What causes blood sugar imbalance? Dr Shura Ford puts the case for traditional Chinese medicine. Physiologically, from both a Western and traditional Chinese medicine (TCM) perspective, blood sugar (glucose) balance involves a process of feedback between the cells, pancreas, and liver, and is an example of how the body is always working to maintain equilibrium.

What goes wrong

Following consumption of foods high in sugar or refined carbohydrates, these elements are quickly broken down into glucose by the digestive system and absorbed into the bloodstream. This elevates blood glucose levels, which in turn alerts the pancreas to secrete insulin to restore balance by increasing glucose uptake by the body's cells and encourage storage of excess glucose in the liver. Once blood glucose normalises, the stimulus for insulin falls, and levels stabilise. A similar process occurs when blood sugar drops: if you fast, skip a meal, or exert yourself, blood sugar falls, triggering the pancreas to release glucagon and the liver to release glucose reserves into the blood.

Sustained elevated blood sugar levels may be a precursor to insulin resistance, pre-diabetes, or type 2 diabetes. The Western perspective is that blood sugar imbalance results when the body cannot manage insulin demands or when high blood glucose levels decrease sensitivity of insulin receptors, making them resistant. This is most likely to happen when the body is regularly flooded with glucose, so diet and lifestyle play a key role, as does genetic predisposition. High blood sugar can be mitigated by regular exercise and a diet high in fibre and whole foods, and low in sugar and high-GI foods.

In Chinese medicine philosophy, the sweet flavour pertains to the Spleen; a little sweetness will tonify the Spleen, but too much weakens it. So the body's inability to digest sweetness efficiently suggests that the Spleen's transforming and transporting functions are sub-optimal. Low blood sugar suggests a deficiency of Qi or Yang body functions and may relate to the Spleen, Liver, or Kidney. Chinese medicine treats blood sugar imbalance with acupuncture, herbs, and Shi Lao (dietary prescription). Remedies and strategies will aim to restore Spleen transformative and transportation function and enhance fluid movement. According to a review and meta-analysis published in The Lancet Diabetes & Endocrine Special Issue, Chinese herbs that have a demonstrated benefit in controlling blood sugar levels are Huang Qi, Huang Lian & Ren Shen.

Both the Chinese and Western medical approaches to managing blood sugar levels boil down to a healthy lifestyle. It's worth noting that complying with such lifestyle changes can be hard for some, and TCM strategies can be a wonderful support in such cases. Chinese medicine can also be used before a high level of intervention is required, and therefore slow the progression from pre-diabetes to diabetes, and reduce or avoid the use of medications with unpleasant side effects. Combining the two approaches may provide the best results, with a study published in Nutrition & Diabetes showing that acupuncture combined with the drug metformin increases sensitivity to insulin and assists with weight loss in diabetic patients, compared to drug treatment alone.

Shura Ford is a doctor of Chinese medicine. Contact her at Ford Wellness Group,