Do you know where you are on the blood sugar scale?

Sunday, 21 February 2021

Blood sugar imbalances are often thought of as being an issue for diabetics, but blood sugar is generally not understood as being a cornerstone of care for other health symptoms like migraine, hot flushes, fatigue, insomnia, depression, anxiety, skin breakouts, thyroid changes, weight gain….. to  name a few! 

Let's dig in some more

We all need sugar in the blood – it is what fuels our muscles, brain and our red bloods, responsible for delivering oxygen - these cells rely on glucose for energy. Four grams (1 tsp) of glucose circulates in the blood of a person weighing 70 kg. This glucose is critical for normal function in many cell types. In accordance with the importance of these 4 g of glucose, a sophisticated control system is in place to maintain blood glucose constant at the expense of accessing glycogen stores ∼100 g in the liver and 400 g in muscle.

Although these 4 g constitute an infinitesimally small fraction of the mass of the total organism (you!), a wide variety of cells rely on it and are super sensitive to its presence, but this “optimal” level is supposed to be within this surprisingly narrow range at all times.  

A serious drop in blood glucose can result in seizures, coma, and even death. A persistent elevation in blood glucose leads to “glucose toxicity.” Glucose toxicity contributes to pancreas β-cell dysfunction and the pathology grouped together as complications of diabetes. 

In the main (with the exception of some autoimmune conditions such as  type 1 diabetes)  the see-saw between hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) occurs on a spectrum. Starting with erratic peaks and troughs, falling outside the narrow range of 4g, we call this dysglycemia. Then more consistently hyperglycemia, graduating towards insulin resistance, as cells and compensatory  mechanisms become worn out to  continual  hyperglycemia and  eventually diabetes and it’s complications.

(courtesy of Kharrazian institute - Functional Medicine Clinical Training)

Both hyper and hypoglycemia, results in the inability for the cells to create our ultimate fuel - ATP.  You don't have the energy to  “get up and go”, because cells now are inefficient in the energy production pathways. That sedentary lifestyle promotes more insulin resistance, and this insulin resistance pattern changes mechanisms in the brain associated with leptin and satiety centers that are involved with appetite, and you’ll be  constantly hungry. This  creates a very complex, vicious cycle.

(courtesy of Kharrazian institute - Functional Medicine Clinical Training)

The spectrum, commonly follows a pattern of: 

  1. Erratic hypoglycemia - low blood sugar - and recovery, through mechanisms that call on our stores to “make new glucose to re-establish balance - homeostasis. We have to remember that drawing on these  compensatory mechanisms, ate energy draining themselves . 

Your body is genetically programmed to recognize low blood sugar as a threat. When your blood sugar levels drop below normal, your nervous system kicks in, releasing adrenaline from the adrenal medulla, and  also your endocrine system responds by secreting a hormone called cortisol( also from the adrenals). Both these hormones then tell the liver to produce more glucose by acessing it’s stores of glycogen, bringing blood sugar levels back to normal.

The problem is that adrenaline and cortisol are sympathetic nervous system hormones involved in the “flight or fight” response, leading to hormone dysregulation such as PMS, poor transition through peri- and menopause , anxiety and so much more. 

(courtesy of Kharrazian institute - Functional Medicine Clinical Training)

Symptoms of hypoglycemia are:

  • Fatigue between meals 

  • Energy crashes between 3- 4pm

  • Sugar cravings in the afternoon

  • Improved energy and function after meals 

  • Irritability, anxiety, shakiness between meals 

  • Difficulty staying asleep - waking at 2-3am 

  1. Progressing to insulin resistance, hyperglycemia metabolic syndrome, into diabetes and diabetes with complications. 

Insulin is a hormone that is produced by the beta cells, which are cells that are scattered throughout the pancreas. The insulin produced is released into the bloodstream and travels throughout the body. 

So one of the key actions of insulin is to cause the cells of the body, particularly the muscle and fat cells, to remove and use glucose from the blood. It does this by binding to insulin receptors on the surface of the cells. You can think of it as insulin "knocking" on the doors of muscle and fat cells. The cells hear the knock, open up, and let glucose in to be used by the cell.

 

With insulin resistance, the muscles don't hear the knock as well (they are resistant), and the pancreas is notified that it needs to make more insulin, which increases the level of insulin in the blood and causes a louder knock.

The resistance of the cells continues to increase over time. As long as the pancreas is able to produce enough insulin to overcome this resistance, blood glucose levels remain normal. When the pancreas can no longer produce enough insulin, the blood glucose levels begin to rise, initially after meals when glucose levels are at their highest and more insulin is needed, but eventually in the fasting state too. 

insulin resistance.jpg

There are other serious physiological consequences from high sugar, some of which are hard to detect until it’s too late. One is triggering a process called glycation which leads to the creation of  AGEs and accelerates the aging process.

What's Glycation?

Advanced glycation end products (AGEs) are harmful compounds that are formed when protein or fat combine with sugar in the bloodstream. This process is called glycation. 

AGEs can also form in foods. Foods that have been exposed to high temperatures, such as during grilling, frying, or toasting, tend to be very high in these compounds.

AGEs, or advanced glycation end-products, are a contributing factor to the aging process because these protein fibers become stiff and malformed in the body. The AGEs also attach to RAGEs (receptors for advanced glycation end products), which upregulate the inflammatory response. When those AGEs attach to the RAGEs, they create more free-radical damage and instigate more internal and chronic inflammation. This protein stiffness, along with increased free-radical damage (and resulting inflammation), have all been linked to many chronic disease states such as diabetes, Alzheimer’s and cardiovascular disease, as well as many inflammatory diseases, like asthma and arthritis.

Symptoms of Hyperglycemia / Insulin Resistance 

  • Fatigue after meals 

  • Impaired brain function after meals 

  • Sugar cravings after meals 

  • Chronic inflammation- over all pain throughout the day 

  • Frequent urination

  • Difficulty exercising( as low ATP- fuel) , BUT if you do - notice improvements to above symptoms 

All that said, this is not a linear progression,  we unique and as such our systems will all respond in slightly different ways, depending on our  individual genetic makeup, lifestyle factors like eating a CRAP- colourless, refined & processed foods, alcohol, being sedentary, age (sadly entering menopause makes our cells less sensitive to glucose- I know mother nature can be a cruel ,mistress! ), smoking and how you manage stress to name a few. Remember my mantra “There is not just one event that causes poor health, but instead, a series of events has to line up to create the ‘perfect storm’ for developing a condition or a set/group of symptoms”

Ultimately, blood sugar imbalances are critically important to address and uncover, no matter what the complaint. It’s foundational to address and support  in any client I work with.  That’s because they are one of the upstream factors that can contribute to the expression of chronic illnesses that impact every system of the body, as shown by my interconnected web:

Some lifestyle tips for blood sugar imbalance:

  • Keep a consistent bedtime by 10pm with at least 8 hours of sleep

  •  Manage stress and stressors (external and internal) - remember those adrenals release adrenaline and cortisol that increase blood sugars

  • Only eat with intention - chew, engage with your food and do not eat “on the run”

  • Follow moderate exercise daily -  30 mins of movement with intention

Some general (remember personalised advice is the gold standard) food tips for blood sugar balance:

  • Keep blood sugar stable with fat/fibre/protein at each meal 
  • Avoid excess caffeine that activates the “stress response”  ( you can assess your sensitivity to caffeine with LifecodeGx Nutrient Core test) *eliminate CRAP- colourless refined & processed foods from you day
  • Reduce or eliminate alcohol 
  • Increase fibre and phytochemicals by choosing only wholegrains, and aiming for 10-12 colours from plants (vegetables , fruit, herbs, spices pulses and wholegrains) each day 
 

In health, Tanya x