This article is the first article in my Troubleshooting series. The second article contains some similar information about general health (exercise, sleep, stress, etc.) but is specific to weight loss. Please see the second article “Troubleshooting Weight Loss” HERE.
I often get messages with people saying that they are on a low carb diet and are still experiencing blood sugar numbers higher than they would like to see. Then they ask me what to do. Well, this raises about a hundred questions in my mind. How many carbs are they eating and when? Do they exercise? Do they take medications? How do they sleep? Control stress? Unfortunately, food is not the only source of high blood sugar. There are many things that can raise our blood sugar (food being the most predominant cause). Without knowing each person’s individual health history and lifestyle habits, it is just impossible for me to give a 100% correct answer to each individual. So, I thought I would compile a list of “troubleshooting” tips that I personally have found effective for me. Maybe these will help you. These may or may not be 100% applicable to you.
Since there is no actual definition of a “low carb diet”, let’s explore this topic first. I personally define “low carb” as under 100g of carbs per day. This may be an adequate range for someone who is “low carbing” for general good health. BUT, if you are overweight or have blood sugar regulation issues, I suggest that you get more aggressive, preferably under 50g per day. If you have significant or persistent blood glucose issues, or you are at high risk for developing diabetes and are trying to PREVENT it, then 20-30g per day may be a better suggestion. I try to stay around the 30g range, as I am at very high risk, and as 20g was not allowing me the amount of vegetables I like to eat. You have to determine your own level of carb tolerance by your individual response to carbs (see article “Eat to Your Meter” HERE.) These carbs should come predominantly from non-starchy vegetables and some nuts (limited). I highly recommend that they not come from sugar or grains. And be careful of low carb “treats” as well as excessive dairy.
Let’s also talk about eating patterns. As we will talk about below, our body works on a rhythm or cycle. I think that, just as it is important to sleep the way we were intended to sleep, I think we should also eat in a reasonable pattern. We have come to develop these eating times based on our work schedules, or convenience factors, that may not be the best for our blood sugar and weight regulation. I do not believe that the biggest meal of the day should be at night. Nor do I believe we HAVE to eat breakfast. Nor do I believe that we need 3 meals per day, although there is nothing wrong with that per se. I also don’t buy into the new fad of using fattened coffee as a meal. Food is not only to provide energy, but to provide nutrients. I don’t consider coffee a nutritious meal. So, if you wake up in the morning, and you are hungry, eat. By all means, eat. Eat to fullness. If not, don’t eat. If you are not hungry, there is nothing wrong with delaying a meal until late morning, say 11 or even noon. In my opinion, THIS should be the biggest meal of the day, either early or mid-day. Then dinner, if hungry, should be lighter and still early, say no later than 5 -6 pm. Then no eating until the next morning to provide a long nighttime fast. I have found that late eating increases my blood glucose and weight. I try to never eat after 6 pm. But I find my BEST blood glucose and weight regulation when I eat at say 10 am (my biggest meal) and then around 3 pm – only 2 meals per day, fasting for the remaining time. I do this occasionally, but sometimes I am just hungry and need that third meal. So my pattern is more one of “intermittent” fasting. Either way, no eating past 6 pm for me. Oh, and PS, no in-between meal snacking….
If you are overweight and have blood sugar issues, I suggest that you make an attempt at weight loss. Excess abdominal fat is both a sign of insulin resistance and can ADD to insulin resistance problems, meaning that you will either have to make (or take) more insulin, which in turn can increase resistance and weight gain, etc, leading to higher blood sugar. I address weight loss in my Troubleshooting Weight Loss article.
While I am in total agreement that exercise is NOT the primary way to lose weight, and exercise DOES NOT make up for a bad diet, exercise is absolutely crucial to good health. Just about every living person can exercise. There are activities that everyone, no matter how limited in abilities, can do. If you are healthy and have no obstacles to exercise, I suggest that you start a daily exercise routine. Exercise can increase insulin sensitivity and improve blood glucose. I understand that for most people, exercise is not enjoyable. Most people hate it. We are overworked, tired, stressed, etc. But those are the exact reasons people NEED to exercise. Exercise increases your energy levels, helps you sleep better and helps relieve stress, not to mention all of the other benefits to your health. We have got to stop making excuses. I have been guilty of this. My problem was that, as with everything else I do in life, I don’t know how to do anything moderately. I always felt I had to do the max amount of exercise I could tolerate and then I would hate it. I really WAS too tired for that kind of exercise. It is so unnecessary. A while back, I decided to find some very simple, enjoyable exercises to do. For instance, I do about 20-25 minutes of high intensity exercise (including warm up, cool down and stretch) that I do daily. I also do strength training 2-3 times per week. Exercise doesn’t have to require hours of time, or a gym membership. Just commit to 15 minutes, then in time, try to increase to 30 minutes each day. Since I have been doing this, I have seen a significant improvement in my BG and the scale, which had been stagnant, has begun to move. If you are limited in ability, try seated strength training exercises, resistance bands, etc. There is SOME type of activity that every person should be able to do. Finally, timing of exercise can be important as well. Exercise earlier in the day being preferable to exercise in the later evening as this coincides better with natural hormone fluctuations. This is more of a factor with vigorous exercise. If you exercise vigorously earlier in the day is better. Mild exercise should be fine at any time. But preferably no exercise within 2 hours of bedtime. No more excuses. As a well known adage states “just do it.” We can’t expect results from work that we don’t do.
All of the disciplined eating or exercise may be for nothing if you aren’t sleeping well. When you don’t get adequate sleep, hormone fluctuations may keep you from being able to regulate your blood sugar and weight. Once again, I know we are all busy, stressed, etc. We’ve got a million excuses of why we can’t get enough sleep. Well, I’ll just say, if you don’t, then you will have serious health consequences. Every adult needs 7-8 hours of continuous, uninterrupted sleep, but no more than 9-10 hours. And it’s not just the amount of time, but the pattern as well. Sleeping from 1 am to noon the next day is not the best pattern. Our body works on a rhythm that should be maintained as close to its natural cycle as possible. I suggest sleeping from 9-5, 10-6 or 11-7, something like that. Staying up late is just not healthy folks. I personally try to be asleep NO LATER than 10. I wasn’t always like this. I used to stay up very late and get up very early. And this pattern took its toll. I understand that shift work may prevent a healthy sleeping pattern. I have worked night shift before. Here is an article that can help you improve your sleep quantity and quality. (HERE)
Once again, if you are doing everything above, but have uncontrolled stress, then all of your efforts may be for nothing. Stress also causes changes to hormone levels that can prevent good blood glucose and weight control. It is not easy to control stressors. We often just cannot remove them. We must then strengthen the way we cope with them. If you have excessive stressors in life, you MUST do something to ACTIVELY control stress. Adequate sleep is the first key to reducing stress. Exercise can also be a stress reducer, and not just vigorous exercise, but also just stretching and practicing active relaxation. Some people pursue spiritual activities. I do all of these. I also use essential oils to help me with both sleep and stress. What I am saying is that stress reduction is not a passive activity. You have to think of things you can do to actively try to control stress. Even if it means going to a private place for 15 minutes and just focusing on your breathing. Or, maybe for you it means going to a private place for 15 minutes, putting on gloves and hitting a punching bag. Whatever it takes, lol! Listening to nature sounds. Aromatherapy. Massages. Accupuncture. Once again, whatever it takes. I don’t suggest “retail therapy” because then the credit card bill will give you added stress, lol! Stress reduction is an area that I have to focus on daily so as not to let stressors get out of control.
There are many drugs on the market that can elevate blood glucose. Some of them are necessary for life. Some, however, may either not be necessary, OR a similar drug can be substituted that does not have this side effect. If you don’t know whether a drug you are taking can contribute to hyperglycemia, do some research. Determine whether you need the medication or if lifestyle change may allow you to discontinue its use. If you cannot discontinue it, find if there may be a substitute that does not carry this side effect.
If you are doing all of these things and you are still having blood sugar regulation problems, then, it might be a good idea to have a thorough medical examination to evaluate any conditions that could be preventing good blood glucose control. Check you health markers, such as your thyroid markers, cortisol levels, etc. There are many tests that can be performed. And when you get these tests, do not rely on the healthcare provider’s interpretation alone. Many providers will tell you that everything is “normal.” “Normal” does not mean “optimal.” For instance, according to a lab, fasting blood glucose up to 105 is “normal.” But it is far from optimal. In fact, it is very problematic. When determining “normal” lab values, they consider what an average is for all people being tested in a population. But all people includes those with advanced disease. So, in order to say that a blood glucose number of 105 is “normal,” the range of blood sugars considered probably contained thousands and thousands of people with diabetes. So “normal” is not optimal, by far. You will have to do your research about what is optimal levels of these health markers and determine what needs to be done to reach these levels.
Finally, if you are STILL having problems with blood glucose regulation, despite all of these measures, maybe you need pharmaceutical intervention in controlling your blood glucose. Let’s face it. Most likely you learned about a healthy low carb lifestyle after years of following bad dietary advice and, well, to put it frankly, the damage has been done. That is the case with me. Or, maybe you WERE taking something to control your blood glucose and you decided to stop taking your medicine. Maybe it was too soon. (See my article “When Can I Stop Taking Medication for My Type 2 Diabetes?” HERE.) If your body cannot make enough insulin to control your blood glucose when you are eating only 30g of carbs per day, have a healthy eating pattern, are active, sleeping well, and controlling stress, then folks, you just don’t make enough insulin. You know what I will do when I get to this point? Take insulin. How about the other diabetes medications on the market, specifically oral medications or other injectables! That is a personal decision you have to make. But I personally am not comfortable with any of them. I personally would take the EXACT thing my body is missing, which is insulin. (My article, “Insulin – Friend or Foe?” HERE.). But that is only my opinion. You must explore your own options.
You are welcome to take my diabetes management course. You may pick up additional pointers there. For more information, go to the “My Services” tab. These courses were designed to take those with little knowledge of LCHF and guide them towards a healthy low carb life. But I have an entire section of the program that deals with these issues above.
So, that is it in a nutshell folks. Hope this is helpful.
Once again, wishing you health and happiness.