With 1 in 10 Americans experiencing diabetes, we know that this metabolic disease of high blood glucose is an increasingly concerning health challenge, costing the US healthcare system $327 billion in 2017.
The complications of diabetes are blindness, kidney failure, neuropathy, and amputations of the lower limbs. Dysregulated blood sugar increases the risk of erectile dysfunction, high blood pressure, heart disease, and stroke. These are serious consequences for a disease that we struggle to manage.
What is worse, is that we struggle to prevent it from occurring in the first place.
1 in 3 adult Americans have prediabetes. Staggeringly, 90% go undiagnosed. Prediabetes means that blood glucose is elevated, but not high enough to warrant the diabetes diagnosis.
Unfortunately, when prediabetes goes undiagnosed and unaddressed, this preventable initial stage of blood sugar dysregulation becomes a full-blown health condition, causing damage that is harder to undo.
The good news? There is so much you can do to reverse this initial process of blood sugar dysregulation. You just need the support and guidance.
Next time you are at the doctor, ask “how is my blood sugar?” Ask if you have prediabetes. If your blood glucose is elevated, don’t wait for diabetes to show up. Take preventative wellness steps that can halt this process in its steps and restore healthy blood sugar levels.
Balancing blood glucose begins with basics, starting with the diet.
Nutrition for blood sugar balance
A diet that focuses on blood sugar health, must have the following components:
1. More fruits and vegetables
5-9 servings of fruit and vegetables is the typical recommendation to obtain the adequate nutrients that our bodies need. Focus on high fiber, low glycemic-index vegetables (the veggies that grow above ground and are fibrous), and low sugar fruits (berries, citrus, avocado, olives). High fiber foods delay glucose absorption from our food and lower cholesterol and triglycerides in the blood, resulting in lower blood sugars and better lipids.
2. Fewer carbohydrates
Very low carb or Keto diets need to be done with provider supervision. However, reducing your carb intake and focusing on healthier carbs is generally helpful for blood sugar, as this food group raises blood sugar the most. The best place to get your carbs is from fruits and vegetables. Grains and oats have the potential to irritate the GI tract, inducing inflammation in those susceptible and driving up blood sugar. Unfortunately, grains are often sources of mold and mycotoxin exposure which can cause further inflammation. Organic produce, grains and meats are the way to go, as pesticide use on crops exposes us to the herbicide glyphosate in many foods, which is also highly inflammatory. Inflammation = higher blood sugar.
3. More healthy fats
If carbs raise blood sugar the most, fats raise it the least. Fats are an important component of your plate at meal times, supporting blood sugar stabilization and increased satiety. Focus on increasing the healthy fats in your diet - avocado, eggs, olives, fish, coconut, nuts/seeds, butter, cheese and yogurt if you can tolerate dairy. It's better to use a stable fat for cooking, and olive/avocado oil for salad.
4. More healthy protein
Protein stabilizes blood sugar and provides lasting energy. Aim for organic, grass-fed, grass-finished, and pasture-raised animal meats. Nuts and seeds are a great source of protein, healthy fats and fiber. Beans and legumes are also excellent protein and fiber, however can be high in starch and should eaten in moderation. Dairy is another good source of protein, however lactose can raise blood sugar and dairy may need to be avoided by those sensitive to casein protein.
5. Limited processed foods and sugar
This one is a no brainier for balancing blood sugar as these foods spike glucose and can disrupt the gut flora, and high fructose in the presence of insulin resistance can lead to the development of fatty liver. Artificial sweeteners may be doing more harm than good, and can further trigger food cravings and gut disturbances. If soda is a part of your daily diet, it’s time to say goodbye. Transition off soda with stevia sweetened beverages like Zevia, then move on to sparkling waters.
6. Balanced, well-portioned meals
Overeating is a huge obstacle for blood sugar to overcome. Stick to balanced meals (protein, fat, fiber) to make the most of meal time to avoid crashing and needing to snack excessively later.
7. More time between meals
More and more evidence is coming out to support time restricted eating for balancing blood sugar and increasing insulin sensitivity. This strategy means that you are fasting overnight in a window of 14-16 hours, only eating during the day in a window of 10-8 hours. Fasting approaches need to be done with provider support.
8. Better planning
Plan your meals with intention. Prepare for grocery shopping with a list and buy only what you need. Don’t buy the things that you know will tempt you at home. This means that your family needs to be on board with food choices and help to create a safe environment for you at home.
Exercise for better blood sugar
The next step towards healthy blood sugar is physical activity
Exercise is foundational to blood sugar control because it enhances insulin sensitivity, improves glucose tolerance, and reduces lipids. This is huge for heart health and vasculature. We have glucose receptor independent uptake in skeletal muscle, meaning that our muscles can get that extra sugar out of our blood stream without needing insulin to open the door. For those with prediabetes and insulin resistance, it is imperative to use physical activity to lower blood sugar without insulin. Incorporating regular exercise into your routine sensitizes the body to the effect of hormones, meaning that your body starts being a more efficient communicator.
The best strategy for blood sugar is to work out 150 minutes/week. It's best to be consistent with physical activity and avoid taking more than 2-3 days off. Cardiovascular exercise such as walking, jogging, biking, hiking, swimming, and dancing, where your heart rate is in the fat burning zone (60-80% of maximum), are the way to go. As you become comfortable with this type of exercise, add in twice weekly resistance training. This is exercise focused on muscle contraction against gravity or opposed by weight, using your own body weight, exercise bands or weights.
How to investigate blood sugar
Ask your doctor about the following investigatory strategies to assess blood sugar:
Hemoglobin A1c - a marker of blood glucose control over three months
Fasted blood sugar - demonstrates the body’s ability to manage glucose away from food intake
Self-monitoring blood glucose - monitoring at home can provide you with more information about how your body responds to different foods, to fasting, to exercise, and to stress, fatigue, sleep and inflammation
Fasting insulin test - to look at insulin levels away from food and provide information on insulin resistance
C-peptide - can provide information about beta cell function (the cells that make insulin) to determine whether there is insufficient or excess insulin production
Vitamin D status - Blood levels of vitamin D level below 50 have been associated with a higher risk of developing diabetes.
Natural health approaches to balancing blood sugar
There are many natural health strategies to support blood sugar balance. Here are some of the most effective:
Chromium & Biotin: Typically dosed 600 mcg of chromium with 2 mg of biotin, delivered once or twice daily. This combination may drop A1c by about 0.5% (PMID: 17506119, 17109595 )
Dietary fiber: At least 25 grams per day is recommended to increase satiety, and lower postprandial glucose (blood sugar levels after eating) (PMID: 1852093)
Magnesium: Magnesium is a common deficiency amongst adults in the US, and more common amongst those with diabetes. Typical dosing is 300-500mg daily in divided doses and may result in increased insulin sensitivity (PMID: 15223977)
Zinc: 15-25mg daily may improve blood glucose and support healthy lipid levels in the blood. (PMID: 22515411)
Alpha lipoic acid: 600mg daily may support kidney health and reduce symptoms of peripheral neuropathy. (PMID: 24659493, 17065669)
Vitamin D: Low vitamin D levels in the blood may be associated with metabolic syndrome and diabetes (PMID: 17389701). Correcting vitamin D levels to 40-70 may be beneficial for some people. This typically requires 2000-5000IU/day dosing, depending on individual status.
Berberine: This natural botanical constituent may effect blood glucose similarly to metformin, decreasing A1c and improving lipids as well (PMID: 18442638). Doses are typically 500-2000mg daily.
Milk Thistle: This herb contains silymarin, a constituent that may be beneficial in lowering blood glucose independent of insulin, and improving total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, AST, and ALT levels. (PMID: 17072885). Typical dosing ranges from 500-2000mg daily.
Cinnamon: Doses of 1, 3, and 6 grams daily have been shown to reduce serum glucose, triglyceride, LDL cholesterol, and total cholesterol levels in patients with diabetes (PMID: 14633804)
It’s important to work with your healthcare practitioner to determine best sources and dosing for you. If you are on insulin, you need to work carefully with a provider on any dietary changes, exercise programs, or supplements to ensure safe blood glucose levels and avoid dangerous episodes of hypoglycemia.
Remember, ask your doctor if you blood sugar is optimal or if it is too high. Ask them if you have prediabetes. Receiving that diagnosis might feel scary or intimidating, but it’s also empowering. Let this news be first step to addressing this dysregulation, taking ownership of your health, and turning this process around.
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