Blood Sugar Dysregulation and Dysglycemia

According to the CDC, more than 1 in 3 adults in America have prediabetes and around 84% do not even know it. Prediabetes is a risk factor for diabetes, as well as heart disease and stroke (Centers for Disease Control and Prevention, 2020). Approximately 1 in 10 Americans have diabetes and 90-95% of those cases are type 2 diabetes (Centers for Disease Control and Prevention, 2019). Prediabetes, when blood sugars are elevated but not to the level of those diagnosed with diabetes, and diabetes are discussed much more often than a state that could perhaps be the missing link in understanding our bodies on a deeper level—blood sugar dysregulation and dysglycemia. Blood sugar dysregulation and dysglycemia are terms that describe abnormalities in blood sugar stability—hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Because these concepts are so important and complex, this article will be part of a multi-week series on blood sugar and its effects on the body.

Most articles discussing blood sugar dysregulation discuss the impact of hyperglycemia, though the term dysregulation should also encompass the lows in blood sugar that some experience, as they also have a huge impact on many aspects of overall health and daily functioning. From an anatomical level, the pancreas is the major organ involved in blood sugar regulation. The pancreas secretes insulin when glucose levels in the blood are high. Insulin is like a key that unlocks the “doors” of cells to allow glucose to enter. That glucose is then used for energy or is stored. Other cells in the pancreas are responsible for secreting glucagon in response to low blood sugar. Glucagon functions to tell the liver and adipose tissue to break down stored glycogen to glucose and stored triglycerides to fatty acids to be released into the bloodstream to stabilize blood sugar.

This process of glucose homeostasis happens all day in order to maintain stable blood sugar. Dysglycemia, or abnormal blood sugar stability, occurs when this system is disrupted. From the perspective of many articles discussing blood sugar dysregulation, the idea is that when the body is constantly exposed to carbohydrates and foods that cause spikes in blood sugar—sweets, sugars, and carbohydrates with a high glycemic index–the pancreas constantly works to pump out insulin and eventually gets tired. When the pancreas gets tired, it stops functioning appropriately. One term used is that the pancreas becomes insulin-resistant, and this is one of the factors in developing type 2 diabetes. Hypoglycemia is another aspect of dysglycemia with its own impacts on the systems of the body and will be discussed in a future article.

Many with diabetes and prediabetes do not have symptoms. They are often diagnosed upon blood tests, such as a fasting plasma glucose test, A1c, an oral glucose tolerance test, or in some instances, a random finger stick (random plasma glucose test). Some experience symptoms such as frequent urination, frequent thirst, extreme fatigue, blurry vision, and some may experience symptoms of disease progression, which affects the nervous system, kidneys, and vision particularly. Other risk factors that may be indicative of blood sugar dysregulation or insulin resistance include: waist circumference >40 inches in men and >35 inches in women; waist-to-hip ratio of >1 inch in men and >0.8 inches in women; fasting blood sugar >100 mg/dl; hemoglobin A1c >5.7; polycystic ovarian syndrome (PCOS) in women; and feeling fatigued, irritable, or light-headed when going a few hours without eating (Cloverlea Wellness, 2020). For some when made aware of risk factors, symptoms, or even diagnosis early on, blood sugar dysregulation can be reversed or disease progression delayed with proper nutrition, exercise, and in some cases with medication.

If you are experiencing symptoms or have any questions about blood sugar dysregulation, prediabetes, or diabetes, please contact a medical professional. Check back over the next few weeks for topics in this informational series.