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When Gail Pagano turned 53, it was like a switch was flipped.
Without any changes to my diet or exercise habits, I suddenly gained weight, my joints hurt, everything felt wrong, and blood tests showed I was pre-diabetic.
Doctors noted that her blood sugar levels were within the upper limit of the normal range and attributed her symptoms to aging and menopause.
“It was incredibly frustrating,” she told Business Insider. “It has nothing to do with the numbers or what's normal, but if I say this is how I'm feeling, I know it's not normal for me.”
Pagano started using a continuous glucose monitor (CGM), a wearable device that reports changes in her blood sugar levels in real time, which she connected to through health tech company NutriSense, which provides support from nutritionists and even a prescription that, until recently, was required to get a CGM.
The device is still just starting to catch on, and researchers are skeptical it will work for everyone, but Pagano said it worked for him.
Now 56, she has lost 50 pounds and says tracking her blood sugar levels has helped her develop healthy habits and make food choices that keep her energized.
Reduce your intake of processed carbohydrates
Pagano comes from an Italian family and is a big fan of pasta.
Tracking her blood sugar helped her realise she didn't have to cut things out completely: After experimenting with how different foods affected her body, she says making pasta and bread at home reduced blood sugar spikes.
She cut out processed foods, salads, and other foods. Though convenient, some pre-made meals can be high in sugar and other hidden additives.
“The biggest surprise and the biggest disappointment is packaged, prepared foods and restaurant foods,” she said. “No matter how healthy you think they are.”
But Pagano has found healthier ways to enjoy similar flavors with more nutrients and fewer preservatives: For example, instead of eating fruit gel for breakfast, she switched to blueberries, raspberries, and blackberries, which are rich in fiber, vitamins, and antioxidants.
Eat plenty of protein and fiber with every meal
Pagano said an easy way to balance blood sugar without cutting out carbs completely is to get other nutrients in first.
“Eat protein first, then fiber, then starches,” she says.
Nutritionists previously told BI that there's scientific evidence behind this approach, as digesting protein and fibre slows down the absorption of glucose from carbohydrates, preventing a spike in blood sugar after a meal.
Intermittent fasting
Pagano said her routine includes 14 hours of intermittent fasting, and that although she now stops eating around 5 p.m., she realized her previous habit of eating late at night was disrupting her sleep.
Research suggests that fasting may help people with prediabetes keep their blood sugar levels within the normal range.
Pagano says she often snacks on nuts and cheese in the evening before fasting, a combo that's high in fiber, healthy fats, and protein, all of which are associated with feeling fuller for longer.
A new supplement: Berberine
To help balance her blood sugar levels, Pagano started taking an herbal supplement also known as “nature's Ozempic.”
Berberine, a yellow compound found in plants such as barberry and goldenseal, has a long history in traditional medicine. There isn't much evidence that berberine significantly promotes weight loss, but some research suggests it may have some effects on blood sugar and cholesterol levels.
However, side effects such as digestive discomfort are possible. Like other supplements, berberine is not well regulated, so it can be difficult to know if you're getting the right amount of a quality product.
Strength training with resistance bands
Pagano is an avid walker who aims to walk 10,000 steps a day, and is now retired and living in Florida, where the heat can sometimes make outdoor exercise difficult.
She added strength training to her routine with 15 minutes of resistance band exercises a few times a week, as research shows that resistance training with bands and weights can improve longevity and help prevent disease.
Pagano still takes regular walks, focusing on short strolls after meals to keep his blood sugar in check.
“You must never move after eating,” she said.
