Blood sugar regulation is a critical part of normal physiology. Cellular functions can be damaged or fail if blood sugar gets too low (hypoglycemia) or too high (hyperglycemia). While both can be dangerous, hyperglycemia-related diseases have reached epidemic proportions and are considered a significant public health concern.
Prediabetes and diabetes are two conditions associated with hyperglycemia that have greatly impacted Western society. Affecting over 37.3 million Americans, diabetes was the seventh leading cause of death in the U.S. in 2017, with total direct and indirect estimated costs at $327 billion that same year. Learning to manage healthy blood sugar levels may help prevent or delay health problems and relieve the personal and societal financial burden associated with hyperglycemic injury.
Innate Blood Sugar Management
The body has an innate, highly sophisticated system to regulate blood sugar around the clock. Accomplished through actions from various hormones and organs in the body, the pancreas is a critical player in blood sugar control through the secretion of hormones insulin and glucagon. When blood sugar is low, such as during sleep, glucagon is released from alpha cells of the pancreas to promote increases in blood sugar. Glucagon acts mainly on the liver to release stored glucose into the bloodstream.
In contrast, when blood sugar is high, such as after a meal, insulin is secreted from the beta cells of the pancreas to keep blood sugar from rising too high. Insulin attaches to receptors on tissues and organs and enables glucose to travel from the bloodstream into the cells, therefore, lowering blood glucose.
The interactions between all organs, tissues, and hormones ensure blood glucose homeostasis in clinically healthy individuals. However, changes in clinical conditions or impairments in insulin sensitivity may result in this system failing, leading to hyperglycemia and metabolic disease.
Factors Contributing to Hyperglycemia
Several factors can impair blood sugar management and lead to hyperglycemia, such as reduced insulin secretion from the pancreas, reduced insulin sensitivity, and elevated blood sugar levels from increased glucose production or unhealthy dietary intake. Some causes of hyperglycemia are secondary to other diseases or events, such as the destruction of pancreatic function from disease, endocrine disorders that cause peripheral insulin resistance like Cushing syndrome, as well as other acute or chronic situations such as decreased insulin sensitivity during pregnancy (gestational diabetes) or the use of certain medications.
Other causes of hyperglycemia, though, are related to behavior and lifestyle factors such as a poor diet, a sedentary lifestyle, or chronic high amounts of stress. While blood sugar control can be improved with pharmacological intervention, there are several other natural strategies to help keep blood sugar in check to reduce the risk of developing hyperglycemia or its long-term complications.
7 Natural Ways to Keep Blood Sugar in Check
- Craft your carb intake. Of the three macronutrients, carbohydrates have the most significant impact on blood sugar. After consuming carbohydrates, the body breaks them down into sugar, which then enters the blood. This is not innately bad because our bodies require blood sugar to function. Yet, when people overconsume carbohydrates or choose low-quality carbohydrates, it can negatively impact blood sugar levels. It’s important to learn how to use carbohydrates to support health rather than hinder it. First, it’s crucial to consider carbohydrate quality. Carbohydrates that are natural or whole grain will include fiber, vitamins, and minerals and will take longer to digest – which means they have a slower and more gradual effect on blood sugar compared to a highly processed carbohydrate. Next, balancing out meals or snacks to include a protein or fat source with carbohydrates can help slow down digestion and absorption, which allows for a gradual effect on blood sugar compared to consuming carbohydrates alone. And finally, controlling carbohydrate portions at each meal can also help control blood sugar levels and promote good health and energy over time. So instead of reaching for that bag of chips when mid-afternoon hunger hits, grab an apple with some peanut butter to better control blood sugar.
- Take exercise snacks. Exercise can benefit blood sugar control in several ways. First, exercise can help with the maintenance of a healthy weight. When overweight, the body needs more insulin to manage blood sugar than it would at a healthy weight. Producing that much insulin over time can push the pancreas beyond its capacity causing it to fail. Reaching and maintaining a healthy weight reduces this risk. Second, exercise allows for easier movement of blood sugar from the blood into the exercising tissues with less work from the pancreas and insulin. After a bout of exercise, the muscles have increased insulin sensitivity, allowing blood sugar to easily move into the muscles to restore the energy they just depleted during activity. Moreover, exercise increases skeletal muscle glucose transport proteins, allowing glucose to enter the cell without the need for insulin. The CDC’s physical activity guidelines for Americans include 150 minutes of physical activity each week. This may sound like a lot for some, but this time can be broken up in a way that’s convenient for you. For example, scientists have found that those who take regular “exercise snacks” throughout the day have better blood glucose control after meals. These exercise snacks can be 3 min bouts of light-intensity walking or simple resistance activities, such as half squats or calf raises, every 30 minutes. Set alarms at work and get your office mates to join to promote health and accountability.
- Rethink your drink. Sugar-sweetened beverages, such as soda, fruit juices, sweet tea, lemonade, energy drinks, and many others, are the single largest source of calories and added sugar in the U.S. diet. Sugary drinks often provide no other nutritional benefits and a lot of calories without the same “full” feeling one might get from consuming the same number of calories from whole food. Moreover, research shows that increased consumption of sugar-sweetened and artificially-sweetened beverages is associated with the risk of type 2 diabetes, cardiovascular disease, and all-cause mortality. Swapping out sweetened beverages for water could help keep blood sugar levels within a healthy range. In addition to preventing dehydration, adequate water intake can help lower blood sugar levels and reduce metabolic disease and diabetes risk. If flavor is what you’re looking for, try naturally flavored sparkling waters, adding slices of citrus fruits or fresh herbs to still water, or home brewing your favorite tea and adding lemon, cucumber, or mint.
- Take a deep breath. Stress can negatively impact blood sugar levels. Stress hormones, like cortisol, increase blood sugar levels by suppressing insulin secretion and promoting blood sugar release from other organs, such as the liver and adipose tissue. It’s easy to vilify cortisol when reading this, but the truth is, it’s just doing its job. Before all our modern comforts, our ancestors likely required blood glucose when they were under stress to have the energy to avoid a dangerous situation or chase down a food source. Cortisol is not the bad guy, but it is important to learn to manage cortisol so that chronic stress does not lead to hyperglycemia. Evidence shows that regular exercise, relaxation, and meditation, can significantly reduce stress and lower blood sugar levels. Developing the proper stress management practice, including 7-8 hours of sleep, can help reduce cortisol levels and the risk of hyperglycemia.
- Trust your gut. The human gut is home to trillions of microorganisms and bacterial species that affect biological functions and metabolism in humans. Over the last couple of decades, scientists have been exploring the role of gut bacteria in insulin resistance and diabetes management. A 2017 and 2021 meta-analysis of randomized controlled studies found that probiotics were associated with significant improvement in glucose metabolism, HbA1c (average blood sugar levels over the past three months), and fasting insulin in type 2 diabetics. While most of the studies used probiotic supplementation, probiotic-rich foods such as yogurt with live active cultures, kefir, tempeh, sauerkraut, and kimchi, can also be added to the diet to support gut health.
- Stick to a schedule. Regular daily eating patterns may improve insulin sensitivity and decrease cardiovascular risk factors. Moreover, eating smaller, more frequent meals may provide additional benefits. Evidence has found that increased eating frequency is related to lower insulin secretion and improved insulin sensitivity. Furthermore, observational research has concluded that a regular meal pattern, including breakfast and multiple smaller daily meals, is best for glycemic control. Treat mealtimes like meetings and plan ahead to look forward to meals you enjoy.
- Know your numbers. HbA1c levels correlate and reflect average blood glucose over the past three months. A healthy HbA1c is <5.7%, and anything above indicates chronic high blood sugar, which warrants lifestyle or clinical change. Periodically checking HbA1c levels, and making lifestyle changes, if necessary, can help stave off more severe health conditions down the line. For many Americans, blood sugar can be controlled through lifestyle and behavior practices. But first, you need to know where you stand.