Blood Sugar Control For Health and Wellness

Metabolic health is defined as our body’s ability to efficiently make and use energy. Our blood sugar (glucose)levels are an indicator of our relative metabolic health. Diabetics and pre-diabetics are inefficient at producing energy as they have difficulty moving blood sugar (glucose) from their blood stream into their cells for storage and energy production. As such, this population often has elevated blood sugar levels, which will ultimately leads to downstream health problems. While approximately 40% of the U.S. population is diabetic or pre-diabetic, approximately 80%-88% of the U.S. population has what is clinically considered to be metabolic dysfunction. That is to say, the overwhelming majority of Americans has some degree of difficulty producing energy.

I see metabolic dysfunction in many of my patients in the form of osteoarthritis and chronic pain. In fact, a study from 2020 showed the causal link of insulin resistance, due to elevated blood sugar, to many forms of arthritis including osteoarthritis. It appears that the low-grade, constant inflammation from chronically and acutely elevated blood sugar contributes to the brake down of our tendons and cartilage while also reducing blood flow to our muscle and joints. The authors of the study even suggested characterizing osteoarthritis as a metabolic disease as opposed to attributing it to excessive, “wear and tear,” on our joints.

There are 4 factors that have been shown to contribute to elevated blood sugar levels. They are poor diet, lack of exercise, poor sleep quantity/quality and excessive stress. It is important to consider that the body’s response to all four of these factors is highly idiosyncratic with respect to blood sugar. While I am may be able to consume a piece of pizza and have a mild glucose effect, you could have a dramatic blood sugar spike.

With respect to diet, sweets are not the only factor to consider when regulating your blood sugar. Any food that is easily digestible, think carbohydrates and process food, is going to hit your blood stream quickly. Foods high in protein and fat tend to be digested more slowly, contributing to a slower rise in blood sugar. Volume of food is also a factor. Large portions of any type of food will ultimately spike your blood sugar. Large blood sugar spikes, although temporary, seem to be more damaging to blood vessels than chronically elevated levels.

Exercise is a very important component to regulating your blood blood sugar efficiently. A 2022 meta analysis in the journal SportMedicine showed a post-meal walk of just 2-6 minutes was able to have an immediate positive effect on a person’s blood sugar level. Other studies have shown that intense exercises can have a positive blood sugar effect for multiple days. In fact, the cardio-protective elements of exercise seem to be directly related to its role in regulating blood sugar levels.

Mental stress also appears to have an impact on our blood sugar levels. Our bodies tend to increase our blood sugar in response to elevated stress. Chronically elevated blood sugar levels damage blood vessels leading to hypertension and heart disease.

Sleep quality and quantity are important elements to ensuring good metabolic health. A 2008 study on healthy young men showed that after 5 nights of sleep deprivation (< 4 hours) the study participants had metabolic profiles similar to people with Type 2 diabetes.

A recent health and wellness innovation, the constant glucose monitor (CGM), has been developed for the non-diabetic population to monitor your blood sugar levels. These small, inconspicuous monitors worn on the back of your arm, give you a 24hr picture of how diet, exercise, stress and sleep impact your blood glucose. Traditional blood sugar monitoring gives you a picture of your blood glucose levels at one point and time in a given day. CGM’s can tell your 24hr blood sugar average , the number blood spikes and their duration, as well as your blood sugar stability.

Good metabolic health is essential for joint health and healing. Chronic and acutely elevated blood sugar levels cause low-grade inflammation, and impede blood flow. Thus it can be reasonably assumed that poor metabolic health will contribute to joint degradation and impede recovery from musculoskeletal injury. Wearing a constant glucose monitor for as little as a month or two can give you a better understanding of how your lifestyle can influence your metabolic health and thus prevent osteoarthritis and more efficiently recover from injury.

I am currently using a company called Levels for constant glucose monitoring. The monitor is very small and has even survived my jiu-jitsu classes. The monitor tracks my overall blood glucose levels and spikes relative to my diet and exercise. I have had some interesting insights into my diet and lifestyle from wearing a CGM. Based on my observations, I have very stable blood glucose levels in the morning, even after a “hearty” breakfast. While in the afternoon, my levels can spike if I eat too much volume or if I eat processed foods from restaurants (I am looking at you Starbucks)! I can further correlate my blood sugar levels to my lifestyle by tracking my sleep and stress levels. My glucose levels become relatively sensitive to spikes if I have had poor sleep.

I have also integrated CGMs into my practice for patients seeking preventative measures in regulating their joint health (ie arthritis), as well as patients that want to optimize their recovery and response to my musculoskeletal rehabilitation prescriptions. Moreover, I am advising athletes on how CGMs can give them a deeper insight to how their lifestyle and diet impacts their athletic performance (i.e. when to take a break, when to get more sleep or why they tend to bonk after 5 miles of running). If you are interested in how you can use a CGM to positively impact your metabolic health and/or your recovery to a musculoskeletal injury, please visit my website to book an in-person or Zoom consultation: www.returntopsportphysio.com.