If you are one of my patients, you have heard me go on and on (and on and on…) about how important healthy blood sugar levels are, and if you’re reading this newsletter (THANK YOU btw!!) you have probably heard or read about the importance of blood glucose levels and may have seen blood glucose results on your lab tests, but do you really know what it means?
If not, it is super important, so here you go…..
What is Blood Sugar?
Blood sugar is also called blood glucose, and is the level of sugar circulating in your blood. It is the primary fuel source your body uses to create cellular energy. Your body attempts to keep your blood sugar within a specific range and has several mechanisms to serve that goal.
While several hormones and body processes assist in regulating healthy blood sugar levels, the two main hormones are insulin and glucagon, which are released by the pancreas, and their primary function is to maintain healthy blood sugar levels.
A rise in blood sugar levels causes the release of insulin, which triggers glucose to enter the cells to be used as energy. As glucose enters the cells from the blood, blood sugar levels decrease.
A drop in blood sugar levels causes the release of glucagon, which raises blood sugar levels in several ways. Glucagon stops the liver from storing glucose that is circulating in the blood, it triggers the liver to convert stored glucose (glycogen) into glucose that can be released into the blood, and it causes the body to create more glucose (called gluconeogenesis) from amino acids (the building blocks of protein).
Phew…. That is a lot of technical stuff but very important to understand!
What Causes Blood Sugar to Be High?
When blood sugar levels are much higher than they are supposed to be, it is called hyperglycemia.
There are a number of conditions associated with high blood sugar including insulin resistance, type 1 diabetes (T1D), and type 2 diabetes (T2D).
With T2D and insulin resistance, the cells become less responsive to insulin resulting in less glucose getting into the cells and more glucose circulating in the blood.
Type 1 diabetes is an autoimmune condition where the body's immune system mistakenly attacks the pancreas' insulin-producing cells, so there is less insulin available to get glucose into the cells.
There is an increased risk of T2D if you have a family history of blood sugar dysregulation or diabetes, are over 45 years old, and are of Black, Hispanic, Native American, Pacific Islander, or Asian American descent
Several dietary and nutritional factors can contribute to elevated blood sugar, such as overeating, eating a diet high in unhealthy fats, sugar, refined carbohydrates, and processed foods, and having nutritional deficiencies.
Nutritional deficiencies associated with high blood glucose or diabetes include inositol (a type of sugar the body produces that supports insulin and blood glucose regulation), Vitamin D, magnesium, zinc and chromium
Certain illnesses like a cold or flu can cause blood sugar levels to be high, as can conditions associated with the adrenal glands, such as Cushing syndrome, the pancreas, such as pancreatitis and the thyroid, such as hypo or hyperthyroidism.
Medications such as corticosteroids, phenytoin, and estrogens, can cause high blood sugar levels.
Experiencing high levels of stress also causes high blood sugar levels. Stress results in a rise in the stress hormone cortisol. An increase in cortisol levels causes a rise in blood glucose as it stimulates gluconeogenesis (production of glucose from amino acids). Over time, hyperglycemia from chronically high stress hormone levels can contribute to type 2 diabetes.
A lack of physical activity and being obese or overweight can contribute to insulin resistance, resulting in hyperglycemia.
Disruptions in the gut microbiome called gut dysbiosis, are associated with blood sugar dysregulation and diabetes.
Symptoms of High Blood Sugar
Symptoms of high blood sugar and diabetes can include:
- Fatigue
- Blurry vision
- Increased feelings of hunger or thirst
- Urinating frequently (especially at night)
- Slow wound healing
- Frequent infections
- Numbness, pain, or tingling in the extremities (feet or hands)
- Unexpected weight loss (or more commonly weight gain)
- Areas of darkened skin (most often around the neck and armpits)
What Causes Blood Sugar to Be Low?
When blood sugar levels get too low, it is called hypoglycemia. Blood sugar that drops too low can be serious, resulting in seizures or loss of consciousness.
A common cause of hypoglycemia in type 1 and type 2 diabetics is taking too much insulin or other diabetes medication.
Dietary factors that may contribute to low blood sugar include skipping meals, drinking alcohol (especially on an empty stomach); fasting for an extended period of time; malnutrition; inadequate amounts of fat, protein, and fiber in a meal; and surgeries that interfere with normal emptying of the stomach post eating a meal (such as stomach bypass surgery).
Stress and other factors that increase stress on the body, such as illness, excess exercise, sleep deprivation, and very hot weather, can cause low blood sugar levels.
Hormone changes associated with puberty and menstruation can cause hypoglycemia.
Symptoms of Low Blood Sugar
Common symptoms of low blood sugar include:
- fatigue
- shakiness
- irritability
- anxiety
- perspiration
- headache
- increased hunger
- nausea
- turning pale
- an irregular or fast heartbeat
- problems concentrating
- dizziness
- Numbness or tingling of the lips, tongue, or cheek
Symptoms of dangerously low blood sugar include:
- confusion
- slurred speech
- strange behavior
- loss of coordination
- vision problems
- seizures
- loss of consciousness
How to Manage High Blood Sugar With Nutrition
A nutritional strategy to help manage hyperglycemia and support blood glucose control is to follow a Mediterranean or a lower carbohydrate diet.
This eating style also supports several other factors involved in hyperglycemia, such as regulating the stress response by supporting the production of stress hormones, boosting the immune system, and shows benefits for people with diabetes, and promotes gut health as well
This diet is based on the traditional diets of people who live nearby the Mediterranean Sea and emphasizes low sugar, anti-inflammatory, unprocessed, nutrient-dense foods. Seasonal fruits and vegetables, herbs, legumes, beans, whole grains, and healthy fats, particularly olive oil, are all components of a Mediterranean diet and low carb diet. While high-fiber plant-based foods are the main focus, fish, eggs, poultry, dairy products, and red wine are consumed in moderation.
An essential aspect of managing high blood sugar with nutrition includes avoiding or limiting foods associated with raising blood sugar and contributing to insulin resistance. This includes refined and processed foods, sugar, and unhealthy fats.
How to Manage Low Blood Sugar With Nutrition
During a hypoglycemic episode in which a person is experiencing symptoms from having low blood sugar, consuming 15 to 20 grams of simple carbohydrates, such as honey or fruit juice, is suggested to help raise blood sugar levels to normal ranges quickly.
However, a long-term nutritional approach for managing low blood sugar shows that the low carb or Mediterranean diet is also an excellent option in this situation. Overall this way of eating supports lower inflammation and improved blood sugar control, making it an ideal choice for people with high or low blood sugar.
People with low blood sugar or prone to episodes of hypoglycemia should aim to swap simple (processed) carbohydrates for complex carbohydrates to help prevent blood sugar spikes and dips. It's also essential to balance complex carbohydrates with protein and healthy fats to help keep blood glucose in healthy ranges, preventing blood sugar spikes and dips.
Avoiding skipping meals and prolonged fasting can also help prevent low blood sugar episodes.
Supplements and Herbs that Help Balance Blood Sugar
There are many supplements and herbs to help balance blood sugar.
Chromium for Balancing Blood Sugar
Chromium is an essential mineral required in trace amounts that supports blood sugar regulation by enhancing the functionality of insulin and the metabolism of carbohydrates, fats, and proteins. It may help improve blood glucose control when it is too low and too high. Chromium is in many blood sugar balancing formulations and can also be found in many whole unprocessed vegetables.
Berber for Balancing Blood Sugar
The active ingredient in the ancient Chinese herb Coptis chinensis is berberine which has been used for thousands of years to support blood sugar regulation. Along with its antioxidant and anti-inflammatory properties, studies show that supplementing with berber may help lower blood sugar, HbA1c, lipids, and insulin levels. The glucose-lowering effects of berber are only observed when hyperglycemia is present; studies show it does not pose a risk for hypoglycemia.
Probiotics for Balancing Blood Sugar
Probiotics are strains of bacteria that promote overall health. Supplementing with probiotics supports a healthy gut microbiome while modulating inflammation, reducing insulin resistance, and supporting blood glucose control.
This Chai flavored tea has a number of herbs such as cinnamon, fenugreek, cardamom, holy basil and gymnema shown to help normalize blood sugars when 1-2 cups are consumed daily