Metabolism: Understanding blood sugar
Do I need a CGM?
This Matters
Let’s paint a picture… if you’ve ever felt the following, you’ll want to read this article.
Feelings of "mom rage"
Feeling tired/chronic fatigue
Craving sugar
Irritability/hanger
Hyperfixation on food/your next meal
Frequent mood swings
Early morning wake-ups (2-3 AM)
Hot flashes/night sweats
Feeling shaky
Lack of focus
Blood sugar dysregulation can contribute to or lead to all of these things!
Blood Sugar + Metabolic Health 101
Metabolic health: how well we generate and process energy in the body. Blood sugar management is one aspect of your overall metabolic health.
Poor metabolic health is associated with worse brain function, energy, memory, mood, skin health, fertility, and risk for chronic disease.
If you have:
Experienced gestational diabetes
Have a family history of diabetes
Have elevated fasting glucose/insulin on labs
Or are entering menopause, keep an eye on this!
Why Manage Your Blood Sugar?
Blood sugar management is a foundational pillar of a healthy lifestyle and metabolism. It’s something I talk about with every client during every session.
It’s something women need to focus on for:
Mental health and mood - including postpartum, PMS, perimenopause
Energy - feeling vibrant
Resiliency - emotional and physical
Relationship health - imbalances contribute to or enhance irritability
Exercise performance - including recovery
Longevity - imbalances impact the entire body + rate of aging
Mindful eating - stable blood sugar promotes healthier choices
I could rattle off more, but you get the point.
Keeping your blood sugar in a healthy range makes sense for all of us, it’s not just important for those with diabetes.
In fact, 90% of people living with prediabetes don’t even know they have it!
How Do I Support My Blood Sugar?
Prioritize Protein: We frequently discuss prioritizing protein, consuming around 30 grams of protein at meals. This helps reduce the need for extreme low-carb approaches to keep blood sugar in check. Protein, fat, and fiber help blunt glucose spikes and allow more flexibility with how many carbohydrates we consume.
If you know you’ll eat more carbohydrates (Mexican dinner date night? Pizza? Holiday?), consider front-loading your day or meal with protein. This could mean having a beef stick (or 2), protein shake or bar, hard-boiled eggs, or Greek yogurt before you indulge.
Choose Fiber-rich Carbs: We all know that selecting less refined carbs (whole grains) over more highly refined carbs (white bread) is the healthier choice. Another consideration is choosing fiber-rich sources of carbohydrates. This includes fruit (especially berries), starchy veggies (squash), beans, and non-starchy vegetables (cruciferous veggies).
Not only will choosing fiber-rich carbs help with blood sugar spikes, but it will also support satiety. You’re less likely to overindulge in carbs if you choose a bowl of broccoli over a bowl of rice. This is NOT to say you shouldn’t have more concentrated carbs, but make sure to include a serving of fiber-rich ones in your meals.
Consider Your Context: Are you sedentary or moving most of the day? Are you pregnant or nursing? Are you in your 20s-30s or perimenopause/menopause? Do you exercise at low intensities or push yourself? While I can’t stand the “earn your carbs” mentality, it is true that our context dictates how many carbohydrates our bodies need to feel nourished and can tolerate.
And this gets me to the next point.
How Many Carbs Do I Need?
It’s the million-dollar question, and it ranks high in Google search engines for a reason.
The pendulum has swung from fearing fat to fearing carbohydrates, leaving everyone and their mom considering cutting carbs or playing with the keto diet out of desperation for an answer or curiosity.
But the answer isn’t to hyperfocus on carbs to the point of avoiding or significantly limiting them. This can be detrimental to women in their reproductive years. Less isn’t “better” in many cases. An individualized approach is needed; it’s not something someone on the internet can dictate for you or make blanket statements about.
While context can help dictate some of this, data helps drive a personalized approach.
Labs to test:
Often, your provider will only look at 1-2 measurements of your blood sugar—fasting glucose and HbA1c. These are a great start and can help you understand your current (fasting glucose) and 3-month average (HbA1c) glucose levels, but I’d also push for additional tests for more context.
Get these tested:
Fasting Glucose - Aim for <90 mg/dL
Fasting Insulin - Aim for 2-6 uIU/mL
Triglycerides - Aim for <100 mg/dL
HbA1c - Aim for <5.5%
These markers will help you better understand your full context. If your numbers are higher than the above, you’ll want to take a more targeted approach to your carbohydrate intake.
Here’s more information about what these tests mean.
Looking for the best supplements to support your blood sugar?
Continuous Glucose Monitors (CGMS)
A CGM is a device that you insert into your arm for 10-14 days. Instead of pricking your finger when you want to check your blood sugar levels, this tiny, disposable filament senses what’s going on continuously (throughout the day and while you sleep). This offers more information about how well your body is handling blood sugar before, during, and after meals. It offers much more precise insight into how the meals you’re eating impact your blood sugar for hours after you eat and overnight.
This can be incredibly helpful for people who aren’t sure how many carbohydrates they need to fuel their performance or energy or why they’re feeling so irritable, hungry, or tired even after they eat!
In the US, these were only available to individuals with prescriptions, but now companies like Levels, Nutrisense, and Veri offer services that provide these sensors to the general public without diabetes or a prescription.
I was an early adopter of these, using them when they were first released to the general public. I’ve used the Levels sensor for over a year and both the Nutrisense and Veri models for a month. They all have their pros and cons, but after using them all, here’s my take.
Levels - This is the OG, OTC CGM sensor. Are you following all the acronyms :)
This one is best for those seeking new research/data and helpful articles for self-study. It’s best for true data nerds who want more information/research. It’s also great for those looking for a longer-term CGM experience, as the price includes an annual membership. Levels is always innovating, and while the personalization and app updates can be fun, there’s often some “buggyness” to the app. They also offer newer CGM models like the smaller Dexcom G7.
Nutrisense - This is the model for those new to/confused about nutrition and their insights.
If you are looking for text support with an RD during your CGM experience and don’t have a nutritionist/dietitian in your corner, this is the best choice for you. The app interface is clunkier than the others, but they offer customized guidance to help you interpret your data.
Use code RESET for $25 off
Veri - This model is a great choice for those looking for a short-term experience or those working 1:1 with a coach.
If you only think you’ll want to use a sensor for a month or less and don’t need text-based nutrition support, this may be the best option for you. If you’re working with a nutrition coach, this is the best platform as they allow users to sync their data into a platform for your coach to see. No more sending screenshots!
Use code VSM-STEPHGREUNKE for a discount
If you have the budget, I highly recommend trying a CGM. You will learn a ton about how your body responds to the meals you’re eating, simple swaps you can make to optimize your levels in real-time, have more accountability with what you’re eating, and share your data with your physician/coach to offer more context. It can also be a great option for those who are pregnant and want to monitor their glucose in real time, as an alternative to the traditional glucose screening/Glucola test.
In general, you’ll want to limit spikes over 30 points, but please don’t stress about keeping your blood sugar levels FLAT. They should rise a little when you eat a meal with carbohydrates, you just don’t want high spikes, often.
My IG Story highlights share more about CGMS
What questions do you have about CGMs? I’ll answer them in another post!