What if I told you that your normal blood sugar levels are killing you? What would you have to say about that? Would you scoff? Laugh? Point to the ADA and say “I’m well within their guidelines and recommendations, you don’t know what you are talking about”.
What if I told you that my personal opinion is that those recommendations simply keep people sick? They are not there for the health of the individual, that’s for sure. Let’s take a deep dive, shall we?
Why Am I Writing This?
You might want to know just what authority I have to discuss this topic. I’m glad you are curious! First and foremost, I have a child with Type 1 Diabetes (well, he is an adult now I suppose), I had Gestational Diabetes 4 times, I have adult onset Type 1 Diabetes and I have a Master’s Degree in Alternative Medicine. My focus for the Master’s degree was holistic nutrition and my topic of choice was all things related to diabetes. In fact, I wrote my Master’s Thesis paper on the use of a Low Carb Diet as an effective adjunct therapy for Type 1 Diabetes.
If that isn’t enough, I have spent the better part of a decade researching, researching, and researching some more on the topic of diabetes and blood sugar.
But what prompted this particular article was my 21 year old diabetic son who has spent the better part of his diabetic journey hanging out in the upper part of normal blood sugars (mid to upper 100s) and is starting to experience diabetic neuropathy. As a mother, my heart was ripped out when he was sick and had his first neuropathy flare in his legs. He didn’t know what it was and was dismissed by the doctors as it was “just being neuropathy”. He has just begun his adult life and this shouldn’t be happening.
If these suggested blood sugar ranges were optimal and meant for health, then hanging out anywhere in the suggested range would not cause adverse health effects…. at 21 years of age.
That was the fuel that started this fire.
Rethinking Normal Blood Sugars
In the world of diabetes management, the concept of “normal” blood sugar levels has long been ingrained in our understanding. However, recent research and evolving perspectives are challenging this notion, urging us to reconsider what truly constitutes a healthy blood sugar range.
Emerging evidence suggests that even within this normal range, there can be significant differences in health outcomes, let alone once you get outside the normal range. For instance, individuals who experience frequent post-meal glucose spikes, known as glycemic variability, may be at a higher risk for developing complications associated with diabetes, such as cardiovascular disease and kidney problems.
What are Normal Blood Sugars?
Here is what the American Diabetes Association says is their recommendations for blood sugar numbers.
- A1C: Less than 7% or less than 154 mg/dL
- Before a meal: 80–130 mg/dL
- 1-2 hours after the beginning of the meal: Less than 180 mg/dL
Diabetes Diagnostic Criteria
Now let’s look at their Diagnostic Criteria below.
Fasting Blood Glucose Levels | 2-hr Post Meal Glucose Levels | |
Normal | < 100 mg/dL | < 140 mg/dL |
Pre-Diabetes | 100 to 125 mg/dL | 140 to 199 mg/dL |
Diabetes | ≥ 126 mg/dL | ≥ 200 mg/dL |
These are the numbers that people must meet in order to get their diagnosis.
Now, I will state this right off the bat – trying to have one set of criteria that fits every person in the world is the same as trying to have one set of criteria for nutrition. We all know how the food pyramid and the American version of “Here is what you should eat” have failed miserably and contributed to disease and death. But that is another topic altogether.
To understand the ridiculousness of these numbers, we have to dive into what the data says. But first, let’s go over some terminology and foundations to make sure we are all on the same page.
Diabetic Terminology
A1C
An A1C is the average blood glucose over the last 2-3 months.
Blood Glucose
Blood Glucose is another term for blood sugar.
Cardiovascular Disease
Cardiovascular Disease is a disease of the heart and blood vessels.
Diabetes
Diabetes is a condition where blood sugars are higher than they should be for health. This results in dangerous complications as well as the body not being able to utilize blood glucose for energy.
Fasting Blood Sugar
A fasting blood sugar is a measurement of blood glucose after not eating for 8-12 hours.
Hyperglycemia
Hyperglycemia is when blood sugar is high.
Hypoglycemia
Hypoglycemia is when blood sugar is low.
Insulin
Insulin is a hormone that helps the body to utilize blood glucose as energy. Basically, insulin is the key that unlocks the door to the cells to allow in glucose from the blood.
Neuropathy
Neuropathy is a nerve disease. With diabetes, a very common complication is neuropathy of the legs and feet.
Post-Prandial Meal Spike
A post-prandial meal spike refers to the highest blood sugar peak after eating.
Prediabetes
Prediabetes is when blood glucose levels are higher than “normal” but not high enough to warrant a diabetes diagnosis according to the ADA.
Type 1 Diabetes
Type 1 Diabetes is an autoimmune condition where the body attacks the insulin producing beta cells in the pancreas. Eventually, the body stops producing any insulin.
Type 2 Diabetes
Type 2 Diabetes is often characterized as a metabolic condition. The body either isn’t making enough insulin or cannot utilize the insulin produced, otherwise known as insulin resistance.
Complications of High Blood Sugar
There are many complications that can happen with blood sugar. The remainder of this will focus on the complications and dangers of being on the higher end of “normal” blood sugars. But first, let’s talk about the general complications of high blood sugar.
The following are common issues related to high blood sugar:
- Insulin Resistance
- Heart Disease
- Kidney Damage
- Nerve Damage
- Eye Issues
- Bone and Joint Issues
- and more…
What Makes Blood Sugar Rise
It is normal for blood sugar to rise after eating carbohydrates. It is normal and natural and happens to everyone. What is not normal is for a huge spike to occur or a prolonged rise to occur.
There are quite a few things that can cause a rise in blood sugar. Some of those include stress, lack of sleep, coffee, the dawn phenomenon (early morning spike), artificial sweeteners, and dehydration.
So the issue at hand is not that blood sugar rises occur, it is how high they are, how often they occur, and how long they last.
The Impact of Post-Meal Glucose Spikes
Post-meal glucose spikes, also known as hyperglycemia if they are high enough, refer to temporary increases in blood sugar levels that occur after consuming a meal. These spikes come with adverse health outcomes. Research has shown that post-meal glucose spikes can contribute to an increased risk of cardiovascular disease and other complications.
Here is where it gets a little tricky, however. When people think of complications from diabetes or from elevated blood sugar, they think of that which is above the current ADA guidelines. However, research shows that damage, disease, and even death can occur within what is considered a “normal” range.
Would you like to see some data? I thought so!
Normal Post Prandial Rise
In a healthy, non-diabetic individual, studies show that this post-prandial rise was less than 30 mg/dL. And that sugar levels after a meal in these healthy, non-diabetic subjects were still below 110 mg/dL.
This is important to note. It is also important to note that spikes occur around the 50-minute mark, give or take. As we have seen, the ADA’s guidelines for a normal, healthy individual is under 140 2 HOURS after a meal. Not 50 minutes, not 1 hour, but 2 hours. And for a pre-diabetic, it can still be 199 after 2 hours. And remember, pre-diabetic is still not reaching the diagnosis guidelines.
It was also shown that even after a sugary, unhealthy meal, the maximum rise was around 50 mg/dL. This is still a far cry from a 200 point rise.
As a member of the diabetic community, I hear people say all the time something like this “Well, my brother’s blood sugar goes up to 180 and he isn’t diabetic so it’s fine for mine too”. Because the ADA guidelines are so ridiculous and loose, there are sick people walking around thinking they are perfectly fine simply because they have not hit the diagnostic criteria.
Optimal Post Prandial Range
Given this data, one might suggest that blood sugar spikes be measured against 110 mg/dL at any time rather than 140 at 2 hours and that the peak be less than 30 mg/dL.
This would be for people striving for optimal health, that is.
Understanding Glycemic Variability
Now we are going to drill down even more. We talked about spikes and post-prandial blood sugars, but now we are going to go deeper and get into how these spikes can be even more detrimental to health than a steady high blood sugar, which is counterintuitive at best. Now, that is NOT saying that one should maintain a high, steady blood sugar. But rather, it illustrates that these spikes are important and incredibly dangerous. Yet, again, the ADA completely ignores them with their guidelines to check blood sugar 2 hours after eating.
A fascinating study was conducted to look at this very thing. I’m going to summarize it loosely because if I go into detail, it will take too long. But you can read the study. In short, they took normal and diabetic patients and either kept them at a steady high blood sugar level or they oscillated them between high and normal.
What they found is that damage to endothelial function was more severe in the group with oscillating blood sugars vs. the group with steady high blood sugar.
“Endothelial dysfunction is a type of non-obstructive coronary artery disease (CAD) in which there are no heart artery blockages, but the large blood vessels on the heart’s surface constrict (narrow) instead of dilating (opening).”
https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/endothelial-dysfunction.html
Vitamin C Protection
One thing this study also did was administer Vitamin C to a subgroup of participants to look at the oxidative stress that was happening.
What is interesting is that vitamin C appeared to counterbalance the damage that the oscillating glucose was introducing. I think of my personal situation and wonder if my 20 years of taking 1000mg of vitamin C daily has helped the damage that oscillating blood sugars have done in my own body. I’d like to think so.
The conclusion of this study is the following:
“These data suggest that oscillating glucose can have more deleterious effects than constant high glucose on endothelial function and oxidative stress, two key players in favoring cardiovascular complications in diabetes. Concomitant vitamin C infusion can reverse this impairment.”
https://pubmed.ncbi.nlm.nih.gov/18299315/
The Impact of Normal Fasting Blood Glucose in the Upper Range
Now let’s get into the area where people start getting a little twitchy and upset. The ADA guidelines are received as the gold standard and everything is measured against that. We’ve already seen that these guidelines are quite dangerous, to say the least.
A 22-year study was conducted on 1973 men who were between the ages of 40 and 59. These were healthy men, non-diabetics, whose fasting blood sugars were below 110. I personally think that the upper limit was a bit high to call them all non-diabetic, but according to the ADA that is what they were. That part doesn’t really matter, though, because the study was fantastic and still stands.
After 22 years, 483 of them had died and 53% of the deaths were from cardiovascular disease. After dividing them up into quartiles, they found the ones with the highest statistically significant mortality rate were the ones in the highest quartile. Wait for it…. These were men with fasting blood sugar above 85. Yes, 85.
The ADA doesn’t consider you diabetic until your fasting blood sugar is above 126, yet this study shows significantly higher mortality for fasting blood sugars above 85. And remember these are all men whose fasting blood sugar is still under 110. Far under the ADA diagnostic guidelines.
The conclusion of this study is the following:
“Fasting blood glucose values in the upper normal range appears to be an important independent predictor of cardiovascular death in nondiabetic apparently healthy middle-aged men.”
https://diabetesjournals.org/care/article/22/1/45/19692/Fasting-blood-glucose-an-underestimated-risk
Why Normal Blood Sugars Are Killing You
At this point, I think we’ve covered why normal blood sugars are killing you. But to recap, if we act according to the ADA’s guidelines, then we have been operating in a range of blood sugar that has incredibly negative complications for years.
It takes years to become what the ADA would consider pre-diabetic and then many more years to become what the ADA would consider diabetic. This could be a decade or more of sub-optimal blood sugar that is doing daily damage to our bodies.
I am personally frustrated at how diabetes and blood sugar are managed in our healthcare system. A Type 2 diabetic is given a pill rather than lifestyle modifications. A Type 1 diabetic is given insulin and told to eat whatever they want and just cover it with insulin. Neither of these things will do anything positive for the patient.
It is time that we become advocates for our own health and stop waiting for a diagnosis that simply tells us we’ve been sick for years and have the high potential to have irreversible damage to our bodies.
Personalized Targets for Optimal Blood Sugar Level
Every person is different. Every body is different. I completely manage my diabetes on my own, but I am well versed in the study of diabetes as well as the body, and, more importantly, I am very in tune with my body.
For diabetics, I always suggest trying to find a healthcare provider who is interested in working with you for the best health outcome and not someone who simply regurgitates outdated and unhealthy ADA guidelines. The same holds true to non-diabetics.
The Role of Continuous Glucose Monitoring (CGM)
However, for non-diabetics, there is a lot you can do on your own first. The first thing I suggest to my clients if they feel called to do so is to invest in a blood sugar monitor kit. You can easily find a kit like this one on Amazon or at your local pharmacy. I like this one because it comes with strips.
Once you have a kit, you can check your blood sugar first thing in the morning and an hour after eating. I know the ADA had their guidelines for 2 hours, but the peak is well before 2 hours and that is the first piece of the puzzle. This helps us see our glycemic variability at its most volatile point. Can can then check periodically throughout the day to see what it is at random points to give you a better idea.
Information is power.
Lifestyle Interventions for Blood Sugar Optimization
There are many lifestyle interventions that one can put in place to assist with blood sugar optimization.
Sleep
Sleep is one of those underrated activities that we all take for granted. Our bodies need sleep to rest and repair. Lack of sleep is a known contributor to insulin resistance which can have a direct result on blood sugar.
Exercise
I think exercise is one that most people can get behind and have heard before. Movement is essential for health regardless of blood sugar. It doesn’t need to be strenuous exercise. Something like walking is perfect for lowering blood sugar and also increasing insulin sensitivity. When you exercise, your body utilizes more glucose in the blood and, hence, lowers blood sugar.
Decrease Stress
This is another one that I think we all know to be true. Acute stress is something that is often needed and important for survival. But chronic stress is where we run into problems in a lot of areas including blood sugars and inflammation. Chronic stress and the hormonal response to it can lead to disturbed glucose homeostasis.
Chronic stress can lead to metabolic dysfunction and type 2 diabetes often follows not too long after.
Nutrition
Nutrition is incredibly important when it comes to blood sugar management since carbohydrates have a direct effect on blood sugar.
Low Carb
I am an advocate of low carbohydrate eating for optimal blood sugar management and as an adjust therapy for diabetes. Higher carbs mean higher blood sugar and higher insulin. Neither of which has a positive outcome for health long term.
Balanced Meals
The phrase “balanced meal” means different things to different people. And to be frank, I think it should mean different things in different circumstances. When it comes to blood sugar control, I believe a balanced meal is lower in carbohydrates for sure and then an appropriate amount of protein and healthy fats.
Increase Fiber
Fiber is incredibly important for stabilizing blood sugars among many other things. One of the issues when people go low carb or keto is that they often forgo fiber in place of something more palatable (insert: sweet). Aside from blood sugar control, there are many dangers of low fiber as I’ve outlined in this short video below:
Weight loss and Insulin Resistance
These two often go hand in hand. Losing weight will help reduce insulin resistance which will increase insulin sensitivity which can lower blood sugar. BOOM.
Supplements for Blood Sugar Optimization
Before we go into supplements, it is important to note that you should not just blindly start taking a supplement. Work with your healthcare team to make sure you understand dosage, precautions, and contraindications.
Berberine
I’m going to start with my favorite supplement and the one (and the only one) that I personally use. Berberine, along with lifestyle modification (which should always be present) has been shown to decrease A1C, post prandial glucose levels and fasting blood glucose. I run a pretty tight range with my blood sugar levels and berberine seemed to lower my baseline by 5-10 mg/dL which is pretty amazing.
Cinnamon
Cinnamon is one of the most scoffed at words in most diabetic groups. People roll their eyes and mock anything even remotely related to the thought of cinnamon and lowered blood sugar. But the facts don’t lie. Cinnamon has been shown to improve glycemic control in type 2 diabetics.
Aloe Vera
Aloe vera has been shown to help lower A1C as well as help lower fasting blood sugars.
Chromium
Chromium is an interesting one. It has been shown that a deficiency of chromium can result in a glucose intolerance. It also potentiates the action of insulin.
Diabetic Friendly Recipes
I am an advocate of low carb lifestyles for assistance in the management of blood sugar regulation. This entire site is dedicated to low carb, low sugar, and gluten free recipes that are almost all diabetic-friendly.
Diabetic-Friendly Breakfasts
The first meal of the day! Some say that breakfast is the most important meal of the day. Others disagree. I think the jury is still out on this one. Whether you like your breakfasts sweet or savory, there are options for everyone! Here are some sweet and savory diabetic-friendly breakfast recipes: hash, chocolate chip muffins, coffee cake, and avocado toast.
Diabetic-Friendly Dinners
Dinners can be a challenge, especially if a family is involved. Let me assure you that diabetic-friendly dinners are not only easy to make but are also flavorful.
Here are a few of my favorite diabetic-friendly dinner recipes: butter chicken, crockpot pork, meatloaf, and chicken alfredo.
Diabetic-Friendly Desserts
Let’s face it, desserts are just something we don’t want to live without. And there is no reason to. The sweeteners used are an important part of what makes up diabetic-friendly desserts. I prefer to use the Besti brand which is made from Monk Fruit and Allulose. I have had the best result with those. There are several to choose from, but if you want to try them out, head over to WholesomeYumFoods and use code Trina10 for 10% off.
Here are a few of my favorite diabetic-friendly dessert recipes: chocolate chip cookies, chocolate truffles, frozen yogurt, and layer cake.
Being an Advocate of Your Own Health
The last thing I want to say is to be an advocate for your own health. Don’t settle for outdated guidelines that put you in the position of having “normal” blood sugar, thinking you are fine, only find out you have diabetic complications even before an official diagnosis.
Fight for your right to have optimal health. It is sad that we must do this, but it is what it is. You are worth it. Investigate, research, and be curious.
References
https://www.cdc.gov/diabetes/library/spotlights/blood-sugar.html
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543190/
https://pubmed.ncbi.nlm.nih.gov/18299315/
https://diabetesjournals.org/care/article/22/1/45/19692/Fasting-blood-glucose-an-underestimated-risk
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769652/
https://novi-health.com/library/optimal-blood-glucose-range
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9561544/
https://www.healthline.com/nutrition/blood-sugar-supplements
https://nutritionj.biomedcentral.com/counter/pdf/10.1186/s12937-015-0098-9.pdf
Low Carbohydrate Diet and Type 1 Diabetes
Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The contents of this article, made available via Holistic Fit LLC, are for informational purposes only and do not constitute medical advice. The Content presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. If you think you may be suffering from any medical condition, you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information provided by Holistic Fit LLC. Reliance on any information provided by this article is solely at your own risk. And, of course, never use an herb or essential oil without first reading the label, doing your research, or checking with a local expert.
Trina Krug is a Holistic Nutritionist, Integrative Health Coach and host of the Carbless Conversations Podcast. With a Master’s Degree in Complementary and Alternative Medicine, her single mission in life is to facilitate self-healing in herself and those around her through awareness, lifestyle shifts and low-carb eating. As a current Doctor of Science student, she continues her studies in functional nutrition.