Tuesday, August 30, 2016

What Causes Blood Sugar to Rise

The key elemnts that cause blood sugar to rise include:

  • Food
  • Drugs
  • Lifestyle

The following is a more detailed breakdown of these key elements that can cause your blood sugar to rise. This is important to understand because it's not just the food that may cause your blood sugar to rise.

By understanding this, you won't become frustrated when you eat properly and notice that your blood sugar is not coming down. This is why it's so important to maintain a daily journal of your meals, exercise regimen, activities, events, stress level, etc.

Normally, the liver releases glucose to maintain blood sugar levels. But when alcohol is consumed, the liver is busy breaking the alcohol down, and it reduces its output of glucose into the bloodstream.

This can lead to a drop in blood sugar levels if the alcohol was consumed on an empty stomach.

However, alcoholic drinks with carbohydrate-rich mixers (e.g., orange juice) can also raise blood sugar because they have plenty of carbs. But your levels may drop for as long as 12 hours after drinking.

Some people with allergies have been known to have higher glucose levels, primarily due to the stress hormone cortisol and the specific medications.

Artifical Sweeteners
An interesting new Israeli study suggests that artificial sweeteners can raise blood sugar levels! In a follow-up study of 400 people, the research team found that long-term users of artificial sweeteners were more likely to have higher fasting blood sugar levels, reported by HealthDay.

Birth Control Pills
Birth control pills with estrogen can affect the way your body handles insulin and cause your blood sugar levels to rise.

Many studies have suggested that caffeine in coffee increases insulin resistance and stimulates the release of adrenaline.

The same goes for black tea, green tea, and energy drinks. But, since each person with diabetes reacts to foods and drinks differently, it's best to keep track of your own blood glucose readings.

Ref: http://online.liebertpub.com/doi/pdfplus/10.1089/jcr.2010.0007

Of course, everyone is aware that carbohydrates raise your blood sugar. However, you should still eat carbohydrates, especially the high quality carbohydrates such as vegetables and some fruits.

It isn't just the carbs in rice, bread, pasta, etc. that cause your blood sugar to rise. It's the high amount of fat in foods such as sesame beef or sweet and sour chicken, which can make your blood sugar stay up longer. The same is true for pizza, French fries, and other foods that have a lot of carbs and fat. Check your blood sugar about 2 hours after you eat to know how a food affects you.

Dawn Phenomenon
The “Dawn Phenomenon” raises your blood sugar due to the body’s daily production of hormones around 4:00-5:00 AM. During this time, the body makes less insulin and produces more glucagon, which raises blood glucose.

Corticosteroids, such as prednisone, which are used to control asthma, arthritis, MS, and other health conditions, can raise blood sugar levels. In fact, steroids may even trigger diabetes in some people. !

In addition, common drugs such as statins to lower cholesterol levels, and diuretics to lower blood pressure, can raise blood sugar levels. Again, statins have been shown to trigger diabetes in some people!

Some antidepressants can also raise blood sugar.

Decongestants that have pseudoephedrine or phenylephrine can raise blood sugar. Cold medicines also sometimes have a little sugar or alcohol in them, so look for products that don't have those ingredients.

Being dehydrated may raise your blood sugar, especially if you're not eating foods that contain water, e.g. vegetables, while eating foods that dehydrate you, e.g. coffee, soda, fried foods, processed meats, alcohol, soy sauce, popcorn, sugary drinks.

Anger, anxiety, fear, etc. cause our bodies to produce hormones such as cortisol that can raise blood glucose even if we haven’t eaten.  These hormones are known as the “fight or flight” hormones.

Modern day stresses can be anything from starting a new job to fighting an illness to getting ready for that big birthday party. These hormones release our body’s emergency stores of sugar into the bloodstream for use as energy.  Sometimes the influx of sugar is too much for the body to use when someone has diabetes and it can cause blood sugars to rise too high.

High-intensity and moderate exercise such as sprinting or weight lifting, can sometimes raise blood glucose. This stems from the adrenaline response, which tells the body to release stored glucose. But this is not a reason to avoid high intensity exercise – studies show it can improve blood glucose for one to three days post-exercise!

Female Hormones 
When a woman's hormones change, so does her blood sugar. Keep a monthly record of your levels to get a better idea of how your menstrual cycle affects you. Hormone changes during menopause may make blood sugar even harder to control.

Heat makes your blood sugar harder to control. You should test it often and drink plenty of water to avoid dehydration. High temperatures can affect your medications, glucose meter, and test strips, too. Don't leave them in a hot car.

When you're sick, your body produces stress-related hormones that help your body fight the illness, but they can also raise your blood sugar level.

Whether it’s a cold, flu, or even a urinary tract infection, your immune system releases germ-fighting chemicals that can raise your blood sugar. Illness can cause the body to release epinephrine (adrenaline), glucagon, growth hormone, and cortisol. As a result, more glucose is released from the liver (glucagon, adrenaline) and the body can become less sensitive to insulin (growth hormone, cortisol).

Illness also causes the liver to increase glucose production to provide more energy. At the same time, stress hormones are released that make cells more insulin resistant. The net result is that blood sugar can rise dramatically when you’re ill.

Meals: Frequency, Timing
Eating less than 3 meals a day leads to larger meals which leads to higher blood glucose levels. Eating 4 to 6 smaller meals spaced out across the day and at the same time every day will help keep your blood glucose levels more consistent.

Meals: Order In Which Food Is Eaten 
A small new study from researchers at Weill Cornell Medical College suggests that the order in which diabetics eat their food may cause blood glucose to rise.

The researchers found that, when carbohydrates were eaten last, the participants’ blood sugar levels were significantly lower at the 30-, 60-, and 120-minute after-meal checks (29%, 37%, and 17%, respectively), and insulin levels were substantially lower as well, compared to when the carbohydrates were eaten first.

However, the study investigators agreed that they need to do follow-up work and conduct more studies.

Meals: Proportion Sizes
If meals are not balanced and contain too many carbs or too little fat or protein, this will raise your blood sugar.

Too much food in proportion to your diabetes medications — especially insulin — may cause your blood sugar level to climb too high (hyperglycemia).

If possible, it is also important to eat about the same amount of carbohydrates at each meal or snack to keep your blood glucose levels within target range, or to have your medication match your carbohydrate intake.

Menstruation and Menopause
Many women report having higher blood sugar levels a few days prior to their period starting, but some women notice a sharp drop in sugar levels. To figure out how you respond, your best bet is to test your blood glucose often during this time of month.

Changes in hormone levels the week before and during menstruation can result in significant fluctuations in blood sugar levels. And in the few years before and during menopause, hormone changes may result in unpredictable variations in blood sugar levels that complicate diabetes management.

Many studies have found that not getting enough sleep leads to high glucose levels and poor diabetes control, insulin resistance, weight gain, and increased food intake.

A Dutch study of patients with type 1 diabetes found that when they got just four hours of sleep a night, their insulin sensitivity dropped 20 percent compared to when they got a full night’s sleep, according to EverydayHealth.com.

Not getting enough sleep is a form of chronic stress on the body, and any time you have added stress, you're going to have higher blood sugar levels.

A 2006 study in the Archives of Internal Medicine found that those who report poor sleep quality have higher A1Cs. This finding is of concern because of the prevalence of obstructive sleep apnea (OSA) in people with diabetes.

Caution: Blood sugar can dip dangerously low during sleep for some people with diabetes, especially if they take insulin. It's best to check your levels at bedtime and when you wake up.

Sugar-Free Foods
Many sugar-free foods will raise your blood sugar levels, because they can still have plenty of carbs from starches. Check the total carbohydrates on the Nutrition Facts label. You should also pay attention to sugar alcohols such as sorbitol and xylitol. They add sweetness with fewer carbs than sugar (sucrose), but they may still have enough to raise your sugar levels.

Some studies suggest that smoking can increase insulin resistance, and people with diabetes who smoke are more likely than non-smokers to have trouble with insulin dosing and managing their diabetes.

A 2011 study from California State Polytechnic University found that the more nicotine samples of human blood were exposed to, the higher the A1C level (a measure of blood sugar control).

Ref: CDC http://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html
Ref: American Society for Clinical Nutrition http://ajcn.nutrition.org/content/87/4/801.long

In people with diabetes, stress can alter blood glucose levels in two ways:

1. People under stress may not take good care of themselves. They may drink more alcohol or exercise less. They may forget, or not have time, to check their glucose levels or plan good meals.

2. Stress hormones such as cortisol can raise blood glucose levels directly. Stress can cause the body to release epinephrine (adrenaline), glucagon, growth hormone, and cortisol.

As a result, more glucose is released from the liver (glucagon, adrenaline) and the body can become less sensitive to insulin (growth hormone, cortisol).

Job Stress: Being overwhelmed, overworked or unhappy at work takes a toll. When you're under stress, your body releases hormones that can make your blood sugar rise. Learn to relax with deep breathing and exercise. Also, try to change the things that are stressing you out, if that's possible.

Stress Monitoring Tip: It's easy to find out whether mental stress affects your glucose levels. Before checking your glucose levels, write down a number rating your mental stress level on a scale of 1 to 10. Then write down your glucose level next to it. After a week or two, look for a pattern. Drawing a graph may help you see trends better. Do high stress levels often occur with high glucose levels, and low stress levels with low glucose levels? If so, stress may affect your glucose control.

Believe it or not, negative thoughts, a negative talk-track of self-blame, self-hate, anger, etc. trigger the release of cortisol and other hormones that can raise your blood sugar. Use positive affirmations, mantras, etc. and replace bad thoughts with good ones.

Each time you notice a bad thought, purposefully think of something that makes you happy or proud. Or memorize a poem, prayer, or quote and use it to replace a bad thought.

Whatever method you choose to relax, practice it. Just as it takes weeks or months of practice to learn a new sport, it takes practice to learn how to relax.

Why Blood Glucose Levels Change During The Day

Your blood glucose levels vary (up or down) due to a number of factors such as those listed below:

1. Eating food. As the carbs in food break down, glucose is released into the bloodstream ready to be absorbed by cells. Increased glucose in the bloodstream = higher blood sugar level.

2. Exercise. Exercise provides many benefits to your body, including burning excess sugar and reducing insulin resistance (by making cells more receptive to insulin, so rather than requiring more insulin to facilitate glucose uptake, the insulin you already have becomes a bit more effective). However the effect on blood sugar depends on the type of exercise, the duration of exercise, glucose and insulin levels before you start exercising.
During long, intense workouts the body may release adrenaline which counteracts the efforts of insulin. The normal process for blood sugar would be to be absorbed by cells (via insulin) for utilization or storage. Adrenaline causes the glucose to be redirected to where it is required for use immediately rather than for storage. 

3. Your physiology. The fitter you are the better. More specifically, if you have a greater muscle to fat ratio, you will burn energy at a faster rate and therefore be more effective at reducing your blood glucose level. Also, muscles do not rely on insulin to absorb/use blood glucose - same goes for the brain.

4. Emotions. Stress increases your blood glucose level. It also causes some people to forget to take their medication, turn to comfort foods, overeat and therefore introduce a higher than normal amount of glucose in the blood.

5. Sleeping. People often talk about the "dawn phenomenon" with regard to diabetes, where your blood sugar level spikes in the mornings as a result of the body releasing hormones which increase insulin resistance. However, another explanation could be a slow metabolism of dinner from the night before. Some research also suggests that not getting enough sleep causes the liver to produce/release more glucose, hence increasing your blood sugar levels.

6. Medications. Obviously, the medication you take regulates your blood sugar level and therefore your readings during the day, depending on when you took the medication. But, the medications don't get rid of your diabetes!

Note: Read Chapter 11 of Death to Diabetes for more information.

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