Functional Medicine Labs to Test for Root Causes of Hyperglycemia

Patients with hyperglycemia are often diagnosed incidentally through a routine wellness panel consisting of a complete blood count (CBC), comprehensive metabolic panel (CMP), and thyroid panel. These panels evaluate blood cells, blood sugar, electrolyte balance, and liver, kidney, and thyroid function. They are helpful labs for patients with hyperglycemia and diabetes to rule out underlying infections and hyperthyroidism, monitor kidney health, and assess blood pH.

Additional functional labs can help to better get to the root cause of hyperglycemia and diabetes, making treatment protocols more effective. Functional doctors commonly order the following labs for patients with hyperglycemia and diabetes.

Diabetes Panel

A diabetes panel offers a more accurate assessment of hyperglycemia and diabetes by measuring multiple markers associated with glucose metabolism, including the most common biomarkers: glucose, hemoglobin A1c, and insulin.

While these biomarkers are valuable, this panel lacks the ability to track blood glucose levels in real-time. This is why many functional practitioners turn to continuous glucose monitoring (CGM) These sensors that monitor glucose levels in the interstitial fluid every five minutes. The glucose patterns obtained through CGM better inform individuals and their doctors about how diet, physical activity, and medications/supplements influence glycemic control.

Adrenal Function

Cortisol can be measured through serum, saliva, or urine. While serum and urinary cortisol are preferred to rule out pathologic disorders related to adrenal function (e.g., Cushing’s), salivarycortisol is preferred by functional doctors to evaluate functional disorders related to the stress axis.

Genetic Panel

Genetic factors may mediate alterations in glucose homeostasis. A genetic panel assesses for genetic variations that influence the efficacy of insulin and glucose pathways in the body and can predispose an individual to type 1 and 2 diabetes mellitus. 

Functional Medicine Labs That Can Help Individualize Treatment Options for Patients With Hyperglycemia

Functional labs can help doctors personalize dietary, lifestyle, and supplemental treatment options. The following labs could be considered on an individual basis for patients struggling with hyperglycemia. 

Micronutrient Panel

Nutritional deficiencies associated with high blood sugar and insulin resistance include inositol, vitamin D, magnesium, zinc, and chromium (2). A micronutrient panel can identify deficiencies or insufficiencies of these (and other) essential nutrients that may contribute to poor glucose control and health outcomes.

Comprehensive Stools testing

Numerous studies have examined the human gut microbiota in relation to type 2 diabetes. The data from these studies suggest gut bacteria directly affect the mechanisms underlying the development of type 2 diabetes and that intestinal dysbiosis contributes to blood sugar dysregulation and hyperglycemia. Additionally, intestinal hyperpermeability and digestive dysfunction can contribute to immune dysregulation, systemic inflammation, and nutrient deficiencies associated with type 1 diabetes, glucose metabolism, and poor cardiovascular outcomes. Therefore, a comprehensive stool analysis can be valuable to thoroughly evaluate gastrointestinal health as it pertains to whole-body functioning.

Sleep Assessment

The sleep-stress cycle refers to the bidirectional relationship between the two and how they affect each other. High stress and cortisol negatively impact sleep by dysregulating the body’s circadian rhythm. Poor sleep, in turn, sustains cortisol hypersecretion and the psychoemotional perception of stress. This sleep-stress cycle can quickly perpetuate hyperglycemia.

In addition to a functional salivary cortisol test (discussed above), ordering a sleep study and measuring melatonin, the body’s master sleep hormone, can help to unravel the sleep-stress cycle.

Integrating Testing, Lifestyle Modifications, and Integrative Therapies

The importance of personalized approaches in managing high blood sugar cannot be overstated. Every individual’s response to treatment, underlying health conditions, and lifestyle factors can vary significantly. By adopting personalized approaches that consider test results and the patient’s goals, preferences, and unique circumstances, healthcare providers can tailor interventions to optimize outcomes. By combining the expertise of different healthcare disciplines, patients can benefit from a comprehensive treatment plan that integrates conventional medical interventions with lifestyle modifications, dietary changes, stress management techniques, and other complementary therapies. Such an approach empowers patients to actively participate in their care and increases the likelihood of achieving desired health outcomes in managing high blood sugar.

Conventional Treatment for Hyperglycemia

The treatment goals of hyperglycemia involve controlling blood sugar, eliminating symptoms related to high blood sugar, and preventing long-term complications. Depending on the cause of hyperglycemia, different conventional approaches may need to be taken. These approaches often incorporate diet and lifestyle counseling, oral glucose-lowering medications, and insulin therapy. (1) 

Nutrition for Hyperglycemia

Nutrition plays a critical role in managing hyperglycemia. Dietary choices can prevent high blood sugar spikes and help the body return to a healthy baseline after eating. Processed foods rich in simple carbohydrates, added sugars, and unhealthy fats contribute to the development of insulin resistance and rapid spikes in blood sugar. Alternatively, well-balanced meals composed of healthy ratios of complex carbohydrates, fiber, lean proteins, and unsaturated fats lead to steadier blood sugars, improved insulin sensitivity, and increased satiety (helping to curb sugar cravings and overeating). Evidence-based, anti-inflammatory, and low-glycemic dietary patterns proven to support healthy blood sugar levels include the Mediterranean, DASH, low-carbohydrate, and plant-based diets. (8)

Supplements and Herbs for Hyperglycemia 

Several supplements have been shown to decrease blood sugar levels and can be added to a treatment plan in addition to lifestyle and dietary modifications to expedite treatment success.

Berberine

Berberine is a naturally occurring plant compound with antimicrobial, anti-inflammatory, anti-lipidemic, and hypoglycemic properties. A meta-analysis of 27 randomized controlled trials and over 2,500 patients found that supplemental berberine increased the therapeutic effects of lifestyle modifications, dietary changes, and oral diabetes medications. Positive clinical outcomes noted in this meta-analysis included reductions in fasting glucose, post-prandial glucose, and hemoglobin A1c.

Cinnamon

Cinnamon is a common household pantry spice that has medicinal properties. The active component of cinnamon, cinnamaldehyde, has been attributed to positive glucose-managing effects. It is believed that cinnamaldehyde promotes insulin release and enhances insulin sensitivity, promoting cellular uptake by cells. Studies have shown that therapeutic doses of cinnamon decrease fasting blood sugar levels. (9)

Chromium

Chromium has been shown to enhance insulin’s metabolic effect; chromium deficiency has been linked to type 2 diabetes. A meta-analysis of 28 studies revealed that oral chromium supplementation significantly reduces fasting blood sugar, insulin levels, hemoglobin A1c, and HOMA-IR (a marker of insulin resistance).

Gymnema

Gymnema is an interesting herb thought to act by multiple mechanisms to lower blood sugar levels successfully. Perhaps the most interesting characteristic of this herb is its ability to interfere with perceiving the sweet taste; by inhibiting the sweet taste of foods, people may naturally limit their intake of sweet foods. Additionally, gymnema decreases gastrointestinal absorption of sugar, stimulates pancreatic insulin production, and improves signaling for peripheral uptake of blood glucose. Research has shown that the culmination of these properties reduces fasting blood sugar and hemoglobin A1c levels. (10)

Exercise for Managing High Blood Sugar

Exercise offers numerous benefits for managing high blood sugar and is crucial to diabetes management. Regular physical activity helps improve insulin sensitivity, allowing the body to utilize glucose for energy effectively. It also promotes weight loss or weight management, reducing the risk of insulin resistance. Engaging in exercise can lower blood sugar levels, enhance cardiovascular health, and decrease the risk of developing complications associated with diabetes. (11)

The American Heart Association (AHA) recommends incorporating aerobic and anaerobic forms of exercise into your physical routine to promote cardiovascular health and prevent insulin resistance. It is recommended to gradually work up to at least 150 minutes of moderate-intensity or 75 minutes of high-intensity aerobic activity, with at least two sessions of muscle-strengthening exercise, every week.

Beginning a new exercise routine can feel overwhelming. The good news is that research shows even small amounts of physical activity are better than none. For example, walking 15 minutes after meals significantly helps 24-hour glucose control. 

Stress Management and Quality Sleep for Hyperglycemia

As discussed earlier, chronic stress and lack of sleep contribute to sustained elevations in cortisol and poorer blood sugar control. Research has shown that diabetic patients who feel stressed also report greater insulin use, poorer glycemic control, and a general sense of less empowerment. Therefore, ensuring patients can implement effective stress management techniques and get adequate good-quality sleep is a very important aspect of a hyperglycemia treatment protocol.

In addition to eating a healthy, well-balanced diet and exercising regularly, mindfulness-based stress reduction practices (discussed in more detail below) and adaptogenic herbs can modulate the “fight-or-flight” division of the nervous system and cortisol levels to help the body better adapt to stress.

Establishing healthy sleep hygiene habits can promote restorative sleep. The following tips are often recommended to facilitate deep sleep. Aim to wake up and go to bed at the same time each day of the week. Avoid intense activity and other stimulants (e.g., caffeine) later in the afternoon and evening. Create a calming wind-down routine before bed that includes dimming lights and avoiding blue light. Ensure your bedroom is dark, cool, and quiet. 

Mind-Body Approaches for Hyperglycemia Management

Mind-body therapies, including yoga, mindfulness-based stress reduction therapy, and acupuncture, effectively manage stress. Interestingly, research demonstrates that each of these modalitiessupports healthier blood sugar control, indicated by improvements in fasting blood glucose and hemoglobin A1c levels. 

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Summary

Hyperglycemia is a medical condition that cannot go unrecognized and untreated. An integrative approach to prevent and treat high blood sugar, incorporating functional medicine labs and a combination of complementary therapeutic modalities, offers promising possibilities for achieving optimal glycemic control.

The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.

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