I am not a medical professional and the information in this blog post should not be considered medical advice. Please discuss any and all medical concerns and interventions with your medical professional.
As of 2017 it was estimated that 462 million people had type 2 diabetes. This means that 462 million people have an AVERAGE glucose of AT LEAST 140 mg/dl (or 7.8 mmol/l). About 1 million people die per year from diabetes. The bad news is that these numbers are only projected to get worse moving forward. (Epidemiology of Type 2 Diabetes – Global Burden of Disease and Forecasted Trends, n.d.)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310804/
This is not even considering the downstream effects that elevated blood sugar can have on our health. As illustrated in the below graphic, type 2 diabetes can contribute to a number of other medical conditions including stroke, cognitive impairment, liver disease, kidney disease, and cardiovascular disease.
https://www.nature.com/articles/s41574-022-00690-7
Elevated blood sugar is a growing concern today, and given the projected increase in type 2 diabetes, the concern is only going to get worse.
Everyone should be paying attention to their blood sugar and be taking action as soon as they see something that is not looking good.
But what is good?
Remember above when I said over 400 million people have an average blood sugar of 140 mg/dl, how high is that?
The #1 influence on our blood sugar for most people is eating. When we eat our blood sugar goes up as the food we digest enters our blood stream. As we will talk about below, our body then goes through a number of processes to remove that blood sugar from our blood stream to bring it back down to a safe level (too much sugar in the blood can be deadly).
In general our lowest blood sugar reading then would be after our greatest period of time not eating, which for most people is when they wake up in the morning. The optimal range is 80-90 mg/dl. After eating a meal, our blood sugar will naturally go up, and in general we probably do not want to see a peak at 140-160 mg/dl for a short period of time and then drop back down to around 80-100 mg/dl.
This puts into perspective how high an AVERAGE blood sugar of 140 mg/dl.
The good news is that testing your blood sugar to determine where you stand currently is relatively simple.
All you need is a blood sugar monitor that can be purchased at most pharmacies and online. To use one of these monitors all you need to do is prick your finger with a small needle (which comes with the monitor) and collect a small drop of blood. The machine will then tell you what your blood sugar is at that moment.
Testing your blood sugar is simple, but interpreting that number is a different story. This is where some more knowledge can help. We discussed some optimal ranges above but let’s dive a bit deeper.
The context in which that reading is taken is important, lots of things can affect your blood sugar. The most common one would be food, but so can (lack of) sleep, exercise, and stress.
One of the best times to take your blood sugar reading is first thing in the morning before eating or drinking anything. This will give you a good idea of your baseline blood sugar. Ideally you want this to be between 80-89 mg/dl. I would do this for 7-14 days to get a nice average. If your average ends up being 90-100 that is a slight concern. If your average is 100-120 that is going to be a reason enough to start to look into why and take action (more on that later).
If your average fasting blood sugar is between 80-89 mg/dl you are doing pretty well. You still might want to check into how it responds to some of the meals you are eating though as it could open up some insights and prevent any issues in the future.
If your average was above 89 mg/dl I would suggest you also check your response to the meals you are eating.
To do this you would take a reading before your meal. Then you would take two more readings at 1 and 2 hours after you finish eating. If you really want to get more data points you could take 4 readings, one at 30 minutes, one at 1 hour, one at1.5 hours, and one at 2 hours after. The benefit to taking four readings is that you are more likely to catch a sharp spike and/or sharp drop.
If you are seeing an average fasting blood sugar in the morning you will likely see readings that are high and high for a prolonged period of time after eating.
The next question is “what is high”?
There is a lot of debate about what number you want to be below. In general though, most people seem to agree that it would be optimal to stay below 140 mg/dl. It seems you definitely want to be below 160 mg/dl (Type 2 Diabetes: Measuring Sugar Levels in Blood and Urine Yourself, 2020). If your blood sugar starts to go above 180 mg/dl your body will start to remove it via your kidneys and you will pee it out…you really want to avoid that.
The other part of seeing your blood sugar go above 160 mg/dl is the drop that often follows. Your body really needs to do all it can to keep blood sugar in line and when it starts to go high it releases a bunch of a hormone called insulin in order to remove it. This often ends up in a dramatic drop and you can experience low blood sugar which is equally as bad. To correct that you need to eat again, this can result in shooting your blood sugar back up. You can see where this goes, it’s a vicious cycle of up and down.
Over time this can become an issue because this hormone insulin becomes less and less effective, so your blood sugar ends up elevated consistently, that is why you could be seeing an elevated fasting blood sugar.
How do we deal with this situation?
The answer is not exactly simple. In reality we need to take a holistic approach looking at diet, sleep, exercise, movement, and stress. However for this post I want to look at the one lifestyle factor that I believe is the most impactful in regulating blood sugar.
Exercise and movement.
To understand why, let’s come back to that hormone insulin, how is it lowering your blood sugar?
When you eat food your body gets the signal that sugar is entering the bloodstream. The body then sends a signal to your pancreas to release insulin. Think about inulin as a key. This key unlocks a door in the cells throughout your body to allow the cell to take in sugar (glucose) in your bloodstream. This is beneficial because it keeps your blood sugar levels in check and also the cell uses the sugar (glucose) to produce energy to support all your body’s functions.
When the pancreas always has to produce insulin, cells become more and more resistant to the insulin, so the door never unlocks and glucose cannot enter the cell.
However, this is not the only way sugar can enter the cell. Notice above that there are two ways glucose enters the cell in the image above, glucose transporters and Glut-4. Glut-4 can be activated WITHOUT insulin (Update on the Effects of Physical Activity on Insulin Sensitivity in Humans, 2017).
How?
Movement and exercise!
Because muscle cells are always using some amount of glucose, even at lower intensities, the muscle has developed a way to get that fuel independent of insulin. When the muscle starts to contract it sets off a cascade of signaling inside the muscle cells which brings the Glut4 receptor to the surface in order to take in glucose and lower blood sugar.
https://www.mdpi.com/2673-396X/2/2/7
The cool part of this is that the movement/exercise method of taking glucose into the cell works even in people who have developed resistance to insulin (Exercise as a Therapeutic Intervention in Gestational Diabetes Mellitus, n.d.). So if you start to have elevated blood sugar movement and exercise are a great way to start to lower your blood sugar!
You might be wondering what type of movement/exercise can help lower blood sugar?
It’s as simple as going for a walk!
A meta-analysis (a study looking at the results of 51 different studies) showed that 30 minutes or more of aerobic exercise within 6 hours of eating significantly lowered blood sugar in the 6 hours after the meal (The Effect of a Single Bout of Continuous Aerobic Exercise on Glucose, Insulin and Glucagon Concentrations Compared to Resting Conditions in Healthy Adults: A Systematic Review, Meta-Analysis and Meta-Regression, 2021).
Here is a nice visual of the effect of walking on a blood sugar response from drinking a can of Coke from the company Levels Health.
As you can see those that drank the Coke and went for a walk tended to have a lower blood sugar response to the Coke.
The other nice thing about exercise is that it also makes you more insulin sensitive after the exercise concludes. This means that once your exercise has finished the cells in your muscles can better respond to insulin to let glucose into the cell, meaning your body needs produce less insulin (Exercise-Induced Molecular Mechanisms Promoting Glycogen Supercompensation in Human Skeletal Muscle, n.d.)!
The other benefit is that people who exercise tend to have more GLUT4 receptors than those who are sedentary (Dunlap, 2019).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899035/
The most important part of movement and exercise when it comes to blood sugar regulation is adding and maintaining muscle. We talked about how muscle cells consume glucose from the blood, but they also store glucose as well.
That means even when they are not moving we can place glucose in the muscle!
Therefore the more muscle mass we have the more cells we have to burn glucose AND store it away (Skeletal Muscle Glycolysis, Oxidation, and Storage of an Oral Glucose Load, n.d.)!
Resistance training is the primary way to build and maintain muscle mass. If we are not resistance training we will lose muscle as we get older and hence we will have less cells capable of utilizing and storing glucose resulting in high blood sugar levels. For more information on resistance training you can check out this previous blog post.
Your blood sugar is one of the easiest and most impactful metrics you can track in relation to health. It is also one of the ones that is most impacted by your lifestyle. This is a great combination because you can make lifestyle changes and get nearly instantaneous results. This can be a HUGE motivator for a lot of people. It’s unlike other blood markers, or things like the scale, or body composition measurements. Literally you can go for a walk and in minutes see a difference! While movement and exercise will make the biggest difference when it comes to your blood sugar it also promotes better body composition, stress management, sleep and engagement in community…it’s a win all around!
My goal is to open your eyes to the massive impact lifestyle can have on your health. By signing up for my newsletter using the form below I will provide you with much more information on how lifestyle can help you reach your goals and overcome your biggest obstacles.
References
Dunlap, K. L. (2019, May 1). Exercise Increases Glucose Transporter-4 Levels on Peripheral Blood Mononuclear Cells. NCBI. Retrieved May 25, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5899035/
The Effect of a Single Bout of Continuous Aerobic Exercise on Glucose, Insulin and Glucagon Concentrations Compared to Resting Conditions in Healthy Adults: A Systematic Review, Meta-Analysis and Meta-Regression. (2021, April 27). PubMed. Retrieved May 24, 2023, from https://pubmed.ncbi.nlm.nih.gov/33905087/
Epidemiology of Type 2 Diabetes – Global Burden of Disease and Forecasted Trends. (n.d.). NCBI. Retrieved May 18, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310804/
Exercise as a Therapeutic Intervention in Gestational Diabetes Mellitus. (n.d.). MDPI. Retrieved May 24, 2023, from https://www.mdpi.com/2673-396X/2/2/7
Exercise-induced molecular mechanisms promoting glycogen supercompensation in human skeletal muscle. (n.d.). NCBI. Retrieved May 24, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6158101/
Skeletal muscle glycolysis, oxidation, and storage of an oral glucose load. (n.d.). PubMed. Retrieved May 25, 2023, from https://pubmed.ncbi.nlm.nih.gov/3130396/
Type 2 diabetes: Measuring sugar levels in blood and urine yourself. (2020, October 22). NCBI. Retrieved May 23, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK279508/
Update on the effects of physical activity on insulin sensitivity in humans. (2017, March 1). NCBI. Retrieved May 24, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569266/