Jay Feldman
Welcome to episode four of the Energy Balance Podcast. I'm Jay Feldman of jfeldmanwellness.com and joining me today is my good friend Mike Fave of sapiensystems.com. Today we're going to be starting with part one of a two part series on blood sugar and today specifically we're going to talk about the different features of blood sugar regulation, the different hormones that help us regulate blood sugar and how all of that relates to energy balance. So basically what we want our blood sugar regulation to look like in order to optimize our cellular energy. And then we'll talk a little bit about how the different macronutrients affect our blood sugar regulation. So how carbs, fats and protein affect blood sugar. And we'll dispel some of the myths out there specifically about protein stabilizing blood sugar and what that really means. And then also the effects of carbs on our blood sugar.

And then at the end, we'll talk a little bit about insulin resistance and diabetes and some of the myths surrounding those conditions as well. Basically the idea is that insulin and carbohydrates are responsible for those conditions and that they cause those conditions. So we'll talk a little bit about that and why that's not true. To check out the show notes for today's episode, head over to jfelmanwellness.com slash podcast, where I'll be linking to any of the studies and articles and other things that we reference throughout the episode. And then if you are dealing with any low energy symptoms, whether that is brain fog or fatigue or gut inflammation, bloating or low libido or weight gain or any sorts of other chronic health conditions, head over to jfeldmanwellness.com slash energy and sign up for a free mini course on energy balance where I will basically walk you through the things that you want to do to make sure that you're supporting your cellular energy production and the things that you want to avoid to make sure that you don't block that process. And with that, let's get started.

To start, let's talk about sugar as a fuel and why it's so important. You want to start us off? Okay. Well, I guess we'll just start with the main fact that sugar is the primary fuel for cells or based on the context we're coming up from should be the primary fuel for a most cells in the body. Particularly the most important would be the nervous system. The neural tissue specifically requires sugar to function and what to oxidize through the mitochondria. And yeah, so I guess we should just set it up like that. The first point would be sugar is vitally important for energy production and energy production being vitally important for our health in general.

And then the nervous and then specifically sugar being very important for the nervous system and energy production in the nervous system. And then I guess where do you want to where do you want to go from there in terms of setting up regulation? Yeah, well, yeah. So just a couple of clarifications. One, when we're talking about sugar, we're not specifically talking about white table sugar. We're just talking about how all carbohydrates break down into sugar or glucose or glucose at its, you at their most basic level. So that's kind of what's circulating in our bodies. That's what our cells are using to produce energy. They're using sugar. So just a little clarification there. And then also we're not going to get too much into the differences between using carbs and fats or sugar and fat as fuel in this episode, because we're going to try to keep it little more basic, but I will link to articles in the show notes that deal with that and also why sugar is a preferred fuel in the brain.

And the rest of the nervous system. So just kind of to get that out of the way. yeah, so starting from that platform, that sugar is extremely important for our nervous system because it's the primary fuel. And the only place that our nervous system gets sugar from is from the blood. Our blood is basically the transport system that transports this fuel sugar throughout our bodies. And so because of that, the regulation of our blood sugar or making sure that we have adequate fuel levels, adequate sugar levels at all times is extremely important. And it's a very tight B regulated process in our bodies. and this, this regulation of blood sugar is mostly performed by various blood sugar regulating hormones. So, probably makes the most sense to dive into those next, right? Yeah, I guess we can go into them. So, our primary hormones for blood sugar regulation would be cortisol.

Glucagon, adrenaline, and insulin. The three main ones, cortisol, glucagon, and adrenaline function to release blood sugar or release sugar into the bloodstream when the sugar levels get too low. then insulin and I guess combination with potassium helps to drive sugar into the cell to be oxidized.

And a lot of this functions through the liver. A lot of these hormones, a lot of these hormones in general and a lot of the regulation of blood sugar functions through the liver with sugar coming in from the food that we digest being processed by the liver and pushed into the bloodstream and then the different hormones and also storing sugar. The liver also directly store sugar as glycogen.

And then these hormones liberating that glycogen specifically from the liver, I guess there's some glycogen in the kidneys and some of the other organs as well. But the main storage so far as we know now is the liver. And basically these hormones, specifically glucagon, adrenaline, and cortisol, more glucagon and adrenaline liberating the carbohydrate from the liver when our blood sugar gets too low. And then insulin itself pushing the
sugar not only or the glucose not only into the liver but into all the cells and tissues of the body that require the carbohydrate. So you basically have the two systems I guess to make it more concise you guys. You have three hormones here on this side cortisol, glucagon, and adrenaline to help raise blood sugar when blood sugar is too low and you have insulin on the other side which helps to push the sugar into the cells when the blood sugar is elevated.

And this is after you eat. this, within the context of not being in a pathological state, that insulin is gonna push the carbohydrate into the cell. And that's its main function and it's what happens, our blood sugar's gonna rise after we eat carbohydrate. I guess a last point to get in there would be the reason I broke out the adrenaline and glucagon separate from the cortisol in regards to releasing the carbohydrate from the liver is because the cortisol may have some function in releasing carbohydrate from the liver, but I think its main function in regards to the regulation of blood sugar is the breakdown of protein through the process of gluconeogenesis to sugar. you have adrenaline and glucagon, which are the first sort of backup hormones that are released in response to low blood sugar, and they cause the breakdown of glycogen by the liver.

To raise blood sugar. And then after a period of time when that glycogen in the liver starts to get a little bit lower, the body says, hey, we don't have enough sugar in storage now and we really need sugar, it's vitally important. So what we're gonna do is we're gonna kick in cortisol. And this cortisol is gonna break down proteins in the body through the process of gluconeogenesis, which basically just means the gluconeo and genesis. So glucose is sugar, neo is the new, and then genesis is the creation. So that's all they are.

That's all the process is. And those amino acids are broken down and sugar is produced from them. So yeah, so that's the basic breakdown of those hormones. All just to tightly regulate sugar. In the medical field, the regulation of sugar, the range that the doctors like to see, it's generally between 70 and 120 fasting. And then if you're gonna go up to 200,
during a meal, so it's between 70 and 200 for a meal and those are the regular accepted, normally accepted ranges for blood sugar. If you were to go below that 70 as somebody who's in a physiologic state, not, it doesn't have a pathology like diabetes or is taking a steroid or something like that, specifically like a glucocorticoid steroid, then your blood sugar, if it drops below that 70, you start to have problems, you start to get symptoms, you can get sweaty, can get, you can start to get mental symptoms all the way to the point of going into a coma. When you get into higher blood sugar levels, the classic signs that they teach you in school of diabetes would be polydipsia, polyuria, polyphagia, which just means hungry, thirsty, and pees a lot.

Not in that specific order, but those are the three basic signs. And then besides that, you can, there is a danger of going very, very high, but for the most point, your blood sugar can go much higher than that 200 and you still function. You still function okay. You're still, you're still mentally functioning. But you don't tend to see super high blood sugars like that unless you're in a pathologic state like diabetes. Right. Yeah. That shouldn't be happening. And it's not necessarily that the high blood sugar itself is the issue, but there's other underlying issues going on that are
resulting in the elevated blood sugar, or preventing it from going down.

We can touch on that a little later. But I want to step back a little bit and talk about those blood sugar regulating hormones and their effects on the liver. So firstly, just one thing that in talking about insulin is there's some evidence that insulin more works as a counter regulatory hormone to glucagon and adrenaline and cortisol, as opposed to being purely about driving glucose into the cells and that the cells can actually absorb glucose and fructose without necessarily needing insulin. it's a signal that we don't need those hormones. It's like a signal that the body has carbohydrate coming in basically. Right, exactly. And in a typical healthy person who doesn't have diabetes or insulin resistance, you don't typically have elevated levels of insulin and elevated levels of stress hormones. That's definitely not a good sign.

Typically it's one or the other because they kind of regulate each other. And so in talking about that, first, just as far as those stress hormones go, I'll just kind of repeat a little bit and clarify. So glucagon is released first and that breaks down glycogen, the stored sugar in our liver to raise the blood sugar and then adrenaline, which further increases that. And then cortisol, which at that point our glycogen is typically lower and we're under a lot of stress because of our very low blood sugar, a very low fuel supply. And so then cortisol causes the breakdown of our tissues like muscles or organs, whatever it is, that causes the conversion of protein to glucose through gluconeogenesis to raise the blood sugar. So that's kind of the cascade of these stress hormones. And most often these stress hormones aren't known for regulating blood sugar. They're typically just considered to be a result of stress or oftentimes psychological stress or really any stress on the body.

Jay
it's not often recognized that their primary role, arguably, is in relation to blood sugar and supplying fuel when the energy supply is low. So when our blood sugar drops, it means that our fuel is low and that our energy supply is low, and that causes the release of these stress hormones in order to bring it back up. And so that's kind of the framework from which our blood sugar regulation operates.

And these stress hormones, they're actually more tightly tied to the energy supply rather than our blood sugar levels. So under certain conditions, they can actually be released at higher blood sugar levels if our energy supply is low, if we're not producing enough energy, even if our blood sugar is slightly elevated. So the blood sugar is kind of like a midway point between those two things, between stress and the production of energy they would technically be more hormones of energy balance. Yeah, exactly. Basically supply and demand. What energy you have available in the body and what the demands are externally or internally on the body. And so, and so when those demands are exceeding our supply, happens when our blood sugar is low, that's always going to happen because we have a low fuel supply. And also if we're under a lot of stress, you know, outside of, to our environment, whether it's because we're doing a lot of physical activity or exercise or whatever it is, that would be another scenario where that happens. And another function of those stress hormones is they reduce the usage of sugar as a fuel and increase the usage of fat as a fuel. And this again is kind of another way that we conserve our prized fuel of sugar and rely on our backup fuel of fats, which again, it's a conservation mechanism and also is another way that we kind of, we regulate our energy production and our metabolism, really down-regulate them in order to conserve energy for the future. It's an adaptive, intelligent process. Yeah. Yeah. Yeah. It's an intelligent response by the body based on the environment that we're placed in. Yeah. So thank you for pointing that out. So these stress hormones, aren't inherently bad.

Jay
Very, very helpful and protective in that if we have some stress going on, we want these stress hormones to increase because they allow us to produce energy. And in the short term, they actually directly cause energy production. They stimulate the cells by increasing calcium release and all of that in order to increase energy production. And that allows us to deal with whatever's going on in that short term. But in the long term, doing these things that cause a lot of stress and cause these stress hormones to increase ends up reducing our metabolism, our metabolic function, our thyroid function, our reproductive function, and those, you know, our reproductive hormones that are very protective. It really down-regulates all those things because it's suggesting to our bodies that our environment is very stressful. It's not ideal. It's basically down-regulating excess functions that we can like stay with core functions so that we can survive, so that we can live, so that we can move forward and get to a better environment.

That's the purpose. And that's that dichotomy that we talked about in the last episode between kind of having that energy surplus and energy deficit and up regulating of those higher level functions versus the down regulating of them. so blood sugar is one of those main kind of midway points or main midway points between our bodies and our environment as far as determining kind of. It's a main signal. The sugar from the environment is the main signal.

I think an interesting point to point out here is that the ingestion of sugar itself, just the sweet taste itself, turns off a lot of these hormones. the sugar itself is the stimulus that is sort of regulating some of these processes. Almost pretty much directly, these hormones are responding to the stimulus that is sugar in our environment.

And I think something else that's important that you mentioned is that sugar is our short term or it's more of an energy, it's a signal of surplus energy. Whereas the fat is sort of a signal of backup energy in an absence of sugar. So your body's always gonna be having some usage of fatty acids. You're never gonna fully get only the usage of sugar.

Jay
But the amount of sugar that you're gonna use in general is dependent upon how much you have in the environment. So it just signals your body that I have, this is a stable environment for me, I have enough energy source coming in, I can meet my demands, I don't have to move to this backup system, which is efficient and necessary in certain circumstances, but it's not something, the ideal state wouldn't be to be running on it chronically or consistently. Yeah, and that's because of its down rate.
down regulating effects of those higher level functions. So that's a perfect bridge. And I think that's also a good bridge into kind of how just the general effects of how our food affects our blood sugar regulation. And you touched on one of the most important, which is that considering the fact that low blood sugar causes the release of stress hormones, one of the most protective things that we can do, one of the best ways that we can reduce stress is by taking in sugar in the form of carbohydrates.

In order to raise our blood sugar and that directly inhibits the release of adrenaline and cortisol and glucagon which are the stress hormones we've been talking about. this happens with these, sugar, this does this even in mentally stressful situations. So sort of any sort of, there's a reason I guess you could say that people reach for or have cravings for your ice cream and your salty potato chips during these times of stress.

And that's because your body is trying, your body is basically trying to counter-regulate the stress, trying to take in an energy source and lower the stress hormones so that they don't have to, it doesn't have to run on the stress hormones. It can run optimally on these exogenous sources. So yeah, so I think that even under mental stress, even under these different, even from exercise, things like this, even the taking of sugar is shown to directly sugar and salt for adrenaline, which is a different story, but has shown to directly lower these stress hormones, lower these adaptive processes. Yeah, and you brought up a good point, which is that kind of in talking about the highs and lows of blood sugar throughout the day, is we do naturally have this flow of highs and lows and peaks and troughs. And at those lower points is when these symptoms come out. So the symptoms of low blood sugar or the release of adrenaline and cortisol and glucagon

Jay
Typically comes in the form of you could have like hot flashes or feeling irritable. You often feel sweating. You feel very hungry. Agitation and so and feeling hungry. And as you said, specifically cravings for carbohydrates are really common. So and a lot of people know this is kind of when they have these large gaps between meals, for example, they start to get really hungry or they feel hangry, which is kind of you start to feel angry and irritable because you're hungry and that's directly related to blood sugar. So if you eat, you know, whatever food that kind of raises your blood sugar because it has carbohydrates in it, then a few hours later, as your body continues to use the fuel of sugar, our blood sugar begins to run low and you have this adaptive protective system of stress hormones that comes out and it causes all these effects. And the goal of these effects is to get you to eat again so that you can bring your blood sugar back up to a normal level that allows your body to produce the energy that it needs.

And I think a lot of people, I think a good example of this is a lot of people who go over into keto diets. They, and I know we talked about this before, but you go onto these like zero carb, low carb diets and you say you have such stable energy. And part of that stability in the energy is that you're not going to get, you won't get the massive fluctuation in blood sugar because you're not going to take in carbohydrate and then have that carbohydrate coming in exogenously from your gut or from the processing of your liver and then have it drop off later and then your body's like, I want more. And when that period of time where your sugar gets low, it starts to stimulate the adaptive hormones. So your sugar drops and then you start to feel a little bit uncomfortable. You get the symptoms that we talk about and then the adaptive hormones come in. know, glucagon first, then adrenaline and then cortisol.

And then once the cortisol sets in or once the adaptive hormone sets in, then your blood sugar sort of comes back up and levels off and stays at the normal level or at a baseline level. But the thing is in order to do this, you're running on cortisol. So a lot of people, they don't have that switch. When you're on the keto diet, you don't have that switch where your sugar has to get really low because you haven't taken in carbohydrates from the last meal with carbs. So you just run on cortisol consistently.

Jay
And your body gets sort of gets adapted to just running on the cortisol consistently and it down regulates the sugar utilization and sort of up regulates fat utilization so that it doesn't have to break down so much protein to reduce the sugar. But that switch is I think what a lot of people feel. It's when the blood sugar drops, you get all those symptoms we just talked about and then the adaptive hormones come on and then you're okay. Once the adaptive hormones come on, you can function, you're fine. Once you get over the hunger pains or the hangryness, your cortisol comes back up, or your blood sugar comes back up from the regulatory hormones, and then you're stable now, but now you're running on these regulatory hormones. And I think a lot of people, they know the switch that we're talking about. think a lot of people, the Snicker commercials are a great example of this. Yeah, yeah, they are, definitely. They're not you when you're hungry. Yeah, and I'll link to, I don't want to dive too much into the whole low carb keto thing, but I'll link to a couple articles talking about how that affects blood sugar regulation. And also just to explain a little bit. So for someone who's not on a low carb diet, when you're eating carbohydrates throughout the day, that increases your blood sugar. And then if your blood sugar drops, you get hungry, you eat more carbs, it goes back up. part of the reason for kind of the stability of one of the low carb or keto diet is because if you're not eating those carbohydrates, basically your blood sugar is constantly at a stable point.

By those stress hormones. Basically always have high levels of those stress hormones. And that's what maintains your blood sugar instead of eating carbohydrates. And that comes with a whole host of other problems, but it can result in that stability. And then another reason for that stability could be if you're not using the carbohydrates well, if your body can't produce energy very well from carbohydrates, which there's separate reasons for that, then they can run better on fats. But that's kind of outside the scope of blood sugar regulation and I talk about that in those articles that I linked to. I'll leave it at that. so in talking, kind of circling back to the natural flow of our blood sugar throughout the day and regulating it the best way for energy balance, basically we want to avoid those drops in blood sugar or reverse them as quickly as possible. And so the way that we do that is by eating carbohydrates throughout the day spaced out in a way that
corresponds with our blood sugar. And for some people who are not as metabolically healthy, this could mean eating every hour or two. Or as your liver function improves, as your ability to use sugar improves, it could extend to every three or four or five hours. So that's the importance of eating sugar throughout the day in the form of carbohydrates is that it keeps our blood sugar steady.

Inhibits the release of stress hormones and allows us to continue to produce energy and maintain a steady energy supply. we'll talk kind of later on in the series when we talk about carbohydrates about how the effects of different carbohydrates, the specific effects of different carbohydrates on our blood sugar. But now in talking about other forms of foods, we also have protein and fats, which also affects on blood sugar. Fat not as much. fat doesn't really because to release the fatty acids doesn't really affect sugar. doesn't get converted into sugar. So you don't really have a big effect there between fat intake. I think ingestion of fats though can have an effect on blood sugar. Yeah, Yeah, no, we will. I was about to but I'll let you take it. But yeah, so the fats don't directly affect our blood sugar by increasing or decreasing it.

What they can do is reduce the usage of sugar for energy, which allows our blood sugar to not drop as quickly between meals. So do you wanna kind of riff off that Mike? Well, I also think besides decreasing the usage of sugar, I also think that the fats can help with digestion. It can help maybe slow digestion down a little bit. That's yeah. stay more stable throughout, like stable between meals.

So I think some people will find that if they do like very low fat diets and they have a high amount of carbs, they're constantly having to eat. And I think if you go to any sort of vegan fruitarian forum where they're doing very low fat and they're eating mostly carbs, you'll see that some people complain about this. It's like I have just hungry all the time. I have to eat all day long and constantly eating fruit and constantly eating sugar. I know that's something that when I did very low fat, that's something that I experienced. I think the fat helps with stability in between meals.

Jay
But you definitely still want to have the sugar and then you want to do protein. Sure. Yeah. And yeah, so just to clarify, so the ways that we're talking about fat being helpful and that stability is by slightly reducing the usage of sugar. So still providing sugar for your nervous system. But some of the other systems that might be at rest can use fat for fuel as opposed to needing sugar. But more so than that, it's the slowing of the digestion and improving of the digestion. Yeah. And so protein and this is not something that's often recognized is, well, it's kind of funny because in a lot of the layman circles are like kind of the very, I don't know, the more like colloquial, like the more common things when talking about protein is that people will say that protein is really good for regulating blood sugar. And they'll talk about eating a lot. Stabilizing it, Yeah, stabilizing it. Yeah, I've heard that so many times and it's really funny because I mean, it's not.

So, yeah, it's a really funny thing to say. I'm not really sure kind of where it came from, but protein eaten on its own will actually lower the blood sugar. And the reason for this is protein is broken down into amino acids, which are traveling for our blood and throughout our blood and need to get into our tissues. And these amino acids cause the production of insulin. They cause the release of insulin, which may help them get into the cells, may help the amino acids get into the cells. And so what that can also do is
cause our blood sugar to drop. when you eat protein alone, it causes our blood sugar to drop because these amino acids cause the stimulation of insulin. And so that's really not ideal because if you're just eating that protein, you cause this drop in blood sugar, then you have the release of the stress hormones and you end up with this low fuel supply, I guess, reverse order, low fuel supply and then increase the stress hormones. And so...

Because of that, it's really important to make sure that we're eating carbohydrates when we eat protein to offset that potential drop and allow our blood sugar to stay balanced and keep a steady fuel supply. Yeah. Yeah, that's it. And there's some studies showing they do like a protein to carbohydrate ratio and they look at the amount of cortisol that the animals or the participants in the studies have. And there was a ratio showing that with an increased amount of protein in relation to carbohydrate, there was a higher amount of cortisol demonstrated in either the animals or the participants. So one of the things that you can look at is how many carbohydrates are you eating in relationship to how much protein you're eating. you generally would want to have a higher amount of carbs to protein. Yeah, a two to one ratio is typically a good place to start.

Yeah. If not more, but at least this is a starting spot of carbohydrates to protein, just to clarify. So that's twice as much carbs as protein that you're eating. Just one more time. Just in case. So just kind of again to wrap up, the general important things to note here is blood sugar as a representation of our fuel supply because sugar is our primary ideal fuel, especially for our nervous systems. because of that, we want to keep a stable blood sugar and we want to keep it stable without the release of stress hormones or with a minimal release of stress hormones. And our blood sugar is kind of always being used, so it's kind of always dropping. And if we're doing excess activity, whether it's mental or physical, it can drop even quicker. And so in those scenarios, you want to make sure that
or in any scenario where your blood sugar drops, you want to make sure that you're getting carbohydrates to inhibit the stress hormone release and maintain a steady fuel supply. And that's especially true after really intense activity. yeah, so along with that is just throughout the day, eating carbohydrates between every couple hours or every several hours, depending on how regulated your blood sugar is and where your metabolic function is and making sure to eat carbohydrates when you eat protein.

And I think that's kind of the main thing. And another kind of interesting side note is that having, one thing we didn't talk about was high blood sugar and diabetes. So maybe we can touch on that. The other thing I want to add before you go there is that also having some saturated fats or some monounsaturated fats, you sort of can't not get those. Having those with your protein and carbohydrate meal, having them all together, will help with digestion and help you to last longer through meals. So yeah, think that's an important point to consider because I think a lot of people can come from the very low fat sphere as well and they find themselves eating, why am I hungry every two hours? So yeah, so taking in your meal, you're gonna have protein, have some carbs with it, have some fats with it too. Obviously it all goes, it all tastes good together.

They're not as good without each other. So I think there's a reason for that. Yeah. Yeah. I just wanted to add that point in. Yeah. Uh, yeah. So to talk a little bit about high blood sugar and diabetes, what made me think of it was I was actually going to mention that, um, higher blood sugar levels are extremely protective against like toxic, um, influences. So there's pretty interesting studies on rats where they have a regular, you know, regular rats at regular blood sugar level and they give them some sort of toxin, typically it's like endotoxin, and it would kill most of those rats. Whereas when they keep the rats at a higher blood sugar level and then they give them the endotoxin, it has very little effect. The rats are able to handle it just fine. And the reason for that is because the elevated blood sugar allows a greater fuel supply, which allows for a greater energy supply, which allows us to handle those sorts of toxins or other insults. And that kind of goes as a testament to the fact that the high blood sugar seen in diabetes isn't actually the issue. It's really a symptom. So the main feature of diabetes without digging into it too much is just the inability to use sugar properly. And so when that happens, there's a buildup of sugar in the cells and that causes a buildup of sugar in the blood because the sugar in the blood can't enter the cells. The cell is already full of sugar. And so that's what essentially, without talking about all the hormones too much, I'll touch on them in second.

That's really what causes the high blood sugar is the fact that the sugars aren't, the cells aren't using the sugar properly. Yeah. And then the other thing is they, lot of the studies that look at blood sugar and things like that also see the high insulin and the high sugar with diabetics. And then they seek to say that, the high insulin, the high sugar is the problem. And then they try and lower the sugar and the lot of diabetics, a lot of the drugs that they provide them with.

Jay
It's like things like metformin actually inhibit the absorption of carbohydrate from the intestine. So what you wind up, what they're basically doing is yes, the diabetic's blood sugar levels improve with that, but it's because they're not taking in any sugar. But you still haven't solved the issue, which is the fact that they cannot use, their cells are not using the sugar. They haven't been using the sugar. So then you have, yes, you're going to get the high blood sugar, you're going to get the high insulin. Your body's trying to push the sugar into the cell or trying to...
to get the cells to use sugar. Right, yeah. and metformin also directly inhibits energy production, which can make the cells kind of waste sugar, which can help with the low blood sugar, but ends up causing more issues. so in talking a little bit about diabetes is typically what you see in diabetes is extremely high stress hormones. Specifically, you start with very high levels of glucagon. And the high blood sugar seen in diabetes is typically because of the liver's production of sugar. So as we talked about, the stress hormones increase the release of sugar from the liver because the body's under stress and needs more fuel. While in diabetes, the body's constantly under stress because it constantly has low energy. And that leads to constant stress hormone production to release tons of sugar into the blood, but the sugar in the blood isn't getting used. So when someone is diabetic and isn't eating carbohydrates, they have very high blood sugar because of the release of stress hormones and the release of sugar from the liver. Diabetics also have, from what I understand, high amounts of fatty acids and free fatty acids in the blood too, no? Yeah, they do. That's the cells are essentially running on instead of the sugar.

And when you get into situations where you have something like diabetic ketoacidosis, you basically have an issue where the diabetic has come under such stress that they're not using sugar at all and they're relying on
the high amount of keto acids, are basically how the cells burn fats, and then it causes a state of acidosis in the blood, and then that has a whole host of problems itself. So the fundamental feature of diabetes is the issue of not being able to use sugar. It's not that the blood sugar is high. It's not that the insulin is high. It's that the body cannot use the blood sugar. And the reason I want to put this in context, because the reason we're talking about this is because there's a lot of research and there's a lot of point of views showing that we should eat low carb diets so that we can manage insulin, so that we can manage our blood sugar. Keep blood sugar and insulin low. People suggest that that's what we should be doing is keeping them low. Exactly. So we're basically going through this now because the problem isn't the high blood sugar and insulin. The problem is the lack of utilization of the sugar by the cells.

And then the subsequent cascade of effects that happens from that because that is from everything that we're talking about. If you don't get anything that we're talking about at all, the most important piece to understand is that your cells need to produce energy and we want them to produce energy from sugar. If they don't have sugar, they're going to use fatty acids, but we want them to use sugar and in the absence of sugar, you're going to run into stress cascade. You're going to run into stress hormones. So the state of diabetes is a state of chronic stress.

The high insulin and high sugar is a symptom of not being able to use it. It is a symptom of this stress. Right. It's a response to it. Like the high insulin is a response to the high blood sugar, which is caused by the high stress hormones, not the other way around. Exactly. Yeah. And the other thing you mentioned is that, in diabetics, they're running much more on fatty acids because their cells aren't using the sugar that's being provided and the stress hormones cause a cascade of effects that lead to increased fatty acid oxidation as well as a backup pathway. it becomes this bone vicious circle. Yeah. that kind of diabetics, yeah, I mean, I think that kind of wraps it up. don't want to harp on too much about that, but I think that that really... Well, I think that the diabetic is a great example of what the problem is. And I think it's also a lot of people who are pushing for the very low carb diets are trying to use that as an example as why we don't want to have carbs.

But I think if you understand the fundamental nature of the problem, it becomes actually more of an affirmation of the need for carbs as opposed to a reason not to use carbs. And I think it sort of affirms the importance of not only having sugar available, but also of being able to utilize, having the cells able to utilize that sugar. I think that those, I think that it's a great example for that.

Jay
to exemplify these points and help to understand the process of blood sugar. Absolutely. And we'll be talking more about the proper utilization of sugar and what can inhibit that and what is necessary in order for it to work properly throughout the rest of the series. That's something that we'll be focusing on. So we'll leave that as a, what's the word? I don't know, a tease. All right, I hope you guys enjoy that episode. Before we wrap up, I did want to make a clarification about insulin and insulin resistance and diabetes. so insulin basically has two main functions. And the first is that it allows our cells to absorb glucose and amino acids or sugar and amino acids from the blood, which ideally allows the cells to use them. And it is important to mention here that our cells can absorb some amount of glucose and amino acids without insulin. But in diabetes and insulin resistance, high fasting blood sugar is one of the main features. And it's known that when somebody who is in this state then takes insulin, that their blood sugar drops. And so the assumption is that that increased the transport of sugar into the cells, which does partially happen. the assumption there is that the issue in diabetes and insulin resistance is that glucose is not being effectively transported from the blood into the cells. But in the situation of diabetes and insulin resistance, the second function of insulin is actually more important here. And so that second function is that insulin opposes the effects of the stress hormones at the liver. And so what we're talking about here is that in these conditions, there are high levels of glucagon and adrenaline and cortisol.

Which one of the things that happens is that increases gluconeogenesis from the liver, which means increases the production of sugar from the liver into the blood. And that's actually what's responsible for the high blood sugar seen in insulin resistance. And so, administering insulin in somebody who has high fasting blood sugar, what that's actually doing is stopping the production of blood sugar from, or stopping the production of sugar from the liver.

Which is what leads to that high fasting blood sugar in the first place. And so the reason why that's important again is because it supports the idea that the issue in insulin resistance and diabetes is not that it's a transport problem, but rather it's an energy problem which leads to increased stress hormones, which leads to gluconeogenesis from the liver, which leads to the high fasting blood sugar. And so the extra insulin in that case is helping to stop that process or helping to at least stop the production of sugar from the liver. So I know that was, that might've been a little bit complicated, but I will link to some extra studies and articles dealing with that whole process in the show notes. And speaking of show notes, you can find those at jfeldmanwellness.com slash podcast. If you guys did enjoy today's episode, please leave a review or like wherever you're listening. It really makes a big difference. It helps us reach more people. And if you'd like to check out some more of my work, you can head over to jfeldmanwellness.com and to take a look at mics, can head over to sapiensystems.com. And I also wanted to mention that if you're dealing with any sorts of low energy symptoms or chronic health conditions, or you're just looking to optimize your health, head over to jfeldmanwellness.com/energy and sign up for a free mini course on energy balance. And that'll basically walk you through the various things that you can do to support energy production and which things to avoid that inhibit energy production.

And I hope you guys enjoyed today's episode. Again, that was part one of a two part series on blood sugar. And in the next episode, we're going to be diving into the specifics of different foods and how those affect our blood sugar. So definitely tune into that one and I will talk to you then.