What Do Hormones Have To Do With Diabetes?

Our country has a major problem with sugar. In fact, the average American eats the body weight of an adult (~150 pounds) in sugar per year. Compare that to 1890, where we consumed only five pounds of sugar per year, a 3000% increase! The emergence of sugar in our culture has a convoluted and political history (check out Sugar Coated if you want to learn more) but that doesn’t change the fact that blood sugar issues and their subsequent consequences are one of the most common concerns that most women face.

More than 80 million Americans have pre-diabetes.

Over the years, I’ve seen a number of patients with diabetes and pre-diabetes who are looking for help with lowering their blood sugar without medications.  Type 2 diabetes affects approximately 29 million people in the United States with almost 2 million new diagnoses each year.  Unfortunately, those statistics don’t include the 80+ million Americans with pre-diabetes and with the growing number of children that are overweight and obese, that number will only continue to rise. And this number doesn’t include diseases that have strong ties to blood sugar issues such as Polycystic Ovarian Syndrome (PCOS) and Alzheimer’s (now being referred to as type 3 diabetes).

Regrettably, conventional medicine rarely stresses the importance of lifestyle factors are in the control and possible reversal of blood sugar issues, which is especially concerning when diabetes is so common. In order to better understand how to prevent or control diabetes, it’s important to know what diabetes is, the hormones involved, and their effects. But let’s start with how.

Insulin (key) binds to your cells to let glucose inside.

Blood Sugar and Hormones

When you eat sugar (carbohydrates), your body breaks down those carbohydrates into glucose and other simple sugars. These sugars enter your bloodstream and signals your pancreas to release insulin. Insulin, a hormone, binds to your cells and tells the body to let glucose inside, since glucose is only useful inside of your cells, not hanging out in the bloodstream. In other words, insulin is like a key; you can’t open a door without the right key and a different key (a different hormone, for example) won’t unlock the door.

In type 2 diabetes, the problem is that the keyhole stops recognizing the key (insulin), your body become desensitized to insulin (aka insulin resistant), and glucose is not able to enter the cells. When glucose is not able to enter the cells, you have high levels of glucose and insulin in your blood. In type 1 diabetes, insulin stops being produced by your pancreas so you have no keys at all. The result in both cases is that high amounts of glucose accumulate in the blood, but in type 1 you have no insulin whereas in type 2, you have too much insulin. And in some instances, as type 2 progresses, some may eventually develop type 1 because they’ve taxed their pancreas by putting out high amounts of insulin over the years.

While sugar itself is damaging to the body, the hormonal imbalances it causes are just as bad. We know that diabetes can result in eye, kidney, and cardiovascular disease, but insulin itself is pro-inflammatory and stimulates the production of cholesterol and triglycerides. And since insulin is a hormone, it is influenced by other hormones, like cortisol.

Cortisol is released during times of stress. Even though our types of stress have changed since humans first evolved, your body has no way of qualifying that stress. So whether it’s actual life-threatening stress from a bear or modern stress from traffic or your boss, the body will release cortisol in anticipation of needing to jump into action. Over time, having chronically elevated levels of cortisol can cause all kinds of issues but with regards to blood sugar, it leads to decreased uptake of glucose by your cells and thereby increased insulin resistance (aka pre-diabetes).

With this basic understanding of how blood sugar and the hormones work, let’s talk about the more important information, what to do to lower blood sugar. Keep in mind, type 1 diabetes is an autoimmune condition, which makes its health approach different, so the rest of this discussion is mainly geared towards type 2 diabetes.

An Ounce of Prevention

One proposed theory is that type 2 diabetes occurs because of your body constantly being exposed to too much sugar over time, and therefore loses its sensitivity to insulin (key), much like the boy who cried wolf. So it stands to reason that eating less sugar will maintain your body’s sensitivity to insulin. Super easy, right?

Sugar has drug-like effects on the brain, which makes it a hard habit to quit.

As most of us can attest, it can be hard to avoid sugar when you get those cravings. In fact, studies have found that sugar acts much like a drug to your brain and is just as addictive. So what to do about it?  For some of us, just cutting out sugar cold turkey is the best way to go. The first week is rough, trust me. All you seem to think about is everything you are avoiding: sweets and sugars and breads. But after a week of strict abstinence, that drug seems to lose its hold over you as the cravings are less intense and more manageable.

If going cold turkey sounds too overwhelming, simply begin by paying attention to what sugar you do eat. You may be surprised to find out how many grams of sugar you’re consuming on a daily basis without even realizing it. And just creating awareness can cause shifts in eating habits. Studies have found that just by writing down what you eat, you become aware of patterns and inadvertently began to make lifestyle changes to replace those habits. This can be done with pen and paper, free apps (MyFitnessPal), or even the notes section in your phone.

Another strategy that make work is moderation.  How many times have you stuck to an extreme diet really well for a few weeks, only to have a stressful day cause a carb-heavy binge session? Instead of practicing monk-like abstinence, practice mindfulness with the few sugars you are eating and really make an enjoyable experience out of it. Or plan a day each week where you can have sugar without any judgment or guilt. If you’re eating well six days a week, that can have a big impact.

Food Is Medicine

In addition to decreasing your daily sugar intake, there are various micronutrient deficiencies that are associated with diabetes. Chromium, a trace mineral, is believed to help the binding of insulin to its receptor (helping the key to find its key hole) and has been shown to improve insulin sensitivity and glycemic control. Chromium is found in brewer’s yeast, broccoli, beef, chicken, mushrooms, mussels, and brazil nuts. Another trace mineral, zinc is important for wound-healing, which is a common concern in diabetes because of diabetic ulcers.  And zinc deficiency was associated with decrease insulin secretion and sensitivity.  Zinc is found in seafood (particularly oysters), dairy products, legumes, peanuts, egg yolk, nuts, and sunflower and pumpkin seeds. Alpha lipoic acid (ALA), a powerful antioxidant, has been shown to increase insulin sensitivity as well as help with diabetic neuropathy.  ALA is found in small amounts in a wide variety of foods. And of course, all of these are available as supplements, some even as a combination for blood sugar support.

Additional Tools And Approaches

While nutrition is a crucial piece of preventing diabetes type 2, there are other things that can be done to support your body’s sensitivity to insulin. Exercise has been shown to increase insulin sensitivity, with as little as 30 minutes of activity.  Another common and easy fix is to optimize your vitamin D levels. Sub-optimal levels of vitamin D are associated with decreased insulin sensitivity.  More and more people are discovering that, despite spending ample time in the sun, their vitamin D levels are either deficient or sub-optimal. I see this constantly, even when I was working in Arizona, where there is no deficiency of sun.  Luckily, it’s easy to fix with supplementation, once you identify the problem.

Cinnamon is a tasty herb that lowers blood sugar.

If you’re looking for more ways to boost your insulin sensitivity, botanical medicine has lots to offer. Herbs like Gymnema sylvestre have actually been shown to decrease high blood sugar levels and help to control sugar cravings.  Even cinnamon (Cinnamomum verum) has been found to decrease blood sugar levels and may prevent Alzheimer’s.

Finally, remember cortisol? Newer studies have shown that managing stress actually helps to keep your blood sugar low.  Tools for stress management will have it’s own dedicated post in the near future but meditation, spending time in nature, and regular (dare I say, daily) self-care practices are vital.

While these are some general tips and guidelines to reduce your risk for diabetes, everyone has their own unique risk factors and may benefit from more individualized support. As mentioned before, blood sugar issues are linked (and will continue to be linked) to lots of other diseases, so even if you don’t fall into the diabetes or pre-diabetes

Which of these strategies and tips are you most likely to try?

References
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2) “Diabetes.” Centers for Disease Control and Prevention.<https://www.cdc.gov/chronicdisease/resources/publications/aag/diabetes.htm>
3) “Type 2 Diabetes Mellitus.” Medscape. <http://emedicine.medscape.com/article/117853-overview>
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7) Chiu KC, et al. “Hypovitaminosis D is associated with insulin resistance and β cell dysfunction.” Am J Clin Nutr. 2004; 79(5): 820-825.
8) Meyers EE, et al. “Contrasting effects of afferent and efferent vagal nerve stimulation on insulin secretion and blood glucose regulation.” Physio Rep. 2016; 4(4).
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