The Best Science-Backed Ways To Maintain Healthy Blood Sugar Balance

Maintaining Healthy Blood Sugar Balance Dr. Will Cole 2

Chances are that you - or anyone else walking around today - has a serious blood sugar problem. Chances are also good that if you do, you don’t even know it. Yes, it’s true: 50 percent of adults living in the United States today have diabetes or pre-diabetes. Even more have some other type of health problem related to blood sugar imbalance or insulin resistance, such as PCOS or metabolic syndrome. What’s worse, the problem isn’t getting any better. The American Diabetes Association (ADA) estimates that up to 50 percent of people with insulin resistance and pre-diabetes will end up with full-blown type 2 diabetes if they don’t make significant lifestyle changes.

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Blood sugar balance basics

You probably already know that what you eat directly affects your blood sugar. It’s a pretty simple formula: The more sugar you eat, whether it is in the form of carbohydrates, artificial sweeteners, sugar, or fruit, the more likely your blood sugar is to be elevated. When you eat a food high in carbohydrates, especially without much fiber or fat, that food is quickly converted into glucose in your bloodstream, triggering the release of insulin to take the sugar out of your blood and send it to where you can use it, like in your muscles, or in short-term storage in your liver. But you only need so much glucose and if you eat a lot of sugar-rich and carb-rich foods all the time, your insulin may have trouble keeping up and your blood sugar may stay too high for too long. This puts you on the path to diabetes and other metabolic health problems.

Know the signs of blood sugar imbalance

If more than one of these is true for you, I suggest getting your blood sugar levels checked, stat.

  1. You crave sweets or breads and pastries….a lot!
  2. Eating sweets doesn’t relieve your sugar cravings and even increases them.
  3. You become irritable and “hangry” if you miss a meal.
  4. You find yourself needing caffeine to get through the day.
  5. You become lightheaded if you miss a meal.
  6. Eating makes you exhausted and in need of a nap.
  7. It’s difficult for you to lose weight.
  8. You feel weak, shaky, or jittery pretty frequently.
  9. You have to pee a lot.
  10. You get agitated, easily upset, or nervous, out of proportion to the reason for these feelings.
  11. Your memory is not what it used to be.
  12. Your vision is blurry.
  13. Your waist measurement is equal to or larger than your hip measurements.
  14. You have an atypically low sex drive.
  15. You’re always thirsty.

If you suspect that your blood sugar is imbalanced, these the labs I run on my patients to assess their blood sugar and check for insulin resistance:

  • Serum insulin: Optimal Range: < 3 ulU/mL
  • C-peptide: Optimal Range: 0.8 to 3.1 ng/mL
  • Fasting blood sugar: Optimal Range: 75 to 90 mg/dL
  • Hgb A1C: Optimal Range: < 5.3 percent
  • Triglycerides: Optimal Range: < 100 mg/dL
  • HDL: Optimal Range: 59 to 100 mg/dL

Triggers of Blood Sugar Imbalance + Natural ways to improve blood sugar balance

1. You are not getting enough antioxidants

Colorful vegetables and fruits naturally contain antioxidants which have been shown to help regulate blood sugar. In fact, multiple studies have shown that alpha-lipoic acid supplements help to improve insulin resistance and balance blood sugar levels. The benefits of this antioxidant don’t stop there either – it also protects brain cells against excitotoxicity, boosts heavy metal detoxification, enhances cell energy production, and strengthens immunity. For blood sugar control, take 200 milligrams three times a day.

Additionally, the bioflavonoid found in cinnamon called proanthocyanidin can alter the insulin signaling activity in fat cells to help manage diabetes. Cinnamon has also been linked to lower triglycerides and blood sugar levels in people with type 2 diabetics. Green tea contains the compound EGCG which also has been shown (1) to stabilize blood sugar. Matcha powder has some of the highest levels of this powerful antioxidant.

Nrf-2 is a protein whose role is to help regulate (2) antioxidant gene induction by turning on genes that are responsible for antioxidant and detox pathways. When Nrf-2 is activated it also drives-down inflammation. You can activate Nrf-2 by including antioxidant-rich foods such as:

  • EGCG in green tea
  • Quercetin in apples
  • Curcumin in turmeric
  • Resveratrol in grapes
  • Rosmarinic acid in rosemary
  • L-sulforaphane in broccoli
  • Thiosulfonateallicin in garlic

Research also shows that peroxisome proliferator-activated receptors – or PPARs for short – can help improve (3) blood sugar.

Some PPAR activators for you to bring into your life: wild-caught fish, (4) green tea, astragalus, ginger, (5) and sea buckthorn. (6)

2. You eat too many snacks

Constantly needing to munch on food is a major sign that your blood sugar is out of whack. Constantly snacking keeps blood and insulin levels spiked with no time to calm down. Intermittent fasting is one of my go-to tools to help keep the hormones responsible for blood sugar in check since it is proven to lower insulin resistance (7) and increase metabolism. (8)

Make sure to work with your doctor if you have a blood sugar problem and want to incorporate fasting into your routine. As your glucose begins to stabilize they can monitor your progress and make adjustments to your fasting periods as they see improvement. Leptin resistance is another hormone problem that has been shown to greatly improve through intermittent fasting.

3. You are low in micronutrients

In a study (9) published in the medical journal Circulation, it was shown that out of 5,000 people, those who regularly took higher dosages of magnesium for 15 years had a decreased risk of metabolic syndrome which is often a marker for diabetes. Another study (10) in the American Journal of Epidemiology found similar results. After 5 years those who consistently had greater magnesium intake had better insulin sensitivity. Magnesium can also lower diabetes risk by lowering blood pressure (11) and triglycerides.

Chromium is another micronutrient that is essential to not overlook as low levels have been linked to increased risk of insulin resistance and high triglyceride levels. Supplementing (12) with chromium can be a simple way to improve the function of blood sugar receptors. Focus on chromium-rich food sources like potatoes, tomatoes, onions, and sea vegetables.

4. Your sleep quality is poor

Poor sleep and blood sugar problems go hand in hand. If you are constantly not sleeping well at night it will impact your blood sugar levels and vice versa. This is because our blood sugar levels rise more with the less sleep we get. No wonder why people with sleep problems are at a greater risk for diabetes. In fact, those who got fewer than six hours of sleep every night had more blood sugar issues (13) than those who slept a full eight hours.

5. You need more water-soluble vitamins

Methylation is your body’s biochemical superhighway that controls many aspects of your body including blood sugar regulation. B vitamins are the fuel behind methylation and can be supported through supplementing with activated B vitamins such as B9 L-Methylfolate (L-5-MTHF) and B6 Pyridoxyl-5-Phosphate (P5P). Dark leafy greens like spinach, okra, and turnip greens along with grass-fed beef and chicken liver are loaded with essential B vitamins.

6. You are low on fat-soluble vitamins

Vitamin E, also known as tocopherol, can help improve (14) insulin sensitivity. A standard dose ranges between 600 and 900 milligrams. Vitamin D is also one of the most common nutrient deficiencies in America and can contribute to a whole slew of health problems. Research showed (15) that after 12 weeks of vitamin D supplementation, body fat was lowered by 7 percent, which is important to note as lower weight can help manage blood sugar. Vitamin D deficiency is also correlated with metabolic syndrome. A good standard dose is between 60 to 80 ng/mL per day.

7. Your microbiome is imbalanced

Your gut controls almost all aspects of your health, including your blood sugar.

Your microbiome’s nutritional needs are, perhaps surprisingly, similar to yours. Many of the same foods that are good for you help to increase the beneficial microbes in your microbiome, while many of the same foods that spike blood sugar also have a harmful effect on your microbiome. For example, artificial sweeteners have been implicated for years in poor microbiome health and bacterial imbalances in the gut - specifically in ways that impair blood sugar control.

Because of the link between these two systems, focusing on healing your gut and optimizing your microbiome should also help to rebalance your blood sugar. That’s exactly what the latest research suggests.

A recent scientific study, (16) published in the journal mSphere, looked at Acarbose - a drug for type-2 diabetes - and how it changes animals’ microbiome composition to favor bacteria that play a role in controlling blood sugar. Even when those animals ate a higher-starch diet while on this medication, their microbiomes still contained higher levels of the beneficial bacteria Bacteroidaceae and Bifidobacteriaceae and lower levels of the bad bacteria Verruocomicorbiacea and Bacteroidales S24-7. However, once the medication was stopped, the positive microbiome features reverted.

Another study (17) followed a group of 300 people over the course of six days. The researchers tracked glycemic responses to foods and found that they could only accurately predict blood sugar between 32 and 40 percent of the time when considering what foods the subjects ate and how many calories they consumed. But when the scientists factored in the specific composition of the microbiomes of each individual, they were able to accurately predict blood sugar response 62 percent of the time.

Other studies also support the blood sugar-microbiome connection. Those who are overweight or struggle with weight loss resistance - a symptom of underlying metabolic problems - tend to have lower microbiome diversity (18) with lower numbers of beneficial microbes and higher numbers of harmful bacteria and fungi. In another fascinating study, (19) scientists were able to transplant the microbiome of diabetic mice into healthy mice to make them diabetic as well, without changing their diets. It seems like our microbiomes are in charge of a lot more about our health than we once realized.

8. You’re not eating enough healthy fats

Omega-3 fatty acids have the power to lower your risk for heart attack and stroke and can also convert diabetes-linked (20) very low-density lipoproteins (VLDL), to healthier low-density lipoproteins (LDL). Research has found that high blood sugar affected the function in areas of the brain affected by Alzheimer’s disease. It’s no surprise then that medical literature refers to Alzheimer’s as “type 3 diabetes.”

ketogenic diet can do wonders for your brain health (21) by transforming you into fat burner instead of a sugar burner. This transitions your body into relying on fat for fuel instead of sugar which has been shown to enhance brain health including in cases of dementia. This is because fat is a more sustainable and longer lasting form of energy. In fact, as babies we relied on fat (22) in the form of breast milk for energy and development. Hop off the blood sugar roller coaster and load up on healthy fats instead.

The Top Mistakes People Make When Eating To Rebalance Blood Sugar

1. Too much fruit

Whole fruits are a fantastic choice to curb your sweet tooth. However, they still contain natural sugars like fructose which can further perpetuate blood sugar imbalance when eaten in excess since your body still reads it as sugar – natural or not. It is still perfectly ok to enjoy fruit but shift your focus to low-fructose fruits like melons and berries instead of high-fructose fruits like apples, pears, cherries, and watermelon.

2. Using the wrong “natural” sweeteners

There are an increasing number of studies showing the damaging effect sugar can have on your health and the food industry has responded with more natural options. However, not every choice is created equal. Agave nectar claims to be the perfect alternative to traditional sugar since it is considered low-glycemic. This measurement of how quickly foods elevate blood sugar, in my opinion, is overly simplistic. Even though it raises blood sugar more slowly, it raises your blood sugar over a longer period due to its fructose content. This ends up being harder on your liver which can contribute to insulin resistance and fatty liver disease.

Many other natural sweeteners are heavily processed which increases inflammation and insulin resistance. It is important to be choosing the 100 percent organic, unprocessed forms of the best natural sweeteners like monk fruit extract and stevia. My sugar guide gives my full rankings of the best sweetener options. And remember, it is possible to have too much of a good thing – enjoy even the best sweeteners in moderation!

3. Too many “healthy” grains

Most of us are familiar with the negative impact gluten can have on our health. This leaves many turning to gluten-free and whole sprouted grains as another option. While these choices don’t have gluten, the proteins they do contain are similar enough to gluten and are high in amylose sugars which also spike blood sugar and contribute to inflammation and insulin resistance.

4. Too many starchy vegetables

Carbohydrates are quickly converted to glucose in your body. While you may be avoiding bread and pasta, starchy vegetables like sweet potatoes are still carbs and can impact blood sugar. Fill up your plate instead with non-starchy options like mushrooms, dark leafy greens, and broccoli. These vegetables are loaded with nutrients that help your body lower inflammation and regulate detox pathways.

5. Overloading on legumes

Legumes are filled with fiber that can help with digestion and support good gut bacteria. But for those with blood sugar issues, the starch content in legumes can spike blood sugar and the lectin and phytate proteins increase inflammation. Since many plant-based dieters eat a lot of legumes for protein, these can be a major contributor to blood sugar problems.

6. Only focusing on blood sugar

All areas of your body are inextricably linked. Focusing on areas that contribute to blood sugar imbalance is just as important as looking at blood sugar itself. For example, poor microbiome health is linked (23) to blood sugar problems. Therefore, when looking to rebalance blood sugar, load up on probiotic-rich fermented foods such as kimchi, sauerkraut, and kefir.

The Best Diets For Blood Sugar Balance According To A Functional Medicine Expert

Every food you choose to eat can be powerful medicine or a powerful risk factor for disease. But with high stakes like these, how do you know which foods do what? You can find information online to justify almost anything you want to eat, so it can be tricky figuring out what’s best for your health. Where do you even start? While each person is different and responds to food in different ways, we do know that for those with blood sugar issues, there are certain foods and dietary practices known to help.

But the foods and diets you think are best for your blood sugar may not actually be therapeutic for your issues. These are the dietary strategies that have been clinically shown to balance blood sugar (and my favorites for reducing inflammation):

1. The Ketogenic Diet

The high-fat, moderate protein, low-carb ketogenic diet has exploded in popularity in the wellness world, and for good reason. This diet has demonstrated healing power for a variety of health problems. Multiple studies show the ketogenic diet’s ability to lower insulin levels, reduce inflammation, and improve insulin receptor site sensitivity, which helps the body function the way it was designed to function. Most impressively, the ketogenic diet can re-balance out-of-control blood sugar so well that in my functional medicine clinic, it has become my gold standard for anyone wresting with health issues like metabolic syndrome, pre-diabetes, and diabetes.

The ketogenic diet accomplishes this feat by transitioning your body from sugar burning to fat burning, so that you no longer need to rely on glucose for energy. Instead, your energy comes from ketones, which are the by-products of fat burning. Ketones are not only a more sustainable form of fuel for your body, but it keeps your blood sugar steadier than a diet fueled by low-fat, high-carb foods like high-fructose fruits, grains, and sugar. Many people who have switched to a ketogenic diet have seen their blood sugar levels normalize rapidly - research has shown (24) that symptoms of type 2 diabetes can even be reversed after just 10 weeks on a ketogenic diet!

No matter what foods you prefer, you can do a ketogenic diet just by shifting your macronutrient ratios and meal plan to focus on the foods high in healthy fat, and away from foods high in carbohydrates and sugar. Even vegetarians and vegans can still do a ketogenic diet by practicing a plant-based version.

2. Intermittent Fasting/Time-Restricted Feeding

Another fantastic tool for blood sugar control is intermittent fasting or time-restricted feeding. These techniques can easily be incorporated into any diet you choose to follow. These techniques incorporate extended periods of fasting into the day and limit the window of time during which you will eat. For example, you may fast for 12 hours (overnight) between the last bite of dinner and the first bite of breakfast. Or, you may choose to fast one day per week, or even as often as every other day. Others choose to limit the window in which they will eat to 10, 8, 6, or even fewer hours, depending on how intensive they want to be.

During the eating window, you must be sure to get all your necessary calories and nutrients for the day. The rest of the 24-hour period, they do not eat. This is not as difficult as it sounds because intermittent fasting tends to suppress appetite, and by limiting your food intake to certain windows of time, your body gets a break from constant digestion. That means it has time to rest and has more energy to devote to healing and regeneration. Intermittent fasting, or IF, is especially good for healing insulin resistance and increasing metabolism, according to multiple studies.

One study (25) tested intermittent fasting protocols on three different patients of various ages who were all diagnosed with type 2 diabetes and had been taking medication for their condition for over 10 years. The patients were required to eat a low-carb diet (think: ketogenic) in conjunction with three 24-hour fasts per week. By the end of the trial, not only did each patient lose weight, but they were all able to completely discontinue their insulin medication.

But that’s not all fasting protocols can do. Periods of fasting can also help improve (26) autoimmune symptoms from multiple conditions including type 1 diabetes, by restoring balance to the immune system and driving-down inflammation.

There are many ways to try intermittent fasting, and many levels of intensity. Which should you try? It depends on your fasting experience, tolerance, and schedule. You can check out my article here for all of the ways to fast, but some of my favorites for each level include:

IF for Beginners: The 8-6 Window Plan

Eat only between the hours of 8 a.m. and 6 p.m., allowing for 14 hours of uninterrupted fasting.

IF for Intermediates: The 12-6 Window Plan

Extend the fasting period and only eat between the hours of 12 p.m. and 6 p.m., increasing your fasting time to 18 hours.

IF for Advanced Fasters: Every-Other-Day Plan

Exactly as it sounds, eat normally every other day, and fast for a full 24 hours every other day.

IF for Super Advanced Intermittent Fasting: OMAD

This is a 23:1 fasting to eating protocol, hence its name: OMAD (one meal a day). For a full run-down on OMAD, check out my article on the subject.

3. Paleo

If fasting sounds too intense, or it’s just not for you, another great way to kick off your wellness journey and get control over your blood sugar at the same time is by trying a paleo diet. This diet focuses on clean, whole-food sources such as vegetables, fruit, meat, wild-caught fish, eggs, nuts and seeds, and healthy non-refined oils, while eliminating dairy, grains, processed foods, sugar, and legumes. This diet provides the body with ample nutrition through natural foods humans are meant to eat, and by removing the foods we know cause blood sugar spikes and processed foods containing chemical preservatives and other artificial ingredients, blood sugars often stabilize naturally.

It’s interesting that a traditional “diabetes diet” focuses on the foods a paleo diet eliminates - whole grains, dairy products, legumes, and root vegetables. It is also lower in total fat. Yet, it is less effective. In a study published in Cardiovascular Diabetology, (27) those following a paleo diet had significantly lowered glucose levels compared to those following a conventional diabetic diet.

4. AIP (Autoimmune Protocol)

This dietary strategy is similar to a paleo diet, but slightly stricter. It eliminates additional foods known to be immune stimulants for some people: eggs, nuts and seeds, and nightshade vegetables and spices (tomatoes, all peppers except black pepper, eggplant, all potatoes except sweet potatoes, tomatillos, paprika, and goji berries). Those with autoimmune blood sugar problems like type 1 diabetes and type 1.5 diabetes (also known as LADA, or Late Autoimmune Diabetes of Adulthood), can benefit from taking these additional foods out from their diets. This isn’t going to cure you, but it can help your immune system as well as your blood sugar to stabilize.

There are limited studies on the effects of an AIP diet on blood sugar specifically, but because it is so similar to a paleo diet (eliminating blood sugar spiking foods like grains, legumes, and sugar), it’s logical to conclude that this diet would be beneficial, if not more so, for blood sugar control, especially when it has an autoimmune component.

Of course, every person responds to foods and dietary strategies differently, and there may be other diets that work to balance blood sugar for some people. However, in my practice, these are the top four methods that I’ve seen yield real results in my patients.

Blood Sugar Balancing Breakfasts

Avocado Egg Bowls

Fat is the building block of a healthy and happy blood sugar level. Your brain is made up of 60 percent fat so you want to feed it exactly what it is made of rather than depriving it. Get your healthy fats in through everybody’s favorite fruit – avocado!


  • 1 medium avocado
  • 2 pasture-raised eggs
  • Sea salt and pepper to taste
  • Shredded grass-fed cheese (optional)


  1. Preheat oven to 425 degrees F.
  2. Cut open avocado, remove the pit, and scoop out just enough to make room for the egg.
  3. Place the avocado in a jumbo muffin tin or oven-proof ramekin to keep it from tipping over. Crack open eggs and place one in each half of the avocado. Sprinkle with salt and pepper to taste and cheese if desired. Bake 15 minutes and enjoy hot.

Nutty Chia Pudding

Creamy, pleasantly-textured chia pudding is the perfect make-ahead option and great for those who would rather stick with plant-based choices in the morning. The abundant healthy fats in this pudding come from the coconut milk, chia seeds, and nuts. This recipe is also rich in sugar-balancing protein. I like to mix this up the night before so it is ready to go in the morning with zero effort (other than finding a spoon). This makes a large single serving or can be split up for two mornings.


  • 2 cups unsweetened coconut milk
  • 1/2 teaspoon vanilla extract
  • 1/4 cup desired sweetener (honey, maple syrup), optional
  • 2 tablespoons peanut butter or other favorite nut butter
  • 1/2 cup chia seeds
  • 1/4 cup chopped walnuts or almonds


  1. Place coconut milk, vanilla, sweetener (if using), and peanut or nut butter together in a blender and blend until smooth.
  2. Stir in chia seeds and chopped nuts. (Or reserve the nuts for right before eating, if you want them to remain crunchier.)
  3. Pour into desired container and place in refrigerator for between 4 and 24 hours.

Omnivore Frittata

This simple frittata celebrates clean protein and even more great fats – perfect for a Sunday morning, with leftovers for the week. The mushrooms and greens promote methylation detox pathway function to help your body fight off the toxins you come across throughout the rest of your day.


  • 8 large pasture-raised eggs
  • 1/2 cup almond or coconut milk
  • 1 tablespoon coconut oil
  • 1/2 cup mushrooms, diced
  • 1/3 cup onion, diced
  • 2 cups kale or spinach
  • 3 slices organic turkey bacon, cooked and chopped
  • 1 cup ground organic grass-fed sausage or ground beef, cooked


  1. Preheat oven to 350 degrees F.
  2. Whisk eggs together with milk, and season with salt and pepper to taste.
  3. Heat coconut oil in skillet over medium heat. Add in mushrooms and onions, and cook for about 3 minutes, then add in greens.
  4. Add the eggs, bacon, and sausage to the vegetable mixture. Tilt the pan to spread the eggs evenly, and cook until the edges and bottom start to set.
  5. Place in oven and bake for 10 to 15 minutes or until the eggs are fully set.

Adaptogenic Green Smoothie

Smoothies are a quick, easy, super-nutritious breakfast option for those who like a lighter breakfast. I usually prefer to drink my breakfast, and this smoothie is packed with all of the fats you need without the load of sugar you will find in most other fruit-based beverages. Reishi is a powerful adaptogenic mushroom that will support healthy blood sugar balance with its ability to down-regulate (28) alpha-glucosidase, the enzyme responsible for breaking down starches into sugars.


  • 2 cups full-fat unsweetened coconut milk
  • 1 cup spinach, kale, or other greens of choice
  • 1/2 avocado
  • 1/2 green apple
  • 1 tablespoon coconut oil
  • 1 teaspoon reishi powder


  1. Combine all ingredients in blender, blend, and enjoy!

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Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.

Gut Feelings Dr. Will Cole 6

Gut Feelings

Healing The Shame-Fueled Relationship
Between What You Eat And How You Feel