Why Isn’t My Blood Sugar Going Down?!
“I’ve done everything, and it still isn’t working!” Janice was exasperated because she was trying so hard to reverse her diabetes, but the numbers weren’t coming down. She was eating right, and had lost a little weight, but her HbA1c actually went UP one point. “This is so hard!” she was almost in tears.
Some people have little trouble reversing their blood sugar numbers with a small effort. However, there are many who seem to have a hard time. Those who make big changes in their lives, including diet and exercise, may have other issues preventing them from seeing the results they seek.
Let’s talk about the things that get in the way of reversing diabetes. There may be many different factors that influence how sugar is used in the body, the most common include:
- Sex hormones and thyroid
- Drugs: diuretics, inhalers, steroids, statins, Caffeine, etc.
- Circadian Rhythm
The most important hormone associated with diabetes is insulin. Without insulin, there is no way for sugar to get into most cells to create energy, so the glucose stays in the blood. We always need some glucose in the blood to feed hungry cells, such as brain, heart, and kidney cells. But when we have too much glucose, insulin will cause the liver, fat and muscle cells to take up the extra sugar and store it for later use.
Insulin opens the ports and allows sugar (glucose) into the cell. As the muscles cells fill with sugar, they start making a starch called glycogen for short-term storage. However, if there is not enough exercise to use up that excess energy, they get crammed with glycogen and block insulin receptors. The cell then cannot take up glucose, so the blood sugar levels stay high.
Fat cells use sugar to make fat as energy storage for the body. They can also become insulin resistant when they get too full of fat, but may continue to produce fat out of sugar.
High insulin levels in the blood indicate insulin resistance, meaning your cells cannot take up the extra sugar from your blood. You will also tend to gain fat easily. Insulin resistance can keep your blood sugar high even if you have a perfect diet!
If your insulin is low, your pancreas may not be making enough to get the sugar from the blood into the cells, and the blood glucose will remain high. This is Type 1 diabetes. If you don’t make enough insulin, your blood sugar will remain high despite a low carb diet.
You may also have both, low insulin and insulin resistance, or Type 1.5 diabetes. In this case there is very little insulin, but you are resistant so the blood sugar stays high because it cannot get into your cells.
Insulin sensitivity is essential to get the blood sugar down and reverse diabetes. Most people on a ketogenic diet, such as “PHASE I” of the Diabetes Solution Kit will have immediate improvement in insulin resistance. They find their blood sugar comes to normal easily. However, for those who don’t they may have insulin resistance. It is important to test for this.
The second most important metabolic hormone is Cortisol. This is the adrenal hormone that controls your sleep/wake and metabolism. Cortisol affects every cell in the body:
- Turning on the energy systems,
- Turning off the immune system,
- And causing the “catabolic” state, where the body is working and breaking down food, muscles, bones, and connective tissue.
Cortisol also makes you resistant to insulin. This is essential to understand, because the problem is not primarily the cortisol, but the insulin. Remember that insulin causes the fat cells to make fat, and prevents the body from burning fat. Cortisol makes this worse. If you have a great diet and exercise program, but have a lot of stress, you may be making a lot of cortisol, which can cause diabetes.
Since stress raises cortisol, it can induce diabetes. I had one patient, Julie, who was overweight and couldn’t control her blood sugar no matter what diet she ate and what medications she was on. At one point, she had four diabetes medications andinjecting a large amount of insulin, but it was still high all the time. Then one day her daughter moved out of the house and into her own apartment and suddenly Julie’s blood sugar dropped to normal – and she got off all her medications! She only had diabetes because of the stress of living with her daughter. Don’t underestimate how powerful stress is in insulin resistance. This is one hormone I always measure.
Sex Hormones and Thyroid
The sex hormones aren’t just for reproduction, they affect metabolism, or the use of energy, to a great degree. For example, lower estrogen causes higher blood sugar, lower progesterone causes insulin resistance. This means that as women age, and go through menopause, they are at increased risk for getting both higher blood sugar and more insulin resistance, even if they have a good diet and exercise program.
On the other hand, men also benefit from estrogen and progesterone. Men make smaller amounts of estrogen from testosterone, and when testosterone is low, the estrogen is also lower, which increases insulin resistance and raises blood sugar. Progesterone in men only comes from the adrenal glands, and during times of stress, it goes down, increasing insulin resistance.
Testosterone is associated with better blood sugar and lower diabetes. Men with diabetes tend to have lower testosterone levels. So, keeping the testosterone up to normal is important for being able to reverse and prevent Type 2 diabetes.
Thyroid disorders also contribute to insulin resistance. But with the thyroid, either too high or too low can cause insulin resistance. Low thyroid makes the muscles resistant to insulin, causing the blood sugar to be high, and high thyroid causes the liver to be insulin resistant, with the same results!
If your blood sugar is not coming down in spite of a good diet, consider a hormone imbalance as a possible cause.
There are a lot of people who try to go on a low carbohydrate diet by increasing protein. Some will eat over a hundred grams of protein per day (20 eggs, or a pound of meat). A high protein diet can increase insulin resistance.  More is not better. If you are having trouble getting your blood sugar down, even though you are eating low carbs, try lowering protein as well.
The oils we eat cause insulin resistance in the muscles. Saturated fats do considerably more damage as they increase inflammation as well. Within three hours of eating a meal high in fat the muscle cells become resistant to insulin. If you find you are eating a ketogenic diet with high fat, and you still have high blood sugar, you may be insulin resistant due to a diet high in fat. The answer, then, is to eat a low fat and low carbohydrate diet by adding a lot of fiber.
Actually, since type 2 diabetes is a disease of calorie toxicity, it is best to detox from ALL calories, including carbohydrates, fat, and protein. People ask, “Then what will I eat?” Fiber. Eat foods that are high in fiber and low in calories: Spinach, lettuce, celery, cucumbers, avocado, tomatoes, peppers, and so forth. Beans and lentils are quite high in fiber, as are nuts and seeds. There are no limits to the amount of fiber you can eat, and it does wonders to bring down blood sugar, even if you have some calories (carbohydrates, fat, protein) with it. Aim for about 40 grams of fiber daily.
There are many drugs that affect blood sugar metabolism. Some actually cause diabetes.