What’s the deal with balancing “blood sugar”? Why is it imbalanced and why should I care?
Well, let’s talk about what actually happens with blood sugar in the first place.
When we eat carbs, they’re broken down by enzymes into their simplest form, glucose, and released into the bloodstream through the intestinal wall.
After we eat carbs, our glucose (aka blood sugar - I will use those interchangeably throughout) inevitably rises. Our pancreas works to produce & secrete insulin, a hormone that signals to cells to “open up” and take in glucose if they can.
Our liver & skeletal muscles are the biggest consumers of glucose when insulin is present. Once those cells in the liver & muscles are full however, that glucose gets stored for later as fat.
Converting these sugars to fat is actually an amazing trait of our bodies, because the alternative would be leaving that sugar to circulate at increasing levels, until it could be used at some later time. However, high blood sugar can be harmful, because when glucose is just left to circulate in high amounts, it can create all sorts of issues & inflammation.
Glucose molecules get ‘stuck’ to other proteins in our blood stream, creating “ Advanced Glycation End Products” (literally called AGEs), which are bio-markers implicated in processes like aging, and development or worsening of chronic inflammatory diseases like diabetes, heart & vascular disease, arthritis, and Alzheimers. Clearly lowering blood sugar, even if that means turning glucose to fat, is in our body’s best interest! But this isn’t always how it plays out.
This breaks down when our cells lose their ability to respond to the presence of insulin, and don’t take up enough glucose to bring blood sugar down or meet the cell's own energy needs. This is called insulin resistance.
Our cells can become resistant to the signals of insulin in a few different ways:
over-exposure from frequent glucose (and resulting insulin) spikes throughout the day from imbalanced snacks & meals, and a diet high in refined carbs
hormone imbalances in estrogen or progesterone, namely low estrogen and/or high progesterone, which is why pregnant women can develop gestational diabetes when progesterone levels are at their highest
inflammation, which turns down a cell’s insulin sensitivity
Insulin resistance is surprisingly common, in fact 1 in 3 adult Americans has prediabetes (a more mature stage of insulin resistance) and 84% of them don’t know they have it. Insulin resistance increases inflammation, which can put someone at higher risk for developing PCOS and other hormonal imbalances, acne, high cholesterol, non-alcoholic fatty liver, heart disease, cancer, Alzheimers, among other chronic health conditions.
Some signs that you might be struggling with blood sugar imbalances or insulin resistance:
Sugar cravings
Excessive appetite, like you can’t get enough even after a big meal
Feeling tired after you eat
Waking up in the night around 2-3 AM
Frequent thirst & peeing
Weight gain around the midsection
Hemoglobin A1c marker ≥5.6 (on conventional blood panels)
Fasting glucose over 100 mg/dL (at-home finger prick, or from a fasting blood panel)
Blood markers like A1c, or at-home glucose monitors are great to keep an eye on, to see how blood sugar is trending over time. When we see A1c creep up towards that 5.6 mark, we want to get more serious about addressing the various factors that lead to those glucose spikes, which over time contribute to insulin resistance.
So how can we minimize those spikes & improve our insulin sensitivity? Contrary to a lot of advice, it’s not all about just cutting out carbs. If that’s your thing, great! But there are SO many other things that determine the size of a glucose spike after a meal & our overall insulin sensitivity.
The first place to start is diet, make sure to include protein, fat, veg or fruit in each snack or meal. Aim for the bulk of your plate to be made up of veg, not the starchy dish. Carbs are not bad, in fact they are needed for many different functions in the body, but they do tend to take up most of the plate in a Standard American Diet: pasta, bread, potatoes, rice, you get the idea
In addition to including veg, proteins & fats on the plate - the order in which you eat your food also has a sizable impact on the rate of glucose absorption in our bloodstream. Eat some veggies first (I love starting with some greens or a salad!), then some proteins & fats, then enjoy the carbs. Here’s a graphic of the difference in glucose response when you eat a salad before the starch - it’s dramatically improved!
Dilute vinegar before meals and drink, or cover some greens to eat first in a tasty vinaigrette! The acetic acid in vinegar improves insulin sensitivity, and works best if taken at the beginning of a meal (1-10 minutes before the rest of the meal).
Regular exercise & weight training to build muscle. Muscle cells readily take up glucose, until they’re ‘all full’, and then turn down their insulin receptors. Building more muscle, and increasing the number of muscle cells we have through weight training is one way we can increase the amount of glucose our cells can take, before they’re all full and our bodies need to turn glucose into fat.
Walking or some form of movement 30 minutes after eating. Gentle movement 30 minutes after meals improving blood glucose response (ie. the post-meal glucose spike does not get as high as sitting after a meal). This can be a 15 minute walk, 50 jumping jacks, or 50 air squats in front of the TV.
“Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4876745/
“Vinegar Consumption Increases Insulin-Stimulated Glucose Uptake by the Forearm Muscle in Humans with Type 2 Diabetes” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438142/
“The Timing of Activity after Eating Affects the Glycaemic Response of Healthy Adults: A Randomised Controlled Trial” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267507/