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Optimizing blood glucose with exercise

Hi in this blog ,I will talk about blood sugar management from a movement science and a functional medicine perspective. Before we dive into the action items let’s briefly see what is the root cause for the glucose levels to vary

 The Spectrum of blood glucose dysregulation

Wake up When we are about to wake up the liver is signaled to release more blood glucose to give us energy to start the day  Post MealSpike in the levels of blood glucose and insulin to move the glucose inside the cells to provide energyStressIt has the same effects as a meal. There is a spike in both glucose and insulin levels. The brain is tricked into believing that you have had a meal. 

In diabetic patients as there is low insulin secretion the early morning glucose levels rise up causing hyperglycemia .. This lasts from 3 am to 8 am and is called the Dawn effect. This spike in blood sugar can wake you up from sleep

Similarly if you have had a very low carb dinner or have skipped it then the sugar levels drop till 2 am and then hormones are released to stop insulin secretion and this will cause rebound hyperglycemia.. aka Somyogi effect

As you can see that our blood sugar levels are not static but quite responsive to what we do, what we eat, and how we feel and when we have too many fluctuations for too long it becomes a blood glucose dysregulation which is seen as increased

Hba1c

Fasting glucose

Estimated average glucose

Fasting insulin

Lets talk about insulin resistance

Image source shutter stock

 A great image to show what happens in insulin resistance…As you can see the glucose from the food is not able to get into the cells as they don’t respond to the insulin secreted. So cells cant utilize glucose our biggest energy source

In my pain and functional medicine practice I have listed a few most common complaints reported

Low energy levels mainly in the morning even after sleeping for 7 to 9 hours

Sleep disturbances 

Delayed recovery from a workout session of moderate intensity. Persistent soreness or low energy even  2 -3 days post-session.

Unable to lose belly fat even with dedicated workouts

Difficulty in building muscle

More exercise injuries which relapse or have delayed healing. I had a patient who had a groin injury that had never really healed even after 3 years and had taken multiple manual therapies and fascial work in physiotherapy before coming to me. When I did a metabolic work-up on him he had an elevated hba1c of 6.3 and fasting insulin. He reported 3 out of 5 above-mentioned symptoms and was confused as to why he was unable to break the injury cycle and tame his expanding waistline even with dedicated hours in the gym. Chronic pain management is all about getting to the root cause of the problem.

After his blood glucose was stabilized not only did his energy levels improve so did his injury susceptibility. 

Why are these happening?

This is science simplified …

Cells are starved of glucose
Can’t produce enough energy due to the body and poor mitochondrial function
CELLS GET TIRED and We feel tired even after a meal
POOR MUSCULAR CONTROL  AND  EFFICIENCY DURING EXERCISE aka  Poor exercise form and poor recovery
MORE EXERCISE CAUSED MICROTRAUMA 
After exercise injuries and soreness increases and this makes more injuries.

Why does my belly fat not reduce?

Increase blood glucose
High insulin production
Cells have become insulin resistant because of constantly high blood insulin
High insulin levels in the blood
Prevents breakdown of fats aka LIPOLYSIS
Increases fat accumulation in the body around the organs  ie the abdomen 
BELLY FAT

If any of the above resonates with you read on for some of the strategies which I use regularly

Food

The food you eat talks to your gut microbiome and decides your health.

Eat whole, natively sourced and a variety of grains.

Go gluten free

Do not skip dinner.

Add more veggies to your diet. A simple ratio of 2:1:1 with 2 of veggies and 1 of grain and 1of protein is great.

Relax , do a few belly breaths and eat slowly and mindfully

Rhythm

Our body has an internal clock and a cicardian rhythm. Our hormones are released as per this clock. So sleep and wake at roughly the same time everyday. Again keep your meal times consistent 

Movements

 Image credit Cleveland center of medicine

A great picture to show why should you exercise and move more 

Do atleast 2 to 3 sessions of strength training per week.

Make sure to recruit more muscles during exercises.

Recruit large groups more like core and gluts.

Focus more on the form and not the number.

Keep your breathing synchronized with the movements.

If you are doing weights follow a scientific protocol like SAID or OXFORD.

Look out for signs of overtraining.

I hope you enjoyed reading this as much as I enjoyed putting it down…. Take care

Additional reading

https://www.webmd.com/diabetes/dawn-phenomenon-or-somogyi-effect

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919480/#__sec12title

https://pubmed.ncbi.nlm.nih.gov/8621015/#:~:text=Abdominal%20fat%20had%20a%20significantly,oxidation%2C%20and%20hepatic%20glucose%20output.

https://scholar.google.co.in/scholar?q=exercise+and+insulin+sensitivity&hl=en&as_sdt=0&as_vis=1&oi=scholart#d=gs_qabs&u=%23p%3Dw4vBtXKoDLwJ

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