Thoughts from a Doc: Why do my sugars DO that?!?

Today's post comes from Dr. Stuart Chipkin, Valley Medical Group's Endocrinologist and Diabetes Program Director. 

This is only Part 1 - stay tuned in coming weeks for more. 

Thoughts from a Doc: 
Why do my sugars DO that?!? (Part 1)

I get asked this question several times a week. I usually take this as a chance to remind people how complicated blood sugar control is.

There are at least six factors that influence blood sugar (glucose) levels. Let's start with two: 

Food: obvious, and yet not so easy. “Simple” sugars cause rapid increases in blood sugar. More complex sugars (those from milk, grains, starches) cause glucose levels to rise more slowly and over a longer period of time.  We try and take advantage of that when we talk about eating more “complex” carbohydrates- either to let your body “catch up” to the carbohydrates that have been eaten or to be available over a longer period of time (after exercise or after a low blood sugar).  And it turns out that the way sugar is absorbed can be affected by other foods such as fiber or fat.  So sometimes foods make sugar levels go up fast and sometimes they go up more slowly.

Exercise: also obvious but also not so easy. Activity that uses a lot of muscles cause those muscle cells to absorb glucose (sugar) from the blood.  But your liver usually makes extra glucose for your muscle cells.  Very vigorous exercise (e.g., running longer distances) can cause your body to release adrenalin (also called epinephrine) which makes your blood glucose levels rise further.  But those muscle cells that absorbed the sugar during exercise continue to absorb it after exercise.  In addition to “soaking up” more sugar following exercise, muscle cells also become more sensitive to insulin.  In some cases, the increase in sensitivity can last over 12 hours!  So sometimes exercise can raise your blood sugars initially but sometimes exercise can make your glucose levels decrease after exercise and then, sometimes, your body may seem to overreact to insulin for many hours afterwards (not typically more than 18 hours).  

Next week's post will discuss other factors, including hormones, medications, not to mention the "element of mystery" that anyone with diabetes knows all too well. With all these different factors, and the ways that each of these factors can change blood sugar values, it’s pretty impressive we ever get things close to being on target!!  This is why each individual has to learn about their own personal diabetes and some of the “quirks” of how their body responds.