Endocrinologists Share 5 Habits to Break for Healthier Blood Sugar

From eatingwell.com

Plus, some everyday habits endocrinologists recommend instead 

KEY POINTS

• Frequent dips and spikes in blood sugar can increase risk of prediabetes and type 2 diabetes.
• Endocrinologists shared five habits they wish you'd stop doing for healthier blood sugar levels.
• Focus on eating more fibre, managing stress and exercising regularly to support blood sugar.

After enjoying something sweet, you may notice a quick burst of energy followed by an afternoon slump. That’s because—similar to a roller coaster—blood sugar levels naturally rise and fall throughout the day. While these fluctuations are normal, frequent highs and lows over time aren’t ideal for long-term health, as they can increase the risk of conditions like prediabetes and type 2 diabetes.

As endocrinologist Jennifer Cheng, D.O., explains, “There are millions of undiagnosed, diabetic and prediabetic people in the U.S. There are significant complications when people develop diabetes that can be potentially preventable.”

So, how can we keep blood sugar levels in a healthy range? We asked endocrinologists which habits to stop for healthier blood sugar, and they shared five. 

                                                                                               Credit: Getty Images. EatingWell Design

1. Drinking Sugary Drinks

From soda to sports drinks to sweetened coffee, tea, cocktails and mocktails, there are many ways to gulp down sugar—often without realizing just how much is in your go-to beverage. Yet sugar-sweetened beverages are the leading source of added sugar in Americans’ diets.

The issue with these drinks is that, unlike solid foods, they don’t contain fibre, protein or fat, so the sugar is absorbed quickly. “This can lead to sharp rises in blood sugar and insulin levels,” says Sowjanya Naha, M.D. “Research shows that regular intake of sugar-sweetened beverages, and even fruit juice in large amounts, is linked with a higher risk of developing type 2 diabetes.”

Beyond that, these beverages don’t offer much nutritional value. So what’s a better option? Dietitians recommend water, seltzers or sparkling water, or unsweetened flavoured beverages like herbal tea or infused water. 

2. Staying Sedentary All Day

Whether we’re at our desks trying to crank out work before a deadline, in meetings, in the car or on the couch, one habit worth breaking for better blood sugar control is sitting for long periods of time. 

“Sitting for long periods reduces the body’s sensitivity to insulin, making it harder to control blood sugar. Even small increases in daily movement—such as walking more often—can improve how the body regulates glucose,” says Naha.

Physical activity helps the body increase glucose uptake by the muscles, effectively lowering circulating blood sugar even without additional insulin, explains Cheng. A simple strategy: Set an alarm to get up each hour, and make it a habit to move after meals. Research suggests that even a short walk after eating can help lower blood sugar.

“Walking, even for 15 minutes after eating, can help sensitize your body’s response to insulin,” explains Anastasios Manessis, M.D. If you’re glued to your desk or couch throughout the day, try quick bursts of movement like body-weight squats, lunges or jumping jacks for 30-second intervals.

3. Relying on Refined Carbohydrates

A common knee-jerk reaction to improving blood sugar is to cut carbs entirely—but endocrinologists say not so fast. The type and amount of carbohydrates matter most. 

Carbs worth limiting are those low in fibre, such as sugary cereals, baked goods and snack foods like pretzels and chips. Experts say regularly relying on these foods can lead to more significant blood sugar swings. “Research using continuous glucose monitors suggests that diets higher in these types of carbohydrates tend to cause larger swings in blood sugar throughout the day. These ups and downs may place more strain on metabolic health over time,” shares Naha.

So what should you choose instead? “Whole carbs like fruits, vegetables and whole grains are not only good for your blood sugar, but your overall health,” says Manessis. “These nutrients are high in vitamins, minerals and fiber, which can help support heart health, brain health, weight management and so much more.”

And don’t be too quick to cut fruit. “Whole fruit is bound in fibre and nutrients which can support a healthy blood sugar response,” Manessis adds. In fact, research has found that people who consume moderate amounts of whole fruit tend to have better insulin function and a lower risk of diabetes, showing an inverse relationship between fruit intake and diabetes risk.

For a steadier blood sugar response, pair fruit with a source of protein or healthy fat, such as a handful of nuts or seeds, or Greek yogurt or cottage cheese. 

4. Getting Poor Sleep

Another habit worth breaking: not getting enough quality sleep. 

“Poor or inconsistent sleep can raise blood sugar levels and make it harder to maintain control. Research shows that sleep restriction and circadian disruption can impair glucose metabolism and increase insulin resistance,” says Naha.

Lack of sleep may also affect stress hormones because when you’re not getting enough sleep, cortisol levels can rise, explains Cheng. “This causes more insulin resistance and higher sugars in the blood. Chronic high stress or cortisol levels may increase risk of diabetes and high blood pressure, leading to more disease.”

On top of that, poor sleep may leave us reaching for more carb-rich foods throughout the day to keep energy levels up, points out Manessis. Research suggests that even two nights of poor sleep may increase hunger hormones and lower appetite-suppressing hormones.

So how can you improve your sleep? Aim to maintain a consistent sleep and wake schedule, target seven to nine hours of sleep each night and limit caffeine and screen time before bed to support healthier glucose regulation, says Naha.

5. Skipping Meals or Eating at Irregular Times

Keeping consistent meal times and avoiding regularly skipping meals may help support healthy blood sugar levels.  

“Eating at irregular times or late at night can interfere with the body’s natural rhythms for processing glucose. Studies show that when eating is out of sync with these rhythms, the body handles sugar less effectively, leading to higher and more variable blood sugar levels,” says Naha.

Skipping meals may have a similar effect—including skipping breakfast. “Our bodies love consistency and regularity, so starting the day off with a strong, protein-rich breakfast can be helpful to stabilize our blood sugars and set the tone for the day,” explains Manessis. 

Try eating around the same times each day when possible. And if you find yourself consistently skipping meals like breakfast, consider prepping something the night before—such as overnight oats or breakfast burritos—so you always have an easy option ready to go. 

Other Tips for Healthy Blood Sugar Levels

When it comes to maintaining healthy blood sugar levels, endocrinologists shared these additional tips:

• Pair protein and fat with carbohydrates. Pairing carbs with a source of protein or healthy fat may help support healthier blood sugar levels. Try adding nut butter to a waffle, or pair fruit with cottage cheese.
• Eat more fibre. Dietary fibre is essential for slowing the absorption of glucose, which significantly stabilizes sugar levels, says Cheng. Aim to include fiber-rich foods at meals and snacks, such as veggies, fruits, beans, nuts, lentils, seeds and whole grains.
• Manage stress. “Ongoing stress has been associated with greater variability in glucose levels and increased metabolic risk,” says Naha. Incorporating stress-relief practices—whether a few minutes of mindfulness, deep breathing or yoga—may help support overall blood sugar regulation.
• Stay hydrated. “Proper fluid intake assists your kidneys in filtering excess glucose from the bloodstream via urination,” says Cheng. Keep a water bottle nearby or set reminders throughout the day to help make hydration a habit.
• Exercise regularly. Physical activity can improve insulin sensitivity and support healthy blood sugar levels even after exercise. Find movement you enjoy—whether it’s walking, jogging, swimming, cycling, hiking or taking a fitness class—to make consistency easier.

Our Expert Take

For healthier blood sugar levels, endocrinologists recommend moving away from habits like drinking sugary drinks, staying sedentary all day, eating only refined carbs, getting poor sleep and skipping meals. Instead, focus on supportive habits such as pairing protein and fat with carbohydrates, eating more fibre-rich foods, managing stress, staying hydrated and exercising regularly. “Blood sugar control is shaped by patterns over time rather than single decisions. Even small daily habits can have a meaningful impact when practiced consistently,” says Naha.

https://www.eatingwell.com/stop-doing-these-things-for-healthier-blood-sugar-12006080

Stress hormone is a crucial component of diabetes management, shows study

From news-medical.net

A new study by researchers at The Ohio State University Wexner Medical Centre and The Ohio State University College of Medicine documents a clear link between the stress hormone cortisol and higher blood sugar levels in people with type 2 diabetes.

The study published online in the journal Psychoneuroendocrinology.

"In healthy people, cortisol fluctuates naturally throughout the day, spiking in the morning and falling at night," said Dr. Joshua J. Joseph, an endocrinologist, and researcher at The Ohio State Wexner Medical Centre's Diabetes and Metabolism Research Centre who led the study.
"But in participants with type 2 diabetes, cortisol profiles that were flatter throughout the day had higher glucose levels."

Previous research has shown that stress and depression are two of the major causes of a flatter cortisol profile. These sustained levels of cortisol make it much more difficult to control blood sugar and manage the disease, which is why it is so important for those with type 2 diabetes to find ways to reduce stress.

"We have begun a new trial to examine if mindfulness practices can lower blood sugar in those with type 2 diabetes," said Joseph, an assistant professor in the College of Medicine. "But this isn't the only effective form of stress relief. It's important to find something you enjoy and make it a part of your everyday routine."

The relationship of cortisol with glucose levels was only observed in those with diabetes. However, Dr. Joseph and his team believe the stress hormone likely plays an important role in diabetes prevention and they continue to research the connection between cortisol and the development of diabetes and cardiovascular disease.

More than 30 million Americans have Type 2 diabetes, according to the Centres for Disease Control and Prevention. With Type 2 diabetes, your body doesn't use insulin properly. Some people can manage their blood sugar levels with healthy eating and exercise, while others may need medication or insulin to help manage it.

"Whether it's a yoga class, taking a walk, or reading a book, finding ways to lower your stress levels is important to everyone's overall health, especially for those with type 2 diabetes."

https://www.news-medical.net/news/20200713/Stress-hormone-is-a-crucial-component-of-diabetes-management-shows-study.aspx

Diabetes & Stress: How Stress Affects Your Blood Sugar

From diabetesstrong.com

Everyone experiences stress at some point in their lives. And stress can have a drastic effect on your blood sugar — both immediately and in the long run.
Even the fun stress of a roller coaster ride triggers an increased production of hormones like cortisol, adrenaline, and glucagon. Without these hormones, your body couldn’t complete the task of grocery shopping, let alone endure a heated argument with your mother. 

In this article, we’ll look at the role of cortisol, adrenaline, and glucagon, and how each of these stress-related hormones can affect your blood sugar.
At the end of the post, we will summarize how all of this comes together to impact the day-to-day lives of people living with diabetes, and what you can do to reduce stress in your daily life.

What is stress?

Quite simply, stress is your body’s response to any situation, event, or change in your life that requires a reaction or adjustment. Stress can develop physically, mentally, and emotionally.
And it’s an unavoidable part of life. Both positive and negative experiences can create a stress reaction in your body and mind.
In some cases, you might experience an event that causes stress with no end in sight. An abusive relationship or an unbearable environment at your work are examples of an ongoing source of stress that a person may struggle to break free from. These types of stress can lead to a state of “distress,” which is putting it lightly if you’ve ever experienced it.
Let’s take a closer look at what stress looks like before we add diabetes to the mix.

The symptoms of stress

Stress can manifest differently in one person from the next. For some, positive or negative stress may produce immediate tears, for example. In others, it may cause them to be silent and speechless. And others may become easily angry and irritable.
Depending on the severity of the stress level, your symptoms can vary. Here are some examples of stress symptoms:

Mild to moderate stress

• crying
• anger
• irritability
• excitement
• high blood pressure
• headache
• lack of appetite
• binge-eating
• acid reflux
• difficulty sleeping
• loose bowels
• muscle tension in your neck
• sweaty palms
• tiredness
• shaking
• trembling
• changes in weight
• lack of sex drive

Severe stress

• chronic headaches
• nausea
• diarrhoea
• severe high blood pressure
• chest pain
• sexual dysfunction
• insomnia
• depression
• panic attacks
• anxiety

Research suggests that stress also can bring on or worsen certain symptoms or diseases. Stress is linked to 6 of the leading causes of death: heart disease, cancer, lung ailments, accidents, cirrhosis of the liver, and suicide.
Before we move on to how stress can affect your blood sugar and what you can do to reduce stress, let’s take a closer look at the hormones involved in a stress reaction.

What is cortisol?

This hormone is often discussed in a negative light because too much of it can be a sign that your body is under severe mental or physical stress, and is associated with inflammation and weight gain. 
While its primary role is to help your body manage stress, it also affects nearly every organ in your body and is something your body needs 24 hours a day to stay alive, just like insulin.
Without cortisol, you wouldn’t be able to climb a flight of stairs let alone endure the intense stress from losing a loved one, going through a divorce, or having surgery. 
Cortisol also helps your body:

• Manage your blood pressure 
• Manage the function of your heart 
• Reduce your immune system’s inflammatory
• Reduce overall inflammation
• Breakdown sugar (with the help of insulin) to be used for energy
• Manage how your body metabolizes protein, carbohydrates, and fat

Just like your insulin needs change based on what you’re doing and eating, your body’s cortisol production must precisely match your needs during any given moment, too.

How does cortisol affect your blood sugar?

Not only can cortisol contribute to unwanted high blood sugars, but it’s also essential for treating low blood sugars, too. Let’s take a look.

When cortisol levels are high

When cortisol production increases beyond a healthy baseline, it blunts your body’s sensitivity to insulin. This means you need more insulin during those hours in order to keep your blood sugar in your goal range.
While your body does produce cortisol 24 hours a day, there are certain times of day anyone can expect to be producing more, like first the thing in the morning. And that explains why many of us notice we need more insulin in the earliest hours of the day, and with breakfast.
As soon as you wake up in the morning, your body produces a surge of cortisol, explains the Society for Endocrinology. This surge is critical for simply starting your day and functioning fully now that you are awake!
And if your overall baseline cortisol needs increase due to constant, ongoing stress, you’ll notice that your baseline insulin needs increase, too.

When cortisol levels are low

On the flip side, without enough or any cortisol you would struggle with constant hypoglycaemia (low blood sugar). 
When a person with diabetes experiences a low blood sugar, cortisol is actually critical to enabling your body to make use of the glucose you consume to bring your blood sugar back up to a safe level.
A severe low blood sugar can nearly deplete your body’s cortisol reserves, which contributes to symptoms of exhaustion even after your blood sugar has returned to a safe level.
If you think cortisol is wreaking havoc on your blood sugar levels, talk to your healthcare team about adjusting your insulin doses to help compensate. And of course, take a look at what areas of your life you could adjust to reduce your emotional and physical stress.

What is adrenaline?

Adrenaline — also known as “epinephrine” — is commonly associated with athletic events, but your body produces adrenaline in response to other events, too. 
An intense argument, a near-miss car accident or a roller coaster ride can all lead to increased adrenaline production.
Adrenaline is your body’s hormonal “flight or fight” response to intense good or bad stress.
This hormone essentially signals to your liver to release glycogen — the stored glucose in your liver. When your body suddenly encounters intense stress, you need extra glucose for energy to endure that stressful event. Without that extra glucose, your blood sugar would drop and you’d simply be lacking the energy necessary to perform during that stressful event.

How does adrenaline affect your blood sugar?

In a non-diabetic body, that surge of adrenaline triggering a surge of glycogen would be accompanied by a surge of insulin, too.
As people with diabetes, we’re missing the “surge of insulin” part, which can easily spike your blood sugar from 120 mg/dL to 300 mg/dL in less than an hour.
Adjusting your insulin for this can be tricky. A quick bolus of insulin using your normal “correction factor ratio” could easily produce little or no effect on the high blood sugar while adrenaline is present.  
Personally, I’ve found that I needed a significant increase in my background insulin doses on the day of a powerlifting competition in order to keep my blood sugar from spiking due to adrenaline. A quick bolus would have no impact and the only thing that would otherwise bring my blood sugar down was when the competition ended and my body relaxed. 
If you’re dealing with predictable adrenaline around a sporting event, for example, talk to your healthcare team about making an adjustment in your background insulin.
If you’re dealing with sudden, unexpected surges of adrenaline because you just got into a car accident, for example, you’ll likely have to try lowering it with a bolus of insulin but may not see it come down for a few hours.

When it’s actually not adrenaline…

One thing adrenaline is often incorrectly associated with is during your workout at the gym. There are other reasons your blood sugar can spike during a typical workout — but unless you’re truly in a competitive environment (rather than just an intense solo workout), it’s unlikely to be adrenaline. 
More likely, you’re breaking down muscle which involves breaking down stored glycogen. Your body then breaks that glycogen down into glucose and cycles it back to your muscles for energy. Without extra insulin on-board, this can easily lead to high blood sugars.

What is glucagon?

Glucagon is another hormone that helps your body endure certain types of stress — including skipping breakfast! 
Glucagon’s role is simple: it tells your liver to release glycogen (mentioned above) which is then converted into glucose and can be used for energy or to purposefully raise your blood sugar.

How does glucagon affect your blood sugar?

Glucagon is actually less associated with emotional stress but does play a role during physical stress when you’ve gone too long without a meal or when you experience a severe low blood sugar.
“The release of glucagon is stimulated by low blood glucose, protein-rich meals, and adrenaline (another important hormone for combating low glucose). The release of glucagon is prevented by raised blood glucose and carbohydrate in meals, detected by cells in the pancreas,” explains Your Hormones.

During a severe low blood sugar…

When you experience a severe low blood sugar, likely below 40 mg/dL, you may seem your blood sugar skyrocket within the hours after, even if you only treated that low with a careful amount of carbohydrates. 
This is your body’s way of saving your life! That surge of glucagon triggers a surge of glycogen which is broken down into glucose and raises your blood sugar. In those of us with diabetes, it simply raises it too high!

When you eat a strict low-carb diet…

During a ketogenic diet, your body is actually going to produce more glucagon throughout the day in order to get more glucose because your body cannot function on ketones alone. 
Your brain requires a second-by-second delivery of glucose in order to function! 
Does this mean you can’t follow a ketogenic diet? No. But it does mean you may notice your background insulin needs actually increase when you cut your carbs that low. This doesn’t happen to everybody but it’s important to keep in mind if you try a ketogenic diet just to see your insulin need skyrocket. 

When you skip breakfast…

Intermittent fasting is all the rage right now, but there are a few things you need to know if you’re experimenting with this trendy nutrition approach as a person with diabetes.
When you skip breakfast, your body is going to produce more glucagon during those fasting hours because — again — your brain needs glucose in order to function! 
This doesn’t mean you can’t practice intermittent fasting, but it does mean you’ll need to take extra boluses of insulin during those fasting hours to compensate for that additional glucose.

Summary: How stress affects your blood sugar

In short, stress will generally cause your blood sugar to rise. It will also be difficult to bring it down because of the insulin resistance created by stress hormones and the production of glucose from your liver’s response to adrenaline.
The larger majority of stressful situations aren’t something we can easily predict, but once you’re experiencing stress, you can predict that your blood sugar might spike.
Remembering to check your blood sugar during and after stressful situations is an important part of diabetes management, but don’t add to your stress by expecting to be able to easily correct any high blood sugars during a stressful state.

How to deal with stress as a person with diabetes

In general, there’s only so much you can do to prevent the blood sugar spikes from different types of stress hormones because we can’t always predict stress. 
However, if you’re dealing with predictable stress or ongoing stress, definitely talk to your healthcare team about an adjustment in your insulin doses that can help tamper those stubborn high blood sugars.

For those unexpected bursts of stress and rapid spikes in your blood sugar:
You should use your established “correction factor” to determine an appropriate dose of insulin to bring the blood sugar down.
But keep in mind: it’s very likely your blood sugar will sit at that higher level (especially in those with type 1 diabetes) until your body has recovered from the stressful state. When those stress hormones are pumping and adrenaline is causing your liver to produce more glucose, it can be very difficult to “get ahead of it.”

For ongoing stress during a period of your life: 
If you know the next few months are going to be stressful because of a promotion at work, a divorce, the death of a loved one — for example — then a simple increase by a few units in your background insulin dose can have a big impact on staying in your goal blood sugar range.
Don’t underestimate how much ongoing stress can affect your daily insulin needs. Even on the “normal” days during a stressful period of your life, your body is still coping with that ongoing stressor.

How to reduce your stress levels

Learning what helps you manage, reduce, and relieve your overall stress level is a vital lesson. Sometimes the simplest thing can help you take a deep breath, lower your blood pressure, lower stress hormones, and release the physical and mental grip of stress.
Here are a few ideas for reducing your stress levels:

Reducing stress in the moment

• Close your eyes and take deep inhales and exhales for 30 seconds
• Go for a walk
• Exercise to get your heart rate UP which causes your central nervous system to relax
• Go for a drive
• Watch your favourite stand-up comedy
• Make a to-do list to get everything off your mind
• Clean your house
• Call a friend
• Create a “voice memo” like your own private therapy session
• Dance to your favourite music

Everything that makes you calm down, makes you smile, or helps your body relax will have a positive effect on your stress level.

Reducing ongoing stress

Reducing ongoing stress usually requires a significant change in your situation or lifestyle. The causes of ongoing stress are different from person to person, but here are a few ideas for how you can help reduce ongoing stress:

• Identify your biggest stressor and ask yourself: what can I change about this?
• Make time to see a therapist weekly/biweekly
• Make time for regular exercise — a daily walk can do wonders!
• Use a meditation app to at least stop and breathe deeply for 2 minutes every day
• Get your house/office clean-up and organized (with help) so your “space” is clear
• Create weekly to-do lists to manage responsibilities and acknowledge productivity
• Look for a new job, sending out two applications per week
• Leave an unhealthy relationship (get help from friends if needed!)

Managing ongoing stress is difficult because in many cases you cannot just walk away from it. Take a deep breath and step back to see the bigger picture around this stressor. There are always going to be things we can control and change, and things we cannot.

https://diabetesstrong.com/diabetes-stress/