You might have been hearing the term hyperglycemia more often these days, and that’s likely because of the (very serious) conversation around diabetes – a disease that affects more than one in five people in the United Arab Emirates. Indeed, high blood sugar and diabetes are very closely linked, which makes understanding this condition, and how to eat for it, all the more important.
Goodness tapped functional medicine practitioner Dr. Lanalle Dunn to get the lowdown on what exactly causes hyperglycemia.
What does it mean to have high blood sugar?
High blood sugar is known as hyperglycemia. Ideally, your levels should be around 80 to 100 when fasting. Anything over 110 is a bit high for me, and definitely occult in mainstream view is about 200. High blood sugar means that you have too much sugar circulating around in your blood system, and your body can have symptoms as a result of that. It’s associated with Type 2 Diabetes, which is a huge epidemic nowadays and is very prevalent in this country.
What are the main causes of high blood sugar?
A poor diet.
We live in an epidemic of inflammation.
Which also happens to be one of the main causes of Type 2 Diabetes.
Yes. Out of the three types of diabetes, Type 2 is the one that is most linked with diet but also inflammation, which people don’t usually talk about. We live in an epidemic of inflammation now because, over the last 50 years, the quality of food has diminished so much. Fifty years ago, organic food did not need to be labeled “organic”. Cows weren’t pumped full of hormones like they are now, so the quality of the casein and the milk was completely different. After 1988, 99 percent of commercial-grade wheat became treated with glyphosate [an herbicide], which was linked just a few years ago to disruptions in the intestinal barrier, increased permeability issues, and damages to your small intestine. It has given rise to more food sensitivity, more inflammation, and more digestive symptoms – and, eventually, to irreversible celiac disease. When I was a child, no one was allergic to anything. There was maybe one child in a school of 300 that might have a peanut allergy, but it was uncommon.
Nowadays, I would say that easily half of the population – if not 75 percent – has food sensitivities. Eating something that you are sensitive to can lead to the production of antibodies. Not only will those foods cause the creation of mucus in your body and slow down your functionality, but you are also creating an antigen-antibody complex, which will cause inflammation, will lead your body and hormone regulation to slow down, and is a precursor to autoimmunity problems and diabetes.
In addition to the quality of the ingredients changing, people eat a lot more inflammatory foods. Sugar is an inflammatory food, for instance, as are processed foods. The gut-brain axis also plays a role here; increased stress and over-stimulation of the neuroreceptors increases inflammation.
Can stress affect your blood sugar levels?
Yes, it can. Stress increases epinephrine, which increases insulin sensitivity. It’s like caffeine, which also increases epinephrine – a hormone also known as adrenaline – so that impacts insulin receptivity. If you are super stressed all the time, your receptors for insulin just kind of want to look away. They become desensitized eventually and don’t do their job.
After eating, it’s normal for blood sugar to spike. How is that different to “having high blood sugar” and it being a problem?
Postprandial blood sugar is the blood sugar you have in your system after having eaten something. It generally rises ten to 15 minutes after having eaten, and should come back down to normal about one or two hours later if the insulin has done its job properly. People who have hyperglycemia or diabetes will have high levels of sugar in their blood even two hours after having eaten, but also when they are fasting.
While fruits, French fries, and a Snickers bar are treated the same way by the body, how they impact your health will vary greatly.
What is the link between sugar in your food and sugar in your blood?
When you eat something, it increases glucose in your blood, so your pancreas releases insulin to take that sugar out of your blood and store it in your tissues. That’s the job of the pancreas. The liver, on the other hand, plays another role in blood sugar regulation and that comes in when you are fasting. If you haven’t eaten anything, there is no circulating blood sugar. At that point, the liver uses IGF-1 – a hormone called Insulin-Like Growth Factor 1 that is a hundred times more potent than insulin – and its job is to take the glycogen stored in the liver. When your circulating blood glucose is too low, the liver can then convert glycogen back into glucose and release it into your blood circulation. Muscles also store glycogen and can convert back into glucose when needed.
If you are eating refined sugars all the time, your blood sugar is just going to be going higher and higher. What happens is something a lot like that “Nicky Nicky Nine Doors” game – it’s a game kids used to play where you keep calling the same person and hanging up or you keep knocking on their door and running away before they have time to open it. Eventually, the person being pranked stops answering the phone or opening the door. Same thing with your insulin receptors. Your blood sugar keeps jacking up, the pancreas has to produce more and more insulin to deal with that because your body is also developing a resistance to those increasing amounts of insulin, and, finally, your insulin receptors start to turn a blind eye and no longer working to pull the sugar back out of the blood vessels anymore. You end up with elevated insulin not doing anything and your blood sugar being elevated.
Do refined sugars and carbohydrates impact the body in the same way?
All sugars (so carbohydrates that range from French fries and Snickers bars to fresh fruits) are turned into glucose by the body for energy. So, while they are treated the same way by the body, how they impact your health will vary greatly. Refined carbohydrates are some of the worst sugar increasers; they have no nutritional value and there are no B vitamins or fiber left in them. Similarly, pure refined sugar is really easily and rapidly converted to glucose in your blood stream, but it doesn’t offer any of the nutrients and nutritional fiber that fruits do.
There are a lot people who avoid fruits because they are high in sugar. What are your thoughts on that?
It really depends on the person. If you already have diabetes and are therefore looking more carefully at the glycemic index of foods and overall glycemic load, you might be more concerned with overall fruit intake and should focus on the lowest-sugar fruits, like berries and cherries. Otherwise, it’s not that big of a concern. In general, opt for fruits that are high in fiber, which will allow your body to process the sugar without a spike.
What role does fiber play in controlling blood sugar?
Fiber doesn’t alter your blood sugar, like carbohydrates or blatant sugars do. Fiber binds to toxins and so it keeps your blood sugar a little bit more level.
Who needs to worry about eating right for their blood sugar?
Everybody needs to worry about it. I would say that, by the time you are in your thirties, you should start thinking about inflammation. Your body works biographically, so, if you partied like a rock star until 30, then your body isn’t going to be as supportive as if you were eating nutrient-dense or vegetarian your whole life, for instance. By the time you are in your thirties, everyone generally suffers from inflammation and high toxicity, and then blood sugar becomes much more of an issue. I think that’s why you’re seeing a lot of people jump on the ketogenic bandwagon. Same goes for intermittent fasting (IF).
IF – especially the 16:8 model, where you fast for 16 hours and eat during an eight-hour window – is an effective way to manage blood sugar, but how crucial is it for people with diabetes to be closely monitored by a doctor if they decide to try this?
It depends on where they are with their blood sugar level. If they are diabetes-diagnosed and they are on some medication, they definitely should be supervised. If they have had their HbA1c [average blood sugar levels over two or three months] be borderline, then it would be more advisable to see someone like me – especially because people get lost with intermittent fasting. Together, we would work on reducing their blood sugar using a functional approach where, for four months, we have them on a very solid eating plan where there is no cheating allowed. The body will start to realign and deal with its own insulin sensitivity. That can be done through diet, and you can also do it with the help of supplements. Even if someone has struggled with diabetes for years, it is doable. It takes a lot longer for every year they’ve been sick, but it can be done. For me, the idea of taking insulin and sugar to manage your blood sugar is just outrageous.
If you were looking at, in a very general way, the foods to avoid and the foods to steer yourself towards – would these be the same for someone who has high blood sugar and someone who is just slightly borderline because of lifestyle choices?
Yes, you can literally take a diabetic and somebody who is simply concerned about his family history or with HbA1c that is a little bit borderline and put them both on the exact same diet and have very successful results. That being said, it will take much longer with one than the other.
If you look at a traditional meal in this part of the world, half of the plate is rice or Arabic bread, and most of the rest is animal protein. There is very little nutrient-dense food. If people just looked at their plate and replaced the half of it that is bread and rice with fiber-rich, nutrient-rich vegetables, right away their blood sugar would start to change. If you are being a little bit more aggressive and doing the 16:8 IF and making sure that you are having adequate amounts of protein, that would really keep your blood sugar flat.
Here at the clinic, I work with the ketogenic and IF diet and get people to go into ketosis for short periods of time. If I can get somebody to do that for six weeks, their blood sugar will just go right down. I recently had a patient whose triglycerides were 1,700 – that number is supposed to be under 150 – and his cholesterol was through the roof, his blood sugar was high, and his insulin receptivity was getting high, so he was insulin resistant. He was a walking heart attack. I put him on small amounts of easily digestible proteins, so good-quality chicken and fish, huge amounts of vegetables (but no major starches like potatoes), zero carbs, and small amounts of high-fiber, low-GI fruits. He did that for two weeks and, when he came back, his triglycerides were down to 80. In two weeks, he went from 1,700 to 80, just by fixing his diet. We also gave him chromium and he was adding a little bit of cinnamon twice a day to his food or tea. It was really all about his diet because he was full of inflammation. So now, not only is he not going to have a heart attack, but he is also not going to get diabetes, which he was heading towards.
Dr. Lanalle Dunn is the founder of The Chiron Clinic,