Why Is My Blood Sugar So Hard to Control?
By Annelie Smith RD IFNCP
Insulin is a hormone produced by the pancreas. Its primary role is to regulate blood glucose (sugar) levels by facilitating the uptake of glucose into cells for energy production or storage.
Insulin resistance is a metabolic condition in which the body’s cells, especially in muscle, fat, and liver tissue, become less responsive to the hormone insulin. This disrupts normal glucose regulation and can lead to elevated blood sugar levels. To compensate, the pancreas releases more insulin, leading to high levels of insulin in the blood, which further disrupts metabolic processes such as excessive fat storage. These disruptions may eventually lead to the development of type 2 Diabetes Mellitus.
1. Is insulin resistance genetic?
Yes, insulin resistance has a genetic component. Multiple genes influence how your body processes glucose and responds to insulin.
Individuals may inherit traits such as poor insulin sensitivity, a tendency for fat storage, and low metabolic flexibility. This affects the body's ability to efficiently switch between burning carbohydrates and fats for energy based on availability and demand, making them more prone to insulin resistance even with modest lifestyle triggers.
Variants in genes involved in insulin action/signalling (e.g., IRS1), glucose production and transport (e.g., TCF7L2, SLC2A2), inflammation (TNFA), and lipid metabolism (ADRB2, PPARG) can predispose individuals to insulin resistance.
2. Why do I crash after eating sugar?
Crashing after eating sugar, also known as reactive hypoglycemia, can occur when a spike in blood glucose leads to a compensatory surge in insulin, which then causes blood sugar levels to plummet rapidly.
Reasons include:
- Eating sugary, processed high-carbohydrate foods causes blood sugar spikes.
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Overactive insulin response due to genetic predispositions e.g., variants in SLC2A2, TCF7L2
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Insulin resistance, when cells are less responsive to insulin, prompting the pancreas to release more insulin than needed.
3. How does genetics affect blood sugar response?
Genetics plays a major role in individual blood sugar responses:
Genes regulate how carbohydrates are metabolized, insulin secretion, cellular uptake of glucose, and inflammatory responses that affect insulin function.
Genetic testing can provide insight into:
- Your body's glucose-insulin dynamics. E.g., TCF7L2 affects the insulin secretion from the pancreas after eating, and MTNR1B affects how sleep cycles and food intake affect insulin production after eating in the morning.
- Genes affect eating behavior and appetite control. Gene variants like SLC2A2 are associated with insulin spikes after eating, and APOA2 affects blood sugar regulation when eating animal fats.
- Genes affect the body’s glucose control in response to exercise. ADRB2 codes for receptors on fat cells that affect the mobilization of energy in response to exercise. Adiponectin (ADIPOQ) is a protein made in fat cells that mediates insulin sensitivity after exercise.
These genetic insights enable personalized strategies to prevent or manage blood sugar imbalances more effectively than generalized diets or treatments.
Recommendations include
- Targeted exercise recommendations to improve insulin sensitivity .
- Optimal timing and meal-distribution of protein, healthy fats, fiber, and wholegrains.
- Addressing chronic inflammation to enhance insulin action through targeted recommendations of herbs,.spices, and nutraceuticals such as omega-3 fats, cinnamon, turmeric, ginger, and green tea.
- Prioritizing sleep cycles and targeted mealtime recommendations to balance hormones that influence insulin regulation, such as melatonin, cortisol, and epinephrine.