Changing blood sugar is a fact of life. Every time you eat something, the sugars in the food are absorbed and pass into the bloodstream. From there, they circulate until your body removes them either for use or for storage. But for those with type 2 diabetes, this second step isn’t so easy. Their body doesn’t remove sugar effectively from the blood because it has trouble recognizing that there’s even sugar there to remove. When it does, it responds sluggishly. Fortunately, new research out this week has found that the amount you eat at different meals can change how well your body responds to sugar, which may help diabetics get their numbers under better control.

How does the body normally control blood sugar?

When the body gets a dose of sugar from the food you eat, it relies mostly on a hormone called insulin to pull that sugar into organs that will use or store it. An organ called the pancreas that sits close to the stomach is responsible for detecting the level of sugar in the blood and releasing insulin to counteract it. Insulin then acts mostly on the muscle, liver and fat cells and signals them to gather up the sugar circulating in the blood. There the sugar is packed into a form that is easy to store and that can be used in the future if the need arises. Insulin also tends to rev up cell activity and boost functions that normally require a lot of energy. It serves to make sure the body responds to high blood sugar by using what it can and storing what’s left.

What happens in type 2 diabetes?

In a type 2 diabetic, the pancreas doesn’t respond the way that it should when sugar is present in the blood. It takes higher and higher levels of blood sugar to trigger insulin release. Because of that, sugar circulates for long periods of time through the blood without getting removed by the organs normally triggered by insulin. In the short run, the body is able to tolerate high blood sugar. But when blood sugar stays high for weeks, months or years, that sugar starts to do some damage. It injures blood vessels, making it harder for them to function normally. It also injures organs like the kidneys, eyes or heart, making disease more likely. And it suppresses the immune system, making it harder for diabetics to heal when they have an injury or infection.

What did this study look at?

The researchers observed that the sugar level in someone’s blood varied over the course of the day, even if the meal they had was the same. A big meal in the morning resulted in a smaller blood sugar spike than the same meal eaten at dinner. This is because meal times help to set the body’s “circadian rhythm,” also known as our internal clock. That clock uses day light as well as meal times to decide when we should be awake and when we should be asleep. It has also been found to control a number of other processes in the body, including insulin release. The researchers wondered if they could time meals to help diabetics better control their blood sugar.

What did they do and what did they find?

The team split the participants into two groups. One group ate a large breakfast (about 700 calories), a medium lunch (about 600 calories), and a small dinner (about 200 calories). The other group ate the reverse. The team measured blood glucose and the body’s response to increased blood sugar both before and after each meal.

They found that those on the large breakfast/small dinner diet had higher levels of insulin and lower spikes in blood sugar than those on the opposite diet. Overall, blood-sugar control was better in diabetics who ate a large breakfast and kept their meals small in the evening.

How can I use this information?

These findings go along with a number of other studies showing that having a high energy breakfast with a small dinner improves insulin sensitivity and lowers body weight. Skipping breakfast has also been linked to poor blood sugar control, more body fat and higher blood pressure. The message is clear: If you have diabetes or a strong family history of diabetes, eat breakfast like a king, lunch like a prince and dinner like a pauper.

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