Even though my stress level has been extremely high lately, I am grateful the stress is from positive things going on in my life. Opening my own practice has been amazing! I am overcome by the support and kindness from my family, friends and patients. Thank you!
In conjunction with opening Balanced Health Functional Medicine, I was also studying for the most comprehensive and challenging exam I have ever taken. (I'll tell you more about that when I get the good word I passed haha).
When I have over-the-top levels of stress, my appetite shuts down, I don't sleep well, and my activity levels drop because I'm "just too busy". Stress causes the Adrenal Cortex to release cortisol to help support the body with the physical demands of the stressor. This activates the sympathetic pathway also known as, "fight or flight". My body perceives stress of taking an important exam, the same as stress from running from an angry dog and needing increased blood flow and increased blood sugar to meet those demands to escape danger. Blood sugars go up, and yet I am more sedentary from all the studying so instead of burning the sugar, it gets stored away (a reason why high stress can lead to weight gain).
So, when I got my recent labs back and saw that my HgA1c had increased from 5.2 last year, to now near prediabetic levels of 5.6 - I was shocked. At the same time not entirely surprised. I have a genetic predisposition to Diabetes II in my family history, but I also have a lot of control with my lifestyle choices and I know I need to be more diligent in my stress management, nutrition and exercise.
I want to take a moment and say that I love and honor my body for all she does and is capable of. I have worked hard to put off guilt and recognize I am human. I don't believe in complete restriction in most cases, and enjoy eating pumpkin pie like the next person. I don't support fad dieting or "diet culture". I support body positivity and health at every size. I believe in finding balance with nutrition, stress coping, body movement and sleep to support my best physical health. I used to subscribe to extremes - that is no more. No more extreme exercise, no more extreme food plans - it's not sustainable and not physically or mentally healthy. It's about finding the balance, and that looks a little different for everybody.
Here's my plan for me:
1. Intermittent fasting 12 hours every night, with the goal to avoid eating at least 3
hours before bedtime. This will help improve insulin sensitivity (and better blood
sugar control), as well as improve sleep. (Intermittent fasting is not safe for
everybody and should be discussed with your provider.) I don't expect to be 100%
consistent with this goal. I understand the benefits will come from applying this
goal most of the time.
2. Use a Continuous Glucose Monitor. I am using the FreeStyle Libre 14 day
sensor. With insurance only covering CGM's for people with Type I or Type II
diabetes, the sensor is cash pay for others (About $75-$100 per sensor depending
on the pharmacy). The FreeStyle Libre is a more affordable option than the
Dexcom sensor. I am able to use the app on my phone as a reader device and
save on the cost from having to buy a reader device. This allows me to scan the
sensor anytime I want to see what my blood sugar levels are at that given time.
I am interested to see where my fasting blood sugar levels are in the morning
and over time, how those levels improve as I implement this plan. At the time of
my labs a week ago, I had been fasting for over 12 hours and my glucose level was
88 ng/dl. For optimal blood sugar control, I'd like to have my fasting blood sugar
in the 65 - 75 range.
3. Fiber - this is the magic ingredient for improving both blood sugar control and
cholesterol levels, feeling satiated for longer, helping with regular bowel activity,
increasing microbiome diversity, and lowering colon cancer risk, just to name a
My goal is to have at least 35 grams of fiber a day. I am not one who likes to
meticulously track things and I don't expect my patients to do this either. Instead,
I will count my fiber intake for a day of "usual" dietary intake for me so I can gauge
about how many grams of fiber I currently eat, and then aim to increase high fiber
foods from there. (Plant foods: whole grains, beans/lentils, whole fruits and
vegetables, nuts and seeds.)
4. Consistent physical movement - When my stress levels are high, it usually feels
right for me to lower the intensity of my exercise. I try to use intuitive exercise. To
me, this means if I have a preconceived expectation for my workout, and I am
starting at a higher intensity, if I am not feeling it, then I will not push through it. I
want to challenge myself, but that doesn't need to be every day and every
workout. I love to feel strong and invigorated with my exercise, no exhausted and
depleted. There are many forms of exercise I enjoy, and depending on the season
it may be hiking, pickleball, resistance training or taking my pup on a walk and slow
5. Last but not least, stress coping. I want to balance my stress with things that
help me relax, calm my mind and make me smile. Being out in nature, spending
time connecting with people I love, cuddling my pup (pet therapy is real), and watching Funniest Home Videos with my hubby are a few of my favorites for
helping me cope with stress.
HgA1c is a level that gives insight into blood sugar control over the past 3 months. That means I can get an entirely new HgA1c level in 3 months. That's my target date to retest. I have a measurable goal, I'd like to have my level below 5.3 the end of February.