Body and Mind, Mind And Body

I don’t believe in gatekeeping, so I’m going to let you all in on one of the biggest “aha moment” generators from sessions with my clients: all of the different factors that can affect our blood glucose.

We’re way beyond thinking just about carbs, exercise, and medications. We’re onto 42 factors, as described by the brilliant Adam Brown over at Diatribe. Brown has written extensively about his lived experience with diabetes, including plenty of peer-reviewed research evidence to help explain the nuances of living with diabetes.

Thanks to over the counter continuous glucose monitors (CGMs) by Dexcom (the Stelo) and Freestyle (the Lingo), more and more people are noticing how their glucose levels are impacted by various lifestyle factors.

Sleep and stress

Some of the big hitters that have floated to the top of the lexicon from this are sleep and stress. As noted in this systematic review published by Singh, et al in 2022, “The causal relationship between sleep deprivation and insulin resistance is multifactorial”. Just a few nights of bad sleep can impact inflammatory markers and GLP-1. Hey… doesn’t that sound familiar? Yep, GLP-1 is what is being mimicked by Ozempic.

The connection between stress and insulin resistance has been well established in the scientific literature as well. In 2022, Yaribeygi, et al noted “It is well recognized that stress hormones, such as cortisol, epinephrine, growth hormone and glucagon, induce acute transient hyperglycemia that occurs in a ‘fight or flight’ reaction”.

Always Evolving

I know this can all sound wildly inconvenient for our modern lives. But, I try to give our bodies some grace by thinking about why it is doing all of this. Don’t our bodies want us to survive and thrive? Why did we evolve this damaging response to poor sleep and stress?

Well - let’s think back to when humans were fighting for survival, just trying to make it to the next generation. Who made it to the next generation? Those individuals who would be able to respond quickly to a prey animal running past hunting camp, or those who could outrun a sabertooth tiger approaching while out foraging. Both instances release a rush of adrenaline, triggering fight or flight, and promoting temporary insulin resistance. In a true fight or flight situation, we needed that insulin resistance - we needed to maintain our limited glucose stores to sustain us through the danger.

However, the danger now is an angry email from an unstable coworker. Or a backfiring car. Or doom scrolling. Or, or, or - the stressors never seem to end. Any number of chronic stressors out there can trigger our evolved primal fight or flight response - and therefore, blood sugar spikes.

I’m not alone in this school of thought - Tsatsoulis et al came to similar conclusions in 2013, noting “insulin resistance evolved as a physiological adaptive mechanism in human survival and that the same mechanism is inappropriately activated on a chronic basis in the current environment, leading to the manifestations of the metabolic syndrome.”

What Can I Do About It?

This might feel like it’s piling just another stressor on top. We’re stressed. We aren’t sleeping well. And here’s just another reason that’s bad. But maybe it can be thought of as justification for finally addressing the root cause of the issues. Not piling on an unhealthy coping mechanism, like drinking, eating, or smoking, but actually setting boundaries around how we let stressors into our lives.

Addressing root causes often requires support. In clinical practice, I've seen great outcomes come from working alongside a professional on changing approaches and behaviors. Metabolic coaches with clinical backgrounds (like myself here at The Signature Plate) can help with accountability and support. If you notice there is a specific mental health trigger, work with a trained counselor or therapist on specific strategies that will work for you.

What’s next?

It’s 2025 and we’re up to 42 factors - and we’ll touch on the others in more detail in future blog posts. When I think about the human body, I think about all of the crazy metabolic processes going on at all times to maintain some level of homeostasis (read: balance and stability). So who knows - maybe by 2030 we’ll be up to 100 identified factors. What factors have you identified for yourself? I’d love to hear more - feel free to reach out to me at kate@thesignatureplate.com!