Authored by Dr. Aidanne
 Photo by Towfiqu barbhuiya on Pexels | Maintaining balanced blood sugar levels is essential for overall health, as it plays a pivotal role in supporting energy production and preventing various health complications. Dysglycemia is an umbrella term for imbalances in blood sugar levels. This can manifest as either hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar). Here we will focus on hyperglycemia, as 38% of people 18 years and older currently live in the pre-diabetic range. |
In this article we will outline how we use sugar, how insulin resistance develops, common signs and symptoms of dysglycemia, and naturopathic approaches to manage blood sugar levels.
How Our Bodies Use Sugar:
Our bodies need three key macronutrients to survive: fat, protein, and carbohydrates. Carbohydrates come from foods such as fruits, vegetables, legumes, nuts, seeds, and grains. When we consume carbohydrates, our body makes enzymes to break it down into glucose. Glucose is a form of sugar that serves as the primary energy source for our cells. As a response to increased sugars entering the blood stream, our pancreas produces a hormone called insulin, the primary role of which is to facilitate entry of glucose into our cells. Once in the cell, glucose can be further broken down through the Krebs Cycle and used for energy.
As glucose levels rise, so does insulin. Due to factors like genetics, lifestyle, and diet, cells can become less responsive to insulin over time. It's like the locks on the cell are getting a bit rusty, and insulin's key can’t work as well to open the door. Once this happens, the body tries to compensate by producing more insulin to complete the same task. This can become taxing on the pancreas and leaves blood glucose levels remain high, which can eventually lead to the development of type 2 diabetes.
Signs of Dysglycemia:
Common signs and symptoms of dysglycemia include increased thirst, increased hunger, frequent urination, fatigue, mood changes, sleep challenges, and difficulty concentrating. Often, we hear that symptoms of fatigue set in shortly after eating a carbohydrate rich meal. Blood sugar imbalances can also impact our other organ systems and often contributes to acne, PCOS, thyroid imbalances, abdominal discomfort, joint pain, reduced kidney function, erectile dysfunction, poor immune function and delayed wound healing.
Testing:
Routine blood work is used to determine one’s glucose regulation. This testing could include a comprehensive metabolic panel (CMP), fasting blood glucose, insulin and hemoglobin A1c.
Fasting blood glucose levels below 100 milligrams per deciliter (mg/dL) are generally considered normal. Levels between 100-125 mg/dL may indicate prediabetes (impaired fasting glucose), while levels of 126 mg/dL or higher on two separate tests typically indicate diabetes.
Hemoglobin A1c (HbA1c) is a marker that reflects average blood glucose levels over the past 2-3 months. It provides a comprehensive view of long-term glucose control. A normal HbA1c level is typically below 5.7%. Levels between 5.7% and 6.4% suggest an increased risk of diabetes (prediabetes), while levels of 6.5% or higher are indicative of diabetes.
Naturopathic Approach to Blood Sugar Management:
Naturopathic medicine emphasizes a holistic approach to healing by addressing the root causes of imbalances rather than focusing on treating symptoms.
Movement:
Engaging in consistent, routine movement is one of the best ways to address dysglycemia, because when we move our bodies our tissues burn sugars for fuel. Regular movement also improves insulin sensitivity over time. The CDC recommends a combination of aerobic exercise and strength training tailored to your fitness level. Ultimately the goal is to achieve 150 minutes weekly of moderate to vigorous exercise, but this could look like many different things! Swimming, biking, walking, pilates, Barré, dancing, yoga, HIIT. You name it! Get creative and get out there.
Nutrition and Diet:
Using food as medicine is key when it comes to blood sugar regulation! Poor food quality is often where the issue arises in the first place. We encourage our patients to focus on a whole-foods, plant rich diet high in fiber, vitamins, and antioxidants. Pairing carbohydrate rich foods with proteins, fiber, and beneficial fats can help to not only improve satiety but also stabilize post-prandial glucose levels to prevent spikes and dips that can negatively impact insulin signaling. Complex carbohydrates and resistant starches found in whole grains and legumes are often a better option than refined carbohydrates as they provide a steady release of glucose and prevent spikes in blood sugar (But be careful with white rice!). Adding 1⁄2 an avocado to meals has also been shown to help stabilize post-meal glucose levels.
Stress Management:
Chronic stress can contribute to insulin resistance. Encourage stress-reduction techniques such as meditation, yoga, and deep breathing exercises.
Herbs & Nutritional Supplements:
After lifestyle factors have been addressed, herbs and nutrients can be a useful tool to both lower blood sugar levels and support insulin sensitivity. The following are a few of the many evidence-based interventions that may help!
Berberine:
Numerous studies have demonstrated berberine's ability to improve insulin sensitivity and reduce blood glucose levels. A meta-analysis from 2021 concluded that berberine can significantly lower fasting blood glucose and hemoglobin A1c levels in individuals with type 2 diabetes. Berberine works by of increasing glucose uptake in cells, improving insulin sensitivity, and reducing inflammation.
Cinnamon:
Cinnamon has been studied for its potential to enhance insulin sensitivity and lower blood glucose levels. Two systematic reviews, one from 2013 and another from 2023, highlighted several clinical trials suggesting that cinnamon supplementation may contribute to improved glycemic control in people with type 2 diabetes., The active compound in cinnamon, cinnamaldehyde, is believed to have insulin-sensitizing effects, helping cells respond more effectively to insulin.
Fenugreek:
Fenugreek is an herb commonly used in traditional medicine and has been studied for its potential antidiabetic effects. A randomized controlled trial from 2014 found that fenugreek supplementation significantly reduced fasting blood glucose and improved insulin sensitivity in patients with type 2 diabetes. The soluble fiber in fenugreek may contribute to its blood sugar-lowering effects, possibly by slowing down the absorption of glucose.
Myoinositol:
Myo-inositol is a naturally occurring sugar alcohol that belongs to the Vitamin B family. Myoinositol has been shown to support insulin sensitivity in those living with PCOS. A recent meta-analysis also suggested that myo-inositol supplementation during pregnancy may help reduce the risk of gestational diabetes due to its insulin sensitizing effects.
Be sure to consult with your naturopathic doctor prior to using these compounds, as dosing can vary per person and regular bloodwork is needed to monitor both their safety & efficacy.
References:
How Our Bodies Use Sugar:
Our bodies need three key macronutrients to survive: fat, protein, and carbohydrates. Carbohydrates come from foods such as fruits, vegetables, legumes, nuts, seeds, and grains. When we consume carbohydrates, our body makes enzymes to break it down into glucose. Glucose is a form of sugar that serves as the primary energy source for our cells. As a response to increased sugars entering the blood stream, our pancreas produces a hormone called insulin, the primary role of which is to facilitate entry of glucose into our cells. Once in the cell, glucose can be further broken down through the Krebs Cycle and used for energy.
As glucose levels rise, so does insulin. Due to factors like genetics, lifestyle, and diet, cells can become less responsive to insulin over time. It's like the locks on the cell are getting a bit rusty, and insulin's key can’t work as well to open the door. Once this happens, the body tries to compensate by producing more insulin to complete the same task. This can become taxing on the pancreas and leaves blood glucose levels remain high, which can eventually lead to the development of type 2 diabetes.
Signs of Dysglycemia:
Common signs and symptoms of dysglycemia include increased thirst, increased hunger, frequent urination, fatigue, mood changes, sleep challenges, and difficulty concentrating. Often, we hear that symptoms of fatigue set in shortly after eating a carbohydrate rich meal. Blood sugar imbalances can also impact our other organ systems and often contributes to acne, PCOS, thyroid imbalances, abdominal discomfort, joint pain, reduced kidney function, erectile dysfunction, poor immune function and delayed wound healing.
Testing:
Routine blood work is used to determine one’s glucose regulation. This testing could include a comprehensive metabolic panel (CMP), fasting blood glucose, insulin and hemoglobin A1c.
Fasting blood glucose levels below 100 milligrams per deciliter (mg/dL) are generally considered normal. Levels between 100-125 mg/dL may indicate prediabetes (impaired fasting glucose), while levels of 126 mg/dL or higher on two separate tests typically indicate diabetes.
Hemoglobin A1c (HbA1c) is a marker that reflects average blood glucose levels over the past 2-3 months. It provides a comprehensive view of long-term glucose control. A normal HbA1c level is typically below 5.7%. Levels between 5.7% and 6.4% suggest an increased risk of diabetes (prediabetes), while levels of 6.5% or higher are indicative of diabetes.
Naturopathic Approach to Blood Sugar Management:
Naturopathic medicine emphasizes a holistic approach to healing by addressing the root causes of imbalances rather than focusing on treating symptoms.
Movement:
Engaging in consistent, routine movement is one of the best ways to address dysglycemia, because when we move our bodies our tissues burn sugars for fuel. Regular movement also improves insulin sensitivity over time. The CDC recommends a combination of aerobic exercise and strength training tailored to your fitness level. Ultimately the goal is to achieve 150 minutes weekly of moderate to vigorous exercise, but this could look like many different things! Swimming, biking, walking, pilates, Barré, dancing, yoga, HIIT. You name it! Get creative and get out there.
Nutrition and Diet:
Using food as medicine is key when it comes to blood sugar regulation! Poor food quality is often where the issue arises in the first place. We encourage our patients to focus on a whole-foods, plant rich diet high in fiber, vitamins, and antioxidants. Pairing carbohydrate rich foods with proteins, fiber, and beneficial fats can help to not only improve satiety but also stabilize post-prandial glucose levels to prevent spikes and dips that can negatively impact insulin signaling. Complex carbohydrates and resistant starches found in whole grains and legumes are often a better option than refined carbohydrates as they provide a steady release of glucose and prevent spikes in blood sugar (But be careful with white rice!). Adding 1⁄2 an avocado to meals has also been shown to help stabilize post-meal glucose levels.
Stress Management:
Chronic stress can contribute to insulin resistance. Encourage stress-reduction techniques such as meditation, yoga, and deep breathing exercises.
Herbs & Nutritional Supplements:
After lifestyle factors have been addressed, herbs and nutrients can be a useful tool to both lower blood sugar levels and support insulin sensitivity. The following are a few of the many evidence-based interventions that may help!
Berberine:
Numerous studies have demonstrated berberine's ability to improve insulin sensitivity and reduce blood glucose levels. A meta-analysis from 2021 concluded that berberine can significantly lower fasting blood glucose and hemoglobin A1c levels in individuals with type 2 diabetes. Berberine works by of increasing glucose uptake in cells, improving insulin sensitivity, and reducing inflammation.
Cinnamon:
Cinnamon has been studied for its potential to enhance insulin sensitivity and lower blood glucose levels. Two systematic reviews, one from 2013 and another from 2023, highlighted several clinical trials suggesting that cinnamon supplementation may contribute to improved glycemic control in people with type 2 diabetes., The active compound in cinnamon, cinnamaldehyde, is believed to have insulin-sensitizing effects, helping cells respond more effectively to insulin.
Fenugreek:
Fenugreek is an herb commonly used in traditional medicine and has been studied for its potential antidiabetic effects. A randomized controlled trial from 2014 found that fenugreek supplementation significantly reduced fasting blood glucose and improved insulin sensitivity in patients with type 2 diabetes. The soluble fiber in fenugreek may contribute to its blood sugar-lowering effects, possibly by slowing down the absorption of glucose.
Myoinositol:
Myo-inositol is a naturally occurring sugar alcohol that belongs to the Vitamin B family. Myoinositol has been shown to support insulin sensitivity in those living with PCOS. A recent meta-analysis also suggested that myo-inositol supplementation during pregnancy may help reduce the risk of gestational diabetes due to its insulin sensitizing effects.
Be sure to consult with your naturopathic doctor prior to using these compounds, as dosing can vary per person and regular bloodwork is needed to monitor both their safety & efficacy.
References:
- National Diabetes Statistics Report
- https://emedicine.medscape.com/article/117853-clinical
- Inzucchi SE, Lupsa B, Nathan DM, Wolfsdorf JI, Rubinow K. Clinical presentation, diagnosis, and initial evaluation of diabetes mellitus in adults. UpToDate. Current through Oct 2023. Updated Nov. 8, 2023.
- Amanat S, Ghahri S, Dianatinasab A, Fararouei M, Dianatinasab M. Exercise and Type 2 Diabetes. Adv Exp Med Biol. 2020;1228:91-105. doi: 10.1007/978-981-15-1792-1_6. PMID: 32342452.
- Park E, Edirisinghe I, Burton-Freeman B. Avocado Fruit on Postprandial Markers of Cardio-Metabolic Risk: A Randomized Controlled Dose Response Trial in Overweight and Obese Men and Women. Nutrients. 2018;10(9):1287. Published 2018 Sep 12. doi:10.3390/nu10091287
- Pang B, Zhao LH, Zhou Q, et al. Application of berberine on treating type 2 diabetes mellitus. Int J Endocrinol. 2015;2015:905749. doi:10.1155/2015/905749
- Guo J, Chen H, Zhang X, et al. The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Oxid Med Cell Longev. 2021;2021:2074610. Published 2021 Dec 15. doi:10.1155/2021/2074610
- Robert W. Allen, Emmanuelle Schwartzman, William L. Baker, Craig I. Coleman, Olivia J. Phung
- The Annals of Family Medicine. Sep 2013, 11 (5) 452-459; DOI: 10.1370/afm.1517
- Zarezadeh, M., Musazadeh, V., Foroumandi, E. et al. The effect of cinnamon supplementation on glycemic control in patients with type 2 diabetes or with polycystic ovary syndrome: an umbrella meta-analysis on interventional meta-analyses. Diabetol Metab Syndr 15, 127 (2023). https://doi.org/10.1186/s13098-023-01057-2
- Rafraf M, Malekiyan M, Asghari-Jafarabadi M, Aliasgarzadeh A. Effect of fenugreek seeds on serum metabolic factors and adiponectin levels in type 2 diabetic patients. International Journal for Vitamin and Nutrition Research. 2014;84(3-4):0196-0205.
- Merviel, P., James, P., Bouée, S. et al. Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies. Reprod Health 18, 13 (2021). https://doi.org/10.1186/s12978-021-01073-3
- Greff D, Váncsa S, Váradi A, Szinte J, Park S, Hegyi P, Nyirády P, Ács N, Horváth EM, Várbíró S. Myoinositols Prevent Gestational Diabetes Mellitus and Related Complications: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2023; 15(19):4224. https://doi.org/10.3390/nu15194224
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