Steps Toward Better Blood Sugar

On my family medicine rotation, I was walking back from the cafeteria with a resident when he suddenly rolled up his sleeve.

 “Check this out,” he said, pointing to a small patch on his arm. “It’s a continuous glucose monitor. There’s a tiny needle under the patch, and I can check my blood sugar anytime on my phone. It’s awesome, I want all my patients to use one.

This meant a lot considering our clinic in Northern Kentucky saw hundreds of patients visits for diabetes checks every week. A tool like this could avoid the pain of fingerstick glucose pricks for patients and remembering to check their sugars after every meal.

According to the CDC (Center for Disease Control), in 2024 about 20–30% of Americans over 45 years old are living with diabetes, and nearly half have prediabetes.¹ These numbers are concerning because diabetes can have serious consequences if not managed carefully: kidney failure, numbness in the feet leading to amputations, and even blindness. In an ophthalmology clinic, I saw young patients in their 30s and 40s needing emergency surgery for detached retinas putting their vision at risk, all from poorly controlled diabetes.

Source: CDC (https://www.cdc.gov/diabetes/communication-resources/diabetes-statistics.html)

Let's Learn How the Body Controls Blood Sugars:

 When we eat, carbohydrates break down into glucose, which is absorbed into the bloodstream. Glucose is the fuel for cells, but it needs the help of insulin to get inside cells. When blood sugar levels get high, the pancreas releases insulin which acts as a key that binds to insulin receptors on cells. They key unlocks transporters that move glucose into cells for energy.

 Type 1 vs Type 2 Diabetes

When people hear “diabetes,” they often lump it all together, but “type 1” and “type 2” are actually very different conditions.

●   Type 1 diabetes is an autoimmune condition. The body’s immune system mistakenly attacks the insulin-producing cells of the pancreas, leaving it unable to make insulin at all. Without insulin, glucose can’t get into cells to provide energy. That’s why people with type 1 usually need insulin pumps or injections from a young age, along with careful carb counting to keep blood sugars balanced. Type 1 makes up only about 6% of all diabetes cases.¹

●   Type 2 diabetes develops more gradually and is much more common. Here, the pancreas can make insulin, but all the cells in the body become resistant to insulin. At first, the pancreas makes more and more insulin to try to overcome the resistance. But over time, the cells decrease their number of insulin receptors. Think of it like getting an endless stream of phone notifications. Soon, you start ignoring or will even turn off the alerts. This causes a worrisome cycle where the pancreas makes more insulin trying to move the glucose into cells, but as the cells pay less attention to insulin, this causes blood sugars to climb.

Complications of Type 2 Diabetes

Unfortunately, excess sugars can cause serious harm throughout the body. High glucose can injure the small blood vessels in the body and react with proteins and fats to form harmful byproducts. The tissues most affected are the eyes, kidneys, and nerves because these are areas where glucose can get in without needing insulin.

• In the eyes, the retina, the camera for our brains, can detach leading to vision loss and blindness.
• In the kidneys, its filtering mechanism can scar and eventually cause kidney failure.
• In the nerves, especially in the feet, damage can cause burning pain or numbness (diabetic neuropathy). If precautions aren’t taken, the numbness can cause foot infections and in the worst scenarios, require amputation.

A Simple Strategy: Walk After Eating

Managing diabetes involves keeping fasting blood sugars (morning levels) ideally below 100 and post-meal (“postprandial”) levels below 140. However, there is some wiggle room here so it’s best to check over your target sugar levels with your doctor.

One study we discussed in that same family medicine clinic really stuck with me: a simple 20-minute walk immediately after eating lowered postprandial glucose spikes, in both people with and without diabetes.³

●     🚶 Right after eating → biggest benefit

●     ⏳ An hour after eating → smaller effect

●     ⏮️ Before eating → no real difference

It’s a low-risk, high-reward strategy. For patients with diabetes, it’s one more tool to keep sugars in check. For everyone else, it’s a way to reduce big sugar spikes and potentially lower the risk of developing diabetes.

So now I’ve made it a part of my routine to walk right after I eat, whether it's a neighborhood stroll or taking the stairs around the hospital after lunch. It’s a small step, but one that can add up to lasting impacts on our health.

And of course continue to eat a healthy diet..

1) CDC Data

2) CDC Diabetes Study

3) PubMed Paper on Diabetes & Walking