#293 Blood Sugar Management is About More Than Carbohydrates

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When it comes to managing your blood sugar, a low carbohydrate diet is only part of the picture. Without understanding the other pieces, you can easily find yourself frustrated by thinking you’re doing all the things and still not having the result you’re hoping for. 

In this episode I’ll tall about 4 other big players in the game of blood sugar management.  

There’s rarely, if ever something in our body that is affected by just one mechanism and blood sugar is no different. There are other lifestyle factors and the process of aging itself that can have a big impact on blood sugar management. 

Because this is such an important aspect off metabolic health, you need to have all the pieces of the puzzle so you can take a holistic approach to this critical piece of your health. 

Listen now and gain more tools to support your amazing body. 

Referred to in this episode: 

Better Than Before Breast Cancer Life Coaching Membership 

#74 The Healing Power of Sleep and What Happens when Sleep Goes Wrong-Part 1 

#75 The Healing Power of Sleep and What Happens when Sleep Goes Wrong-Part 2 

Tests to determine menopausal status 

Estrogens and the regulation of glucose metabolism 

The Impact of Poor Sleep on Type 2 Diabetes 

Chronic stress puts your health at risk 


Read the full transcript below: 

Laura Lummer 0:00
You're listening to the breast cancer recovery coach podcast. I'm your host, Laura Lummer. I'm a Certified Life health and nutrition coach, and I'm also a breast cancer thriver. If you're trying to figure out how to move past the trauma and the emotional toll of breast cancer, you've come to the right place. In this podcast, I will give you the tools and the insights to create a life that's even better than before breast cancer. Let's get started.

Laura Lummer 0:32
Hey, friends, welcome to another episode of Better than before breast cancer with the breast cancer recovery coach podcast. I'm your host, Laura Lummer. And today is our Tuesday terrain talk, where we talk about all things that you have control over and that you need to have information on to be able to be in that power seat of working towards and achieving your optimal metabolic health, healthy body, the terrain and the tissues of your body. So important. Now, if you listen to this podcast with any regularity, you know that I talk a lot about a low carbohydrate diet and managing blood sugar. Now, following a low carbohydrate diet, or the consumption of carbohydrates is definitely one very big player in the management of blood sugar. And I've talked about many times before why that's important, right? Managing our blood sugar is so important one as we age because we become less insulin sensitive and more glucose intolerant, as we age. Menopause is a player in that which I'll talk about more today. And there are also some other significant pieces of our lifestyle that can impact our blood sugar. And when we understand that, I think it can save us from a lot of frustration. And here's how if you are trying to manage blood sugar for just your overall health, or for supporting your body's ability to heal itself from cancer, or just to stay healthy. And you're following a low carbohydrate diet, and you're finding that you're not getting the results that you want, you can lead to frustration, if you're really tracking and you're really falling, you know for sure like this is I'm following the right macronutrient intake, I have a low carbohydrate diet, I'm eating good healthy foods, I'm not eating processed foods, when you've worked through all of that. And you still find yourself not getting the results you want. There may be some other parts of your lifestyle that you don't realize can keep that glucose level high and increase it. And if you don't know that, then you tend to get really frustrated and give up on the nutrition part of it, which is really important. So I want to talk today about three different things in our life that have an impact on increasing our glucose levels are playing a role in the management of our glucose levels. So when you get this whole picture, then you realize that there's so much more to supporting your body than just what you eat, although what you eat is a very important part. But I don't want you to give up on what you eat, because you're missing these other pieces. So let's talk about three important things that play a role in increasing your blood sugar aside from what you ate, okay, so the first one we're going to talk about is stress. Do you know that stress, chronic stress plays a role in increasing your blood sugar, that there's this whole stress response that happens inside of our body, I'm going to tell you about that. And when it happens, it increases our glucose levels. So if we're undergoing chronic stress, and there are other factors that play a role in the management of stress, and the management of glucose, I'm going to talk about next was kind of all intertwined. But when we're under a lot of stress, if it's acute, if it's for a short period of time, it's still going to affect your glucose levels. But if it's something like let's say, a deadline at work, or a party or an event that you're planning, and it's a lot of stress for a short period of time, then we don't worry about it so much, because it may affect glucose temporarily, but then it's gonna go right back down. But if we're under chronic stress, if we're in a situation or in a way that we're not managing our mind and our thoughts, such that we're able to maintain a sense of calm and peace for most of the time, but we're undergoing chronic stress. This plays a major role in keeping blood sugar levels elevated. So what happens is this mechanism when we're under stress, so what is stress really, but a perceived danger, right? It's a perceived kind of a threat. So I just mentioned party planning and event planning. You're thinking, okay, that's not really dangerous. But in our head, it is because you're thinking about a deadline. And it's not the deadline itself that triggers the brain to experience stress. It's your thoughts about what's going to happen if you don't meet the deadline, right? So if I don't meet the deadline, I don't let's say that I'm planning a wedding, but I'm planning a wedding and I don't meet the deadline. The flowers aren't to be there, the cakes not going to be there, people are gonna judge me everything's gonna fall apart, right? It's those kinds of thoughts that create stress, if it's something from work, and it's interactions with coworkers, or bosses, or it's deadlines at work, or it's just the overall experience, and whatever it is that you're doing for work, there's even more thoughts there about what people think about you financial security, all of the things that are involved in what work represents for our life. And that can create an environment of chronic stress. We tell ourselves, we can just push through it, it's okay, I can deal with it, I can push through it. But I just want you to really think about what that means to your health. And why we think pushing through it is acceptable, rather than actually seeing it for what it is, and stepping back and caring for yourself. So when we're in this condition of stress, what happens is our body produces more adrenaline and more cortisol. And when they're released in our body, they increase our glucose levels. So let's talk about like, like, at the most fundamental level, right, we're just these animals, we're mammals out there, like trying to survive. And so we have that fight or flight response. And you may not think about things like a deadline, or a party or something at work as a fight or flight situation. But it really is, depending on how you think about it, as I just refer to. So what happens when our body goes into fight or flight? Is it excretes more cortisol, more adrenaline, which causes our livers, okay, let me put more blood sugar out there. Because in a situation where we have a perceived threat, we want to be able to be active, right, we want to step up, we want to do things. And so our body is going through that chemical process of saying, Let me increase this. So you have more blood sugar, so you have more energy, so you have less appetite. So your digestive system is going to get shut down and not be as effective. So that this kind of a natural alarm system and your body says get up and do something, get up, get up, get up and meet the deadline, get up and face the day, get up and push through things, right. And as we're doing that, the blood sugar levels are increased, because glucose gives us energy. So if we're following a good low carbohydrate diet, but we're living a life of chronic stress, we could still be seeing elevated glucose levels. And if you're not following a low carbohydrate diet, and you're living a life of chronic stress, then it's kind of like a double jeopardy, right. But the good thing is that when the perceived stressor, ends, or stops, our body does return back to a normal state, a less heightened state a less fight or flight state, and we're producing less of those elevated levels of cortisol and adrenaline. So doing much less harm to ourselves, which is why it's so important to really be honest with yourself about stress levels. And I say I emphasize being honest with yourself, because I coach women all the time, who really just don't want to embrace and sit in the fact that they live with a lot of stress, or that they create a lot of stress for themselves. And I want to be really careful when I say that when I say you create a lot of stress for yourself, that is not a judgment, that is not a Oh, it's all your fault, or oh, it's all in your head kind of thing. The way we think is the way we think it's the way we've been conditioned to think. And without doing intentional work on training your brain to think differently, then it's just going to keep happening, you know, we have this cycle we get into and we don't know how to get out of it. And we don't even realize that this cycle and the way we perceive things, and the way we think about things is elevating this level of stress. So it's hard for us to see that things could be any other way. Right? You think well, this is how I've always done it. This is how I think about it. And it's stressful. How could there be any other way. But there are other ways because we can be in situations that are demanding. And we can look at them in different ways to lower the level of stress in our body. There are some times with my clients, especially if you're going into stressful situations, we use a tool called the thought download to get lots of thoughts out of your head that are just floating around there stressing you out and look at them, honestly, and ask different questions about them. That help you see like, is this a true thought? Is this a useful thought? Is this thought serving me in any way? Is this supporting my health to think be thinking like this? Or could I change the way I'm thinking about the situation, change it in a ways that's still truthful and still honest. But the first thing you have to do is admit to yourself when things are stressful, and then realize that if you hear yourself say this, like I'm so stressed, stop, you have some power over that. You can step in and do things to reduce that level of stress by shifting that paradigm and that lens that you're looking at specific situations through. Now, some factors in life are just going to be challenging, right. And so we may be going through some stress, but we can manage it and keep it as low as possible for our own benefit. And one of those things that actually increases our levels of chronic stress is the second thing I want to talk about that has an impact on our blood sugar levels. And that is sleep. So I think about breast cancer treatment. And you know, I have always been a person who I can sleep anywhere, anytime, anywhere, doesn't matter how much noise there was, I am not an insomniac, I go to sleep, and I wake up, you know, eight hours later and go, Whoa, I have eight hours passed. That's how I always was until chemotherapy, right? Chemotherapy changed everything. Because I would be up all night playing Words with Friends taking a bath, something I mean, I couldn't, I couldn't sleep. I had horrendous dehydration, insomnia. And of course, if you've gone through menopause, I'm sure I've gone through menopause. If you're going through chemotherapy, you can feel what I'm saying here. You've been through this as well, and it puts us right into menopause. So then we've got the menopausal symptoms that we're dealing with to the hot flashes, the night sweats the discomfort, right? So cancer treatment has a huge impact on the body from the point of stress, physical stress, emotional stress, mental stress, and it impacts our sleep. And when our sleep is impacted, our stress levels go through the roof and our glucose management is tremendously impacted. So I want to share something straight out. I'm going to quote this from the National Institute of Diabetes and Digestive and Kidney disorders to give you a really solid idea of how important sleep is, and the major impact that it has on our blood sugar management. So this is a quote, and I will link to this article in the show notes for this episode, which we'll find at the breast cancer recovery coach.com forward slash 293. So this study talks about not enough sleep and irregular sleep. And what it says about having not enough sleep is that probably the most common sleep disturbance is insufficient sleep. People are not in bed long enough. They want to take advantage of leisure opportunities social networking in our 24 hour society. High school aged children are probably among the most sleep deprived segment of the population. And the sleep routines they develop at that age set them on a trajectory of not prioritizing sleep as a pillar of health, a pillar of health Okay, super important, and goes on to say that studies show that many sleep problems associated with insulin resistance, pre diabetes and diabetes have a significant impact on glucose tolerance. For example, experimental evidence says that if you take healthy volunteers and force them into a schedule, where sleep does not occur consistently during the night, the result is a decrease in glucose tolerance and insulin sensitivity. And that's in addition to the established connection between type two diabetes and sleep disorders like insomnia and obstructive sleep apnea. Obstructive sleep apnea. This is mind boggling affects about two thirds of people with type two diabetes. Its severity affects our glycemic control in people who have diabetes and the more severe the obstructive sleep apnea, the lower the insulin sensitivity. It says that sleep problems are also an issue for people with no diabetes risk factors. Studies on young healthy adults without obesity or any diabetes risk factors have examined the effects of reduced sleep under controlled conditions in the laboratory. And there's a consistent association with decreased insulin sensitivity in the range of 25 to 30%. So decrease insulin sensitivity, our insulin is released, it knocks on ourselves, it tells ourselves Hey, suck up some glucose. But when we don't have that sensitivity, the insulin comes knocking and the sales don't open. And so the glucose stays in our blood. So this is showing an association with a decreased insulin sensitivity of 25 to 30%, after as little as four to five days of insufficient sleep. So that's reliable evidence that insufficient sleep has an adverse effect on glucose tolerance, and can bring people who are otherwise healthy to developing pre diabetes. That's major listening because I was just talking about what happens to us when we go through chemotherapy when we go through menopause and we're getting insufficient sleep because we're having hot flashes or feeling sick or having night sweats. So this study goes on to say that subsequent cohort studies showed that after controlling for factors such as age of body type, body mass index, being sedentary and fat, family history, and excluding people who have diabetes. Participants who slept for short durations are 40% more likely than those who slept for seven to eight hours of sleep to develop diabetes. And for people with sleep disorders, we know that moderate to severe obstructive sleep apnea is a risk factor for developing type two diabetes. And the increased prevalence of sleep disorders such as obstructive sleep apnea parallels, the rise in obesity. And these two epidemics contribute to the dramatic increase in the prevalence of diabetes. So it's a lot of reading that study, but I thought that was such important information. And again, I will link to that in the show notes. But think about the impact that sleep has on glucose management, on weight and weight gain, and diabetes. And then think about what we go through when we are thrown into chemically induced menopause, or we're already in menopause, get a diagnosis go into chemotherapy in exacerbates those types of symptoms, and affects your sleep. So what can you do? Well, sometimes you can't stop a hot flash, right? Where if we're especially having hormone positive cancer, hormone sensitive cancers, we're taking hormone blockers, we're not going to go out and do you know, hormone replacement therapy to try to get more sleep. So what can we do? And how can we reduce this impact of increased glucose intolerance and decreased insulin sensitivity when we're experiencing ie regular sleep. So one thing is go back and listen to the podcast I did I think their episode 74 and 75. With Dr. Stephanie green on sleep studies, and sleep apnea, and sleep hygiene, such important information in those two podcasts, I'll link to those in the show notes. But you've got to make sure and focus on your sleep hygiene to make it as comfortable as possible that your room is as dark as possible electronic devices and LED lights and all that kind of stuff is shut off in your bedroom, because it is the light that wakes us up. When our body our optic nerve senses light, it sends a signal that it's time to wake up. What happens when it's time to wake up, our body releases cortisol to stimulate the liver to say, hey, release more glucose, wake this person up. That's what wakes us up during the day. So during the night, we've got to make sure our room is cold and dark. And having a sleep routine, being very effective about how you relax into going to sleep will help with that. And then something else also is really working. And it's kind of a meditative process of working on what you expect from your sleep. This may sound a little weird. But when we tell ourselves that we're not going to sleep well, we're more likely to not sleep well. But when we have a nice routine, and we had to have a little bit of a meditative kind of routine, where it's like, I expect to sleep soundly. And well. It's kind of another part of changing our thoughts and training our brain. Because when we're going to bed sometimes, and there was a time in my life where I realized and I worked with my own coach on this because I realized, I was stressed out about the idea of going to sleep because sleep was so uncomfortable, which was a new experience for me and a not a fun experience that I was dreading going to bed and I was dreading the experience of a long night of uncomfortable sleep. And so I had to do a lot of work on changing my expectation and training myself to believe that I was going to be able to sleep better, making sure that I was well hydrated, making sure I had a sleep routine, and making sure that I had a dark cold environment. All these things were key factors. And it really made a substantial difference in my ability to sleep. But can it be fixed 100% I don't know. It may be for you, it may not be for you. But that's why it's important to know that stress management is a major factor. So let's say you're having irregular sleep, that increases stress. And we're already having stressful situations in your life. There's a double stack. If you're not following a low carbohydrate diet and you have high glucose levels, there's a triple stack. That's why I say we have to take this holistic approach, there may at times be things in life that we can't get complete control over. So we've got to do the best we can. We've got to realize this thing is a major player in my glucose management. But maybe I can't sleep all the way through the night or maybe I don't sleep more than five hours. So I know that has an impact. So I've got to be even more diligent with the other things that support my ability to manage glucose in a healthy way. Okay, super important to realize that. Now the third thing that you may be a little surprised about is dehydration. And as I mentioned, when I went through chemotherapy, and for years after you guys, actually, it's never been the same, I never understood why people would have a glass of water next to their bed. And so I went through chemotherapy, and the high dehydration was so severe that I was constantly waking up to have a drink of water. And I still to this day, have water by my bed and probably wake up one or two times during the night to take a drink of water, even though I focus on hydration throughout the day. So the last few months, I focus a lot on consuming more electrolytes and and just really focusing on Deep Hydration for my body. Because here's what happens when we're dehydrated, it's less fluid, right? So let's think about our blood, we've got blood sugar, our blood is a fluid, when we're well hydrated, that fluid has a nice balance. When we're dehydrated, our blood is less fluid, it's gets thicker, it gets stickier. So let's say that you have a certain level of blood sugar. If you're dehydrated, you have that same level of blood sugar, but you have less fluid in the blood. So that ratio, right, that concentration of glucose actually increases because you have less fluidity in the blood. So dehydration can be a major player. Also, when we're dehydrated, our kidneys, which is one of the jobs that our kidneys do, or one of the jobs our kidneys have is to urinate out excess glucose from the body. So you may have heard one of the signs or one of the symptoms that people are moving into diabetes is frequent urination. Because the glucose levels are too high, our bodies are super smart. They're always sending signals to other parts of the body and say, Hey, this is too high, get rid of this. And so our body is trying to work to get this extra glucose out by urinating more frequently. And then when we're dehydrated, and we don't have that fluid, our kidneys are less effective and less efficient at ridding ourselves from that excess glucose. What happens then it triggers a stress response, right, because the glucose is too high. And when is our body respond with stress when we're in danger. If glucose is too high, it's going to send danger, it's going to increase stress, the kidneys aren't working properly, and we're not sleeping right. All of those things increase stress, they stimulate and trigger the stress response, more stressful hormones go out on our body, higher glucose levels. So these three things come together in this amazing symphony of support or of undermining each other. So sleep, hydration, and stress are some major players in the management of blood sugar. Now, at the time of this recording, we're moving into the fall in winter. And people oftentimes don't realize that hydration during cold weather is equally if not more important, then when we're in the hot weather. And I say more important, because when we're in the hot weather, we realize that we're thirsty, we're sweating, and we realize that we're thirsty and we're we're filling that thirst response, right, our mouth is getting dry, which we're already into dehydration when our mouth is dry. But we have a tendency to go and get more water and think about water more frequently when it's hot outside. But when it's cold outside, we actually get dehydrated just as easily. And we lose fluid through the process of breathing, especially in cold dry air. So when you breathe in cold dry air, your body has to use fluid to warm up that air because we have a certain body temperature, we got to keep things warm inside of us. And as we exhale, we lose water, right? So as we inhale, we got to humidify. As we exhale, water droplets are being exhaled. And so this fluid loss can add up when it's cold and dry outside, and we don't realize it because we're not sweating. And then colder temperatures also kind of suppress that thirst response. So we don't feel as thirsty as we would when we're in hot weather and sweating our butts off. And here's a really interesting thing. I talked about increased urination when it comes to getting high levels of glucose out of our blood. Well, when we're cold. This is fascinating. It this phenomenon called Cold induced diuresis happens when the body is exposed to cold temperatures, so it increases our urine production. And that's partially because when it's cold, our blood vessels constrict. When our blood vessels constrict, it increases our blood pressure. And so then our body tells itself I got to get rid of extra fluid to take some of this pressure off and get the blood pressure back down to a normal level. And so that can even lead to more dehydration. Okay, so when the weather gets cold, don't kid yourself into thinking that you don't need to drink as much water as you do when it's hot. Also Don't go crazy, don't go like drinking gallons and gallons and gallons of water, right. So think about drinking half of your body weight in ounces of water on a daily basis. That should do it. If you are super active and you're exercising a lot, you may need more than that. If it's really hot or really cold where you're at, you might need more than that. But don't overdo it right? We want to see balance at all times excess craziness is just it's totally unnecessary. So we've talked about menopausal symptoms. But I want to just go a little deeper into glucose management and menopause because a very common thing for us after breast cancer treatment is weight gain, belly fat especially, and difficulty losing weight. Well, what are some major factors in weight loss, insulin and glucose. And I've just explained to you how different lifestyle factors diet, sleep stress,

Laura Lummer 25:56
hydration can affect those glucose levels. But let's look at another big player that you probably wouldn't suspect in glucose management. And that's estrogen. So what is menopause? It is the cessation of the menstruation cycle for a period of one year, right? When you hit one year without a period you are considered to be in menopause. And as far as estradiol levels, so one of the estrogens in our body and normal level of that is 30 to 400 pico grams per milliliter, that's the measurement for estrogen. But after menopause that falls below 30. Right, so very, very low levels of estrogen in our blood. So I looked at a 2021 study in the Journal of World Diabetes. And that speaks volumes to estrogen. And just to preface what I'm about to share with you. In the study itself, it says that there's a dramatic oversimplification of estrogen because there's many variants in estrogen, but most of these studies have been done on what's called 17 beta estradiol, so a form of estrogen, that when people refer to estrogen, that's generally what they're referring to, and what's been the most studied. So when looking at these studies and talking about estrogen, insulin, and glucose, and how those three impact each other, the study says that the effect of estrogens on glucose and energy handling this is I keep emphasizing energy, because how many times after cancer treatment and after menopause, we hear I don't have energy, I don't have energy, okay? The effects of estrogen on glucose and energy handling are mediated through four coordinated actions. One is the protection and facilitation of insulin secretion. And the function in the control of glucose availability to the tissues. This is what estrogen does to is the modulation of energy partitioning. So deciding what energy gets used. And it favors the use of lipids or fats as the main energy substrate when their availability is higher than that of carbohydrates. So when we have a lot of estrogen that estrogen says, Hey, use the fat stores first. Can we all think back to when we were kids when we could eat anything, and maybe as teenagers and maybe even still in our 20s. And maybe if we were lucky still in our 30s when we had lots of estrogen, and it's like, sure I can eat that See's Candy, and not have to worry about it. Okay, three. Another function is the protection through antioxidant mechanisms. And four is the central effects on the whole body energy metabolism, and homeostasis maintenance. So keeping our body even keel not up and down hot and freezing, right, exhausted and energetic, the manic effects of menopause on our body. So estrogen plays a significant role in weight gain, weight management, glucose management, and insulin sensitivity. So when we're in menopause, we have to remember that our body is different than what it was before menopause, okay. And when we realize my body works differently now, I don't have 30 to 400 pico grams of estrogen per milliliter, right? We don't have that substrate in us at the levels we once did. And so we've got to remember that that affects our glucose levels, our insulin sensitivity and that both of those things can have an impact on our overall metabolic health and on cancer, cancer management and recurrence. Okay, so it doesn't do us any good to not be here in that moment and say, this is where I'm at. in menopause. This is what happens in menopause. This is how it affects my sleep when it affects my sleep. This is how it affects my stress. Because now we've got a big picture. So now you say, Well, what I'm screwed, and it's coming at me from all sides. But no, understanding that there are all of these players in the management of glucose gives you a lot more opportunity. So not any one of them is probably going to be perfect. But if you can focus on all of them, right, if you can focus on stress reduction, if you can focus on low carbohydrate consumption, if you can focus on making sure you stay well hydrated, that you're exercising and not staying sedentary, and that you're doing all the other things that can increase insulin sensitivity, and help with glucose management, then nothing may be perfect, and nothing's gonna go back to the way it was before menopause. But the picture comes together much more nicely. And all of your energy that you are focusing on eating can be balanced around everything and say all of these factors make a difference, right? Life is a holistic experience. It's not nothing is isolated, our mind is not isolated from our body. Our sleep is not isolated from our stress. Our food is not isolated from the way that our gut works from the way that our gut affects our brains like we are one big synergistic being. And the more we realize that, and the more we understand that all around lifestyle factors are what we need to be addressing, and not in a stressful way. And not at all. I got to do everything and pay attention to everything, but just in an awareness. Where are you taking care of yourself? Where are you open to making some changes? What is your body telling you? Maybe it needs differently? And do you understand how these lifestyle factors affect and support your body's ability to feel good, so if you're lacking in energy, if you're struggling with glucose management, if you're struggling with weight loss, now you have more factors to think about, and to focus on to just kind of bring everything together in one holistic supportive plan. All right. If you need help with that, you know, I am a certified metabolic train advocate. I practice teach and support people in the metabolic approach to health. I'm a certified nutrition and health coach. And the bottom line is as a life coach working on your thoughts around all of these things can make a significant change. So come and get the support you need and join me in the better than before breast cancer life coaching membership. You can find all the details at the breast cancer recovery coach.com forward slash life coaching and I hope that this information has kind of helped to open a whole new vision a whole new world for you have all kinds of opportunities that you have to do something good for yourself. Alright a friend I'll talk to you soon Until then be good to yourself.

Speaker 2 32:54
Use your courage to the test laid all your doubts you your mind is clearer than before your heart is full monty more your futures Give it all you know has you been waiting



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