Food matters, but it's not the whole story. Here's what the research says about meal order, movement, sleep and stress, and how to apply it to life here.
When people first put on a continuous glucose monitor, they usually expect to learn about food. And they do. But one of the most common questions I hear is: "Why did my glucose go up when I didn't even eat?"
That's the moment they discover that blood sugar is a conversation between your food, your muscles, your hormones, your sleep and your nervous system. Here are the six factors I see make the biggest difference, what the research says about each, and how to use them in everyday Singapore life.
Glucose is one of your body's main fuels, and it's normal for it to rise after a meal and come back down. The problem is large, frequent spikes and crashes, and blood sugar that stays high over time. These patterns are linked with energy dips, cravings, weight gain around the middle, and, over the years, insulin resistance, prediabetes and Type 2 Diabetes.
The goal isn't a perfectly flat line. It's gentler curves and a body that handles glucose well.
Refined carbohydrates and sugar (white rice, noodles, white bread, kuih, sweetened drinks) are digested quickly and tend to produce the steepest rises. For those of us in Asia, this is especially relevant: a large meta-analysis found that higher white rice intake was associated with a 55% higher risk of Type 2 Diabetes in Asian populations, where people eat far more rice than in Western countries.2
That doesn't mean rice is the enemy. It means the portion and the company matter. Fibre, protein and healthy fats slow digestion and soften the rise.
This is the one that surprises people most, because you don't have to change what is on your plate. In a small but striking study, people with Type 2 Diabetes ate the same meal on two days. When they ate the vegetables and protein first and the carbohydrates last, their glucose was about 29% lower at 30 minutes and 37% lower at 60 minutes, with insulin levels also markedly lower, compared with eating the carbs first.1
Try it: veggies first, then your fish, tofu, egg or meat, then the rice or noodles. It takes no willpower and costs nothing.
Geraldine came to me with an HbA1c of 10. Food sequencing was one of the first things we worked on together, alongside exercise and wearing a CGM so she could see the effect for herself. She's since lost 17kg and is off her medications for diabetes, blood pressure and cholesterol.
Your muscles are one of the biggest users of glucose, and when they're working, they can pull glucose out of the blood with less need for insulin. That's why when you move matters as much as how much.
A 2022 meta-analysis found that breaking up long periods of sitting with light-intensity walking significantly reduced post-meal glucose and insulin, and worked better than simply standing.3 The breaks studied were as short as 2 minutes.
Over the longer term, strength training builds more muscle, which gives glucose somewhere to go. It's one of the reasons I made strength training part of my own recovery.
If there's one factor Singaporeans consistently underestimate, it's sleep. In a study of healthy adults, a single night of about 4 hours' sleep reduced insulin sensitivity by roughly 20% and increased glucose production by the liver the next day.4 In other words, the same breakfast can hit harder after a short night.
On a CGM, poor sleep often shows up as higher morning readings and bigger spikes to meals that were fine the day before.
Try it: aim for a consistent bedtime, keep your room cool and dark, and put your phone down 30 minutes before bed.
When you're stressed, your body releases hormones like cortisol and adrenaline that raise blood sugar to prepare you to "fight or flee". That was useful when stress meant a tiger. It's less helpful when stress means back-to-back meetings or a difficult email at 11pm.
This is why many people are surprised to see their glucose rise on a CGM during a stressful day, even when they haven't eaten. Over time, chronic stress also nudges us toward poor sleep and comfort eating, which compounds the effect.
Try it: a few minutes of slow breathing (for example, breathing out for longer than you breathe in), a short walk outdoors, or time in green spaces like the Botanic Gardens or your nearest park.
Two people can eat the same bowl of laksa and have very different glucose curves. A landmark study that tracked 800 people with CGMs found that responses to identical meals varied widely between individuals, influenced by factors such as their gut microbiome.5 Genetics, muscle mass, age, hormones and existing insulin resistance all play a part.
This is why generic "good food" and "bad food" lists only get you so far, and why I'm such an advocate for personal data.
Rosalind had gained 7kg during COVID, despite eating clean and exercising. Even her doctor couldn't find the issue. It was only when she wore a CGM that she discovered hidden carbs quietly spiking her blood sugar. Once she learnt simple ways to manage them, she lost all 7kg and more, and got her energy and confidence back.
You don't need to overhaul your life. Pick one factor this week:
Small, consistent changes like these are exactly what Singapore's own guidance on preventing diabetes emphasises: regular physical activity and modest weight loss can meaningfully lower the risk of progressing from prediabetes to Type 2 Diabetes.6 And if you'd like to see which of these levers matters most for you, a CGM is the most direct way to find out.
I'm May, a breast cancer survivor who reversed my Type 2 Diabetes with the help of a CGM. I now coach people in Singapore to understand their blood sugar and build habits that last.
Work with meJoin a CGM workshopThis article is for education only and is not medical advice. Please speak with your doctor before making major changes to your diet, exercise or medication, especially if you have a pre-existing medical condition.
