The Roller Coaster Ride of Blood Sugars

Written by October 2017 Phoebe Wynne-Lewis, BHSc, Dip Nat Med, Dip Herb Med – FxMed Technical Support

Glucose (the sugar in our blood) is essential to health because it is required for the formation of ATP, the energy molecule in our bodies, which is necessary for every organ and cell to function. Blood sugar levels are regulated by negative feedback in order to keep the body in homeostasis. The levels of glucose in the blood are monitored by many tissues, but there are two key hormones for blood glucose regulation – insulin and glucagon.

Glucagon

If blood glucose levels fall to dangerous levels (as in very heavy exercise or lack of food for extended periods), the alpha cells in the pancreatic islets release glucagon, a hormone that affects liver cells to increase blood glucose levels. They convert glycogen into glucose (glycogenolysis). The glucose is released into the bloodstream, increasing blood sugar.

Insulin

When levels of blood sugar rise, whether as a result of glycogen conversion, or from digestion of a meal, Insulin is released from beta cells in the Islets of Langerhans in the pancreas. Insulin causes the liver to convert more glucose into glycogen (glycogenesis), and to force about 2/3 of body cells (primarily muscle and fat tissue cells) to take up glucose from the blood through the GLUT4 transporter, thus decreasing blood sugar. Insulin also provides signals to several other body systems, and is the chief regulator of metabolic control in humans.

Dysglycemia

Dysglycemia refers to any abnormalities in blood glucose levels that lead to disease. Abnormally high, low or unstable glucose levels indicate a lack of control that can be attributed to a variety of causes. Dysglycemia can weaken and inflame the gut (leaky Gut), lungs (leaky lungs) and brain (leaky Brain), imbalance hormone levels, disrupt the HPA Axis and affect thyroid and adrenal function, disrupt detoxification pathways, and impair overall metabolism.

Types of Dysglycemia

Although Type 1 and Type 2 diabetes are two of the better-known types of dysglycemia, conditions such as gestational diabetes, prediabetic conditions, drug-related and genetically related abnormalities of blood sugar levels also represent types of dysglycemia. Symptoms related to both abnormally high and abnormally low glucose levels can occur with these problems, and they can be signs of a more systemic condition such as Metabolic syndrome.

Causes of Dysglycemia

  • Hereditary or environmental factors, or a combination of both. Genes can predispose an individual to developing dysglycemia over time just as much as certain lifestyle habits can ie a diet high in unhealthy fats, sugars, and processed foods and a diet lacking certain vitamins and minerals may enhance the body’s sensitivity to insulin also contributing to dysglycemia.
  • Both Stress and HPA axis dysfunction – contribute to dysglycemia due to key roles the adrenal hormones epinephrine, norepinephrine and cortisol play in blood sugar regulation. Stress signals the body to raise blood sugar levels in order to generate energy to respond to the stress. If the body cannot meet this higher demand for blood glucose, hypoglycemia can result.
  • Low thyroid function can cause dysglycemia and Metabolic syndrome (MetS) through a variety of mechanisms; slowing the rate of glucose uptake by cells, decreasing the rate of glucose absorption in the gut, slowing the response of insulin to elevated blood sugar and slowing the clearance of insulin from the blood. When we are hypothyroid, our cells aren’t very sensitive to glucose. Because our cells aren’t getting the glucose they need, the adrenals will release cortisol to increase the amount of glucose available to them. This causes a chronic stress response that suppresses thyroid function.
  • Gut Microbiome – research suggests that specific gut bacteria have the ability to change the composition of the microbiome within the large intestine and actually improve how the entire body metabolizes glucose and manages blood sugar.
  • Sex Hormones – estrogen and progesterone affect how our cells respond to insulin and therefore blood sugar levels during various phases of the menstrual cycle. For example, during the pre-menstrual phase these two hormones are at their peak. Increased levels of progesterone cause insulin resistance, leading to hyperglycemia. While some women will experience hypoglycemia during this time due to high levels of estrogen causing increased insulin sensitivity. During menopause, production of progesterone and estrogen diminishes. A decrease in progesterone levels results in increased insulin sensitivity, and on the flip side, decreased estrogen can increase insulin resistance. It all depends on which hormone seems to have more control.

Hyperglycemia Effects:

  • Heart Problems – Hyperglycemia can increase the rigidity of the blood vessels increasing BP; increased insulin resistance also decreases the body’s ability to process harmful fat which circulates in the blood and accumulates on the blood vessel walls increasing BP and possibly blocking blood flow.
  • Skin Problems – From normal allergies to complicated skin problems, hyperglycemia affects the healing ability of the body to injuries and infections, as the supply of oxygen and nutrients are impaired. The wound healing process is either slowed down or completely halted (in severe cases when there is no blood flow).
  • Mood Disorders – The fluctuation in blood sugar levels directly affects the mind and can bring about negative changes in mood. Inadequate blood flow to the brain and blood that is of unhealthy composition because of high blood sugar levels, can change our moods and psychological state.
  • Neuropathy – As the nervous system also absorbs glucose directly from the blood, chronic hyperglycemia can affect its functioning and health severely. Another reason for diabetic neuropathy is the damage to blood vessels that supply blood to the nerves. This deprives the nerves of glucose, oxygen and other nutrients necessary for their normal functioning.
  • Depression – The brain primarily relies on glucose as a source of energy and unstable blood sugar levels can have a significant impact on mental health problems especially depression, anxiety and bipolar syndrome. Fluctuations in blood sugar can disturb the brains ability to manufacture neurotransmitters; Serotonin, Dopamine or GABA.
  • Insulin Sensitivity – Continued elevated blood sugar can have a very negative effect as the body must release a consistent stream of insulin into the bloodstream to maintain healthy sugar levels. This will cause the tissues to become “insulin resistant”, due to the constant exposure to insulin. More and more insulin is released to remove circulating sugar that keeps rising as tissues are not responding to insulin anymore. Insulin resistance is one of the components of MetS. MetS has become so common that it’s predicted to eventually bankrupt our healthcare system. Both MetS and insulin resistance are risk factors for heart disease and diabetes, two of the leading causes of death in the developed world.
  • Sex hormones – Insulin is closely connected to all the other hormones in our body, including estrogen and testosterone. When insulin spikes, typically after a meal high in sugar, this can lead to lower levels of sex hormone binding globulin (SHBG). SHBG binds excess estrogen and testosterone in the blood, but when it is low, these hormone levels increase. Insulin also increases the production of testosterone, which is then converted into even more estrogen by fat tissue in the belly. These effects mean the ratio of estrogen to progesterone (known for keeping us calm and happy) is too high, leading to irritability, anxiety, insomnia and more. And as women reach menopause, symptoms get more intense and can include hot flashes and night sweats.
  • Blood Vessel Injury – The cells present in the walls of blood vessels absorb glucose directly from the blood without the need of insulin. So, when blood sugar levels are high, they become overloaded with glucose, and over a prolonged period, the blood vessels will be damaged. The cell walls become thick and weak, causing them to block the blood flow to the organs with small blood vessels, especially the nerves.

Hypoglycemia Effects:

  • Central Nervous System – Low blood sugar levels can cause a variety of problems within our CNS, including weakness, dizziness, tingling, nervousness, anxiety and a lack of coordination, chills, clammy skin, and sweating. Other symptoms include blurred vision, headache, and confusion. We may have difficulty performing simple tasks. When blood sugar levels drop during the night, it may cause people to have nightmares, cry out during sleep, or other unusual behaviors.
  • Thyroid Dysfunction – just as high blood sugar can weaken thyroid function, chronically low blood sugar can also cause problems. When blood sugar levels drop below normal, our adrenal glands respond by secreting cortisol. Cortisol instructs the liver to produce more glucose, bringing blood sugar levels back to normal. Unfortunately for hypoglycemics, repeated cortisol release caused by episodes of low blood sugar suppresses pituitary function. Without proper pituitary function, the thyroid cannot function properly.

How to balance blood sugar levels:

Eating a diet with a focus on regulating blood sugars will result in optimal functioning of certain hormones in our body and allow the feedback system to work properly, achieving higher energy levels and optimum health.

  • Eat a low-to-moderate carbohydrate diet (to prevent blood sugar fluctuations), and eat frequent, small meals every 2-3 hours (to ensure a continuous supply of energy to the body)
  • Avoid blood sugar spikes – by avoiding refined sugar and refined carbohydrates (baked goods, white bread & pasta) as they have a high glycaemic index (raise blood sugar quickly) as well as sodas and sweet drinks, which are filled with artificial sweeteners and preservatives that will inevitably lead to hormonal imbalance and a blood sugar spike. Switch to whole grains when possible.
  • Reduce stimulants like caffeine and nicotine that cause blood sugar to rise due to a surge in adrenaline.
  • Include in the diet: Green leafy vegetables – broccoli, spinach, kale and other leafy greens are high in dietary fibre and rich in magnesium, which both help to regulate blood sugar levels, slowing down energy release and glucose absorption. Starchy vegetables like sweet potatoes and squash contain much more fibre than white potatoes, and help with balancing blood sugar.
  • Whole grains – like oats, brown rice or buckwheat are high in soluble fibre and are slower to digest. Slower digestion creates a smaller fluctuation in blood sugar compared with refined carbohydrates. Quinoa and millet are high in plant protein, which help sustain energy without crashing blood sugar.
  • Legumes – black, pinto, kidney beans, chickpeas and lentils. These are all high in fibre, complex carbohydrates and protein, keeping blood sugar steady.
    Substitute legumes for foods that are high in saturated fats or refined carbohydrates to help lower the risk of type 2 diabetes and cholesterol.
  • Cinnamon – has been shown to improve insulin sensitivity and cells ability to respond more readily to insulin so that less is released into our body, allowing improved blood sugar balance. It can also reduce CVD risk by improving triglycerides, LDL cholesterol and total cholesterol levels.
  • Avocados – are full of mono-unsaturated fat which helps slow the release of sugars into the bloodstream, promoting less insulin release.
  • Chia seeds – improve insulin sensitivity and aid symptoms related to MetS, including imbalances in cholesterol, high BP and significant rises in blood sugar levels after meals. They also have potent anti-inflammatory powers and a high fibre content.
  • Spices – Turmeric, ginger, coriander and cumin seeds all have diabetes-fighting properties, improving insulin sensitivity and metabolism of both glucose and cholesterol, reducing blood sugar and insulin levels.
  • Nuts and seeds – are a great source of fibre, healthy fats, protein and magnesium, which all prevent blood sugar spikes and promote slower digestion and longer satiety.
  •  Apple cider vinegar – has been found to blunt blood sugar and insulin increases. It slows the absorption of carbohydrates into the blood, and slows the breakdown of starches into sugars.