hard not to spiral. I keep thinking things like:

• Am I going to lose control of this?
• Will I ever be able to enjoy food again, pizza, a burger, something sweet?
• Will I end up sick or worse?
• Is this going to take years off my life?

I try to stay focused on the day in front of me, but the future feels overwhelming. I’m not sure what to do, please tell me it gets better.

Helen, thank you for your honesty in sharing. What you’re feeling is incredibly valid, and you’re not alone. That fear? So many people feel it in those early days. A diagnosis can feel like your future has just been rewritten and that all is lost, that is all perfectly normal. But here’s the truth, it doesn’t have to be and I assure you things do get better and easier.

You’ve already taken massive steps. You cleaned up your diet. You’re running again. That right there? That’s what it looks like to be proactive, to take control. Not just of diabetes, but of your future.

Yes, type 2 diabetes is serious. But it’s also one of the most manageable and even reversible health conditions when approached with the right strategies. Thousands of people, including many in their 40s, 50s, 60s and beyond, have lowered their blood sugar, reduced or stopped medications, and are living full, healthy lives. You can too. You only have to listen to some previous episodes to be inspired by others stories – Wilma in episodes 7 and 36, Dean in episode 31 and others in episode 25 – a diabetes diagnosis is not the end of the world, although it can feel like that way at first. 

Will you ever eat pizza again? A burger? Something sweet? Yes. With the right knowledge and balance, you can still enjoy food. It’s not about punishment or deprivation, it’s about making informed choices most of the time, and knowing how to enjoy the occasional indulgence without spiraling.

As for losing control? No. You are not powerless. This diagnosis can actually be the turning point that leads you to a stronger, healthier version of yourself, physically, emotionally, and mentally. For many people that’s exactly what happens and it leads them to better health than they’ve had in many years. 

So yes, it gets better. Much better. One step at a time. You’ve already started. And I promise, you’re not alone on this road. Make sure you listen to all the podcast episodes and if you need more help and support please do consider joining us as a member, where we’ll be with you every step of the way. 

Lee asked: Why is my fasting sugar in the prediabetes range but my A1c is normal, which one is final?

Great question, Lee, and this is actually a really common source of confusion, some of which we covered in episode 86 on diagnostic criteria. The short answer is that neither test is more final than the other, they are just measuring different things.

Fasting blood sugar tells you what’s happening in that moment, after not eating for at least 8 hours. It’s very sensitive to things like stress, sleep or even late-night eating but it is also sensitive to liver insulin resistance and hormones. A fasting result between 100 and 125 mg/dL (5.6 to 6.9 mmol/L) falls in the prediabetes range.

A1c, on the other hand, is a 3-month average of your blood sugar levels. If your A1c is under 5.7 percent, that’s considered normal. In some locations the normal range is up to 6.0 – yes, a bit confusing but that’s the way it is so worth mentioning. 

So how can one measure be elevated and the other not?

If your fasting sugar is consistently high but your A1c is normal, it often means your blood sugar is spiking mostly in the morning, possibly due to early insulin resistance in the liver or the dawn effect, which happens in response to hormones, but it is not staying elevated throughout the day.

That’s still a red flag. Diabetes doesn’t just appear, it happens on a spectrum and if fasting sugars are high, it means you are on the spectrum and that it’s worthwhile taking action now to prevent further progression.

So rather than asking “which number is final?” a better question is, what is this telling me? And what it’s telling you is, your metabolism is starting to struggle, and this is your chance to turn things around before your A1c starts creeping up too.

Our last question of today comes from Lacey, who asked: What is the alternative if I can’t tolerate Metformin?

Great question, Lacey. Metformin is the most commonly prescribed medication in both prediabetes and type 2 diabetes. But one of the downsides is the nausea and gastrointestinal effects are intolerable for some people. While you could speak to your doctor about other medications, the good news is there are natural alternatives that can be just as effective for many people.

One of the best-studied options is berberine, a plant compound that’s been shown in multiple clinical trials to work similarly to Metformin. In fact, clinical trials have compared berberine to metformin and it has lowered blood sugar and A1c levels more than metformin, so it really is a powerful natural therapeutic, and for most people it does not come with those same awful gastrointestinal side effects. 

We’ve discussed bereberine in detail in episode 21 and we’ll also include some more info in the show notes alongside this episode so you can head to our website to find out more about recommended dosages etc. 

There are also other supportive nutrients that can help improve blood sugar naturally, but berberine is by far the most potent when compared to metformin so start there and see how you go.

So if Metformin isn’t a fit for you, there is a natural path forward, and many people have found success improving their numbers with the right combination of food, supplements, and lifestyle habits.

That’s it for our Q&A today. As always, the questions you send in help so many others who are going through similar experiences, or are helpful to inspire and motivate others too, so thank you to everyone who shared.

If you have a question, don’t be shy, please send it in. Head to Type2DiabetesTalk.com/message – and leave me an email or voice message so we can include your question in a future Q&A. 

What matters most is not how fast you go, but that you keep going. You’re learning, growing, and creating better health one step at a time.

Until next week,

Dr Jedha, over and out.