Blood sugar is the amount of glucose present in the bloodstream at any time. It is also called as Blood Glucose in medical terminology and in common usage. Our body tightly regulates our blood glucose levels throughout the day as glucose is a key ingredient to our survival.
Glucose is one of the most simple forms of sugars as it is a monosaccharide. It is the primary and preferred source of energy for our body and brain’s cells and hence vital to our existence. In fact, our brain is one of the biggest consumers of Glucose inside our body.
Our brain only weighs 2% of the body but consumes 20% of the energy as compared to the rest of the body for all its neural activity. Blood acts as the primary carrier for glucose and helps its transport to the cells, organs, and muscles.
Glucose Absorption and Assimilation – Source of Blood Sugar
We receive Glucose through the foods rich in carbohydrates such as grains, vegetables, fruits, and dairy. Carbohydrates such as fibre, starch, and sugar are formed by the union of multiple Glucose molecules or of Glucose molecules with other monosaccharides such as Fructose and Galactose.
Glucose can pass through the extra-cellular walls to provide energy. It also participates in several biosynthetic activities such as the synthesis of proteins and fatty acids. At any time, multiple hormones are acting together to create a series of actions in the body that allow us to
- Absorb Glucose from food
- Transport it to the organs in need
- Store the excess
- Release it in blood from the stored organs as needed
Our body stores Glucose in the form of Glycogen (multiple Glucose molecules connected together) in the liver and the muscles and the rest is floating in the blood as blood glucose.
What is the Normal Blood Sugar Level?
A high blood sugar level is often a symptom indicating that the body’s functions are not happening properly. Diabetes is termed as a state where your blood sugar levels stay much higher than normal for a prolonged period i.e. over a couple of months.
Chronically high blood sugar levels or hyperglycemia indicate metabolic disorders, which result in high amounts of Glucose in the bloodstream.
Since the body’s function to regulate the glucose level is not working properly; it is quite often that Diabetic patients face low blood sugar levels or hypoglycemia as well. Hence, one needs to be watchful of their diet and physical activity.
For a healthy adult weighing approximately 70 Kg, around 4g Glucose is present in the bloodstream. Following levels are considered normal for individuals who are healthy or suffer from co-existing health conditions as listed below.
- A1C should be less than 7% (53 mmol per mol)
- For patients with hypoglycemia, micro, or macro vascular disorders, the blood sugar levels are less restricted to less 8% (64 mmol per mol).
- For patients with no significant hypoglycemia, no poly pharmacy, or treated with metformin, are more restricted to less than 6.5% (48 mmol per mol).
- Preprandial or fasting blood glucose should be 80 – 130 mg per dL (4.4 -7.2 mmol per L)
- Peak postprandial blood glucose should be less than 180 mg per dL (10.0 mmol per L)
At high risk of Diabetes – PreDiabetic
If your reading is over and above 180 mg/DL on a consistent basis (an interval of 2-3 months), then you will be prone to Diabetes and hence need to be extra careful on your diet, stress levels, and lifestyle.
Dangerous Blood Sugar Levels – Diabetes
If your blood glucose reading is in the range of 300 mg/DL or more, then is considered dangerous and requires the immediate attention of a qualified medical professional.
Understanding the Glycemic Index and Glycemic Load.
Glycemic Index (GI)
- Glycemic Index or GI is a scale from 0 -100 that is utilised to classify how a specific food product would affect our blood sugar levels.
- Low GI foods such as vegetables, lentils, and whole grains generally have complex carbohydrates.
- As they need more time for assimilation in our body, they are a much healthier choice.
- High GI foods consists of white sugar, white flour, highly refined grains, and high fructose corn syrup.
Glycemic Load (GL)
- Glycemic Load (GL) is a term used to measure the overall effect of any ingredient on the blood sugar level when one serving of the food is consumed.
- This is a better measure to understand the overall impact as it takes into account the quantity of the food item.
- For example, Sweet Potato can have a high GI but when one serving is considered, it will have a low GL for all the additional nutrients present. Hence, there is an overall positive impact on the body.
GI and GL though very popular nowadays, are fairly unrepresentative of the impact any food item can have on our body post-digestion. Additionally, this benchmark does not take into account the effect on the body when different foods are mixed together or of different variations of the same food (regional, seasonal, or species).
Simple Carbohydrates Processed Foods load our Metabolic Pathways
- Highly processed foods such as white bread, white flour, white sugar, or sugar-laden foods are the primary sources of simple carbohydrates.
- Simple carbohydrates can be easily metabolised by our body, thus quickly releasing all the Glucose molecules in our bloodstream.
- This sudden dump can actually elevate our blood sugar levels temporarily and create a haywire in our bodily systems.
- While our bodies can handle such spikes, they put too much pressure on our organs that manage the blood sugar levels.
- In fact, too many and too frequent of such spikes put our body’s metabolism at risk and we get exposed to lifestyle disorders such as Diabetes, Hypertension, and Obesity.
Complex Carbohydrates nurture and protect our body
- Whole grains, fruits, and vegetables are classified as the sources of complex carbohydrates.
- Our body takes time to break down the complex carbohydrates.
- Additionally, complex carbohydrates contain additional vital nutrients that our systems need.
- Hence, a slow release of glucose in our bloodstream along with desired nutrients such as Vitamins, Minerals, and Anti-oxidants helps our body to send the right fuel and nutrition to all the organs in need.
Hypoglycemia – Low blood glucose levels
Glucose is the primary fuel for our body. It has vital role towards sustenance of life and is utilised by all tissues and cells in the body. Chronic high levels of glucose in the blood are damaging to the organs and they hamper their capacity to process glucose to energy.
Since, the our body’s machinery is not working well, a Diabetic is often at risk of low blood glucose episodes. Low blood glucose for long hours is even more detrimental and can lead to death. Hypoglycaemia symptoms include: shakiness, irritability, tachycardia, hunger and confusion.
Hypoglycemia is the major limiting factor in glycemic control in Type I and II Diabetes as often the diabetic medication can also cause low blood glucose episodes. Classification of Hypoglycemia:
|Level 1||Glucose < 70 mg per dL (3.9 mmol per L) and glucose ≥54 mg per dL (3.0 mmol per L).|
|Level 2||Glucose < 54 mg per dL (3.0 mmol per L)|
|Level 3||Severe event characterized by altered mental and/or physical status requiring assistance as: unconscious, coma, seizures. It may lead to death.|
Hence, it is of utmost importance that the blood glucose level of a Diabetic individuals are monitored if he/she is at risk of hypoglycemia.
Hypoglycemia Emergency Management
- Pure glucose or any form of carbohydrate containing glucose (15-20gram) is preferred for conscious patients with hypoglycemia < 70 mg per dL (3.9 mmol per L). After 15 minutes if patients still with hypoglycemia, patient must repeat this treatment. When blood glucose returns to normal, patient should consume meal or snack to prevent recurrent hypoglycemia.
- Glucagon is prescribed for all patients with level 2 hypoglycemia. Care givers and Family members should be educated to how administer it to the patient.
- Patients taking insulin with level 2 hypoglycemia should raise their glycemic goals for several weeks to partially reverse hypoglycemia.
- Patients who experience level 3 hypoglycemia should evaluate their diabetic treatment.
Hyperglycemia – High blood glucose levels
Prolonged periods of elevated blood sugar levels or hyperglycemia is termed as Diabetes. In modern days, Diabetes has become endemic and has badly affected the health situation of even the young generation.
Today, Diabetes is considered to be the biggest threat to lifecycle and productivity around both developing and developed economies.
Ayurvedic Diet and Lifestyle to manage Diabetes and Hyperglycemia
The good news is that our bodies are amazing machines that can adapt well into changing environments and food habits! Modern Lifestyle practices that brought us to this grim state can be slowly modified to normalise the blood sugar levels and also to manage our health in a better way.
Food Habits for Diabetes – Ahara
- Eat wholesome foods such as minimally processed carbohydrates – rolled oats, barley, buckwheat, and whole-grain flour with good amount of chaff in it.
- Add millets such as foxtail millet, barnyard millet, and protein-rich cereals such as quinoa and amaranth in your diet.
- Bring in multiple tastes or Rasa in your diet – add bitter, sour, and astringent food products such as gourds, squashes, green leafy vegetables, and tubers. Fruits such as berries and citrus fruits carry Astringent and Sour tastes, which help to curb the cravings for sugar-laden foods.
- Always try to eat locally grown food products such as cereals, fruits, and vegetables as they are best suited to your body’s requirements per season and per environment.
- Similarly, seasonal vegetables and fruits should be preferred as they constitute the required nutrients per the time of the year to balance your body’s doshas.
- Seeds and nuts should be consumed in moderation as they provide with healthy fatty acids and complex carbohydrates.
- Sweeter dried fruits such as raisins, peaches, and dates should be consumed with moderation. They should be soaked in water for at least 4-6 hours and then consumed. Soaked water can be consumed by children, given to plants, or added to cooked meals.
- Lentils, Pulses, and beans should be added as a major portion of the diet. They will provide with required protein, fiber, and also help manage hunger cum energy levels of the body.
- Include herbs and spices such as Cinnamon, Coriander, Basil, Curry Leaves, and Fenugreek in your diet. Herbs and Spices are a storehouse of nutrients and antioxidants that help to bring the balance in your bodily functions.
Nutrition for Diabetes
- Fats should constitute about 20-35% of total calories. Taking monounsaturated and polyunsaturated fatty acids is very beneficial and decrease cardiovascular disease and improve glucose metabolism.
- Increase protein intake to 1-1.5 g per Kg per day or constituent 15-20% of total calories through healthy protein sources. Research showed that a 20-30% of dietary protein intake leads to increased satiety.
- Carbohydrates should constitute 44-46% of total calories through complex carbohydrates as stated in food principles.
- Sodium consumption is limited to < 2300 mg per day. For diabetic and hypertensive patients, Sodium intake should be below 1500 mg per day.
Foods to Avoid
- Stop eating packaged snacks such as biscuits, shortcakes, and cakes as the majority of them have processed flour.
- Remove fast food from the diet altogether.
- Stop consumption of sugar-laden beverages, artificial juices, sugar-free drinks, zero calories drinks, carbonated beverages, or anything that claims to use unnatural sugar replacements/artificial sweeteners.
- Do not eat till very late in the night. Take your last meal or dinner at least 1 hour before sleeping. This will allow enough time for food to get started on the digestion process.
- Smoking and Alcohol is prohibited as it leads to hypoglycemia.
- Patients with diabetic nephropathy should limit protein intake to 0.8 g per Kg per day
- Artificial Sweeteners or any other unnatural sweet sources to satisfy the sugar syndrome.
Physical Activity and Lifestyle – Vihara
It has been widely studied and reported that physical activity in long term can help lower the blood sugar levels for Type 2 Diabetes patients.
Benefits of Physical Activity
Exercise in any form, whether walking, swimming, sport activity, running, and trekking is one of the cheapest and safest ways:
- to have a positive effect on your metabolic activity
- to lower cholesterol
- to increase mental balance
- to lower blood sugar levels
- to increase sensitivity to insulin
- to lose weight
- for stronger heart and lungs
- and for multitude of health benefits that encompass your physical and mental functions
Adopt a Physical activity per your Interest and Age
One should adopt a physical activity, duration, and regime such that it can help them stay consistent and active over a long term as that is the most important part.
It may be difficult to change your lifestyle in the beginning, however that is what is required after all as with every slight change comes a big positive impact on your health. So, GET MOVING!!
- Obesity and Diabetes are highly correlated. Hence, strenuous physical activity on daily basis is recommended should you have high BMI and gearing towards obesity.
- Moderate physical activity such as long and brisk walks and or a combination of yoga and walks is recommended for aged and persons who are not able to carry out heavy lifting.
- Hiking, Trekking, and walking in natural set-ups works out very well to increase blood circulation and also to bring mental calmness.
Weight Loss to Manage Diabetes
- At least 5% weight loss is beneficial for diabetic patients and showed improvement in lipids, blood pressure and glycemic outcomes.
- Calorie intake should be limited and meal plans should be individualised.
- Daily recommended caloric intake for men is between 1500-1800 KCal and for women is between 1200-1500 KCal.
Stress Management – Vichara
While good food habits and physical activity are an important aspect to normalise your blood sugar levels, a stress free mind is even more desirable than the combination of above two.
It has been studied and reported that stress can lead to chronic hyperglycemia by stimulating release of hormones that elevate blood sugar levels and hence worsening the situation for a Diabetic patient.
Therefore, it becomes even more imminent to lower your stress levels by engaging in activities that can help you relax. Physical activity also can help to lower down stress levels as more often than not, one feels happy about themselves and their body after a workout (besides the hormonal release and other additional positive attributions to body that help us relax after increased physical activity).
- Pursue a hobby or passion that can help you divert your mind towards a creative side.
- Go for walk in natural set-ups or near water bodies.
- Opt for spa or wellness treats to take off the mental load.
- Spend time with family and friends.
- Take time off screen and social media. DISCONNECT TO CONNECT with your inner-self.
- Exercise and Diabetes
- Diabetes and Stress
- Stress: How it affects Diabetes and how to decrease it
- Diabetes: An Ayurvedic Perspective