Mastering Blood Sugar - Ask a Nutritionist

Transcript:

BRITNI: Welcome to Dishing Up Nutrition's mid week segment called “Ask a Nutritionist”. My name is Britni Vincent. I'm a registered and licensed dietitian at Nutritional Weight & Wellness. And on today's show, I will be answering a few questions related to blood sugar, including can prediabetes be reversed, and will weight loss improve glucose levels?

Can prediabetes be reversed?

Well, let's start with the 1st question. Can prediabetes be reversed? The short answer is yes, prediabetes can absolutely be reversed, and I have even seen type 2 diabetes be reversed. So I want to start by discussing what a prediabetes diagnosis is. Prediabetes is a condition where your blood sugar levels are higher than normal, but not high enough to be diagnosed with type 2 diabetes.

It's essentially like a warning sign that your body is struggling to manage blood glucose efficiently. Specifically, if your fasting blood sugar is between 100 to 125 milligrams per deciliter or your hemoglobin A1C is between 5.7 percent and 6.4 percent is when you will get a prediabetes diagnosis from your doctor.

You know, optimally, your fasting blood sugar or blood glucose should be below 90 and your A1C should be 5.4 or below. One study showed that people with a fasting blood glucose above 95 had more than three times the risk of developing future diabetes than people with a fasting blood glucose below 90.

So below 90 really is optimal. Getting your fasting blood glucose tested is really just one snapshot in time though. Whereas your hemoglobin A1C measures your glucose over the last eight to 12 weeks. And when these numbers are elevated, it indicates that your body is becoming resistant to insulin.

You have insulin resistance. Insulin is the hormone responsible for moving that sugar from your blood inside your cells so that your cells can create energy. I also recommend my clients get their fasting insulin tested. This measures the amount of insulin that your pancreas is producing.

Optimally, it should be five or below. So it's just one other number to look at. And I have seen that sometimes your insulin is really elevated, but your fasting blood glucose isn't very elevated. So getting all those numbers can really be helpful to paint the picture of what's going on in your body.

And without intervention, around 50 percent of people with prediabetes will progress to type 2 diabetes within 5 years. But, the good news is, this condition, like I said, it's reversible with diet and lifestyle changes. I have seen it done many, many times, and taking action early can really help you to avoid more serious complications like cardiovascular disease, nerve damage, kidney issues.

What is insulin resistance?

All of these can arise from uncontrolled blood sugar levels. I mentioned insulin resistance. You have probably heard us talk about that on previous podcasts if you're a long-time listener, but I will do a quick recap of what insulin resistance means. So when in a healthy metabolism, what happens is we eat carbohydrates that turns to glucose in the blood.

All along our cells, we have insulin receptors. And so insulin is produced by your pancreas, grabs onto that glucose in the blood, acts like a key to unlock that insulin receptor, brings the glucose in the cell, and then we turn that glucose into energy. So that is what should happen. In the case of insulin resistance, that insulin is not able to unlock that receptor site as efficiently.

So then you're not getting as much glucose inside the cell to create energy, and then you're getting higher amounts of glucose just circulating in your blood. And oftentimes in that situation, your body is compensating. So you may have more cravings for sugar and carbohydrates as a way for your body to try to get more glucose inside the cells.

And also then your pancreas is going to start producing even more insulin. So it becomes a little bit of a vicious cycle until you make these modifications that we're going to talk about.

Diet & lifestyle modifications to improve insulin resistance

I mentioned that those carbohydrates are going to increase your blood sugar. Protein does a tiny bit. Fat does not at all. So a really good rule of thumb is to never have a carbohydrate alone, combining that protein and fat along with that carbohydrate is going to reduce the blood sugar effect from the carbohydrate. Also choosing fiber rich carbohydrates, like vegetables. That fiber is also going to slow down the absorption and reduce that blood sugar effect too.

So, big picture, you know, cutting back on those processed carbohydrates, like bread, pasta, sugary snacks, trying to replace them with more whole foods. Getting in lots of vegetables, leafy greens, broccoli, cauliflower, just to name a few. Fruit and berries are typically best if you're going to do any fruit because they're higher in fiber, lower in sugar.

Healthy fats like avocados, olive oil, nuts, those are also very crucial because that beneficial fat is going to help to stabilize your blood sugar, keep you fuller longer, and that's going to help to reduce the urge to snack on other sugary foods. Think of them as the anchor of your blood sugar. And I always recommend when people are making modifications to start with breakfast because whatever you eat that first meal of the day is going to impact the rest of the day.

If you start your day with a lot of carbohydrates, you know, an English muffin, a bagel, cereal, you're going to get that big blood sugar spike 2, 3 hours later. You're going to dip. You're going to have the urge to eat more carbohydrates and sugar, which sends you on another spike. And then you're just on this blood sugar roller coaster throughout the day.

Whereas, if you have a more balanced breakfast that is lower in those carbohydrates like eggs, some veggies, put some butter on it, that naturally is going to change your food choices throughout the day, and also affect the way you feel. So, starting with breakfast is a great place to focus your efforts when starting out.

Taking it a step further, once you have replaced some of those processed foods with real foods, the sequencing of your meals can also affect your blood sugar. Starting your meals with vegetables, then the protein and the fat and the fruit or the starches last can also reduce blood sugar a lot. You can learn more about this by listening to our podcast called “Why Does Eating Protein or Vegetables First Give You Better Weight Loss?”

​-----

Exercise is another big factor. You don't need to spend hours in the gym every day. Even a 10 minute walk, especially after meals is going to help to reduce your blood sugar because it's pushing that glucose inside the cells to be able to utilize it. And don't forget about sleep and stress management.

Both can impact your blood sugar and overall health. You know, I had a client that was checking her blood sugar every morning, and if she got a poor night's sleep, her fasting blood sugar that next morning was 10 points higher, and she saw that pattern consistently. So everything really, this whole big picture of lifestyle really does make a big difference on your blood sugar.

Possible supplement support for assisting in blood sugar management

And lastly, if you're working with a dietitian or nutritionist, we might discuss supplements to help to regulate blood sugar as well. Magnesium, omega-3s are a couple basics, but remember that supplements are just one part of the equation.

Glucose monitors can be a helpful tool

Lifestyle changes that include real food diet, regular movement, that's really going to be the best approach for reversing prediabetes. Supplements alone are just not going to do the trick. I also want to mention, you know, continuous glucose monitors have become more and more popular or, you know, just doing it the old school way using a glucometer. Those are helpful tools. If you're already doing them, we do help clients analyze that data to really see what's your body telling you.

It can be very overwhelming so just think about maybe one thing that you could modify to start with, and then, you know, keep building on that as you feel comfortable.

Will weight loss improve glucose levels?

Next question, will weight loss improve glucose levels? The answer is yes, there is a strong connection between weight and blood sugar levels. However, generally speaking, it's often the behavior changes that reduce the blood sugar and reduce the insulin that leads to the weight loss.

Insulin is our primary fat storage hormone. So reducing insulin is going to help you to lose weight. I talked about insulin resistance earlier. So when your cells are insulin resistant, your body is going to start to store that excess sugar as fat. And over time, those high insulin levels can create weight gain, especially in the midsection area.

The good news is, again, when we practice these healthy habits, move to a real food diet, eating in balance, that protein, carbohydrate, and fat combination, maybe adding some additional movement, stress management, all of that is going to lead to better blood sugar levels.

And also those behaviors are going to positively impact overall metabolic health and just overall health in your body. So as you lose weight and burn more fat, your body becomes more efficient at using glucose for energy. And, you know, 1 sign is as you start to lose weight in your midsection, that can be a great sign that the insulin resistance is reducing. And you can think of insulin resistance as really a spectrum. And so you can be at different parts of that spectrum. And sometimes getting that data, getting those labs retested that we talked about earlier can be nice to see the movement in your body.

How much weight would need to be lost to impact glucose levels?

The last question today is how much weight would you need to lose to positively impact glucose levels? Well, I think, again, going back to what I talked about, improving glucose is really going to oftentimes naturally lead to weight loss, but this is where some small changes can make a big difference is what research shows.

Studies have shown that weight loss of 5 to 10 percent of your body weight is correlated to significantly improved glucose metabolism. For example, if you weigh 200 pounds, that's just 10 to 20 pounds. This amount of weight loss can lower your blood sugar levels, reduce insulin resistance, and then increase that insulin sensitivity, which means that your cells are just more responsive to insulin.

So, the goal here is to reduce the amount of glucose circulating in your bloodstream, which is not only going to help prevent further damage to your cells, but also improve your energy overall and reduce overall inflammation. To recap today, if you've been told that your blood sugar is elevated or diagnosed with prediabetes, or maybe you yourself are just concerned, don't panic.

With small changes, you can positively impact these numbers, focusing on reducing those processed carbohydrates, the combined meals, protein, carb and fat together to reduce blood sugar, increasing movement, getting better sleep; all of those things are going to help to lower your blood sugar and help you to reverse that prediabetes.

I hope today's discussion has cleared up some of these important questions about blood sugar, and again, remember small changes over time can lead to really big results when it comes to your health. I want to thank you so much for listening to Dishing Up Nutrition's “Ask a Nutritionist”.

And if you found this episode helpful, be sure to leave us a rating or review on your favorite podcast app, so we can help even more people discover the connection between what they eat and how they feel. And if you yourself have a nutrition question that you would like us to answer, I invite you to join our private Dishing Up Nutrition Facebook community. Just search Dishing Up Nutrition on Facebook. Once you've joined, feel free to ask whatever questions are on your mind. Thanks again so much for listening and have a wonderful day.

Join Our Dishing Up Nutrition Facebook Group