We need to stop blaming sugar and a lack of insulin for pre-diabetes/diabetes. Insulin obviously plays an important role in blood sugar regulation as the pancreas produces insulin to shuttle glucose into the cell. However, there is a lot more to look at when it comes to blood sugar dysregulation like potassium and magnesium levels which most of the population is deficient in. It's interesting that when type 2 diabetes is diagnosed, there is no measurement of insulin that takes place to see if someone is actually deficient yet they are still prescribed insulin for the rest of their life. We need to stop jumping to insulin medication and start looking at why blood sugar is high. Following the glycemic index is not a long term solution.
I think the most important first step after addressing mineral status is looking at glucagon, cortisol, adrenalin and thyroid health which unfortunately, are not commonly measured. The reason adrenalin and cortisol need to be addressed is because leucine stimulates insulin and insulin then stimulates your cells to absorb amino acids and synthesize proteins. Insulin will lower blood sugar to dispose amino acids which is why eating protein alone can cause a drop in blood sugar thus leading to an increase in adrenalin and cortisol in order to raise blood sugar. Once cortisol is chronically high or consistently spiking, thyroid is going to be suppressed along with an increase in estrogen and inflammation leading to low progesterone, hypothyroidism and insulin resistance. I commonly see low thyroid function in all of my insulin resistant clients because T3 is used by all your cells to determine how your body will respond to insulin and glucose. Spoiler alert! This requires you to be eating enough carbs and sugar.
Essentially, it's your cells resistance to insulin that is the problem. Stop blaming the carbs and sugar. Cutting out these are just a bandaid approach that truly does more harm than good. I think paying attention to what kind of carbs, fats and protein you are eating and the balance between them is key to preventing insulin resistance. Generally I don't recommend grains and refined sugars in excess. Grains are not the best for blood sugar like the food guide says. Fruits are a lot more beneficial especially due to their high potassium content. When it comes to fat, saturated is going to be best because they are a lot more stable and are less likely to lead to oxidative stress and inflammation like polyunsaturated fats will. I have done other blog posts on this you can refer back to. When it comes to protein, the biggest mistake I see is people eating mainly plant based protein and just not getting enough of protein in general. Plant based protein is not bioavailable, very hard to absorb and usually has a very high carbohydrate to protein ratio. Animal protein is going to be the most nourishing and most supportive for blood sugar.
Once you are eating a balanced diet with enough calories and the right types of each macro as well as ensuring that you are never eating carbs or protein alone then I would begin looking into mineral levels through an HTMA test. Calcium, potassium, magnesium and sodium are the major ones to have in balance as these are the main macro minerals that actually change how your cells respond to insulin and balance out all the other minerals. I then would look at if any gut inflammation is present through a GI Map test. This will give you indication for SIBO and any sort of bacterial overgrowth as well as yeast and parasites which all play a role. When there is inflammation anywhere in the body, there is stress. Lastly, address liver health- this is where I see clients struggling a lot. If your liver is overburdened, you won't be converting thyroid hormone or clearing estrogen very well. A lot of clients come to me not having any appetite for breakfast and it's a big sign stress has been present for awhile stealing their nutrients, hormones and appetite. Keep in mind, stress is not always coming from external sources; the biggest stressor I see is nutritional stressors. For example, eating carbs or protein alone is a big stress on your body because it causes that blood sugar rollercoaster. When you're constantly stressing out your body, it's going to stay in fight or flight mode which is going to throw off your hunger hormones and suppress appetite. When your liver runs out of glucose (should be using most of its stored glucose overnight while you sleep) then it should send hunger cues to ask for food but when stress is high, it will find a quicker solution and use cortisol as fuel instead. It's important to understand that it is NOT normal for your body to lose appetite in the morning. As much as intuitive eating is important, sometimes you just need to push through and eat in the mornings even when you're not hungry in order to stimulate your appetite to get back to work. If you continuously keep skipping breakfast, you are going to be suppressing thyroid and increasing stress hormones leading to a blood sugar rollercoaster so you don't truly heal. It's a vicious cycle.
If this is one of my clients, I stress the importance of eating a high carbohydrate, high protein bedtime snack to keep your blood sugar stable overnight and give your liver enough glucose to make it through the night without waking. I also recommend eating a full breakfast (protein, fat, carb) within 30 min of waking even if you are not hungry. After a week or so of doing this, your appetite should start to come back.
not medical advice.