
8 Factors That Influence Blood Sugar Control
People living with diabetes understand the importance of blood sugar control and how it increases and decreases in response to dietary changes and environmental factors. Insulin and glucagon are the two primary hormones that control blood glucose. People with diabetes lack sufficient insulin to maintain a healthy blood glucose level.
Excessive blood sugar fluctuations contribute to serious health conditions, such as heart disease, blood vessel damage, kidney disease, obesity, diabetic ketoacidosis, and high blood pressure. Rising and crashing blood sugar levels affect your mood, brain function, mental focus, energy levels, body composition, and longevity.
Even if you have not been diagnosed with insulin resistance or type 2 diabetes, it is important to understand the factors that can affect your blood sugar levels. Family history and lifestyle factors such as diet and exercise can cause fluctuations in your blood sugar.
Table of Contents
1. Carbohydrate type
Carbohydrates vary in structural complexity. Simple sugars containing only one or two sugar molecules are easily broken down and absorbed, often leading to a spike in blood sugar followed by an increase in insulin release. More complex carbohydrates take longer to digest and, therefore, are less likely to cause a glucose spike.
The glycemic index is a ranking from 0 to 100 that is based on how quickly and how much carbohydrates raise blood sugar levels after they are consumed.
- Low glycemic index: 55 or less; fruits and vegetables, legumes and beans, nuts and seeds, whole grains
- Medium glycemic index: 56 to 69; brown rice, oatmeal, sweet potatoes, corn, whole wheat bread
- High glycemic index: 70 to 100; white bread, white rice, sugary cereals, watermelon, potatoes
Many factors affect the glycemic index, including ripeness, cooking method, fiber content, processing, fat content, acidity, and physical form.
Consuming a diet rich in high glycemic foods can increase your risk of type 2 diabetes and coronary heart disease.1,2 Whenever possible, choose low-glycemic foods and pair them with fats or proteins to decrease glucose absorption and sudden increases in blood glucose.
2. Carbohydrate quantity
After you consume a high-carbohydrate meal, glucose will be absorbed across the lining of your gastrointestinal tract and enter your bloodstream. Your blood sugar rises. In response, your pancreas produces insulin, which ushers glucose from your bloodstream into your body cells. This lowers blood sugar levels. Excess glucose is stored in muscle and liver cells as glycogen.
Glycemic load is determined by multiplying the glycemic index by the amount of carbohydrate in the food. Consuming diets with foods high in glycemic load is linked to an increased risk of type 2 diabetes and coronary heart disease.1,2

3. Exercise
Insulin resistance develops when body cells do not respond as well to insulin, which raises blood sugar levels. Regular exercise lowers insulin resistance, improves cardiovascular fitness, and helps with weight management. When exercise intensity increases, stress hormones, such as cortisol and adrenalin, are released. These hormones increase blood glucose, making it readily available for muscles to use for energy.
Insulin resistance, an inability to produce adequate insulin, and intense exercise all cause blood glucose levels to rise during and after exercise.
4. Stress
Emotional and physical stress increase adrenalin and cortisol, stress hormones that help your body respond to a threat. When you encounter a physical threat, stress hormones are released and increase blood glucose. Glucose is an easily used source of energy for muscles and other tissues. This allows you to “fight or flee” from the stress.
When the stress is psychological, your body releases the same hormones. However, your muscles do not use excess glucose. This can increase your risk of developing metabolic syndrome, obesity, type 2 diabetes, and cardiovascular disease. Managing stress can reduce your risk of developing these conditions.

5. Poor quality or inadequate sleep
Poor quality or inadequate sleep contributes to insulin resistance, which increases blood sugar. Poor sleep can also increase appetite and cause weight gain by increasing ghrelin release (hunger hormone) and decreasing leptin (fullness hormone). Sleep deprivation is also linked to decreased physical activity and increased inflammation.
6. Hormones and menstrual cycle
Blood sugar can vary throughout your menstrual cycle in response to changing hormone levels. Progesterone levels are at their highest during the second half of your menstrual cycle. Higher progesterone levels are associated with reduced insulin sensitivity.
Estrogen may suppress glucose production in the liver and increase uptake into skeletal muscle, which reduces blood glucose. Premenopausal women are at lower risk for type 2 diabetes than postmenopausal women or men.3,4

7. Illness
Infections and illnesses put stress on your body and increase inflammation. Inflammation can reduce insulin’s effectiveness.
Your body responds to infection or illness by releasing cortisol and other stress hormones. These hormones increase insulin resistance, which increases blood glucose levels. Dehydration and decreased physical activity can also increase blood sugar.
8. Medications
Some medications, such as steroids, birth control pills, antipsychotics, and others, increase blood glucose. For example, steroids can reduce insulin secretion, and antipsychotics can increase insulin resistance. They may act differently, but the end result is the same.
Everyone is different. Factors such as pain, alcohol consumption, smoking, weather changes, and caffeine consumption can also affect blood sugar control.

Why blood sugar control matters
A small fraction of American adults, only 12%, can be classified as metabolically healthy. Few individuals across different weight categories meet the standards for metabolic health: less than one-third of those at a healthy weight, 8% of those who are overweight, and 0.5% of those with obesity.5
Optimally, we consume enough nutritional calories to supply our bodies’ needs without providing excess calories that are stored as fat. Insulin resistance, prediabetes, and type 2 diabetes are on the spectrum of disorders that affect glucose metabolism and blood sugar. Minimizing blood glucose spikes can reduce your risk of diabetes, obesity, and metabolic syndrome.
If you have obesity and find it difficult to lose excess pounds, medications are available that improve blood glucose control in adults with type 2 diabetes and treat obesity. Tirzepatide activates hormone receptors that stimulate insulin release and lower blood sugar.
If you are concerned about your blood sugar or type 2 diabetes risk or want to learn more about your options to treat obesity, contact a treatment specialist at Invigor Medical.
Get started today with a monthly subscription of Tirzepatide.
Disclaimer
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.
References
1. Beulens JW, de Bruijne LM, Stolk RP, et al. High dietary glycemic load and glycemic index increase risk of cardiovascular disease among middle-aged women: a population-based follow-up study. J Am Coll Cardiol. 2007;50:14-21.
2. Halton TL, Willett WC, Liu S, et al. Low-carbohydrate-diet score and the risk of coronary heart disease in women. N Engl J Med. 2006;355:1991-2002.
3. Moreno, M., Ordoñez, P., Alonso, A., Díaz, F., Tolivia, J., & González, C. (2010). Chronic 17beta-estradiol treatment improves skeletal muscle insulin signaling pathway components in insulin resistance associated with aging. Age (Dordrecht, Netherlands), 32(1), 1–13. https://doi.org/10.1007/s11357-009-9095-2
4. Yan, H., Yang, W., Zhou, F., Li, X., Pan, Q., Shen, Z., Han, G., Newell-Fugate, A., Tian, Y., Majeti, R., Liu, W., Xu, Y., Wu, C., Allred, K., Allred, C., Sun, Y., & Guo, S. (2019). Estrogen Improves Insulin Sensitivity and Suppresses Gluconeogenesis via the Transcription Factor Foxo1. Diabetes, 68(2), 291–304. https://doi.org/10.2337/db18-0638
5. Araújo J, Cai J, Stevens J. Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016. Metabolic Syndrome and Related Disorders. 2019/02/01 2018;17(1):46-52. doi:10.1089/met.2018.0105
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