Glycemic Control: Managing Your Blood Sugar
You may not think about your daily blood sugar until you get a scary diagnosis such as diabetes. Then, you have to think about it a lot in order to manage or reverse this chronic disease.
There is another way: prevention.
By understanding your body’s response to carbohydrates and your personal glycemic control now, you’ll work to prevent metabolic disease, and a host of other symptoms and diseases related to high blood sugar tomorrow.
Over 100 million adults in the United States have been diagnosed with diabetes or pre-diabetes.
That includes 10 percent of U.S. adults with type 2 diabetes and 25 percent with prediabetes. A diagnosis of prediabetes typically leads to diabetes within 5 years.
These statics are staggering, yet also are likely an underrepresentation of the true scope of the issue. Once thought of as a disease confined to a wealthier demographic as those found in Western countries, diabetes now affects countries across the globe.
Since an ounce of prevention really is worth a pound of cure, especially when focusing on glycemic control from a Functional Medicine perspective.
The information and tips outlined here will be helpful for preventing health effects of poor blood sugar regulation and also helping to regain balance if glycemic dysregulation is already present.
If you live in today’s modern world and care about your health, this information is foundational.
Learn more about:
- What glycemic control is
- The health consequences of poor glycemic control
- The causes of blood sugar dysregulation
- How to test for glycemic control
- How to improve glycemic control with diet and lifestyle change
Let’s dive in!
What Is Glycemic Control?
Glycemic control is another term for blood sugar, or blood glucose, balance.
Instead of high blood sugar levels followed by lows that keeps you on a rollercoaster of fatigue, irritability and cravings, we want to keep levels within a tighter range.
Think about it this way: when it comes to blood sugar, we want rolling hills instead of peaks and valleys.
Your glycemic control is influenced by your diet, stress levels, exercise, sleep (both quality and quantity) and other factors as well. However, diet is the largest player.
When you eat a high carbohydrate food such as a piece of fruit, a potato, a slice of bread or a soda the carbohydrates from that food break down into single sugars, called monosaccharides, in the digestive system.
These sugars then move from the small intestine into the bloodstream where they can be measured.
Insulin is the hormone that moves sugar from the bloodstream into the cells where it can be used for energy. Therefore, insulin, when working properly, lowers blood sugar.
Glucagon, on the other hand, is a hormone that signals the body to release more glucose into the bloodstream as levels dip low.
Cortisol, a main stress hormone produced by the adrenal glands, also raises blood sugar.
The body has all of these mechanisms in place to maintain glycemic control. However, the system is not very well adapted to a modern diet and lifestyle.
Hence, there is a rise in metabolic diseases including metabolic syndrome, pre-diabetes, and type 2 diabetes. Even cancer and Alzheimer’s can have a component of blood sugar dysregulation or insulin resistance.
Insulin resistance occurs when blood sugar is high (hyperglycemia) consistently over time. The pancreas pumps out a lot of insulin to try and get the glucose into the cells, but the demand is too great.
Eventually, the signal at the cell receptor gets foggy and you end up with a state of both high blood glucose and high insulin.
What Are The Consequences Of Poor Glycemic Control?
High blood sugar and insulin resistance may be root causes to:
- An increased risk of developing severe COVID-19 and other infections
- Metabolic syndrome, prediabetes and diabetes
- Increased inflammation
- Cardiovascular disease
- Cancer
- Mitochondrial dysfunction
- Microbiome imbalances
Let’s face it, poor glycemic control creates a stress and the entire body pays the price.
What Causes Poor Glycemic Control?
The short answer is the modern way of life.
The following contribute to poor glycemic control and elevated blood sugar:
- Standard American Diet high in processed, refined, sugary and fast foods
- Sedentary lifestyle
- High levels of stress
- Exposure to toxins
- Inadequate or poor quality sleep
Often obesity goes hand-in-hand with blood sugar dysregulation and the term “diabesity” is used to describe them together.
It’s important to note that someone who is thin or of a normal weight can still experience highs and lows in blood sugar based on their epigenetics, habits and lifestyle.
How Do I Find Out My Glycemic Control?
There are several ways to test glycemic control or blood sugar regulation. Some of these tests are quite standard and some will provide more information than others.
Functional Medicine doctors will typically test a series of these.
- Fasting blood glucose is a simple blood test you’ve likely had done before that measures glucose levels after an 8-12 hour fast.
- Postprandial blood glucose is a blood test or a finger prick that measures blood sugar levels in a non-fasting state. Typically, blood glucose is measured one to two hours after a meal.
- Hemoglobin A1C is a blood test that measures the percent of hemoglobin, a protein in red blood cells, that has glucose bound to it. The higher the percentage, the higher the average blood sugar was over the previous three months.
- Fasting insulin is a blood test that measures the hormone insulin after an overnight fast. High levels may suggest insulin resistance.
- Oral glucose tolerance test (OGTT) is a test where someone drinks a solution containing 75 grams of pure glucose and blood glucose and insulin levels are measured at intervals for two or three hours afterward. This test shows if you are able to handle that load of glucose.
- Continuous glucose monitor (CGM) is a device that attaches to the back of the arm and provides continuous glucose levels throughout the day. This allows you to observe fasting levels, overnight levels and levels after meals. It provides the most comprehensive data about how your unique body responds to different foods that you eat.
How To Take Control of Your Blood Sugar
Blood sugar regulation is important for health as blood sugar levels affect every cell in the body.
Here are some strategies to both prevent insulin resistance and to repair glycemic control if dysregulation is already present:
1. Focus on carbohydrate quality. This means eating whole foods such as sweet potatoes, spinach and berries instead of breads, soda and candy. By eating the whole versions, you will naturally increase fiber and micronutrients, which also support glycemic control. Need recipe inspiration? Click here.
2. Focus on carbohydrate quantity. As you increase whole foods and decrease processed food with added sugar, your carbohydrate intake will naturally decrease. A Standard American Diet easy contains over 300 grams of carbs per day.
Contrast that with a plant-based Paleo diet that is naturally a moderate carbohydrate diet, providing 75-150 grams per day.
If you have insulin resistance or diabetes, you may need to be on the lower end of the carbohydrate spectrum, or even follow a ketogenic diet, in order to regain glycemic control. Conventional medicine still largely promotes high carbohydrate diets for diabetes management. A growing body of research supports lower carbohydrate diets for managing blood sugar.
3. Consider your eating environment. The body may be more resilient to higher carbohydrate foods when you are relaxed and calm, such as on a beach vacation with no work, low stress, spending time in nature and moving your body. In a stressed, sedentary state your body may not be as resilient to the same food.
4. Eat balanced meals. It isn’t all about carbs, both fat and protein will help with blood sugar control. Be sure to eat all three with each meal. Fat will help to slow down digestion and the release of glucose into the bloodstream, while also signaling the brain that you’ve had enough to eat. Protein helps to maintain blood sugar between meals.
5. Move your body. While it’s impossible to exercise out of a poor diet, movement is important for so many reasons and one of them is improving glycemic control.
Exercise is special because it allows you to get glucose into your cells without insulin! Even a 10 minute walk after meals is helpful for improving postprandial glucose levels.
6. Reduce stress. This is often easier said than done, but it’s truly critical for a healthy metabolism. When the stress hormone cortisol is high, it signals for blood sugar to go up so you are ready to run or fight.
If you are just sitting at your desk worried about a work deadline, this high blood sugar is not doing you any favors.
7. Reduce toxin exposures. Toxins, including heavy metals and endocrine disruptors (add link), are known as obesogens because they make it hard to lose weight and regulate blood sugar.
Toxins are everywhere and it’s impossible to avoid them all, but eliminating what you can control, while supporting detoxification, is often the missing piece when it comes to glycemic control.
8. Use key supplements. Nutrients including B vitamins and magnesium are critical for glycemic regulation, so supplementing if deficient or providing extra to your body may be helpful.
In addition, herbs such as berberine, cinnamon and bitter melon may be helpful.
You may also consider adrenal support, fiber and microbiome support such as probiotics. There are many supplement protocols that may be useful depending on your individual needs.
Glycemic control may seem like a simple concept or something that is only important for those with diabetes, but it is critical for health and wellbeing in all of us.
The good news is that testing is relatively easy and blood sugar responds very well to how you live your daily life. It’s empowering to know that health is a choice.
p.s. You may see changes very quickly! 🙂
References
- https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html
- https://diabetes.diabetesjournals.org/content/66/6/1432
- https://pubmed.ncbi.nlm.nih.gov/11460565/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7217100/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298690/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5720913/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045050/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554894/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537452/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6412701/
- https://pubmed.ncbi.nlm.nih.gov/26224300/
