Have you made the assumption that you have healthy blood sugar levels because you were told you had normal glucose after having bloodwork done?
I see this often in my practice. Client comes in with symptoms like dragging in the afternoon, waking a couple times at night, fatigue, irritability, headaches, craving carbs. Before I run one of my standard blood work panels they often mention that they’ve been told their glucose is normal.
We have a brief little chat about the difference between normal and optimal for labs before diving into our work together.
Basic Blood Sugar Overview:
One of the body’s top priorities is maintaining healthy blood sugar levels and it will do whatever it needs to do to make that happen. This can be at the expense of other body systems because blood sugar is such a high priority.
When blood sugar levels rise from eating (or anything else that can raise blood sugar, such as stress), the pancreas releases the hormone insulin to shuttle the glucose (sugar) into the liver and muscle cells to be stored for later use as glycogen. So when insulin is elevated, the body is in storage mode.
Between meals, overnight, or during longer fasting periods the body relies on other means to maintain stable blood sugar.
The hormone glucagon is basically the opposite of insulin. The pancreas releases it in response to low blood sugar and it triggers the liver to convert that stored glycogen back into glucose in the blood.
If glycogen stores become depleted and no new fuel is coming in, the liver can create glucose from amino acids and fatty acids.
If blood sugar gets too low, stress hormones such as cortisol can be released to also trigger the body to convert amino acids (protein) into glucose. This isn’t ideal long term because we want our amino acids to be used as building blocks for muscle, tissues, hair, skin, nails, hormones, neurotransmitters, etc.
The liver can also convert stored fat into ketones if little glucose is coming in and glycogen stores stay low. This is what happens on a ketogenic diet.
Normal blood sugar but high insulin
We have several ways of making sure blood sugar doesn’t get too low and making sure the body has energy, whether that’s in the form of glucose or ketones in the case of prolonged low glycogen.
We only have one way of keeping blood sugar from getting too high (insulin) and we are taxing this hormone system at a rate we can’t keep up with.
When the cells of the liver and muscles are sensitive to insulin, it is able to easily shuttle the glucose into those cells. After years of consuming too many foods that spike glucose, the pancreas has to pump out more and more insulin.
Our modern lifestyles often include three meals plus snacks of high carb foods that all require insulin in order to prevent all that sugar from staying in the blood too long. Kids are more sensitive to insulin because they haven’t had as many years (yet) of the body being inundated with sugar (though the prevalence of diabetes in children is alarming).
But as the years go by and dietary habits don’t change, the cells become desensitized to insulin and it’s unable to get that glucose into the cell.
Along with that, if we keep trying to replenish glycogen by eating more carbohydrate-rich foods but don’t really use much glycogen because of sedentary lifestyles, the cells actually get full and can’t take in any more glucose to store as glycogen.
The body has to do something with that glucose so it stores it as fat.
All this time, insulin levels have been climbing. The fasted morning glucose blood test can still show “normal” but insulin levels have been increasing all along the way to try to maintain that normal glucose.
Eventually the body just can’t maintain that and blood sugar levels start to climb. When that happens, that means the cells have already started to become insulin resistant.
Labs to determine blood sugar health
I do like to see fasting blood glucose with ideal levels falling between 75 and 89. Now, as is the point of this article, you can fall within this range but still not have healthy blood sugar response. Insulin resistance builds up overtime while trying to maintain that ideal level.
I also like to see HbA1c between 4.9 and 5.4.
I also test something called C Peptide which interestingly enough is a better indicator of insulin levels than insulin itself. It’s produced by the pancreas along with insulin in response to elevated blood sugar but it lasts longer in the body so by the morning when the test would be done we could still see whether there might have been an exaggerated insulin response to the last meal. Insulin doesn’t last as long in the body and therefore it also might fall back to normal levels even if it had spiked after the last meal. C peptide I like to see between 1 and 2.1
Fasted insulin isn’t something I test as much anymore because I generally do the C peptide but if I were looking at insulin I’d want it between 1 and 6.
The majority of people in this country are walking around with insulin resistance. It is a component of most of the major health issues people face.
The good news is that there is much that can be done to address this problem! Our bodies are amazing at healing themselves when we give them the right tools and managing healthy blood sugar levels is no different.