- Living with type 1 diabetes since the age of 14 (2 decades) I have at times been puzzled by blood sugar spikes despite maintaining an A1C under 6%. The algebra equation I was originally provided by the endocrinologist only had 3 or 4 variables. But I have noticed there are really about 20, some of which I explain here.
- Dehydration: As we say in chemical laboratories, “the solution to pollution is dilution.” When your body is not holding enough water, glucose concentration in the blood rises because the volume of blood is low. Concentration = (quantity of glucose)/blood volume. Read my post about hydrotherapy for type 1 diabetes for the full scoop.
- Delayed metabolism of proteins and fats: About 10% of fats and up to 50% of proteins consumed can be converted to glucose through gluconeogenesis in the liver and skeletal muscle. Protein metabolism takes 2-4 hours. Fat metabolism takes 2-8 hours.
- Over-consumption of protein: The body can assimilate only so much amino acids (the building blocks of proteins) at any given time and any given day. I suspect this is around 100 grams max per day for a 150 pound person. I’ll need to investigate that quantity further. But regardless, when you eat more protein than your body’s cells need, the excess is converted to glucose through gluconeogenesis for storage (glucose is the building block of fat it seems).
- Strenuous exercise: This breaks down muscle through a process known as catabolism under certain conditions. It also increases absorption of insulin into the tissues – the lower level signals glucagon release and hence the release of glucose into the blood from the glycogen stores. The solution is not to overexert yourself. Moderate aerobic exercise is inherently fat-burning (ketone burning) and below the “anaerobic threshold,” the body won’t start releasing glucagon hormone to breakdown glycogen into unwanted glucose (which a T1D will struggle to assimilate without enough insulin supply).
- Stress: Stress in many forms can do sabotage your blood sugar. Read my post about cortisol for more info.
- Not enough sleep:
On the other side of the equation, just wanted to mention one reason for seemingly unexplained blood sugar drops (hypoglycemia in severe cases): Delayed release of insulin from injection site: As one example, insulin glargine (such as Lantus long-acting) is present as a crystal in the injection site. The crystals can accumulate and then suddenly dissolve as conditions in the body change (pH, hydration, exercise, etc.) Just keep in mind that some types of insulin build up in the tissues. In glargine specifically, it is injected as an acidic clear solution but then crystalizes in the alkaline environment in the subcutaneous tissue.
Just realize that insulin therapy is governed by a complex equation that is only an approximation. The body is a wonder created by HaShem (the Holy One of Israel). It is infinitely more complex than we can conceive. Hormone therapy in general is degrading and it is best to minimize and wean off it as best you can. Read my information about keto diet and optimizing insulin sensitivity to get started in the right direction. When you introduce an exogenous hormone such as insulin into the body, it immediately induces chemical (hormone/emotional) and electrochemical (disharmonizing) influence on more than one system and organ.
Also keep in mind that long-term insulin therapy has long-term deleterious side effects, even when one maintains ideal A1C levels.