The 5 Causes of High Blood Sugar
Blood sugar levels are getting out of control. With increasing rates of diabetes and its complications, people are looking for answers. But it seems like everyone is saying something different.
The dizzying array of voices and opinions makes you want to throw your hands up in the air and give up because you don’t know who to believe.
It doesn’t seem to matter anyways because everything you’ve tried hasn’t worked.
Either you avoid seeing your doctor because you’re afraid of receiving bad news, or you do see your doctor and he tells you that there’s nothing you can do about it and let’s just wait and see if it gets worse.
And if (or when) it gets worse, they put you on a lifetime subscription of medications, blood sugar monitoring strips, needle pricks, and hospital visits. Didn’t know you’d be signing up for that, did you? No wonder you were avoiding the doctor in the first place!
In the midst of all this, a small thought pops into your head that maybe there is something you can do to keep your blood sugar in check and avoid the new lifestyle of monitoring, taking meds, and scheduling visits, not to mention the hefty bill and time this new lifestyle requires along with the worries that come when your numbers get too high.
So you ask your doctor, who sees diabetic patients all the time and the most obvious expert, if there is anything you can do to avoid all this. He tells you that, basically, there isn’t anything you can do. That a lot of it is genetic (it isn’t), you can watch what you eat but it doesn’t really matter (it does), and that you could probably stand to lose a few pounds (he’s probably right but so could he). He emphasizes that it’s very important that you keep a close eye on your blood sugar levels and the medications will help you manage the numbers. He’ll keep the focus on the numbers and stress how important it is and all the complications that could happen if the numbers stay too high for too long so that you know he means business and that you should take this seriously.
Somehow, he doesn’t really mention that your medications might make it harder for you to lose weight which he just told you to do1. Nor the complications and possible side effects of the medications he is prescribing to you. Or that you will have to take these medications for the rest of your life. And if you do experience any side effects, he has more medications that he can prescribe to you… to manage the side effects of the drugs he already prescribed you.
Is this just a big shell game? You’re being told to focus over here on the numbers and manage the symptoms, while the real problem is over there: what is causing these symptoms that are making you “have to” take the medications, that stresses you out every time you think about the next time you have to check your numbers, that are making you dependent on your doctor and the endless check-up visits where he just tells you what you already know?
In order to fix the problem, you have a much better chance if you know what caused it. When you know the possible causes, you can address them one by one and see if it affects the outcome. Eliminating a possible cause may eliminate the problem altogether and you’d avoid the cascade of events that your doctor would take you through.
Once you’ve exhausted the possible causes, THEN you should move on to managing the problem. Even then, knowing and understanding the causes can help you manage the problem better and minimize the damage.
And who knows? Addressing the possible causes first might just prevent the problematic symptoms from arising in the first place.
Isn’t this a more sensible approach?
Let’s take a look at the five things that make your blood sugar go up and why.
1. Carbohydrate Consumption
This is what most medical professionals focus on for blood sugar control as it is the most obvious. When you eat sugar or anything that breaks down into sugar (carbohydrates), that sugar gets digested and released into your bloodstream, which causes your blood sugar levels to go up. So obviously, eating less carbohydrates would keep your blood sugar levels from going up. It’s a pretty logical conclusion, right?
But sugar is such an important nutrient as it is the preferred source of energy for every living organism. You might be thinking, “if sugar is so good for you, then why is increased blood sugar so bad for you and lead to things like diabetes and increased risk of cardiovascular disease?”
Your body seeks to maintain homeostasis, in this case by keeping the sugars in the blood within a safe range for the body to function optimally. The problem is not that sugar levels go up, as that is inevitable if you are consuming carbohydrates, which are essential for optimal health. In a healthy body, blood sugars will go up and come back down within 2 hours back to the normal baseline. The problem occurs when the body is unable to keep the blood sugars within that healthy range, possibly due to some of the other causes of increased blood sugar levels like the body not being able to produce enough insulin (insufficient insulin production), insulin resistance, or some other dysfunction or external factor.
Focusing primarily on limiting carbohydrate consumption to control blood sugars would be a mistake and will lead to a lot of frustration and hopelessness because the underlying problems are being left unaddressed. I would say that elevated blood sugar levels from eating carbohydrates are more of a sign or symptom that something is wrong, rather than what is actually causing the issue.
It would be like blaming other people for losing your temper.
Normally, you can manage your emotions, re-center yourself and maintain emotional homeostasis. But we’ve all had one of those days where someone says or does something that triggers us and we uncharacteristically lash out. It’s not really the other person’s fault. There’s something I need to deal with internally that is causing me to feel this way. If I really think about it, they could have said or done anything. This person just happened to be there while I was brooding and gave me an excuse.
It would be silly to make the conclusion that other people cause you to be angry and so you will avoid people. People are everywhere and you have to share this world with other humans. It’s normal and is an integral part of a healthy life: being around people who love and support you. Having the support and being in the safety of loved ones is also associated with less stress. And less stress is associated with healthier blood sugar levels, which we’ll talk about more in just a bit.
Trying to limit carbohydrate consumption is like trying to avoid people: it may help you manage for a little while but it’s never going to address the real problem.
2. Insufficient Insulin Production (Type 1 Diabetes)
When sugar levels in the blood gets high, the beta cells in your pancreas releases the hormone insulin into the bloodstream. Insulin binds with receptors on certain cells, primarily those of your muscles and liver, which then signal a cascade of events that brings a glucose transporter, known as GLUT4, to the surface of the cell to allow glucose into the cell for use as energy or to store as glycogen to use later.
Without insulin, glucose would remain in the bloodstream and build up to unsafe levels because insulin is what triggers the mechanism of letting glucose enter the cells.
Type 1 Diabetes Mellitus (T1DM) or insulin-dependent diabetes mellitus (IDDM) is when the pancreas is unable to produce insulin or cannot produce enough insulin to bring blood sugar levels back down to normal levels. So it is dependent on external insulin, hence the name IDDM.
One possible theory of how the beta cells of the pancreas, which produce insulin, get destroyed is that it is caused by an autoimmune reaction called molecular mimicry where the body attacks a foreign antigen (which normally is a good thing) but in the process, confuses the pancreatic beta cells for that antigen because, to your immune system, it looks similar and destroys them (not so good).
Some possible causes of molecular mimicry may occur from a viral infection2, chemical toxins, the proteins in cow’s milk3–5, or even milk and meat from cows that are infected with paratuberculosis6.
Once these beta cells are destroyed, there is no way to regenerate them so people diagnosed with T1DM will need to monitor their blood sugars and must use insulin injections to control blood sugar.
Although there is currently no cure for T1DM, you do not have to live in fear of its complications. Your body may not be able to produce the amount of insulin that it needs but it does not mean that you need to suffer many of the long-term effects of living with diabetes.
In fact, you can minimize how much insulin you need by optimizing how well your body uses the insulin you give it which we’ll learn about in the next section.
3. Insulin Resistance (Type 2 Diabetes)
To recap: when you eat food containing carbohydrates, blood sugar levels go up. In order to bring the blood sugar levels back into homeostasis, your pancreas releases insulin into the blood stream, which signals to certain cells that there is glucose in the bloodstream and to let it in.
But what happens if the cells don’t respond? Either they don’t get the signal or something happens within the cell that causes the glucose transporter to be unable to latch onto the surface of the cell to let the glucose in.
This is called insulin resistance and is what characterizes Type 2 Diabetes.
When your body detects higher glucose in the bloodstream, the pancreas produces insulin so the cells know to remove glucose from the bloodstream for its energy needs. But when you have insulin resistance, the signal isn’t getting through. So the glucose stays stuck in the bloodstream. And because the blood sugar is not going down, the pancreas goes into overtime and continues to pump out insulin to overcome the body’s insulin resistance. In the beginning stages of prediabetes, your body is able to produce enough insulin to eventually overcome the insulin resistance and bring your blood sugar levels back down… but your pancreas is producing a lot more insulin than it would normally need to.
And you know what happens to you when you hustle, hustle, hustle?
You burn out.
Your pancreas needs to rest, too.
Over time, from chronic overuse, the pancreatic beta cells get exhausted. And as would be expected, being overworked with no rest and brought to exhaustion time and time again, these beta cells start to die off. When the pancreas can no longer keep up this overproduction of insulin to bring blood sugar levels down, your blood sugar levels skyrocket and you get diagnosed with type 2 diabetes.
Thankfully, type 2 diabetes is completely preventable and reversible, especially in the early stages and as long as there is enough beta cell function. The key is in improving insulin sensitivity, not in reducing carbohydrate consumption.
Increasing insulin sensitivity is also helpful for type 1 diabetics.
If you are a type 1 diabetic, you need insulin injections because your pancreas cannot make it on its own so it needs to get insulin from somewhere else. However, the more sensitive your body is to insulin, the more efficient and effectively your body can use that insulin. So in effect, you would be able to maintain your blood glucose levels with less insulin than someone with insulin resistance. More good news is that increasing insulin sensitivity (without drugs) is also associated with improving other important health markers as well.
Less insulin resistance = less insulin required = less symptoms and complications
4. Liver Glucose Production (Hepatic Gluconeogenesis / Glycogenolysis)
The liver plays a very important role in maintaining blood sugar homeostasis. When blood sugar is high, the liver will store the extra glucose as glycogen. When blood sugar is low, the liver can down-convert the stored glycogen back into glucose for the body to use, called glycogenolysis. In addition, the liver can also make glucose from non-glucose precursors, called gluconeogenesis.
Normally, in between meals, your liver will release glucose to prevent your blood sugar from getting too low. When you have a meal, the pancreas will release insulin to tell your cells that it’s mealtime and that they can take the glucose out of the bloodstream. The release of insulin also tells your liver to slow down the release of glucose because there is plenty of glucose coming from the food you just ate.
However, if your cells are not responding to the insulin (insulin resistant), not only are your cells unable to get the glucose but your liver also doesn’t get the message and doesn’t know to slow down its release of glucose into the bloodstream.
You can imagine what happens as a result: not only is the dietary glucose stuck and accumulating in the bloodstream due to insulin resistance, but if the liver is insulin resistant, it continues to add glucose to the bloodstream because it doesn’t detect insulin which signals that glucose is coming in from digestion and that it should take a break.
As you might also imagine, if you improve insulin sensitivity, the liver would get the message, slow down its production of glucose, and this would become a non-issue.
You don’t really hear anybody talking about how stress raises your blood sugar. Not only does stress make you feel more tired and gain weight (stress eating, anyone?) but stress also spikes your blood sugar, and for good reason.
When your body undergoes stress, your body goes into fight or flight mode: either you stay and fight the threat, or you run away from danger as fast as you can. Both of these responses require your muscles to move your body. To do that, your body needs a quick burst of energy as it thinks it is in a life or death situation. Your adrenal glands release adrenaline (epinephrine), norepinephrine, and cortisol which tells the liver to open the floodgates and raise blood sugar levels so that you will have energy available quickly in anticipation of responding to the perceived threat.
This response is critical when you are actually facing a life or death situation every once in a while. But being chronically stressed will lead to many health problems physically, emotionally, and mentally.
Stress can come in many forms. The most familiar chronic stressors are fear and anxiety.
Whether work-related, relational, speaking in public, an increase of responsibilities, having unrealistic expectations, an unexpected circumstance, or any number of things, chronic stress can lead to many other serious health problems in addition to higher blood sugar levels.
But did you know that your body can also be jolted into the fight or flight response by watching horror movies? News stories often use fear and anxiety-inducing tactics to get you to click on their headlines. Marketers love to work you up into a frenzy to “Shut up and take my money!”
It may be time to reevaluate your recreational and shopping habits. Trust me, your adrenal glands (and your wallet) will thank you for it 😉
Other stressors that can cause your blood sugars to rise are illness, injury, systemic inflammation, and lack of sleep.
Some simple and effective strategies are to get enough sleep, learn how to destress, take care of your body, and eat anti-inflammatory foods. And laugh. A lot.
That’s one of the goals I aim for through Perpetual Remission: to show that health is fun. While it can be stressful to think up new content, write it, shoot it, edit, and manage everything, I try to keep it fun and lighthearted while still being educational and providing you with value. And I find that when I help others to get that light bulb moment, I also feel that same joy and excitement. Those who refresh others will themselves be refreshed.
Battling rising blood sugar levels can feel like a losing battle but now you know how and why these five factors cause your blood sugar to go up. In the next post, we’ll learn about how these five factors work together and which of these five factors is the single most important factor, if you haven’t guessed it already. The good news here is that when you focus on this one factor, almost all of the other factors can be mitigated and their effects lessened or even eliminated. Even better news is that you can do something about it and take back control of your health.
Did you already know all five of these causes? Have you figured out which one of the five factors is the most important? Let me know in the comments below.
And please like and share this with anyone you think also needs to know these five factors.
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I’m Peter Chung from Perpetual Remission.
Thanks for watching and never stop doing good!