Blood sugar 101 (the sheep, the sheepdog and the farm hand)

Blood sugar balance is a nutritional hot topic at the moment, but what does it actually mean, and what’s really going on in our bodies when we eat sugar? 

Before we dive in, let’s meet the key players: 

• Glucose – the sheep 
• Insulin – the sheepdog  
• Glucagon – the farm hand  

First up, there’s insulin, the clever little hormone whose job it is to manage our blood sugar levels. Insulin helps to shivvy the glucose (sugar) in our blood stream into our cells, where it can be used for energy. So when we eat a meal or snack, our blood glucose rises, insulin is released from the pancreas and glucose obediently skips off into our cells. If you like a nutritional metaphor, think of insulin like a sheepdog, herding the glucose (in this case the sheep) from the field (our blood stream) into their pens (our cells). 

When there isn’t any glucose in our blood stream (perhaps because we haven’t eaten in a while), another equally clever hormone called glucagon steps in, calling for our stored glucose (called glycogen) to be released and burned for energy. Going back to our sheep-farming metaphor, glucagon is the farm hand that releases the sheep from their pens back into the field. 

If everything is working smoothly, this delicate insulin / glucagon see-saw goes on all day without us even realising, ensuring that we always have enough glucose (but not too much!) in our blood stream, as the green line below shows.

But when we eat too much sugar, glucose and insulin can end up being constantly high (hyperglycaemia). Over time, our cells stop responding to insulin (known as insulin resistance) and stop taking glucose into our cells. Imagine the sheep becoming so used to the sheepdog trying to herd them into the pen that they no longer respond to its command. 

Imbalanced blood sugar levels are a big disruptor of our other hormones. Regular peaks and troughs in blood sugar can cause cortisol (our main stress hormone) to be released in order to break down our blood-sugar stores. This is not what we want, especially if we’re already under high levels of stress. The release of cortisol triggers yet more insulin to be produced and can ultimately lead to too much circulating insulin (hyperinsulinemia).

High insulin causes the ovaries to create more testosterone, as well as the conversion of testosterone to oestrogen – the result is more testosterone and more free oestrogen whizzing around in the body, which can lead to excess oestrogen / oestrogen dominance. All this might manifest itself in acne, excess facial hair, weight gain, fatigue, anxiety, irregular periods, and fertility issues, as well as many other symptoms.

Over time, hyperglycaemia can lead also to inflammation, gut bacteria imbalances, compromised immunity and many more health issues.

Insulin resistance is going to worsen and prolong the symptoms of perimenopause and menopause. It can also can lead to or worsen health issues like diabetes, obesity, cardiovascular disease, metabolic syndrome, and polycystic ovary syndrome (PCOS). 

When there’s too much glucose in our blood stream, glucagon stays on the sideline, and we never get to the point of releasing glucose from our energy stores. If our glucose levels are constantly high, excess glucose is converted into fat by the liver, which is stored in our fat cells.[1] 

More fat cells = more body fat, especially around the middle (hello muffin top).

(Our sheep are now getting very fat in the field, ignoring the tired old sheepdog and eating all the grass.)

Certain foods are likely to spike our blood sugar levels more than others. Yes, I’m looking at you, carbohydrates! (More on carbs below…).

The obvious offenders are foods with added sugar such as sweets, biscuits, cakes, breakfast cereals, pastries, and fizzy drinks. Also try to limit foods with a high Glycemic Load (GL), like white rice, pasta, and bread, white potatoes, shop bought granolas and cereal bars, oat and rice milks, dried fruits, and certain fresh fruits like bananas and pineapple. Fruit juice can also spike your blood sugar levels, as it doesn’t contain the fibre that whole fruit does.

It’s not just about food though. Lifestyle also counts, so stress, lack of sleep and movement can also impact our blood sugar levels. And for us women, hormones also play a part, as oestrogen improves insulin sensitivity.[2] For menstruating women, this means we will be more sensitive to insulin at certain times of the month, and we may need to think about insulin resistance after the menopause, when oestrogen levels are low.

You might have heard of continuous blood glucose monitors, and programmes like Zoe which track our blood sugar levels and responses to food throughout the day. These can be a useful insight into our blood sugar levels and patterns with certain types of foods.

But if fancy gadgets aren’t for you, there are some things to look out for in your body that might signal a blood sugar imbalance: 

• Energy slumps 
• Feeling dizzy / lightheaded 
• Hanger (feeling angry when you get hungry!)
• Anxiety 
• Feeling shaky and/or weak
• Cravings
• Fuzzy head
• Headaches 

Thankfully there are loads of ways to keep those blood sugar levels balanced and those pesky sheep in check. So here are some things to think about for more stable blood sugar levels: 

Contrary to popular belief, carbohydrates are not all evil. In fact, they play a crucial role in a balanced diet. The key here is having the right kind of carbs. Aim for complex carbs like root vegetables and wholegrains (e.g. oats, brown rice, quinoa, millet, buckwheat) over refined carbs (the sweet, white floury stuff) where you can.

Have a look at my simple carb swaps below for the right kind of carbs to focus on.

Protein is your friend when it comes to managing blood sugar levels, as it helps to slow any blood glucose spikes.[3] Aim for a palm-sized piece of protein at each meal. Fibre can also help to manage blood glucose levels,[4] so aim for 30g of dietary fibre per day – include a wide range of lovely, colourful plant foods in your diet and you can’t go far wrong.

It’s not just about what you eat, but when you eat it.

If you’re constantly grazing on food throughout the day, your blood glucose and insulin levels may be constantly raised. This means that the hormone glucagon won’t be called upon to release stored glucose from our body’s stores.

Equally, skipping meals can make already dysregulated blood glucose levels worse, so aim for three balanced meals a day (with maybe two balanced snacks if you need them).

Try and give your body time to recover over night, with a good window where you don’t eat anything (at least 12 hours). Intermittent fasting can also work well for some people – though everyone is different, so it’s best to speak to a nutritional practitioner about whether this might be suitable for you.

It’s not just about diet. Exercise, stress and sleep all play a part in healthy blood glucose management.

Movement after a meal can help with glucose uptake into cells, so think about building a short 30 minute walk or other movement into your day around a meal time.

Stress and lack of sleep can also negatively impact our blood sugar levels, so focus on prioritising sleep and reducing stress as much as you can!

There are some other nutrients – available in food and supplement form – that can help manage blood sugar levels, which can be a useful addition to a balanced diet. In particular:

• Cinnamon has been found to help with blood glucose metabolism, by improving insulin sensitivity.[5] Enjoy sprinkled on porridge or added to smoothies.
• Chromium, found in foods like meat, shellfish, whole wheat, grapes, Brazil nuts, green beans and broccoli, can also help with insulin sensitivity.[6]
• Alpha Lipoic Acid, found in foods like broccoli, tomatoes, spinach, and Brussels sprouts, can also improve insulin signalling.[7]
• Research suggests that apple cider vinegar may also have some benefits for lowering blood sugar levels.[8] I would recommend a good quality, organic ACV with ‘the mother’ – give it a good shake and dilute with water.

Think you need support with your blood sugar levels? Get in touch here to see how Nutritional Therapy can help you with your health goals, and download my free Sweet Tooth Reset eBook here.

1. Erion KA, Corkey BE. Hyperinsulinemia: a cause of obesity?. Current obesity reports. 2017 Jun;6:178-86.
2. Yan H, Yang W, Zhou F, Li X, Pan Q, Shen Z, Han G, Newell-Fugate A, Tian Y, Majeti R, Liu W. Estrogen improves insulin sensitivity and suppresses gluconeogenesis via the transcription factor Foxo1. Diabetes. 2019 Feb 1;68(2):291-304.
3. Shimy KJ, Feldman HA, Klein GL, Bielak L, Ebbeling CB, Ludwig DS. Effects of dietary carbohydrate content on circulating metabolic fuel availability in the postprandial state. Journal of the Endocrine Society. 2020Jul26;4(7). 
4. Webb GP. Nutrition: Maintaining and improving health. Boca Raton: CRC Press; 2020. 
5. Anderson RA, Broadhurst CL, Polansky MM, Schmidt WF, Khan A, Flanagan VP, Schoene NW, Graves DJ. Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. J Agric Food Chem. 2004 Jan 14;52(1):65-70.
6. Anderson RA. Nutritional factors influencing the glucose/insulin system: chromium. J Am Coll Nutr. 1997 Oct;16(5):404-10.
7. Rochette L, Ghibu S, Muresan A, Vergely C. Alpha-lipoic acid: molecular mechanisms and therapeutic potential in diabetes. Can J Physiol Pharmacol. 2015.
8. Hadi A, Pourmasoumi M, Najafgholizadeh A, Clark CC, Esmaillzadeh A. The effect of apple cider vinegar on lipid profiles and glycemic parameters: a systematic review and meta-analysis of randomized clinical trials. BMC Complementary Medicine and Therapies. 2021 Jun 29;21(1):179.