Is Your Blood Sugar Increasing Your Chronic Pain
Your body strives to be in balance.
Blood sugar is literally that: the sugar in your blood. Your blood contains all kinds of important nutrients and other substances that you need to be healthy, including glucose (i.e., sugar), a crucial energy source for your brain and your red blood cells. Blood is the liquid transporter that distributes these compounds to all parts of our bodies.
Sugar (a type of carbohydrate) is one of our body’s main fuels. The other two fuels are fat and protein. I call it “fuel” because our cells literally burn it to do work. It’s this “biochemical” burning of fuel in all of our cells that is our metabolism.
So, How Does Blood Sugar Get Too High?
This post will talk a bit about blood sugar balance, insulin resistance, type 2 diabetes, and pain. Then I’ll give you 10 proven strategies that can help manage blood sugar levels naturally. The good news is that blood sugar levels are responsive to diet and lifestyle upgrades.
You have the power to help manage your blood sugar with these key strategies!
A Bit About Blood Sugar Balance
Our body strives to be in balance. It exerts a lot of energy to make sure that our systems are all running smoothly. Our digestive system, nervous system, cardiovascular (heart & blood vessels) system, etc. And this includes our blood too. Our bodies try to balance our blood pressure, blood volume, blood sugar, etc.
There is a normal and healthy range of sugar levels in our blood. The problem doesn’t start until these levels are out of range, i.e., too high for too long.
Here’s how our bodies strive to maintain optimal levels of blood sugar:
We eat food containing carbohydrates (i.e., sugar and/or starch). This includes whole foods like fruits, vegetables, grains, and legumes. But it also includes processed and refined foods as well.
Our digestive system breaks down the sugar and/or starch into smaller sugars like glucose. These smaller sugars are then absorbed into our bloodstream. This naturally raises our blood sugar level.
When our blood sugar gets too high, the pancreas (a gland in our digestive system) sends out insulin. Insulin is a hormone that tells our muscles, liver, and ultimately, fat cells to grab that sugar from the blood. These cells use the sugar they need for energy now and store the rest for later.
The muscles and liver store sugar (e.g. glucose) temporarily. When we need it, our muscles and liver give up their sugar into the blood. This happens, for example, when we haven’t eaten for a few hours, we’re exercising, or we’re under stress.
NOTE: None of these are a substitute for professional medical advice. If you have any of these conditions, make sure you’re being monitored regularly by a licensed healthcare professional.
As you can see, the amount of sugar in your blood is constantly flowing up and down. Up when we eat; down when the insulin tells the cells to pull it out of the blood. Then up again when we eat again and/or start using some of the stored glucose. And down again as it’s used (burned) or stored.
This is all good and healthy! This is what we aim for.
Blood sugar imbalance
(insulin resistance & type-2 diabetes)
The problem is when the balance is thrown off. When the blood sugar ups and downs become unhealthy. When the “ups” get too high, and they stay there for too long.
Too much blood sugar can cause heart rate issues (arrhythmias), and in extreme cases, even seizures. Too high blood sugar for too long can eventually cause long-term damage to organs and limbs.
A healthy blood sugar balance is key.
A common way our blood sugar gets too high is when we eat a lot of sugar or highly processed carbohydrates (breads, pastries, pasta, etc.) in a short time. Our digestive system absorbs as much sugar from our food as possible. This is an evolutionary thing. We inherited this from thousands of years ago when food was scarce and the next meal was unknown. Our bodies adapted to crave, absorb, and store as much sugar as possible in one sitting because they didn’t know how long it would be until the next meal. It’s a survival mechanism.
Over the years, if we frequently eat a lot of sugar and have increased body fat, our bodies can change. The muscle and liver cells start ignoring insulin’s call to absorb sugar from the blood. They become “insulin resistant.” When this happens, the sugar stays in the blood for a lot longer than normal. Blood sugar levels become too high for too long.
But this doesn’t stop the pancreas from releasing even more insulin. When this happens you have the paradox of high blood sugar and high insulin.
Some symptoms of insulin resistance are:
Fatigue & drowsiness after meals
Intense cravings for sweets after meals
Sugar cravings that don’t go away, even if sweets are eaten
Constant hunger and thirst
Difficulty losing weight
Waist girth equal to or larger than hip girth
General fatigue
Wandering aches & pains
Frequent urination
Trouble falling asleep
Too-high levels of both blood sugar and insulin is not a healthy place to be in. In fact, it can be dangerous and lead to pre-diabetes, and eventually type 2 diabetes.
Type 2 diabetes is a long-term (a.k.a. “chronic”) condition of too high blood sugar, insulin resistance, and inflammation. It increases the risk of many serious conditions like heart disease, kidney disease, blindness, and amputation. Not to mention the number of medications often prescribed to try to keep blood sugar balanced.
Does high blood sugar impact your pain?
Another problem with high blood sugar is that it promotes the production of advanced glycation end-products, or AGEs. AGE compounds are sometimes called Glycotoxins because they can easily bind with many different cell types and cause damage, oxidative stress, and inflammation. These compounds prematurely age our bodies and have been linked to several serious health concerns and degenerative diseases such as arthritis. In fact, people with diagnosed diabetes are nearly twice as likely to have arthritis. OUCH!
But that's not all.
Those with diabetes can also experience diabetic neuropathy, a type of nerve damage that can occur if you have diabetes. The nerve damage is caused by high blood sugar and the damage can occur anywhere throughout your body. However, for most, diabetic neuropathy damages nerves in their legs and feet. For some people, these symptoms are mild; for others, diabetic neuropathy can be incredibly painful and even disabling.
The good news about blood sugar imbalance
The good news is that improved blood sugar balance can be achieved with clean eating and lifestyle improvements! What you eat, how you eat it, how much exercise and sleep you get, and how you handle stress are all factors that you can improve.
CAUTION: If you’re already diagnosed, and/or taking medications or insulin injections, make sure you speak with your doctor and/or pharmacist before making any changes. They may also want to monitor your blood sugar levels a bit closer when you start making diet and lifestyle upgrades.
10 tips for keeping blood sugar balanced
Here are my 10 best tips to help you better balance your blood sugar with diet and lifestyle upgrades.
#1
Stop eating and drinking things that are mostly sugar
First things first. If a food or drink is mostly sugar, please try to reduce, or even cut it out of your diet. I’m talking sweetened beverages (e.g. soda pop, juice, energy drinks, candy, etc.). Many desserts, breakfasts, and even seemingly-healthy choices like some granola bars often have a lot of sugar.
Significantly reducing these will give you the most bang for your buck when it comes to better blood sugar levels. That’s why it’s my number one recommendation.
#2
Don’t eat too many carbohydrates
Your body digests starches by breaking them down into sugar. By reducing the number of sugars and starches (carbohydrates) you eat, you can reduce that blood sugar spike that happens right after you eat. This has been shown in many studies.
It’s been said that one of the strongest predictors of blood sugar response is the total amount of carbohydrates in a meal. Reducing your overall carbohydrate intake can help to reduce your blood sugar levels.
#3
Choose “low glycemic” starches
If you’ve already cut out a lot of sugary foods and want to reduce your starch intake, then start by ditching the “high glycemic starches” (i.e. ones that raise your blood sugar too high).
As you can imagine, researchers have measured how fast and how high blood sugar increases with different foods. Foods that are “high glycemic” quickly raise blood sugar quite high. “Low glycemic” foods raise blood slower and to a smaller extent.
This “glycemic effect” is the result of the components in the food itself. Things like the amount of carbohydrate, the type of carbohydrate (i.e. sugar vs starch), and what other nutrients are in the food (i.e. protein, fiber, etc.) as well. The fiber, fat, and protein in food slows down the digestion and absorption of the carbohydrates, so the blood sugar rise slows down too. This results in a lower “glycemic effect.”
High glycemic foods (i.e. ones to avoid) include sugary foods, as well as starchy foods like white bread, many pastas, and rice. Low glycemic foods include ones that are higher in fiber, fat, and protein. Examples are meat, seafood, eggs, legumes, sweet potatoes, and non-starchy vegetables.
NOTE: Eating a low glycemic food along with a high glycemic food will help to slow down the blood sugar rise from the higher glycemic food. It’s not just the single food that matters, but the rest of the meal also affects your blood sugar.
Which leads us to…
#4
Eat your protein and fibrous vegetables first
Since blood sugar is affected by the amount of carbohydrates you eat, studies have also looked at the order in which you eat different foods.
A few small studies looked at adults with type 2 diabetes. They all had the same meal, but some were asked to eat their protein and fibrous (i.e. non-starchy) vegetables first; while others ate their carbohydrates first. They found that people who ate the protein and vegetables first had better blood sugar control. One of the studies also showed lower levels of post-meal insulin when the carbohydrates were eaten last.
Another study found these blood sugar benefits to be true even in people without type 2 diabetes.
It’s thought that when we eat carbohydrates first, we start digesting them right away. But, if we eat them after our protein and fibrous vegetables, they have a chance to mix in with the rest of the food in our stomachs. This can slow down their absorption, which slows down how fast and high our blood sugar gets after we eat.
The effects of changing food order haven’t been tested in many big studies, but it seems to be a simple and safe habit to get into to help our bodies better regulate blood sugar levels.
Try to eat your protein and fibrous vegetables first, and starches last.
#5
Evidence for a link between what we eat and how we feel is fairly new. The first studies to be published on this were as recent as 2009. This new area is called “nutritional psychiatry.” The relationships between foods and mental health are complex, and we’re just starting to understand them. While many studies show a link, all of them don’t.
#6
Fruit is OK ...especially dark berries.
Unless your doctor or health practitioner has said otherwise, or you have an intolerance to them, fruit and the fruit sugar “fructose” are generally ok. Fructose has a lower glycemic index than glucose (regular sugar). By replacing your glucose intake with whole-food fructose sources, you can reduce the average blood sugar levels over a two to three months period.
A diet high in fruits and vegetables is great for your health. They contain phytochemicals (phyto=plant), vitamins, minerals, and fiber. Eating whole (not processed or juiced) fruits can help with blood sugar balance. Berries are delicious, as they contain a lot of fiber and not a lot of sugar. Not to mention that they’re delicious!
Berries, especially dark berries, contain pigments known as “anthocyanins.” These dark-colored pigments have lots of health benefits, including helping sugar metabolism in people with insulin resistance. They can also improve your ability to think, and their antioxidant effects are linked to reduced DNA damage.
You can get enough anthocyanins from a regular serving of dark berries, so give them a try.
#7
Seasonings that support healthy blood sugar
Vinegar: Try having 1/2-1 tablespoons of vinegar shortly before or with a meal that contains sugars or starches.
Why? Because a recent analysis of several studies (a meta-analysis) showed that vinegar can lower blood sugar by up to 60% and insulin by up to 130% compared to the same meal without vinegar. This worked for insulin-resistant people. Even healthy people had a significant benefit.
Cinnamon can help to lower blood sugar levels and improve insulin sensitivity. This effect can happen with even less than one teaspoon per day.
It’s thought that cinnamon works by slowing the emptying of the stomach. Slower emptying means slower absorption and slower blood sugar rise after a meal. Cinnamon also contains antioxidant polyphenols (plant chemicals) that may improve insulin sensitivity.
#8
Get enough good quality sleep
Our bodies are wired to work along with the sun’s schedule. The objective is to wake up when the sun comes up, and get tired when it goes down. Not enough sleep can affect many of our body’s systems, including negatively affecting our blood sugar levels and insulin sensitivity. It can also increase appetite and promote weight gain.
Even one or two nights of poor sleep can affect our blood sugar levels.
Regularly getting enough good-quality sleep is a great step toward helping our bodies manage blood sugar.
#9
Get your move on
Remember how insulin tells your muscle cells to pull some sugar out of your blood to store for later? Guess what it’s storing it for?
Movement!
By moving with vigor (i.e. exercising) and burning that stored sugar, you not only improve your blood sugar levels but also reduce insulin resistance. Win-win-win.
This means your muscle cells, especially when they’re moving, absorb and burn more sugar from the blood. This goes for both medium- and high-intensity exercise.
#10
Manage your stress
Remember we talked about a couple of those things that release sugar stored in the liver and muscles and delivers them back to the blood? Things like not eating for a few hours and when we’re under stress. Let’s talk about the blood sugar effect of stress hormones like cortisol.
The reason stress hormones release stored sugar is to prepare for the “fight or flight” reaction. Your body becomes physically ready to fight or run. And to do this, you need fuel in your blood, i.e., sugar.
How can you reduce stress? Relaxation techniques like deep breathing, meditation, and yoga can reduce stress and lower blood sugar levels.
Quick Summary
If your blood sugar is creeping up, there are some food and lifestyle upgrades you can make for better health. But you don't have to do them all at once. Pick just one thing from this list that you feel comfortable with changing and start there. When you've got that one integrated into your life, add another.
Which of these will help you to better control your blood sugar levels?
NOTE: None of these are a substitute for professional medical advice. If you have any of these conditions, make sure you’re being monitored regularly by a licensed healthcare professional.
+ References + Supportive Studies
Adisakwattana, S., Lerdsuwankij, O., Poputtachai, U., Minipun, A. & Suparpprom, C. (2011). Inhibitory activity of cinnamon bark species and their combination effect with acarbose against intestinal α-glucosidase and pancreatic α-amylase. Plant Foods Hum Nutr, 66(2):143-8. doi: 10.1007/s11130-011-0226-4.https://link.springer.com/article/10.1007%2Fs11130-011-0226-4
Akilen, R., Tsiami, A., Devendra, D. & Robinson, N. (2010). Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet Med, 27(10):1159-67. doi: 10.1111/j.1464-5491.2010.03079.x. https://www.ncbi.nlm.nih.gov/pubmed/20854384
American Diabetes Association. (2017). Blood Glucose and Exercise. Accessed 2017 Sep 28.
American Diabetes Association. (2013). Stress. Accessed 2017 Sep 28. http://www.diabetes.org/living-with-diabetes/complications/mental-health/stress.html
Bernardo, M.A., Silva, M.L., Santos, E., Moncada, M.M., Brito, J., Proença, L., … de Mesquita, M.F. (2015). Effect of Cinnamon Tea on Postprandial Glucose Concentration. Journal of Diabetes Research, 2015, 913651. http://doi.org/10.1155/2015/913651 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516848/
Brand-Miller, J., Hayne, S., Petocz, P. & Colagiuri, S. (2003). Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care, 26(8):2261-7.
http://care.diabetesjournals.org/content/26/8/2261.long
Chicco, A.G., D’Alessandro, M.E., Hein, G.J., Oliva, M.E. & Lombardo, Y.B. (2009). Dietary chia seed (Salvia hispanica L.) rich in alpha-linolenic acid improves adiposity and normalises hypertriacylglycerolaemia and insulin resistance in dyslipaemic rats. Br J Nutr, 101(1):41-50. doi: 10.1017/S000711450899053X. Epub 2008 May 20. https://www.ncbi.nlm.nih.gov/pubmed/18492301
Cozma, A.I., Sievenpiper, J.L., de Souza, R.J., Chiavaroli, L., Ha, V., Wang, D.D., Mirrahimi, A., Yu, M.E., Carleton, A.J., Di Buono, M., Jenkins, A.L., Leiter, L.A., Wolever, T.M., Beyene, J., Kendall, C.W. & Jenkins, D.J. (2012). Effect of fructose on glycemic control in diabetes: a systematic review and meta-analysis of controlled feeding trials. Diabetes Care, 35(7):1611-20. doi: 10.2337/dc12-0073.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3379616/
Dijk, D.-J. (2008). Slow-wave sleep, diabetes, and the sympathetic nervous system. Proceedings of the National Academy of Sciences of the United States of America, 105(4), 1107–1108. http://doi.org/10.1073/pnas.0711635105 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2234097
Dhurandhar, E.J., Dawson, J., Alcorn, A., Larsen, L.H., Thomas, E.A., Cardel, M., Bourland, A.C., Astrup, A., St-Onge, M.-P., Hill, J.O., Apovian, C.M., Shikany, J.M., & Allison, D.B. (2014). The effectiveness of breakfast recommendations on weight loss: a randomized controlled trial. American Journal of Clinical Nutrition. doi: 10.3945/ ajcn.114.089573 http://ajcn.nutrition.org/content/early/2014/06/04/ajcn.114.089573.full.pdf+html
Examine.com Research Digest. (2015). Carbs-protein or protein-carbs … does food order matter? Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. 10(1). https://examine.com/store/erd/
Examine.com Research Digest. (2016). Starches last for better blood glucose Manipulating the sequence of food ingestion improves glycemic control in type 2 diabetic patients under free-living conditions. 25(2). https://examine.com/store/erd/
Franz, M.J., Bantle, J.P., Beebe, C.A., Brunzell, J.D., Chiasson, J.-L., Garg, A., Holzmeister, L.A., Hoogwerf, B., Mayer-Davis, E., Mooradian, A.D., Purnell, J.Q. & Wheeler, M. (2002). Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications. Diabetes Care, 25 (1) 148-198; DOI: 10.2337/diacare.25.1.148 http://care.diabetesjournals.org/content/25/1/148.long
Gannon, M.C. & Nuttall, F.Q. (2004). Effect of a high-protein, low-carbohydrate diet on blood glucose control in people with type 2 diabetes. Diabetes, 53(9):2375-82.http://diabetes.diabetesjournals.org/content/53/9/2375.long
Gibbons, C., Dempster, M. & Moutray, M. (2011), Stress, coping and satisfaction in nursing students. Journal of Advanced Nursing, 67: 621–632. doi:10.1111/j.1365-2648.2010.05495.x
Hartmann, M., Kopf, S., Kircher, C., Faude-Lang, V., Djuric, Z., Augstein, F., … Nawroth, P. P. (2012). Sustained Effects of a Mindfulness-Based Stress-Reduction Intervention in Type 2 Diabetic Patients: Design and first results of a randomized controlled trial (the Heidelberger Diabetes and Stress-Study). Diabetes Care, 35(5), 945–947. http://doi.org/10.2337/dc11-1343 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3329807/
Health Canada. (2006). Dietary Reference Intakes. Reference Values for Macronutrients. Accessed 2017 Sep 28. https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/dietary-reference-intakes/tables/reference-values-macronutrients-dietary-reference-intakes-tables-2005.html
Imamura, F., O’Connor, L., Ye, Z., Mursu, J., Hayashino, Y., Bhupathiraju, S. N., & Forouhi, N. G. (2016). Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. British Journal of Sports Medicine, 50(8), 496–504. http://doi.org/10.1136/bjsports-2016-h3576rep https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853528/
Jenkins, D.J., Wolever, T.M., Taylor, R.H., Barker, H., Fielden, H., Baldwin, J.M., Bowling, A.C., Newman, H.C., Jenkins, A.L. & Goff, D.V. (1981). Glycemic index of foods: a physiological basis for carbohydrate exchange. Am J Clin Nutr, 34(3):362-6. https://www.ncbi.nlm.nih.gov/pubmed/6259925
Khan, A., Safdar, M., Khan, M.M.A., Khattak, K.N. & Anderson, R.A. (2003). Cinnamon Improves Glucose and Lipids of People With Type 2 Diabetes. Diabetes Care, 26(12): 3215-3218. https://doi.org/10.2337/diacare.26.12.3215 http://care.diabetesjournals.org/content/26/12/3215.full
Kim, S.D. (2014). Effects of Yogic Exercises on Life Stress and Blood Glucose Levels in Nursing Students. Journal of Physical Therapy Science, 26(12), 2003–2006. http://doi.org/10.1589/jpts.26.2003 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273078/
Kirkham, S., Akilen, R., Sharma, S. & Tsiami, A. (2009). The potential of cinnamon to reduce blood glucose levels in patients with type 2 diabetes and insulin resistance. Diabetes Obes Metab, 11(12):1100-13. doi: 10.1111/j.1463-1326.2009.01094.x. http://onlinelibrary.wiley.com/doi/10.1111/j.1463-1326.2009.01094.x/abstract;jsessionid=514E8E89A56C254E12EAECA1EC68AFDA.f02t03
Klein, S., Allison, D.B., Heymsfield, S.B., Kelley, D.E., Leibel, R.L., Nonas, C. & Kahn, R. (2007). Waist Circumference and Cardiometabolic Risk: A Consensus Statement from Shaping America’s Health: Association for Weight Management and Obesity Prevention; NAASO, The Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Diabetes Care 30(6): 1647-1652. https://doi.org/10.2337/dc07-9921 http://care.diabetesjournals.org/content/30/6/1647.full
Krebs, J.D., Parry Strong, A., Cresswell, P., Reynolds, A.N., Hanna, A. & Haeusler, S. (2016). A randomised trial of the feasibility of a low carbohydrate diet vs standard carbohydrate counting in adults with type 1 diabetes taking body weight into account. Asia Pac J Clin Nutr. 25(1):78-84. doi: 10.6133/apjcn.2016.25.1.11. http://apjcn.nhri.org.tw/server/APJCN/25/1/78.pdf
Li, D., Zhang, Y., Liu, Y., Sun, R. & Xia, M. (2015). Purified Anthocyanin Supplementation Reduces Dyslipidemia, Enhances Antioxidant Capacity, and Prevents Insulin Resistance in Diabetic Patients. doi: 10.3945/ jn.114.205674 http://jn.nutrition.org/content/early/2015/02/04/jn.114.205674.abstract
Lu, T., Sheng, H., Wu, J., Cheng, Y., Zhu, J. & Chen, Y. (2012). Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res, 32(6):408-12. doi: 10.1016/j.nutres.2012.05.003. Epub 2012 Jun 14. https://www.ncbi.nlm.nih.gov/pubmed/22749176
Magistrelli, A. & Chezem, J.C. (2012). Effect of ground cinnamon on postprandial blood glucose concentration in normal-weight and obese adults. J Acad Nutr Diet, 112(11):1806-9. doi: 10.1016/j.jand.2012.07.037.https://www.ncbi.nlm.nih.gov/pubmed/23102179
Mang, B., Wolters, M., Schmitt, B., Kelb, K., Lichtinghagen, R., Stichtenoth, D.O. & Hahn, A. (2006). Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest. 36(5):340-4. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2362.2006.01629.x/abstract
Meyer, K.A., Kushi, L.H., Jacobs, D.R., Slavin, J., Sellers, T.A. & Folsom, A.R. (2000). Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr. 71(4):921-30.http://ajcn.nutrition.org/content/71/4/921.long
Mohamed Sham Shihabudeen, H., Hansi Priscilla, D., & Thirumurugan, K. (2011). Cinnamon extract inhibits α-glucosidase activity and dampens postprandial glucose excursion in diabetic rats. Nutrition & Metabolism, (8)46. http://doi.org/10.1186/1743-7075-8-46 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155477/
National Institutes of Health, National Center for Complementary and Integrative Health. (2017). Stress. Accessed 2017 Sep 28. https://nccih.nih.gov/health/stress
Nielsen, J.V., & Joensson, E.A. (2008). Low-carbohydrate diet in type 2 diabetes: stable improvement of bodyweight and glycemic control during 44 months follow-up. Nutrition & Metabolism, 5, 14. http://doi.org/10.1186/1743-7075-5-14 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424054/
Parker, L., Shaw, C. S., Banting, L., Levinger, I., Hill, K. M., McAinch, A. J., & Stepto, N. K. (2016). Acute Low-Volume High-Intensity Interval Exercise and Continuous Moderate-Intensity Exercise Elicit a Similar Improvement in 24-h Glycemic Control in Overweight and Obese Adults. Frontiers in Physiology, (7)661. http://doi.org/10.3389/fphys.2016.00661 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220056/
Pham, A.Q., Kourlas, H. & Pham, D.Q. (2007). Cinnamon supplementation in patients with type 2 diabetes mellitus. Pharmacotherapy, 27(4):595-9. http://onlinelibrary.wiley.com/doi/10.1592/phco.27.4.595/abstract
Qureshi, A.A., Sami, S.A. & Khan, F.A. (2002). Effects of stabilized rice bran, its soluble and fiber fractions on blood glucose levels and serum lipid parameters in humans with diabetes mellitus Types I and II. J Nutr Biochem, 13(3):175-187. https://www.ncbi.nlm.nih.gov/pubmed/11893482
Radahmadi, M. et al. (2006). Effects of stress on exacerbation of diabetes mellitus, serum glucose and cortisol levels and body weight in rats. Pathophysiology, 13(1):51-55. http://www.pathophysiologyjournal.com/article/S0928-4680(05)00071-4/fulltext
Rosenzweig, S., Reibel, D.K., Greeson, J.M., Edman, J.S., Jasser, S.A., McMearty, K.D. & Goldstein, B.J. (2007). Mindfulness-based stress reduction is associated with improved glycemic control in type 2 diabetes mellitus: a pilot study. Altern Ther Health Med, 13(5):36-8. https://www.ncbi.nlm.nih.gov/pubmed/17900040
Sacks, F.M., Carey, V.J., Anderson, C.A.M., Miller, E.R., Copeland, T., Charleston, J., … Appel, L.J. (2014). Effects of High vs Low Glycemic Index of Dietary Carbohydrate on Cardiovascular Disease Risk Factors and Insulin Sensitivity: The OmniCarb Randomized Clinical Trial. JAMA, 312(23), 2531–2541. http://doi.org/10.1001/jama.2014.16658: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4370345/
Sahay BK. (2007). Role of yoga in diabetes. J Assoc Physicians India. 55:121-6. https://www.ncbi.nlm.nih.gov/pubmed/17571741/
Sancini, A., Ricci, S., Tomei, F., Sacco, C., Pacchiarotti, A., Nardone, N., Ricci, P., Suppi, A., De Cesare, D.P., Anzelmo, V., Giubilati, R., Pimpinella, B., Rosati, M.V. & Tomei, G. (2017). Work-related stress and blood glucose levels. Ann Ig. 29(2):123-133. doi: 10.7416/ai.2017.2139. https://www.ncbi.nlm.nih.gov/pubmed/28244581
Schade, D.S. & Eaton, R.P. (1980). The temporal relationship between endogenously secreted stress hormones and metabolic decompensation in diabetic man. J Clin Endocrinol Metab. 50(1):131-6. https://www.ncbi.nlm.nih.gov/pubmed/7350176
Sheard, N.F., Clark, N.G., Brand-Miller, J.C., Franz, M.J., F. Pi-Sunyer, X., Mayer-Davis, E., Kulkarni, K. & Geil, P. (2004). Dietary Carbohydrate (Amount and Type) in the Prevention and Management of Diabetes: A statement by the American Diabetes Association. Diabetes Care, 27(9): 2266-2271. https://doi.org/10.2337/diacare.27.9.2266: http://care.diabetesjournals.org/content/27/9/2266.full
Shishehbor, F., Mansoori, A. & Shirani, F. (2017). Vinegar consumption can attenuate postprandial glucose and insulin responses; a systematic review and meta-analysis of clinical trials. Diabetes Research and Clinical Practice. 127, 1-9. https://doi.org/10.1016/j.diabres.2017.01.021 http://www.sciencedirect.com/science/article/pii/S0168822716308518#!
Shukla, A.P., Iliescu, R.G., Thomas, C.E. & Aronne, L.J. (2015). Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels. Diabetes Care, 38(7): e98-e99. https://doi.org/10.2337/dc15-0429 http://care.diabetesjournals.org/content/38/7/e98.full
Simard, A-A. & Henry, M. (2009). Impact of a short yoga intervention on medical students’ health: A pilot study. Medical Teacher, 31(10): 950-2. http://dx.doi.org/10.3109/0142159090287406 http://www.tandfonline.com/doi/full/10.3109/01421590902874063
Stull, A.J., Cash, K.C., Johnson, W.D., Champagne, C.M. & Cefalu, W.T. (2010). Bioactives in blueberries improve insulin sensitivity in obese, insulin-resistant men and women. J Nutr, 140(10):1764-8. doi: 10.3945/jn.110.125336. Epub 2010 Aug 19. | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139238/
Tasali, E., Leproult, R., Ehrmann, D. A., & Van Cauter, E. (2008). Slow-wave sleep and the risk of type 2 diabetes in humans. Proceedings of the National Academy of Sciences of the United States of America, 105(3), 1044–1049. http://doi.org/10.1073/pnas.0706446105 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2242689/
The Diabetes Prevention Program (DPP) Research Group. (2002). The Diabetes Prevention Program (DPP): Description of lifestyle intervention. Diabetes Care, 25(12), 2165–2171. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282458/
Tricò, D., Filice, E., Trifirò, S., & Natali, A. (2016). Manipulating the sequence of food ingestion improves glycemic control in type 2 diabetic patients under free-living conditions. Nutrition & Diabetes, 6(8), e226–. http://doi.org/10.1038/nutd.2016.33 | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022147/
Tuomilehto, J., Lindström, J., Eriksson, J.G., Valle, T.T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., Salminen, V., Uusitupa, M.; Finnish Diabetes Prevention Study Group. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 344(18):1343-50. http://www.nejm.org/doi/full/10.1056/NEJM200105033441801#t=articleTop
USDA (United States Department of Agriculture) Nutrient Database. Search = Fiber. Accessed 2017 Sep 28. https://ndb.nal.usda.gov/ndb/nutrients/report/nutrientsfrm?max=25&offset=0&totCount=0&nutrient1=291&nutrient2=&nutrient3=&subset=0&sort=c&measureby=g
Vuksan, V., Choleva, L., Jovanovski, E., Jenkins, A.L., Au-Yeung, F., Dias, A.G., Ho, H.V., Zurbau, A. & Duvnjak, L. (2017). Comparison of flax (Linum usitatissimum) and Salba-chia (Salvia hispanica L.) seeds on postprandial glycemia and satiety in healthy individuals: a randomized, controlled, crossover study. Eur J Clin Nutr. 71(2):234-238. doi: 10.1038/ejcn.2016.148. https://www.ncbi.nlm.nih.gov/pubmed/28000689
Westman, E.C., Yancy, W.S., Mavropoulos, J.C., Marquart, M. & McDuffie, J. R. (2008). The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus. Nutrition & Metabolism, 5, 36. http://doi.org/10.1186/1743-7075-5-36 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633336/
Yancy, W. S., Foy, M., Chalecki, A. M., Vernon, M. C., & Westman, E. C. (2005). A low-carbohydrate, ketogenic diet to treat type 2 diabetes. Nutrition & Metabolism, 2, 34. http://doi.org/10.1186/1743-7075-2-34 : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1325029/
RELATED POSTS
