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What does it mean if you have high blood sugar? Maybe you are under immense stress, or haven't had the best diet lately, or have been fairly inactive. Even a big, carb-heavy meal will lead to higher blood sugar. Just because you once registered high blood sugar doesn't mean you're immediately at risk of poor health. But consistently high blood sugar should be taken seriously.

It's usually related to a few health concerns—most often, diabetes. Both type 1 and type 2 diabetes are characterized by high levels of blood sugar (or blood glucose).

Type 1 diabetes usually begins in childhood and is considered an autoimmune condition. In cases of type 1 diabetes, the pancreas produces little-to-no insulin. Generally, type 1 is caused by a genetic predisposition—meaning most people are born with it.

Type 2 diabetes is far more common, accounting for a majority of all cases. This form of diabetes is typically developed in older children and adults, but can occur in people of all ages. In type 2 diabetes, the body fails to properly use and store glucose because it doesn’t respond to insulin.

Obesity is one of the main risk factors for developing type 2 diabetes.

Diabetics also tend to have other health issues, often relating to processes involved with the heart, kidney, eyes, and blood vessels. According to a study from 2015, type 2 diabetes has become worryingly prevalent in the American population; 12% - 14% of adults are estimated to have the disease.Menke2015

Even before diagnosis, having higher-than-recommended blood sugar levels can be harmful to your health and may ultimately be a sign that you are on the path to developing type 2 diabetes. This is called "pre-diabetes." Pre-diabetes means that you have blood sugar levels that are higher than recommended (possibly due to insulin resistance), but below what is considered in the diabetic range. An additional 38% of the population has been diagnosed with pre-diabetes.

What role does elevated blood sugar play in diabetes, pre-diabetes, and obesity? And how can you lower your blood sugar? Do you even need to lower it in the first place?

Let's explore the science behind the data to understand how blood sugar is correlated to these health concerns.

Science Behind Blood Sugar

Many people use the terms “sugar” and “glucose” interchangeably, but their differences are nuanced. All forms of sugar consumed must be converted into glucose as a fuel source for the body; this energy is created through a process called glycolysis. Any extra glucose from the diet is stored in the body as glycogen.

When present, the brain and body prefer to burn carbohydrate (and thus glucose). The brain is reliant on carbs, but the rest of the body can switch to burn fat in between carb-rich meals. Glucose stores are low compared to the seemingly endless bodily fat stores. Thus, on a typical eating plan, carbs or sugars are regularly consumed and metabolized into glucose to be used as energy for the brain.

However, if you don’t eat carbs, small amounts of glucose can also be made through non-carbohydrate food sources through a process called gluconeogenesis. The body can also slowly learn to make ketones from fat, and ketones can supplement glucose as brain food.

While glucose can power the body, uncontrolled levels can lead to complications.

Diabetes is a disease characterized by high blood sugar (glucose) levels. In healthy humans, blood glucose levels are controlled by the secretion of insulin from the pancreas. The insulin acts as a regulator, lowering blood glucose levels as needed.

When you eat certain food, blood glucose levels increase. Insulin is secreted from the pancreas to normalize levels through the uptake of glucose into the body’s cells. In people with type 2 diabetes, cells don't respond correctly to insulin. The result? Blood sugar doesn't get into cells and thus, can't be stored for energy. When sugar can't enter these cells, that's when high levels of blood sugar occur (this is called hyperglycemia).

Connection Between Weight and Blood Sugar

Although a definite link cannot be established, there is some evidence to suggest weight gain is often associated with increased blood glucose. A study showed weight gain increased risk of diabetes among overweight adults.Resnick2000 Weight loss was shown to have major beneficial effects over time. Every kg of body weight lost annually was associated with a 33% lower risk of diabetes.Resnick2000

An illustration of a brain, separated by a light switch, showing how the brain and body use sugar

For people who are considered overweight and have high blood glucose, improving body composition may help lower blood glucose levels thereby lowering the risk of developing type 2 diabetes.

Losing Weight

Maintaining healthy weight is key for overall health.

Many studies have shown being overweight has been linked to hypertension and type 2 diabetes.PiSunyer2009 There is no one-size-fits-all weight for each and every person. However, for many people having a body mass index (BMI) below 25 is considered within normal weight range. BMI calculators online can help determine whether or not you are considered overweight.nhlbi2019

Even modest weight gain can have a substantial impact on the development of diabetes.Colditz1995 Careful monitoring and maintenance of weight is important for overall health, especially in the case of diabetes prevention.

Lowering Blood Sugar Through Diet

The most direct way to impact blood sugar levels is through healthy diet. Blood sugar or blood glucose is directly affected by the foods that we eat; carbohydrates are readily converted into glucose, entering the bloodstream and becoming blood sugar.

It’s important to make the right dietary choices to minimize the risk of high blood sugar, and potentially developing type 2 diabetes. Instead of a diet, think about these strategies as lifestyle changes.

Consume the Right Carbs

The body converts dietary carbs into glucose to be used as energy. Because carbs are so readily converted into glucose, foods high in carbohydrate have the largest impact on blood sugar levels (which normally increase after a high-carb meal). But when you consistently consume too much sugar, the pancreas will secrete extra insulin; and over time, it can’t produce enough to keep blood glucose at normal levels.

images of chickpeas, sweet potatoes and beans, the right carbs to consume

One way of maintaining healthy blood sugar is to simply eat the right type of carbohydrates.

Just like calories—not all carbs are created equal. Every source of carbohydrates has a Glycemic Index (GI), which is a ranking of carbohydrates in food relative to how blood glucose is affected. Carb sources with a GI index of 55 or less digest slowly, causing a lower and slower rise in blood glucose. Commonly, they’re referred to as “complex carbs.” Carb sources with a GI index closer to 100 are considered “simple carbs,” broken down quickly to be used as energy.

But what makes a carbohydrate complex or simple? Often, it’s how processed the food is.

More processed, sugary items have likely been stripped of all natural fiber, leaving it to be rapidly metabolized into glucose. Whole grains, on the other hand, will have a lower glycemic index (GI).

Consuming low GI carbohydrate sources may help manage blood sugar levels to stay within normal range.

Foods with a low glycemic index include meats, oats, beans, lentils, legumes, sweet potatoes, corn, yams, some fruits, and all non-starchy vegetables.

Consume Little or No Carbs

Instead of considering what types of carbs you’ll eat, another approach is to consume little-to-no carbs. Studies have shown that limiting carbohydrates is an effective strategy for improving glycemic control.Gillespie1998

Consuming very few (or zero) carbs and higher amounts of fat can control blood sugar and limit your glycemic response, which can help prevent diabetes.

There have been numerous instances in which diabetics have benefited from low carbohydrate diets. Andrew Koutnik, a graduate researcher at the University of South Florida found that type 1 diabetics were able to lower their blood sugar levels to normal range on a low carb diet.Koutnik2019 He says, “I simply took the foods in my diet with the highest elevation in blood glucose and replaced them with nutrient-dense fat sources.” His TED Talk provides anecdotal evidence of using low carbs to combat type 1 diabetes.

In 1976, another researcher named Bruce Bistrian discovered that seven cases of type 2 diabetes were reversed within one year on a low-calorie ketogenic diet, which employs a low-carb, high-fat eating regimen.Gannon2006,Phinney2017 Individuals on a ketogenic diet saw better improvements in health compared to a low-glycemic index diet.Westman2008

Increase Fiber Intake

Fiber can help you control blood sugar levels.

In diabetics, soluble fiber can slow the absorption of sugar and help improve blood sugar levels by controlling glucose and insulin spikes.Fung2017 If you have (or are at risk of) type 2 diabetes, introducing high-fiber foods into your diet may help control high blood sugar. Fiber will pass through your digestive tract and will not cause a large spike in blood sugar, and it has been shown to be helpful in managing type 2 diabetes.Post2012

The national fiber recommendations for individuals over 50 is to consume 30g - 38g daily for men and 25g per day for women. Another guideline is to simply consume 14g of dietary fiber per every 1,000 calories in your diet. Try adding more fiber to your diet if you are looking to lower your blood sugar.

Count Calories and Monitor Food Intake

Being overweight or obese has been linked to high blood sugar and an increased risk of diabetes. Like it or not, one of the best ways to lose weight is through a caloric deficit, consuming less energy than you expend. A healthy weight has been proven to help lower blood sugar levels, thereby lowering your risk of developing type 2 diabetes.Hannum2012

Ever been to a restaurant and got served a plate the size of your head? Portion control can be difficult, but today, when portion sizes seem to get bigger and bigger, it can be a method to help you lose weight. Although not as precise, studies have shown that portion control has been an effective way to help obese individuals lose weight.Pedersen2007

General “I’ll finish eating when I’m satisfied” portion control may work for some people, but precise methods will provide more consistent results.

Some of the best ways to make counting calories easier include:

  • Use a food scale: it can be difficult to accurately determine caloric intake without determining precise serving sizes
  • Use a food diary app: there are several free apps that will record calories and servings
  • Learn to read food labels: you should learn to read serving sizes to more accurately record meals in your food diary
  • Eat slower: studies have shown the speed at which you eat can have a direct effect on obesity, BMI, and waist circumference. Eating slower may prevent weight gainHurst2017

Counting calories and constantly monitoring food intake may be time-consuming, but it can pay dividends for weight loss, which means dividends for overall health.

Additional Ways to Lower Blood Sugar

Diet may be the most direct and obvious way to keep your weight within healthy levels and help you control blood sugar. In addition to diet, there are also other techniques to supplement your journey along the way.

Sleep More

It’s no secret adequate sleep is essential for overall health and well-being. Sleep can help lower stress, strengthen our immune system, and decrease blood pressure. Sleep is also important for mental function including: alertness, memory consolidation, mood regulation, and physical health.

Poor sleeping habits also affect blood sugar levels and insulin sensitivity.

Slow wave sleep (SWS) is thought to be the most restorative sleep stage, as it affects hormonal changes. These hormones impact glucose regulation. Studies show when people do not get enough SWS, they have decreased levels of insulin sensitivity without an adequate compensatory increase in insulin release. This leads to an increased risk of diabetes due to reduced glucose tolerance.Tasali2008 Reduced sleep quality may contribute to an increased risk of type 2 diabetes.

The benefits of a good night’s rest are important for maintaining hormonal balance and glucose regulation. But just how much sleep should you be getting? The amount of sleep required will differ depending upon age. For adults, seven to nine hours of sleep are recommended.

Getting enough sleep is vital for performance. Several non-habit-forming sleep aids/supplements have been shown to decrease time it takes to get to sleep and improve sleep quality, leaving you feeling refreshed upon waking.Brzezinski2005,Ferracioli2013,Inagawa2006

Illustrations of a brain, a drop of blood in a shield, a blood pressure monitor and a brain, showing all the benefits of sleep

Drink Apple Cider Vinegar

Apple cider vinegar has many benefits to overall health and wellness. Studies have suggested ingesting vinegar before sleeping may favorably impact waking glucose concentrations in people with type 2 diabetes.White2007

The everyday kitchen staple can influence the body’s response to sugar by improving insulin sensitivity, with studies indicating vinegar can improve postprandial insulin sensitivity in insulin-resistant subjects.Johnston2004

An easy way to incorporate apple cider vinegar into your diet is by creating vinegar-based salad dressings. You can also mix two teaspoons into a glass of water and drink it that way. The use of apple cider vinegar is an inexpensive remedy to potentially improve blood sugar levels.

Exogenous Ketones

A low-carb, high-fat ketogenic diet and the state of endogenous ketosis is a great way to bring blood sugar down over time. Focusing on consuming healthy fats, along with general carb restriction, will undoubtedly lower insulin and glucose.

Interestingly, exogenous ketones can also regulate blood sugar in the short term. But it doesn’t require weeks of dieting to get into ketosis, so the effects on blood sugar are fundamentally different, because the body can still consume carbs and be in ketosis with ketone ester supplementation.

Studies have shown that ketone ester lowers blood sugar and may even reduce the insulin spike if you consume carbs.Myette2018 Maybe it’s not just the macros of the food you don’t consume—maybe the food you do eat can have a direct blood-sugar lowering effect.

Exercising Regularly

Regular exercise in conjunction with a proper diet can help you maintain or lose weight. People with type 2 diabetes can benefit from aerobic exercise, because physical activity is effective for reducing visceral fat as well as liver adipose tissue.

A single bout of exercise can increase insulin sensitivity for up to sixteen hours through multiple adaptations in glucose transport and metabolism.Borghouts2000 When you exercise, blood sugar is more effectively used for energy and muscle contraction.

Exercise can come in several forms including walking, running, biking, swimming, boxing, and weight lifting. The most important part of exercise is making the time to do it.

Regularly Monitor Blood Sugar Levels

Regular monitoring of blood sugar levels will help determine where you stand. If you are pre-diabetic, it’s important to get levels down to normal range to prevent full diabetes from occurring.Freeman2008 If you already have type 1 or type 2 diabetes you must regularly check and log blood sugar levels to prevent seizures or a diabetic coma.

If you are not pre-diabetic, type 1, or type 2, it is still important to check readings regularly. Blood sugar levels are fluid and always fluctuating. Based on test results, you can adjust your diet (or medication if applicable) to help regulate blood sugar levels.

There are different ways of checking blood sugar.

  • Fasting Plasma Glucose Monitoring: fasted glucose levels are considered the baseline, used to compare against times when sugar was ben consumed. In order to obtain fasted plasma glucose, don’t eat for twelve hours prior to measurement. Then, prick your finger and obtain a small drop of blood to be used on a test strip. The strip is then placed into a glucose meter that reads blood sugar levels. Normal fasted glucose levels range from 100 - 125. If your blood sugar is 126 or higher you may be at risk for diabetes or pre-diabetes.
  • Oral Glucose Tolerance Test: in this method, you are given a measured dose of glucose (approximately 75g) after taking the fasting glucose test. Blood is tested prior to the intake of glucose, immediately afterwards, and two hours later. The two hour measurement is most important. Normal range is considered blood glucose of less than 140. If your blood sugar is 140 - 199 after the second test, you may be at risk for pre-diabetes. If your blood sugar is 200 or higher after the second test, you could be at risk for diabetes.
  • Hemoglobin A1C: this method of blood sugar testing provides data over a three month period. As blood sugar levels are elevated over time, the sugar molecules will bind with the hemoglobin. Some of the sugar molecules will bind with the hemoglobin. The HbA1C tests determines the percentage of hemoglobin with bound glucose and is considered a much better measurement of long term glucose control. Using a percentage of glycosylated Hb, the HbA1C tests determine the percentage of hemoglobin with bound glucose. Hb A1C tests consider A1C levels of 4.5 - 5.6 range to be normal. An A1C test of 5.7 - 6.4 is considered pre-diabetic and 6.5 or higher is considered diabetic.

Glucose levels can vary significantly depending on many outstanding factors, like sleep and diet. It’s important to continually monitor levels on a regular basis to get a clearer picture of health.

Lowering Blood Sugar for Overall Health

Keeping your blood sugar within normal recommended ranges is important for overall health.

By effectively controlling these levels you are less likely to develop diabetes. Make smart lifestyle decisions, including practicing regular exercise along with having a proper diet. There is no excuse when it comes to your health. Stay healthy. Stay strong. Stay happy.

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