Blood Sugar Regulation

Authored by Chris McDermott, Nurse Practitioner, practicing with autonomous authority in Florida | Intercoastal Health, Florida

Background: What Is Blood Sugar Dysregulation?

Glucose is the body’s primary energy source. After food is consumed, blood sugar levels rise, prompting the pancreas to release insulin—a hormone that facilitates the uptake of glucose into cells. Blood sugar dysregulation occurs when this system becomes imbalanced, leading to:

• Hyperglycemia: Elevated blood glucose levels
  
• Hypoglycemia: Abnormally low blood glucose levels
  
• Insulin Resistance: Reduced cellular response to insulin, often preceding Type 2 diabetes
  
• Hyperinsulinemia: Elevated insulin levels, which may persist before overt hyperglycemia emerges
  
  

Dysregulation develops gradually, often progressing silently for years. Identifying early-stage changes in blood glucose metabolism is essential in preventing long-term complications.

Clinical Symptoms: Early Signs of Blood Sugar Imbalance

Recognizing symptom patterns associated with blood sugar instability is key to early intervention. These signs may appear long before overt laboratory abnormalities.

Indicators of Dysglycemia May Include:

• Awakening in the middle of the night with difficulty returning to sleep
  
• Craving sweets or caffeine, particularly in the afternoon
  
• Uncontrolled eating or excessive hunger between meals
  
• Fatigue relieved by eating
  
• Irritability, shakiness, or headaches when meals are skipped
  
• Brain fog or poor concentration
  
• Sleepiness after meals
  
• Frequent urination or increased thirst
  
• Family history of diabetes or metabolic syndrome
  
  

These symptoms suggest impaired glycemic control and may reflect underlying insulin resistance, reactive hypoglycemia, or hyperinsulinemia.

Diagnostic Evaluation and Biomarkers

Functional medicine expands upon conventional laboratory assessments to identify dysregulation before it meets diagnostic thresholds for diabetes.

Core Biomarkers Assessed:

• Fasting Glucose: Measures current blood glucose level after overnight fast
  
• Hemoglobin A1c: Reflects average glucose over 2–3 months; used to monitor long-term control
  
• Fasting Insulin: Assesses insulin secretion and resistance
  
• C-Peptide: Reflects pancreatic insulin production
  
• Fructosamine: Short-term marker of glycemic control over 1–2 weeks
  
  

Additional markers such as DHEA-S, lipid panels, and LDH are also often assessed.

Physical Examination Clues:

• Elevated Blood Pressure
  
• Earlobe Crease
  
• Skin Tags and Acanthosis Nigricans
  
• Adult Acne
  
• Slow wound healing or recurrent infections
  
• Chronic fungal infections or oral white patches

Causes of Blood Sugar Dysregulation

Blood sugar imbalance results from a convergence of genetic, environmental, and lifestyle-related factors.

Contributing Factors Include:

• Genetic predisposition
  
• Sedentary lifestyle
  
• Poor diet (high refined carbs and sugar)
  
• Obesity and visceral fat
  
• Hormonal imbalances (PCOS, cortisol excess, thyroid dysfunction)
  
• Medication use (e.g., corticosteroids, beta-blockers, antipsychotics)
  
• Chronic stress
  
• Autoimmune activity such as Type 1 Diabetes
  
  

Infections, chronic inflammation, and environmental toxin exposures may also contribute.

Related Conditions and Health Risks

Persistent dysglycemia has systemic implications.

Associated Conditions Include:

• Metabolic Syndrome
  
• Type 2 Diabetes
  
• Hypoglycemia
  
• Hyperinsulinemia
  
• Type 1 Diabetes
  
  

Long-Term Complications:

• Cardiovascular disease
  
• Neuropathy
  
• Nephropathy
  
• Retinopathy
  
• Impaired immune function

Drug Influences and Interfering Factors

Certain pharmaceuticals and biological variables affect glucose metabolism.

Medications That May Elevate Blood Sugar:

• Corticosteroids
  
• Thiazide Diuretics
  
• Beta-Blockers
  
• Atypical Antipsychotics
  
• Statins
  
  

Testing Interferences and Variables:

• Acute illness or stress
  
• Fasting duration
  
• Hydration status
  
• Alcohol intake
  
  

Reviewing medications and clinical status is crucial when interpreting lab results.

Functional Medicine Approach at Intercoastal Health

Our proactive approach emphasizes early identification and correction of metabolic dysfunction.

Comprehensive Functional Strategies:

1. Nutritional Intervention: Stabilize blood sugar with low-glycemic foods, personalized macronutrients, intermittent fasting strategies.
   
2. Physical Activity: Structured aerobic and resistance exercise plans.
   
3. Stress Reduction and Sleep Optimization: Cortisol regulation, circadian rhythm support.
   
4. Targeted Supplementation: Nutrients like magnesium, vitamin D, chromium, and berberine.
5. Monitoring and Reassessment: Biomarker tracking and functional evaluations.