- Marie Belzile-Davidson, MS, RDN, LD
Blood Sugar Management, Insulin, and Inflammation
Sugar in our blood is inherently a good thing, we need it to survive. The sugar circulating in our bloodstream, known as blood glucose, is used by our cells for fuel to power every function our bodies carry out. Blood sugar is the reason you can get out of bed, carry out your daily tasks, do the things you love to do, be able to have thoughts and analyze things critically, you name it.
Our blood sugar levels change throughout the day, increasing and decreasing depending on what we are doing and/or experiencing. We do want blood sugar to rise and fall above a healthy baseline, within a specific range. It rises after we eat meals and snacks, then should fall back to a healthy baseline as sugar moves into our cells for use as fuel.
It is the high highs, low lows, and frequently elevated blood sugar that can cause short and long-term trouble. When it comes to blood sugar, we want the ups and downs to be small, like rolling hills rather than large peaks and valleys. The image below is a visual of what we are talking about, where the green flat line is a baseline healthy blood sugar level and the purple waves are blood sugar levels. Our bodies love to be in a steady state whenever possible so large changes in blood sugar (those peaks and valleys) are less-than-ideal.
Managing our blood sugar means helping our bodies have relatively steady blood sugar (those rolling hills) throughout the day. Why does this matter? If our blood sugar is poorly managed (back to those peaks and valleys or even frequently elevated above a healthy baseline), this can impact our insulin response and cause inflammation throughout the entire body. We are going to break each of these down.
Insulin is a hormone made by your pancreas that helps blood sugar move into your cells (where it is used for energy or stored as fat). You want your body to be sensitive to insulin. That means, your cells recognize insulin when it is around, which allows sugar to move into the cells and out of your blood stream. If you are less sensitive to insulin (also referred to as insulin resistance or being insulin resistant), your cells are not able to recognize all the insulin that is around. Your body is producing enough or possibly too much insulin but your cells are not getting the full memo. That means, your blood sugar stays above a healthy level because the cells are not getting the insulin memo to take in sugar.
Your insulin response is a large component of your metabolic health. Quick pause, what the heck is metabolic health? Metabolic health is a term is thrown around a lot. It actually does not refer directly to your metabolism. Rather, metabolic health is a measure of health that takes into account your blood pressure, waist circumference, blood sugar levels, blood triglyceride levels, and HDL cholesterol levels. If three of these five measures fall into an above-healthy range, then you have metabolic syndrome - a condition that puts you at increased risk for some serious conditions including diabetes, stroke, and coronary heart disease.
The latest data from the National Health and Nutrition Examination Survey (NHANES) showed that only 12% of Americans meet the criteria for being metabolically healthy. Remember that your insulin response plays a role in blood sugar levels, one of the measures of metabolic health. What can tip you off that you may have insulin resistance? Feeling fatigued and/or foggy and craving sugar are often symptoms. Your registered dietitian or doctor can order some lab work to help you confirm whether or not you have insulin resistance.
I want you to think of water with a pinch of table sugar added to it. Now, compare that to syrup. These two liquids have very different consistencies, right? Water with some sugar still flows well (like our blood with controlled sugar levels and a good response to insulin) while syrup is thicker and does not flow as easily (like our blood when sugar levels are too high for too long and we have insulin resistance).
Too much sugar in our blood not only changes its consistency but causes inflammation. Inflammation has a place and a time - it is a beneficial and necessary response that helps us fighting off an infection or heal an injury. Inflammation is meant to be relatively short-term though. Long-term or chronic inflammation can have some serious negative impacts on our health, including an increased risk of cancer and heart disease. On top of that, it can downright make us feel lousy because of the symptoms that come along with it, including chronic pain, gastrointestinal discomfort, eczema, acne, and more. Poorly managed or chronically elevated blood sugar is not the only thing that can cause chronic inflammation but it is one factor that we can often impact through diet and lifestyle.
In addition to the increased risk of certain diseases and undesirable symptoms, chronic inflammation can also throw off systems in the body, no matter how well you try to manage them. For example, you may be doing everything you need to support your hormones but if you have chronic inflammation (due to poor blood sugar management or other reasons), your hormones may remain at undesirable levels.
Putting It All Together
So what can you do to help better manage your blood sugar through diet and lifestyle? This depends on a variety of factors: stress, your age, your hormone levels, your typical food intake, other medical conditions, medications, etc. These can all impact your insulin sensitivity and ultimately blood sugar levels throughout the day. Your best bet is to reach out to your registered dietitian to talk through a plan that may be best for you and your unique needs.
Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009-2016. Metab Syndr Relat Disord. 2019 Feb;17(1):46-52. doi: 10.1089/met.2018.0105. Epub 2018 Nov 27. PMID: 30484738.
Harvard Health. (2018, November 7). Foods that fight inflammation. Retrieved from
Harvard Magazine. (2019 May-June). Could inflammation be the cause of myriad chronic conditions? Retrieved from https://harvardmagazine.com/2019/05/inflammation-disease-diet
Harvard Health. (2020, April). Understanding acute and chronic inflammation. Retrieved from
Harvard Health. (2020, May). Quick-start guide to an anti-inflammation diet. Retrieved from
Harvard Health. (2020, June). All about inflammation. Retrieved from
Mayo Clinic. (2017, November 21). C-reactive protein test. Retrieved from https://www.mayoclinic.org/tests-procedures/c-reactive-protein-test/about/pac-20385228
Mayo Clinic. (2018, May 25). Home remedies: How a healthy diet can help manage pain. Retrieved from https://newsnetwork.mayoclinic.org/discussion/home-remedies-how-a-healthy-diet-can-help-manage-pain/
Mayo Clinic. (2019, August 13). How to use food to help your body fight inflammation. Retrieved from https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/how-to-use-food-to-help-your-body-fight-inflammation/art-20457586
Medscape. (n.d.). Inflammation, Cardiovascular Disease, and Cancer. Retrieved from https://www.medscape.com/viewarticle/923743
National Heart, Lung, and Blood Institute. (May 18, 2022). What Is Metabolic Syndrome? Retrieved from https://www.nhlbi.nih.gov/health/metabolic-syndrome
National Institute of Environmental Health Sciences. (2020, April 4). Inflammation. Retrieved from https://www.niehs.nih.gov/health/topics/conditions/inflammation/index.cfm
Neuroscience News. (2020, March 5). Social isolation could cause physical inflammation. Retrieved from https://neurosciencenews.com/social-isolation-inflammation-15864/
University of California Berkeley News. (2020, June 4). Fitful nightly sleep linked to chronic inflammation, hardened arteries. Retrieved from https://news.berkeley.edu/2020/06/04/fitful-nightly-sleep-linked-to-chronic-inflammation-hardened-arteries/
University of Wisconsin-Madison School of Medicine and Public Health. (2018). The anti-inflammatory lifestyle. Retrieved from https://www.fammed.wisc.edu/files/webfm-uploads/documents/outreach/im/handout_ai_diet_patient.pdf