Why Blood Glucose Levels Matter Even When You Don’t Take Insulin




Blood glucose levels (BGLs) are a very important measure for people who have diabetes or prediabetes, but it can get old hearing about them. Plus, there’s often shame and stigma around type 2 and prediabetes, making it tempting to ignore the disease. Out of sight, out of mind, right? Well, not so much. 

As it turns out, BGLs are often talked about by providers for a reason—even if you don’t use insulin for your diabetes management. Here’s why it’s important to monitor your BGLs, regardless of your treatment plan.

The importance of managing blood glucose levels

While BGLs can seem insignificant, as the glucose is something we don’t actually see, they truly do play a big role in how well our organs work in the long run. Having low and high BGLs can negatively impact the body, especially if they occur frequently.

Low blood sugar levels, or hypoglycemia, affect many parts of the body, including the endocrine system. Low BGLs cause epinephrine to be released, which is the “fight or flight” hormone. It can cause symptoms of hypoglycemia including shakiness, a rapid heart rate and sweating. In addition to the endocrine system being affected, the central nervous system is activated when you are sweaty and shaky, while the cardiovascular system is affected when you have a fast heart rate. 

High BGLs also affect the body in different ways. The circulatory system can be negatively impacted if fatty deposits form in the walls of blood vessels when BGLs are elevated regularly. This can lead to restricted blood flow, contributing to heart disease, stroke and peripheral neuropathy—nerve damage in the hands and feet. 

High BGLs can also impact the digestive system, leading to the development of gastroparesis. This condition prevents the stomach from emptying completely; it can lead to high BGLs and other unpleasant side effects.

Diabetes can definitely be a challenge to take care of, but managing your BGLs now is a way to avoid some of these complications later on. And even if you are someone with prediabetes, BGL management is important in order to delay or even avoid the onset of diabetes! 

The role of environmental factors + food 

Regardless of your treatment plan, there are still many other factors that impact BGLs. While many probably think of food first, there are other things that play a role too.

In terms of food, carbohydrates are what break down into sugar and therefore raise BGLs when digested. Carbs are found in many foods, from breads to vegetables to fruits.

Other factors that can impact your blood glucose levels include movement, stress, illness and incorrect doses of diabetes medications. 

Stress can raise BGLs because of adrenaline and cortisol being released into the bloodstream, while being sick might also increase BGLs because of hormones that are meant to help you recover. However, eating less than usual when sick can, in turn, decrease BGLs. Exercise may also decrease BGLs because your cells are better able to take in glucose and use it as an energy source due to increased insulin sensitivity. However, different forms of exercise may also raise your glucose levels.

What can you do if your blood glucose levels are high?

Everyone will have high BGLs from time to time for a variety of reasons. When this happens, there are a few steps you can take to help lower them. 

  • If you’re sick, follow your sick day plan as discussed between you and your medical provider.
  • If you are vomiting and unable to keep fluids down, you may need to seek emergency care. 
  • If you are sick or have ketones, avoid exercising.
  • Even if you are not sick, contact your medical team if your BGL is extremely high in case of emergency.
  • Go for a walk or a jog.
  • Drink plenty of water or fluids with electrolytes to avoid dehydration.
  • Reflect on any possible reasons or changes in your routine that could play a role in causing high BGLs.

Medications other than insulin

There are many medications and resources available to help treat prediabetes and type 2 diabetes besides insulin. Common ones include:

  • Biguanides, such as Metformin, which increase insulin sensitivity.
  • DPP-4 Inhibitors, such as Januvia and Tradjenta, which increase the amount of insulin made by the pancreas when BGLs are high.
  • SGLT2 Inhibitors, including Jardiance and Farxiga, keep your kidneys from absorbing too much sugar, and route the extra glucose through your urine so your BGLs don’t rise.
  • GLP-1 Antagonists, like Trulicity and Ozempic, increase the production of insulin when BGLs start to increase and also slows down the rate of digestion.

Many of these medications work to help lower BGLs, making it important to still monitor them. You can monitor your BGLs with a blood glucose monitor (BGM) which measures the amount of sugar directly in your blood, or a continuous glucose monitor (CGM), which measures the glucose in your interstitial fluid of body fat.

The benefits of CGMs

Studies have shown that CGMs are effective at decreasing BGLs. One study found that people with type 2 diabetes using multiple daily injections (MDIs) and a CGM decreased their average A1c from 8.5% to 7.7%. 

Other advantages of CGMs include: 

  • Being able to see your BGLs in real-time.
  • Seeing how your body responds to different factors like food, exercise, stress, heat, etc.
  • Catching and treating both high and low BGLs more quickly.
  • Having the ability to easily share data with your healthcare team. 

To receive a CGM under Medicare or Medicaid, please contact your local state health exchange to check your eligibility.

If you are unable to get a CGM through a prescription, some companies offer a free trial—a great option to get a sense of how your BGLs are in real-time. You and your healthcare team can use that data to make informed decisions about your diabetes care. 

Managing BGLs, whether you are someone with prediabetes or type 2 diabetes, can be challenging, regardless of your treatment plan. However, your body will thank you in the long run for doing your best. If you are looking for support as you navigate life with diabetes, consider joining the Beyond Type 2 Community!

Editor’s Note: Educational content for newly diagnosed people with diabetes is made possible with support from Abbott, makers of the Freestyle Libre 3 system, a founding partner of Beyond Type 2. Editorial control rests solely with Beyond Type 2.

WRITTEN BY Kourtney Johnson, POSTED 04/27/23, UPDATED 04/27/23

Kourtney is a registered dietitian living with type 1 diabetes. She was inspired to study nutrition after learning about the role food plays in managing this condition. When she’s not writing about all things food and diabetes-related, she enjoys reading, cooking, traveling, going to the beach and spending time with loved ones.


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