To kick things off, it’s a good idea to make sure you are up to speed on how parts of the body, and systems within the body, are involved in elevated blood sugars.
Let’s start with some basic terminology:
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Blood sugar - This is the amount of glucose, or sugar, within your blood, and is the main source of energy that comes from the food you eat. For the most part, “blood sugar” and “blood glucose” will be used interchangeably throughout this education series.
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Glycogen - A stored form of glucose. When the body has enough glucose for energy, it will store extra glucose as glycogen in the liver and muscles.
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Body fat - Excess food and sugar can be stored as fat cells.
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Insulin - A hormone the body uses to move sugar from the bloodstream into cells to be used for energy. We make insulin in an organ called the pancreas.
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Glucagon - A hormone that raises blood sugar levels. It causes the release/breakdown of glycogen and triggers gluconeogenesis (creation of glucose from non-carbohydrate sources, such as fat and protein) when blood sugars drop.
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Insulin resistance - A phenomenon that happens when the body doesn’t use insulin as well as it should.
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Insulin sensitivity - How sensitive cells in the body are to insulin. Higher insulin sensitivity means the body will have an easier time using glucose effectively. Lower insulin sensitivity means the body will not use glucose as well.
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Metabolism - The ability of cells to convert protein, fat, and carbohydrates from food into energy to be used immediately or stored for later use.
Glucose regulation is part of the endocrine system, and there are several organs involved. Here’s a breakdown of some of the biggest players worth knowing about:
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Pancreas - This organ produces insulin, glucagon, and other hormones that help regulate blood glucose levels. The alpha cells of the pancreas produce glucagon while the beta cells produce insulin.
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Liver - The liver responds to insulin from the pancreas by taking up glucose from the bloodstream (helping to lower blood glucose levels). This glucose is then stored as glycogen. On the flip side, when glucagon is released from the pancreas, the liver will push glucose back into the bloodstream (thereby raising blood glucose levels).
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Adrenal gland - This gland sits on top of the kidneys and can be responsible for increasing blood glucose and speeding up the heart rate through the release of epinephrine (the hormone that triggers our ‘fight or flight’ response).
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Thyroid gland - The thyroid helps regulate metabolism. If the thyroid is imbalanced, a potential side effect is difficulty managing glucose levels.
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Kidneys - The kidneys are responsible for filtering, reabsorbing, and, in some cases, excreting glucose in the urine.
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Muscles - Skeletal muscle acts as a storage space for glycogen. The more muscle you have, the more glucose storage space you have.
Lock and Key Analogy
One way to visualize the relationship between insulin and glucose is to think of the muscle or liver cell that glucose is trying to move into. There’s a “lock” on that cell that controls the glucose channel that allows glucose to move from the bloodstream into the cell where it can then be used as energy. Insulin is the “key” that opens the lock. If there isn’t enough insulin being produced, then there’s no key to open that lock and allow glucose to move into the cell. In addition to that, at times, the body produces excessively large amounts of insulin over a long period of time (in response to large amounts of carbs being consumed). Over time, the lock on the cell becomes so used to insulin being around, that it no longer responds to it in the same way, meaning that the glucose channel doesn’t open to allow glucose to move from the blood into the cells. This is known as insulin resistance.
Complications
One reason it’s so important to regulate blood sugar levels is that uncontrolled, elevated glucose levels can contribute to a number of complications, such as:
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Cardiovascular disease - Having diabetes increases the risk of heart disease, stroke, atherosclerosis (narrowing of blood vessels), and high blood pressure.
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Neuropathy (nerve damage) - Consistently high glucose starts to damage nerves, leading to tingling, numbness, pain, or even loss of feeling in the limbs.
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Digestive system issues - Nerve damage to the digestive system can create problems with nausea, vomiting, diarrhea, constipation, or gastroparesis (slow digestion).
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Eye problems - High glucose values can lead to damage to blood vessels in your eye, contributing to increased incidence of blindness, cataracts, and glaucoma.
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Kidney disease - For some, diabetes can lead to chronic kidney disease or even end-stage kidney disease.
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Skin conditions - Diabetes contributes to not only slow wound healing (meaning even a small cut or blister can become a serious infection more easily) but also issues like bacterial or fungal infections.
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Dementia - New research suggests there may be a connection between type 2 diabetes and an increased risk of Alzheimer’s and other types of dementia.
The good news here is that you are in control of your future and your health! While it can be overwhelming to learn about these potential complications, you can make lifestyle changes now to optimize your glucose levels so you can stay healthy longer and live the life you want to.