According to the World Health Organization (WHO) there are 422 million people with diabetes mellitus (DM) and 318 million with impaired glucose tolerance (dysglycemia). This is an important public health issue that requires therapeutic measures given its relationship to a number of chronic diseases as well as economic burden. We know that being overweight (BMI > 25) and obese (BMI>30) also lead to increased health risk. However, we must look beyond these numbers alone and consider numerous factors that contribute to metabolic imbalances.
Insulin resistance (IR) occurs when excess glucose in the blood reduces the cell’s ability to utilize blood sugar for energy. Blood sugar regulation is vital because when cells lose their ability to respond normally to insulin, the result is an accumulation of glucose in the blood. The body attempts to cope with this situation by producing more insulin. Over time, the pancreas may lose its ability to produce insulin, resulting in conditions with insulin resistance as the underlying cause.
“Metabolic syndrome” describes a group of pathophysiological changes based on insulin resistance that may lead to damage of the heart, blood vessels, kidneys, and nerves. Improving diet is certainly a contributing factor to resistance to insulin. However, other important factors such as toxin exposure, sedentary lifestyle, chronic inflammation, and chronic stress may also contribute to unhealthy blood sugar metabolism.
Impaired glucose control has many stages. In the beginning, a person may experience no symptoms whatsoever. However, as blood sugar builds to higher levels, symptoms may include fatigue, hunger, brain fog, increased weight gain, high blood pressure and high cholesterol.
To help support healthy blood sugar metabolism, the first step would be to include therapeutic dietary guidelines, weight loss, and regular exercise. Oftentimes an unhealthy diet is deficient in the nutrients necessary to support healthy cell membranes, insulin receptors, and a strong insulin signal. In addition, poor diets associated with high glucose levels have been shown to affect gene expression, which plays a role in blood sugar metabolism.
Some basic dietary changes include replacing sugar and grains, inflammatory fatty acids, and conventional grain fed meat with healthy fats such as olives/olive oil, avocado, and grass-fed meats and wild fish. Controlling the glycemic load of a meal is important and can be accomplished by combining protein, fats, and whole food carbohydrates at every meal/snack while avoiding quickly absorbed carbohydrates that raise sugar and insulin levels.
Nutritional supplementation that supports blood sugar metabolism may also be appropriate. A combination of nutrients that support blood sugar metabolism may include a quality multivitamin and mineral in addition to some or all of the following:
Lipoic Acid: Studies have shown that lipoic acid improves insulin sensitivity and repairs damaged glucose tolerance. In addition, “Lipoic acid quenches reactive oxygen species, chelates metal ions, and reduces the oxidized forms of other antioxidants such as vitamin C, vitamin E, and glutathione. It also boosts antioxidant defense system through Nrf-2-mediated antioxidant gene expression and by modulation of peroxisome proliferator activated receptors-regulated genes. ALA inhibits nuclear factor kappa B and activates AMPK in skeletal muscles, which in turn have a plethora of metabolic consequences.”
Chromium: An essential trace mineral needed in small amounts. According to research, chromium supplementation supports blood sugar metabolism by helping maintain its balance. Also, by activating the glucose transport molecule GLUT-4, it supports lipid metabolism.
Berberine: A 2019 study found that berberine “can effectively regulate blood glucose and blood lipid of patients, support the insulin response and the level of inflammatory response in the body.” A meta-analysis found that berberine (in conjunction with appropriate dietary and lifestyle changes) lowered FPG and HbA1C compared to diet and lifestyle changes alone or a placebo.
EGCG: Epigallocatechin-3-gallate (EGCG) is a polyphenol extract from green tea. Researchers found that EGCG protected high glucose-induced reactive oxygen species (ROS) production while enhancing the insulin-signaling pathway.
Taurine: Taurine is critical to blood sugar metabolism and exerts a number of biological actions including antioxidation, ion movement, neurotransmitter modulation, all which help maintain physiological homeostasis.
CoQ10: A 2018 study indicated that CoQ10 demonstrated beneficial effects on glucose metabolism, malondialdehyde (MDA), and advanced glycation end products levels (AGEs).
Achieving and maintaining proper blood sugar metabolism is imperative for health and longevity. Screening for blood sugar imbalances should be conducted and addressed to avoid progression to significant health problems.
The following tests may be ordered to determine blood sugar imbalances:
- Fasting plasma glucose (FPG)
- Oral Glucose Tolerance Test (OGTT)
- Fasting Insulin
- Lactic Acid Dehydrogenase (LDH)
- C-Reactive Protein (CRP)
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