by Cassie Irwin, ND
Healthy blood sugar is a balancing act between glucose (sugar) and insulin, a hormone required to absorb glucose from the bloodstream and transport it into cells. I tend to think of insulin being a bouncer at an exclusive club (ie the cell). You need insulin to open the door for glucose to gain entry into the club.
But if glucose molecules build up in the blood, too many glucose molecules knock at the door of the club. Insulin may not answer the door as often anymore because it’s overworked (and wants a pay raise!). Then we have what’s called insulin resistance – where insulin doesn’t respond to glucose anymore. A vicious cycle of elevated blood glucose ensues.
The Rise of Prediabetes
Prediabetes is the term given for moderately elevated blood sugar. It’s when blood sugar isn’t as high as it is in type 2 diabetes, but it could pave the way there if no diet or lifestyle changes are made.
Rates of prediabetes are creeping up in Canada. It’s estimated that 6.1% of our population has prediabetes, and that more fit the diagnosis but don’t yet know it. The sweet news about prediabetes is that it is entirely reversible with even the simplest monitoring methods, nutrition tweaks, lifestyle practices and supplements.
Underlying Causes of Prediabetes
- Insufficient antioxidant intake
- Mitochondrial dysfunction
- Reproductive hormone imbalance (PCOS, estrogen dominance)
- Hypothyroidism
- Grazing on food throughout the day
- Magnesium and chromium deficiencies
- Vitamin E and D deficiencies
- Insomnia and poor sleep quality
- Poor gut microbiome
- Inflammation
- Stress
Prediabetes can manifest from myriad different underlying causes and contributors. Speak with your Naturopathic Doctor about getting to the root cause of your blood sugar imbalance.
Signs of Blood Sugar Issues
- Intense cravings for sweets and carbohydrates (bread, pasta, baked goods)
- Irritable and “hangry” with missing a meal
- Relying on caffeine for energy
- Frequent urination
- High thirst
- Fatigue after eating
- Blurry vision
- Weight loss resistance
- Feeling shaky and jittery
1. Monitoring
Prediabetes is diagnosed with a marker called Hba1c, which takes account of your blood sugar over a three-month period. While values may differ between labs, in general prediabetes is defined by an Hba1c ranging between 6.0-6.4 %. Diabetes, by contrast, is defined by an Hba1c value of 6.5% and above, paired with elevated fasting glucose (7.0 mmol/L and above), and an elevated oral glucose tolerance test (11.1 mmol/L).
If you have an at-home glucometer, you can track your glucose randomly throughout the day. Pay particular attention to elevations in your levels after a meal, as this may suggest you need to rejig the macronutrient composition of your meals. Have your doctor check Hba1c at least once per year to assess for changes.
Since insulin resistance can elevate blood glucose, testing for insulin now can actually give us an idea of your type 2 diabetes risk for five or even 10 years down the road! Ask your ND to test insulin to determine your risk. Knowing this can be helpful to encourage diet and lifestyle changes now so that there are no surprises in the future.
If you haven’t had blood work done recently or are needle-shy, pay attention to the signs of possible blood sugar issues as a barometer for how you’re managing (see the list of signs above). If symptoms aggravate, it might suggest that your blood sugar control is having a rough go. Reach out to your health care provider for more support in getting a handle on it.
2. Nutrition
The Mediterranean diet boasts the most evidence for glycemic control and overall cardiometabolic health among those with diabetes. The same principles apply for managing and reversing prediabetes.
Focus on a whole foods diet with a wide variety of plant-based foods including leafy greens, vegetables, and nuts and seeds. Have your primary protein come from the sea and have poultry less frequently. Keep red meat on a biweekly basis. Overall, reduce your intake of grains and opt for whole grains when you do. Keep dairy to a small amount and avoid processed foods. Embrace healthy fats like extra virgin olive oil by drizzling about 2 Tbsp per day on your salad.
Choose low-glycemic index carbohydrates and pair them with a source of healthy fat or protein when you enjoy them. For instance, pair crackers with hummus or with some canned tuna.
Avoid grazing throughout the day to ensure your glucose levels aren’t constantly high. Speak with your Naturopathic Doctor about whether intermittent fasting is right for you, as there are some adverse effects including irregular menstrual cycles.
3. Lifestyle
Move it, move it! Exercise is the only way that glucose can bypass insulin to get from the blood and into the target cells. Physical activity involving the thigh muscles specifically (think walking, squats, and running) can be very effective for lowering blood glucose.
Consider going for a 20-minute walk around your neighbourhood after every meal to help blunt the anticipated rise in glucose. While you’re outside, take in the sunshine to make vitamin D. Deficiency of vitamin D is associated with metabolic syndrome.
Stress wreaks havoc on your hormonal and nervous systems and can have implications on your blood sugar balance. Connect with nature as a way to manage your stress. If you’re more of an indoorsy type of person, play around with a guided deep breathing exercise or meditation practice to help your body and mind come into balance.
Do a deep clean of your personal care products and cleaning products in the kitchen and bathroom to reduce your exposure to endocrine disrupting chemicals. Stock up on toxin-free soap, shampoo, and dishwashing fluid to minimize the burden on your hormonal system (remember, insulin is a hormone!).
4. Supplements
Supplements always depend upon the underlying causes of your blood sugar imbalance. Working with an ND and testing for hormonal, gut microbiome, nutrition, and inflammatory contributors will be helpful for building a targeted supplement protocol that’s fit for you.
The following supplements may be helpful to lay a healthy foundation for managing blood sugar issues:
- Omega 3
- Vitamin D
- Vitamin E
- Magnesium
- Chromium
- Cinnamon
- ALA
Dr. Cassie Irwin, ND
Naturopathic Contributor, The Peanut Mill Natural Foods Market