We’re learning so much from Functional Medicine Registered Dietitian and founder of My Food is Health, Brigid Titgemeier! In her piece below, Brigid lays out a very modern and functional approach to weight management and overall health: how to regulate your blood glucose levels. As a Functional Medicine pro, Brigid thinks in terms of prevention over treatment wherever possible. If the prevention of certain diseases or conditions is on your shortlist of health goals this year (pretty sure that’s all of us!), learning to manage your blood glucose levels is crucial. Here’s how to get started…

Rather than focus on losing a few pounds on the scale this year, you may want to switch gears to focusing on how you can improve your blood glucose levels and overall metabolic fitness. The better your metabolic fitness, the better your metabolic health and the more stable your blood glucose levels are.

Fact: High blood glucose levels and metabolic dysfunction put you at a greater risk of insulin resistance and diabetes. They are also related to weight gain, inflammation, non-alcoholic fatty liver disease and cardiovascular disease—and you don’t need to be drinking a 2-liter bottle of soda every day to develop poor metabolic health.

Approximately One in Two Americans Has Normal Blood Sugar Levels

You might think that if you haven’t been diagnosed with Type 2 Diabetes (T2D), there’s no way you could have blood sugar dysregulation. However, nearly one in two adults in the United States has either diabetes or pre-diabetes , which means almost half of the adult population has abnormal blood sugar levels. Here are a few more statistics, based on the United States population:

+ Approximately 11% have type 1 diabetes (autoimmune) or type 2 diabetes (lifestyle induced).
+ An additional 35% of adults in the United States have pre-diabetes.
+ 6-9% of women who are pregnant develop gestational diabetes.
+ Of those with pre-diabetes, more than 84% do not know that they have it.

The saddest part about this shocking statistic is that elevated blood sugar levels—and the diseases it causes—are entirely preventable, in most cases!

In the last 50 years, the evolution of metabolic dysfunction has been largely driven by increased access to highly processed refined carbohydrates, too many added sugars, alcohol and imbalanced meals. After all, 6 of the top 10 most common sources of calories in the United States are glycemic-provoking foods, including: baked desserts, bread, soda, processed snacks, candy and alcohol. Add to that our increasingly sedentary lifestyles, inordinate amounts of stress, and lack of sleep, and you’ve got a scenario in which we’re all teed up to have poor glycemic control.

Pay the farmer now or pay the doctor later.

One of my core beliefs is that we can either make time for optimal health now or pay later. You may have heard it said, ‘Pay the farmer now or the doctor later’. Metabolic dysfunction is the perfect example of what paying later looks like. Because here’s the truth: You will not wake up one day and develop pre-diabetes out of nowhere. Poor metabolic health and elevated blood sugar levels are a gradual progression that builds over the course of many years and many meals before it fully manifests into a diagnosis of pre-diabetes or T2D. In other words, pre-diabetes can develop one meal at a time.

There is a well documented correlation between high blood glucose levels and increased risk of poor outcomes from COVID-19. The correlation between an infectious disease and poor metabolic health has unfortunately led to more immediate consequences that we would have seen prior to the pandemic.

I previously drew attention to a JAMA study from April 2020 that showed 88% of patients that required hospitalization for COVID had an average of 2.6 underlying chronic conditions, with the most common being hypertension, diabetes and obesity–otherwise known as poor metabolic health.

Hyperglycemia in Non-Diabetic Patients Predicts Mortality + Disease Severity in COVID-19

We’ve also learned that having diabetes is not the only indicator of an increased risk of poor outcomes when a person is diagnosed with COVID-19. Non-diabetic patients who get COVID-19 and have higher than optimal glucose levels upon admission to the hospital have a higher risk of death and disease severity. One meta-analysis showed that patients with high blood sugar levels were two times more likely to develop severe illness and three times more likely to die from COVID-19.

Another study that included more than 11,000 patients found that non-diabetic patients were twice as likely to die from COVID-19 if they had elevated blood sugar levels upon admission to the hospital, compared to those with optimal levels. They also were more likely to need a medical ventilator or to be admitted to the intensive care unit (ICU). One thing to note: people’s blood sugar levels very commonly rise from the stress of an infection. But that does not take away from the importance of taking proactive action to improve your baseline metabolic health and glycemic response.

Whew! We’ve cut Brigid’s article into two parts. We thought we’d let some of these medical vocabulary words sink in for all of us and bring Brigid’s nutrition and lifestyle tips — the actionable part of this story! — to you tomorrow. We hope you enjoy.