We have gone through a number of ways in which your energy can be stolen throughout the day, but blood sugar dysregulation is one of the most common that I see in my patients.
What is Blood Sugar Dysregulation?
Your blood sugar level is kept within a health normal range by a number of hormonal factors, of which, insulin and glucagon will be discussed today. After you eat a meal your food is digested in the stomach and small intestines into its smallest components, fatty acids, amino acids, glucose and fructose. These can then be absorbed and used as energy sources in various tissues. When your body detects levels of glucose, certain amino acids, and to some extent fructose in the blood stream it will trigger the release of insulin. Insulin is an anabolic hormone, meaning it builds, it will build our muscles, our livers stores of glycogen but also build our fat stores. This will lower your blood sugar to a normal, and safe level. Glucagon, is the antithesis of insulin, where it will increase levels of blood sugar, when blood sugar is low. Glucagon performs this function mainly by triggering the release of glucose from the liver stores, and also increasing lipolysis, allowing us to use fat as fuel. When these systems are working properly our blood sugar remains within the optimal range all day long, leading us to have a consistent level of energy!
When this system is not working properly though, due to any number of factors including stress, insulin resistance and diet composition, your blood sugar will sky rocket after a meal, and then plummet shortly after.
You might be saying to yourself at this point, “Well, my blood work was fine so this doesn’t relate to me!” But not so fast, check out the optimal levels of blood sugar below. And don’t trust HbA1c! Indeed, one study showed that although fatigue was correlated with acute levels of high or low blood sugar, it was not related to a long term measurement of blood glucose, called HbA1c1. This means, your blood sugar could regularly swing between high and normal, or high and low, between meals and your regular physical blood work would NOT show any issues! Yikes. That is why I tend to focus on ‘functional’ assessment of blood sugar. This means testing your blood sugar after a meal, regularly for up to two hours. This can be done at home, with a glucose monitor, or in the lab with a test we regularly run known as the Insulin and Glucose challenge test. The insulin aspect of this test is critical to investigate as well because it can tell us whether you are insulin resistant, and how your body responds to a large amount of carbohydrates.
What if You Don’t Have Access to Testing?
Here symptoms play a critical role! Ask yourself, are there specific times of day when you feel particularly tired?
15-30 minutes after a meal- you might not be metabolizing that meal properly or your blood sugar may be sky rocketing
2 hours after a meal- this could be hypoglycemia. It may indicate that you did not eat enough fat or protein at your previous meal, or alternatively, it can indicate that you have high levels of insulin remaining in your system, and therefore you cannot access your fat stores for energy.
Of course many things play into fatigue, and just because you are having those symptoms does not mean that glucose metabolism is the cause, but testing to check is worth it!
The Effects of Diet
No matter how resilient your blood sugar regulation mechanisms are, if you wake up in the morning and scarf down a bowl of sugar cereal and orange juice then you will feel the effects of blood sugar dysregulation! The ideal composition of a meal includes protein, fat and fiber for a reason! In simple terms, the fat component will help to slow the rate at which your stomach empties, slowing the rate in which glucose and amino acids can be absorbed into your blood stream. Protein, which is critical to every function in the human body, also prolongs your feeling of fullness, and has been shown to positively affect post-meal blood sugar levels2. Fiber is another missing component from the Standard North American diet and can have similar effects of regulating gastric empting, slowing absorption and increasing satiety.
Functional Blood Sugar Levels and ow to Achieve Them
Having data on your blood sugar levels is an important part, not only in understanding how your blood sugar could be contributing to your fatigue, but also because the long term health consequences of elevated blood sugar are vast, and life altering. Knowing your post-prandial, or post meal blood sugar levels can also help you to choose foods that are most appropriate for you! Although your blood sugar levels are just one piece of the puzzle, and insulin is CRITICAL to your metabolic health as well, there are not currently insulin meters on the market, so blood sugar measurement it is!
Fasting blood sugar levels are ideally between 4.2- 5.0mmol/L, in addition, after a meal your blood sugar levels should stay under 7.0mmol/L and by 2 hours after your meal should be back down to less than 5.5mmol/L.
In order to achieve these levels of blood sugar regulation it is important to eat a nutrient dense meal that consists of a large portion of non-starchy vegetables, a small palm sized amount of carbohydrates, two thumb sized portions of fat and a palm sized amount of protein.
Try This At Home Activity!
Although it may sound daunting to change your diet, check blood sugar levels and worry about your insulin it doesn’t have to be! Start with one change and see the difference it can make on your energy levels. Swap your breakfast for a 2-3 egg omelet with mushrooms, spinach, peppers and zucchini. Add a side of chicken sausage or some avocado to round out the plate. You will be full and energetic until the afternoon.
- Fritschi, C. & Quinn, L. Fatigue in Patients with Diabetes: A Review. Journal of psychosomatic research 69, 33–41 (2010).
- Gannon, M. C., Nuttall, F. Q., Saeed, A., Jordan, K. & Hoover, H. An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes. Am. J. Clin. Nutr. 78, 734–741 (2003).