Outline:

  1. Certain medications may raise glucose levels or increase insulin resistance.
  2. Hormone shifts associated with menstruation, pregnancy, breastfeeding, and menopause may affect glucose levels.
  3. Illness, stress, and age can all contribute to glucose variability.

While our eating habits have the largest impact on our glucose levels and overall health, food is only one piece of the puzzle. This article is an overview of other, less obvious factors that may be playing a role when things don’t quite seem to add up.

Medications

There are a few major groups of medications that have been shown to impact glucose levels. If you have a recent medication change or are prescribed any of the medications listed below, a further discussion with your healthcare provider is warranted. 

Corticosteroids: These medications are typically prescribed to reduce inflammation, or treat asthma, COPD, and arthritis. They can block insulin release and decrease insulin sensitivity causing the liver to make more glucose than necessary.

Birth control: Additional estrogen in some types of birth control causes certain women to have elevated blood glucose levels. 

Statins: These medications function to lower cholesterol, but their action on the liver can also decrease insulin release and reduce cell sensitivity to insulin – leading to  elevated blood sugar.

Diuretics (thiazide): These medications are prescribed to prevent fluid build-up and  can lower blood pressure, they have been associated with increased insulin resistance. Glucose should be monitored if taking diuretics, especially thiazide type diuretics (hydrochlorothiazide, chlorthalidone, metolazone, etc).

Beta-blockers: These can affect beta cells in the pancreas and cause an impaired insulin response and result in elevated blood glucose. 

Nicotine: Nicotine can change the way our body responds to insulin, leading to insulin resistance. If nicotine is obtained from smoking cigarettes, additional risk factors may be present.  

Gender

Hormones play a major role in glucose and energy metabolism, so it only makes sense that when females experience major hormonal shifts, glucose will also be impacted. The massive monthly shifts in estrogen and progesterone experienced during menstruation can interfere with normal insulin signaling, causing a temporary insulin resistance effect. These two hormones rise to their highest levels around weeks 2-3, between ovulation and the first day of a period. This may be the time that you notice higher than normal blood glucose values due to slight insulin resistance. 

Women tend to have very individual and varied responses during their cycle. The key is to correlate your glucose levels with your cycle to understand how you respond to the hormone fluctuations. Utilize the "note" feature in the NutriSense app to track changes. 

If you notice higher than normal glucose levels during certain weeks of the month, this is the perfect opportunity to counteract them with lifestyle modifications such as ramping up exercise, decreasing carbohydrate intake, getting enough sleep, and monitoring stress levels. 

It stands to reason that if the monthly fluctuations in hormones affect your glucose levels, then major life events such as pregnancy and menopause will also cause major shifts. If you are pregnant, recently given birth, breastfeeding, or going through menopause it is prudent to have a further discussion with your healthcare provider regarding expected glucose changes versus abnormal glucose changes. 

Colds & Flu

With the average American adult experiencing a cold or minor illness 2-3 times per year, being prepared is important. While many other illnesses and conditions may affect glucose levels, cold and flu are the most commonly experienced illnesses and will at some point affect the majority of people. 

When harmful viruses or bacteria find a way into our system, their unwanted presence sets off a chain reaction from our immune system. This includes deploying inflammatory mediators, antibodies, and killer cells to track down the invading organisms. One side effect of this heightened immune response is a shift in hormone release, prioritizing the hormones to help fight the illness rather than the hormones involved in everyday life. 

Chronic Stress

The most prominent illness of our generation is, of course, chronic stress. When our bodies or minds perceive anything as a threat - an illness, physical danger, or even a distressing thought - our stress response can be triggered. A small amount of stress can have a beneficial effect and can help us become resilient (exercise and fasting), whereas chronic, long term stress can have detrimental effects. 

When we are faced with excessive daily stress - being overworked, unemployed, feeling isolated, or taking on too many obligations - our bodies are constantly flooded with stress hormones such as cortisol and epinephrine. These hormones raise our blood pressure and initiate the release of glucose for energy. It is essential to separate what is true physiological stress (such as physical danger) and demands real attention, from stress which can be managed - such as annoying emails or coworkers. 

In another section, we discuss some strategies to manage and monitor stress levels.

Age

The process of aging is unavoidable and can add to both the physical and mental stress our bodies experience. As our organs feel the effects of aging, their ability to function optimally can be impaired. This can impair our immune system and our metabolism. The increased limitations coupled with muscle loss and potential physical disability associated with older age makes glucose management more challenging. We can curb some of these effects by maintaining a regular exercise routine and altering our eating patterns.

Some of these factors are out of our control, but being aware of them gives us the flexibility to adjust our behaviors accordingly. As mentioned, there are many nuances to getting "The Big Four" (food, fasting, physical activity, and stress) right which we will continue to dive into. Your health team at NutriSense is here to help you put all these moving pieces together. 

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