
Why Do My Blood Sugars Rise After A High Protein Meal?
Complex issues often require more detail than you can pack into a Facebook post. One such area of confusion and controversy is gluconeogenesis and the impact of protein on blood sugar and ketosis. Some common questions that I see floating around the interwebs include: If you are managing diabetes, should you avoid protein because it can convert to glucose and “kick you out of ketosis”? If you’ve dropped the carbs and protein to manage your blood sugars, should you eat “fat to satiety” or continue to add more fats until you achieve “optimal ketosis” (i.e. blood ketone levels between 1.5 and 3.0mmol/L)? Then, if adding fat doesn’t get you into the “optimal ketosis zone”, do you need exogenous ketones to get your ketones up so you can start to lose weight? This article explores: the reason that some people may see an increase in their blood sugars and a decrease in their ketones after a high protein meal, what it means for their health, and what they can do to optimise the metabolic health. You’re probably aware that protein can be converted to glucose via a process in the body called gluconeogenesis. Gluconeogenesis is the process of converting another substrate (e.g. protein or fat[1]) to glucose. Gluco = glucose Neo = new Genesis = creation Gluconeogenesis = new glucose creation As shown in the table below, all but two of the amino acids (i.e. the building blocks of protein) can be converted to glucose. Five others can be converted to either glucose or ketones depending on the body’s requirements at the time. Once your body has used up the protein, it needs to build and repair muscle and make neurotransmitters, etc. any “excess protein” can be used to refill the small protein stores in the blood stream and replenish glycogen stores in the liv Continue reading >>

What A High Blood Sugar Feels Like.
The American Diabetes Association cites the following symptoms as indicative of high blood sugar: High blood glucose [Editor’s note: Duh] High levels of sugar in the urine Frequent urination Increased thirst And if high blood sugar goes untreated? “Hyperglycemia can be a serious problem if you don’t treat it, so it’s important to treat as soon as you detect it. If you fail to treat hyperglycemia, a condition called ketoacidosis (diabetic coma) could occur. Ketoacidosis develops when your body doesn’t have enough insulin. Without insulin, your body can’t use glucose for fuel, so your body breaks down fats to use for energy. When your body breaks down fats, waste products called ketones are produced. Your body cannot tolerate large amounts of ketones and will try to get rid of them through the urine. Unfortunately, the body cannot release all the ketones and they build up in your blood, which can lead to ketoacidosis.” – ADA website But what does a high blood sugar feel like? Because when you see someone who is working through an elevated blood sugar, they may not look terribly out of sorts. But what is happening inside of them is real, and plays out in a myriad of ways for every person with diabetes. I’ve tried to write about it several times, but each high is different, and affects me in different ways: “It’s a thick feeling in the base of your brain, like someone’s cracked open your head and replaced your gray matter with sticky jam. I find myself zoning out and staring at things, and my eyeballs feel dry and like they’re tethered to my head by frayed ropes instead of optic nerves. Everything is slow and heavy and whipped with heavy cream.” – Oh, High! “There’s something about a high blood sugar that makes my body feel weighted down, l Continue reading >>

Can You Have Low Blood Sugar With Type 2 Diabetes?
back to Overview Know-how Type 2 A tag-team approach on low blood sugar with type 2 diabetes. Markus recently wrote an article on our German language blog talking about low blood sugar with type 2 diabetes. The question (“can I have low blood sugar with type 2 diabetes?”) is very common, and it’s easy to see why it’s of concern. So I’ve helped Markus bring his German post to life here in English. I hope it helps! Here’s Markus: Low blood sugar In 2014, results from the DAWN2 study were announced. It was the largest study of its kind (15,000 participants) on the “fears & needs of people with diabetes and their families.” One result stood out: The gravest fears are related to low blood sugars, especially at night. Up to 69% of the participants share this fear! So! Can you have low blood sugar with type 2 diabetes? Yes! Of course! But let’s think about who exactly is at risk – and why. It’s common to think: Type 1 diabetes = at risk for lows Type 2 diabetes = not at risk for lows But that isn’t correct at all, so we should wipe it from our mind. So… what do I need to know? Maybe it’s more accurate to say that people with type 2 diabetes who take certain types of medication are more at risk for lows. We’re getting closer! But to get to the truth, we should take a look at someone without diabetes. Is it possible for them to have lows, too? Theoretically yes, especially if doing long-lasting physical activities without proper food intake. Additionally, extreme stress and binge drinking are also common causes of low blood sugar for people without diabetes. However, it’s pretty rare because as soon as BG’s drop below 80 mg/dl (4.4 mmol/L), the natural counterregulatory system kicks in, raising blood sugar back to normal levels. I’ve never exp Continue reading >>

Why Is Blood Sugar High In The Morning?
Here you'll find info about why blood sugar is high in the morning, along with tips and resources to lower those numbers! A while back I had a client sending me her blood sugar charts every few days and on those charts she always made some notes if she had questions. Every time she sent them through, I noticed she had 3 big question marks (???) against her morning blood sugar results. And on another morning when her morning blood sugar levels were high at 160 mg/dl (or 8.9 mmol/l). She had written: I don't understand. 97 mg/dl (or 5.5mmol/l) last night when I went to sleep. I didn't eat anything because I didn't feel well. Humm… I was also over in one of the online diabetes groups I'm involved in today and this message popped up. I'm struggling with my morning BS number. When I went to bed around 11PM my BS was 107. I'm waking up with my BS between 120 – 135. I did put two pieces of string cheese next to my bed and when I woke up around 3am, I ate one. Since I was told to eat protein at night. When I woke up 3 hours later my BS was 130. I didn't want to eat anything large since it's so close to 140 (my goal is to keep it below 140). So I had 1 piece of toast (sugar free wheat bread) and just a tiny bit of peanut butter. I checked it an hour later and it was 161! What am I doing wrong? Do these morning situations sound familiar to you? Are you constantly questioning: Why is blood sugar high in the morning? I mean, logically we'd think that it should be at it's lowest in the morning right? Well don't panic, there is a reason for it, so let's explore why morning blood sugar is often higher. And at the end, I'll also point you toward some resources to help you lower those levels. Why Is Blood Sugar High In The Morning? Although it would seem logical that your body would Continue reading >>

Diabetes: What You Need To Know As You Age
Overview Diabetes is a problem that has many consequences: If you have the disease, your body can no longer keep its blood sugar at a healthy level. But over time, the effects of diabetes can become much more complicated. The disease can lead to serious, even life-threatening problems from your head to your toes. Too much blood sugar (also called glucose) can damage the blood vessels and nerves that run throughout your body. This can set the stage for many other medical conditions: stroke heart disease kidney disease vision problems and blindness damage to the feet or legs However, there is good news for the 26 million Americans with diabetes—and those at risk. Experts are learning more all the time about lifestyle steps for diabetes control and prevention. New medications and devices can also help you keep control over your blood sugar and prevent complications, says Johns Hopkins expert Rita Kalyani, M.D. Definitions A1C Test: A blood test used to diagnose and monitor diabetes. By measuring how much glucose (also called blood sugar) is attached to the oxygen-carrying protein in your red blood cells, this test gives you and your health-care provider a picture of your average blood glucose levels over three months. A normal result is below 5.7 percent. If you have type 2 diabetes, you should have this test done twice a year to check if your blood glucose is under control. Blood glucose: Also referred to as blood sugar, the primary energy source for the cells in your body. Blood glucose levels rise after meals and fall the longer you’ve gone without eating. Your blood glucose level is a measure of how much glucose you have in your bloodstream. A normal fasting blood glucose level is between 70 and 100 mg/dl (milligrams per deciliter of blood). Insulin (in-suh-lin): A Continue reading >>

6 Things That Can Cause Your Blood Sugar To Spike Or Drop
While roller coasters can be thrilling at amusement parks, theyre not so great when it comes to your blood sugar levels. Also known as glucose, blood sugar is a critical source of energy for your body, according to the Mayo Clinic . When its either too high or too low, you can feel pretty terribleespecially if you have type 1 or type 2 diabetes . Heres a quick primer on how blood sugar works in people with and without diabetes. You absorb sugar from food and beverages into your bloodstream, where insulin (a hormone from your pancreas) helps it gets into your cells to provide energy, according to the Mayo Clinic . As a backup of sorts, your liver also makes and stores its own glucose to help keep your blood sugar within a normal range. In general, when you dont have diabetes, your body does a good job of regulating glucose levels, Amisha Wallia, M.D., an endocrinologist at Northwest Memorial Hospital, tells SELF. But if you have type 1 diabetes, which typically appears in childhood or adolescence, your pancreas produces little or no insulin to help glucose get into your bodys cells, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). That can allow too much sugar to build up in your bloodstream (hyperglycemia). If you have type 2 diabetes, which usually develops in adults, you experience high blood sugar because your pancreas either doesnt make enough insulin or your body cant use insulin properly, according to the NIDDK . When your blood sugar gets over 200 milligrams per deciliter, it can cause symptoms like headaches, fatigue, increased thirst, and frequent urination, per the Mayo Clinic . On the flip side, problems managing your diabetes can also result in glucose levels that swing in the opposite direction and become too low ( Continue reading >>

Questions And Answers - Blood Sugar
Use the chart below to help understand how different test results can indicate pre-diabetes or diabetes Fasting Blood Glucose Oral Glucose Tolerance Test (OGTT) Random Blood Sugar (taken any time of day with or without fasting) A1C Ideal Result Less than 100mg/dl Less than 140 mg/dl Less than 140 (even after eating a large meal) Less than 5.7% Pre-diabetes 100-125mg/dl 140-199mg/dl 140-200 5.7% to 6.4% Diabetes 126mg/dl and greater 200 mg/dl and greater 200 or greater 6.5% or more Q: I have been told that I have diabetes, or "pre-diabetes", or that I am in the "honeymoon period" . My readings are all over the place: sometimes in the 120's, others in the 90's, sometimes, but rarely in the 150-170's. My doctor does not want to put me on medication yet. I exercise regularly and am not overweight though my diet is variable. I certainly like sweets, pizza, and pasta. What is the long term effect of these continued high blood sugar levels? A: Firstly, kudos for your physician for giving diet/lifestyle changes a chance to work. Reduction of body fat often is the first best start. This may or may not be true in your case but certainly sweets, pizza, etc. are affecting your numbers. If you can discipline yourself at this time to eat unrefined foods and be more active, your beta cells that produce insulin may get the rest they need to become efficient again. Our diabetes management booklet has many referenced foods/supplements that may help to stabilize your glucose levels. In time, your favorite foods may be reintroduced in moderate amounts. You appear to be more in the pre-diabetes range at this time. Complications are a long process. If your daytime levels stay under 120-140, that is good. Fasting levels are higher due to hormonal activity nighttime; these levels are a much sl Continue reading >>

10 Ways To Balance Blood Sugar Naturally
Blood Sugar Balance in Plain English Before we get started with tips to balance your blood sugar, I want to cover some basic blood sugar terms that I will be using in this discussion. Blood sugar/blood glucose – Glucose is the form of sugar that is in our bloodstream. Glucose is the body’s preferred source of fuel. Insulin – the pancreas secretes insulin, a hormone that shuttles glucose from the blood into body cells. It knocks on the cell and says, “Open up, I’ve got some glucose that I need to get out of the bloodstream so take it and use it for energy.” Insulin resistance – When we consume a large amount of refined carbs with very little fat and protein, our blood sugar spikes very high and the pancreas frantically overcompensates with insulin release. This overcompensation of insulin eventually causes insulin resistance, which leads to Type 2 Diabetes if poor dietary practices are continued. The good news, however, is that it can an be reversed through a healthy diet that balances your blood sugar. Glycogen – Glucose that doesn’t enter body cells is taken to the liver where it is converted to glycogen. This is a form of stored sugar that is broken down to stabilize low blood sugar levels between meals and during the night. It is healthful for the body store of glycogen, but stress and hormone dysfunction deplete our ability to store glycogen and this can contribute to blood sugar imbalance. Hyperglycemia – Hyperglycemia is another term for high blood sugar. It is normal to have a spike in blood sugar after a meal, but chronically high blood sugar causes severe health issues. Hypoglycemia – Hypoglycemia is low blood sugar. Glycogen, the sugar stored in the liver, is responsible for raising blood sugar in-between meals and should prevent hypoglyc Continue reading >>

4 Ways To Keep Your Blood Sugar Steady
You’re having a hot or cold sweat, losing your concentration, and you feel shaky. Maybe you’re a little nauseated or even faint. Most of us know the feeling. Most of us have been there at one time or another, especially women. The blood sugar crash, or what my colleague at The UltraWellness Center, Dr. Mark Hyman, calls “The Food Emergency,” is super common. It’s an awful feeling that can interfere with work, productivity, and even our safety if it happens while we’re driving! As a young mom, keeping up with a breastfeeding baby and toddlers, then again later as a medical resident working insanely long hours, I often skipped meals, or at least skimped on them, only to find myself at the bottom of the blood sugar barrel. And what happens when you land there? You’re body goes into survival mode – literally – and you will eat ANYTHING in front of you. Since most Americans live in a sea of quick carbohydrate and sugar “fixes,” we grab what is quick and right in front of us. Most often that is bread, chips, a cookie or brownie, a soda, juice, a candy bar, or other quick acting sugary food. And hey, in a pinch, it really does feel life saving. But in the long run, this is not a fix at all. In fact, the cycles of low and high blood sugar, and the reliance on sweets and carbs to rescue us from our blood sugar crashes are a key cause of our national diabetes and obesity epidemics. And did you know that Alzheimers disease is now considered a form of diabetes? YIKES! Over time I learned how to keep my blood sugar steady, completely prevent blood sugar crashes, and always have access to good quality foods. Here are my 4 key tips so you can do the same! 1. Eat a quality breakfast. What you eat for breakfast sets the barometer for your day’s blood sugar. Eat a Continue reading >>

How Many Factors Actually Affect Blood Glucose?
A printable, colorful PDF version of this article can be found here. twitter summary: Adam identifies at least 22 things that affect blood glucose, including food, medication, activity, biological, & environmental factors. short summary: As patients, we tend to blame ourselves for out of range blood sugars – after all, the equation to “good diabetes management” is supposedly simple (eating, exercise, medication). But have you ever done everything right and still had a glucose that was too high or too low? In this article, I look into the wide variety of things that can actually affect blood glucose - at least 22! – including food, medication, activity, and both biological and environmental factors. The bottom line is that diabetes is very complicated, and for even the most educated and diligent patients, it’s nearly impossible to keep track of everything that affects blood glucose. So when you see an out-of-range glucose value, don’t judge yourself – use it as information to make better decisions. As a patient, I always fall into the trap of thinking I’m at fault for out of range blood sugars. By taking my medication, monitoring my blood glucose, watching what I eat, and exercising, I would like to have perfect in-range values all the time. But after 13 years of type 1 diabetes, I’ve learned it’s just not that simple. There are all kinds of factors that affect blood glucose, many of which are impossible to control, remember, or even account for. Based on personal experience, conversations with experts, and scientific research, here’s a non-exhaustive list of 22 factors that can affect blood glucose. They are separated into five areas – Food, Medication, Activity, Biological factors, and Environmental factors. I’ve provided arrows to show the ge Continue reading >>
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Controlling The Dawn Phenomenon
Do you wake up with a blood glucose level that’s higher than when you went to bed? You might wonder how this could be. Is this “dawn phenomenon” serious, and what can you do about it? Our reader Mishelle commented here, “I don’t eat [much] during the day. [I take metformin morning and night.] My blood sugar is still too high in the morning…sometimes 125–140ish.” How can Mishelle’s glucose levels go up if she didn’t eat anything? She probably has a mild case of dawn phenomenon. Her glucose is going up from sources other than digested food. Some of it is produced by the liver from stored starch and fatty acids. Livers that produce too much glucose are one of the main ways diabetes causes high blood glucose levels. Other organs also produce small amounts of glucose. This is called “gluconeogenesis” for you science freaks out there. Organs do this to keep blood glucose from going too low at night or other times of not eating. From about 2 AM to 8 AM, most people’s bodies produce hormones, including cortisol, glucagon, and epinephrine. All these hormones increase insulin resistance and tell the liver to make more glucose. The idea is to get you enough glucose to get out of bed and start the day. The whole process is apparently started by growth hormones. Everyone has a dawn phenomenon. Otherwise they’d be too weak to get breakfast. But in people without diabetes, insulin levels also increase to handle the extra glucose. People with diabetes can’t increase insulin levels that much, so their early morning blood glucose levels can rise dramatically. Experts disagree on how many people have a dawn phenomenon. Estimates range from 3% to 50% of Type 2s and from 25% to 50% of Type 1s. Is dawn phenomenon a serious problem? It can be serious. According t Continue reading >>

Proven Tips & Strategies To Bring High Blood Sugar Down (quickly)
Untreated, high blood sugar can cause many problems and future complications. Recognizing signs of high blood sugar levels and knowing how to lower them can help you prevent these complications and increase the quality and length of your life. Topics covered (click to jump to specific section) High blood sugar level symptoms and signs Symptoms of high blood sugar include: Increased thirst Tired all the time Irritability Increased hunger Urinating a lot Dry mouth Blurred vision Severe high blood sugar can lead to nausea and fruity smelling breath The signs and symptoms for high blood sugar are the same for both type 1 and type 2. Signs usually show up quicker in those who have type 1 because of the nature of their diabetes. Type 1 is an autoimmune disease that causes the body to stop making insulin altogether. Type 2 is caused by lifestyle factors when the body eventually stops responding to insulin, which causes the sugar to increase slowly. People with type 2 can live longer without any symptoms creeping because their body is still making enough insulin to help control it a little bit. What causes the blood sugar levels go to high? Our bodies need sugar to make energy for the cells. Without it, we cannot do basic functions. When we eat foods with glucose, insulin pairs with it to allow it to enter into the cell wall. If the insulin is not there, then the glucose molecule can’t get through the wall and cannot be used. The extra glucose hangs out in the bloodstream which is literally high blood sugar. The lack of insulin can be caused by two different things. First, you can have decreased insulin resistance which means that your insulin doesn’t react the way that it is supposed to. It doesn’t partner with glucose to be used as fuel. Secondly, you can have no insuli Continue reading >>

Blood Sugar Spikes: Causes, Symptoms, And Prevention
Diabetes is a disease that causes a person's blood sugar to become too high. This can lead to various complications. A person with diabetes must be careful to keep their blood sugar levels under control. Glucose comes from the food we eat. It is the main source of energy for the body. The pancreas secretes substances, including the hormone insulin, and enzymes. Enzymes break down food. Insulin makes it possible for body cells to absorb the glucose we consume. With diabetes, either the pancreas is unable to produce insulin to help the glucose get into the body cells, or the body becomes resistant to the insulin. The glucose stays in the blood instead. This is what raises blood sugar levels. High blood sugar is known as hyperglycemia. Contents of this article: Causes of blood sugar spikes People with diabetes have to be especially careful about keeping their blood sugar levels under control. There are several reasons why blood glucose levels may spike. These are: Sleep: A lack of sleep can be especially bad for people with diabetes, because it can also raise blood sugar levels. One study performed on Japanese men found that getting under 6.5 hours of sleep each night increases a person's risk for high blood glucose levels. Prioritizing healthy sleep and promoting sleep hygiene are good habits for everyone, but especially for people with diabetes. Stress: When under a lot of stress, the body produces hormones that make it difficult for insulin to do its job, so more glucose stays in the bloodstream. Finding a way to keep stress levels down, such as yoga or meditation, is essential for people with diabetes. Exercise: Having a sedentary lifestyle can cause blood sugar levels to go up. In addition, exercise that is too difficult can cause stress and blood glucose levels to ri Continue reading >>

How To Treat A Low Blood Sugar (without Eating Everything In Sight)
We’ve all been in the position of having a bad low, where all you want to do is eat everything in sight. There’s no reasoning with yourself. It’s like a demon has hijacked your self-control! It makes perfect sense–your body just wants to get your blood sugar back up to a safe level, and it’s doing its best to ensure that the low is corrected. But eating your weight in carbs is just going to result in a high blood sugar, and then you are dealing with the opposite problem. What’s a person with diabetes to do? First of all, fix the low. Get your blood glucose level above 70 mg/dl (4 mmol/L). It’s best to use a dextrose-based treatment, like glucose tablets or gel, to get the BG up to a safe level. Using something high glycemic index is important when you are very low and need to quickly raise the blood glucose, especially if you have a lot of insulin on board. Be careful to treat with the right amount of carb, as opposed to over-treating. If you weigh less than 60 lbs, a gram of carb will raise your BG about 6 points. If you weigh 100-160 lbs, a gram of carb should raise your BG about 4 points. If you weigh 160-220 lbs, a gram of carb might raise you 3 points. And give the carbohydrates 15-20 minutes to raise the BG. Do a follow-up fingerstick because there is a lag time with sensors, and the BG you get with a fingerstick will be a more accurate reflection of your response to your treatment. If you are still low, repeat the treatment. I remember a low where I munched my way through the pantry, and I neglected to count my carbs as I was doing it. I had absolutely no idea how much to bolus for! Boy, did I learn my lesson. I never did that again – I’ve always made sure to carb count and take insulin to cover whatever I eat that’s in excess of what I needed Continue reading >>

Correcting Morning Blood Sugar Highs — Know The Causes Of These Spikes And Ways To Treat Them
Today’s Dietitian Vol. 14 No. 11 P. 18 Jill is frustrated. Her type 1 diabetes seems out of control, and she comes to your office at her wits’ end. She says she’s doing everything right: counting carbs, taking her insulin as prescribed, monitoring her blood glucose levels four times per day. A look at Jill’s testing logs and most recent blood work confirms there’s a problem. She has a hemoglobin A1c of 9.2, and her blood glucose levels are all over the map. Her numbers generally are fine before she goes to bed but incredibly high in the morning. Recently, her physician increased her nighttime basal insulin dose to counteract the morning highs, but things seem worse now than ever. Her breakfast bolus doesn’t seem to be effective, and her high blood glucose levels persist into the afternoon. “Fluctuating blood sugars can be very frustrating,” says Eileen M. Sturner, RD, LDN, CDE, BC-ADM. “RDs can play an important role in helping patients get to the bottom of problems such as morning highs. Working with patients to gather the appropriate data and facilitating the sharing of those data with the healthcare provider that’s managing their diabetes can have life-changing results.” Hyperglycemia In type 1 diabetes, the pancreas can no longer provide either the steady drip of basal insulin that keeps blood sugar levels stable between meals or the bolus release of insulin that directs the uptake of glucose after eating. Patients must take basal insulin to keep their fasting blood sugar levels steady and bolus insulin to match their carbohydrate intake and correct highs. The primary cause of hyperglycemia in type 1 diabetes is carbohydrate intake that isn’t matched with bolus insulin dosing. Perhaps Jill is underreporting her carbohydrate intake, administer Continue reading >>