The CGM Blog
How is Glucose Regulated in the Body?
Glucose regulation is an important part of diabetes management. Diabetes is caused by issues with insulin, the main hormone that regulates glucose in the body. In people living with type 1 diabetes (T1D), the body doesn’t produce insulin at all due to an autoimmune condition that has destroyed the cells that usually produce it. For those living with type 2 diabetes (T2D), the body either can’t produce enough insulin or is unable to effectively use the insulin it does produce. Because of these issues in how insulin works in the body, people living with diabetes need to pay extra attention to their glucose levels on an ongoing basis.
When you’re living with diabetes, understanding the basic underlying biology of what you’re going through can help you navigate your diabetes management journey with a little more confidence. Knowing how glucose is regulated in the body can give you insight into what might affect your glucose levels. This can give you some idea about the habits that enhance your health and well-being.
What is Glucose?
Glucose is a type of simple sugar molecule that our bodies use for fuel. We get glucose from the foods we eat, in particular, foods that contain carbohydrates and sugar.2 Our brains rely on glucose to function and it’s an essential part of our dietary needs.
Insulin & Glucagon: How Hormones Regulate Glucose in the Body
The process of glucose regulation is complex, but there are a few main events that are important to understand as a person living with diabetes. To give you an idea of what’s happening in your body, here are some of the major steps in the glucose regulation process:
Step 1: Digestion
When we eat, our food gets broken down into its various parts, including vitamins, minerals, proteins, fats, and sugars, to name a few. Carbohydrates are the primary source of sugars, which our bodies use for energy. After carbohydrates are broken down, sugar molecules enter the bloodstream from our digestive system. The concentration of sugar in the blood is called blood sugar or blood glucose.4
Step 2: Glucose Absorption & Storage
Any time blood sugar rises, particularly after a meal, the pancreas releases a hormone called insulin.5 Insulin acts as a gatekeeper that lets glucose into our cells so that it can be used for energy. If there is too much glucose in the blood, insulin also tells the liver to absorb glucose and store it for later as glycogen—which you could think of as a “container” of glucose.2
After the cells and the liver have absorbed and stored adequate amount of glucose, insulin levels drop. When blood glucose levels are very low, for example after fasting or not eating for a few hours, the pancreas releases another hormone called glucagon that steps in to increase the glucose available in the blood. It does this by triggering the liver to release the glucose that was stored as glycogen and prevents the liver from absorbing more glucose. It also helps the body make glucose from other sources in the body like amino acids, which come from protein.6
However, in individuals living with T1D, the pancreas no longer produces insulin.1 For those living with T2D, the body either doesn’t make enough insulin or it’s unable to use insulin properly, which is called “insulin resistance”.7 The glucose absorption process outlined above can’t be completed because of these complications with insulin.
Step 3: Balancing the Energy Supply
When the pancreas is functioning normally, there is always a small amount of insulin in the body, known as basal insulin, which keeps blood glucose levels steady throughout the day and night. This helps ensure that when glucagon is letting glucose into the blood, things don’t get out of balance.1
For individuals living with diabetes, the processes that usually help out with balancing the highs and lows of glucose in the body aren’t there to get the job done. People living with type 1 diabetes need to inject insulin or use an insulin pump to make sure their bodies can use glucose effectively and manage their blood sugar levels.1 Type 2 diabetes can sometimes be managed with diet and exercise, but people living with T2D may also need insulin or other medications that influence glucose levels.1,8 It’s vital to speak to your healthcare provider about the options available and which ones might work best for you.
Taking Control of Glucose Regulation
Because glucose is a key energy source that keeps us alive, diabetes care is centred around managing glucose in the body. Different therapies help you control your blood sugar in different ways. It’s important to connect with your healthcare provider to discuss your options. Whether you’re living with type 1 or type 2 diabetes, you will very likely need to pay attention to your blood glucose levels on a regular basis.
When managing T1 diabetes with insulin, or T2 where bolus insulin is required, you often need to take on the role that your pancreas typically plays in the body. You must monitor your glucose levels instead of relying on your organs and hormones to do it independently. When you look at it this way, managing diabetes is no small feat. Taking care of your health is a full-time job, so it’s important to acknowledge the incredible effort you’re putting in each and every day.
One of the ways you can make keeping track of your glucose levels a little more manageable is by using continuous glucose monitoring (CGM) technology like the Dexcom G7 CGM System. Dexcom CGM use is proven to lower A1C—a test that measures your average glucose levels—while reducing hypoglycemia and helping to increase time spent in your target range (generally defined by Diabetes Canada as 3.9–10.0 mmol/L).9,10,11 Time in range (TIR) is the percentage of time you spend within your target range of glucose levels each day. Increasing TIR has also been shown to improve A1C levels over time. You can determine your personal ideal target range with the help of your doctor.
Learn more about time in range and why knowing your ideal TIR may help you feel better as you move through your diabetes management journey.
1 What is diabetes? Diabetes Canada. Accessed August 22, 2022. https://www.diabetes.ca/about-diabetes/what-is-diabetes
2 Hantzidiamantis PJ, et. al. Physiology, Glucose. StatPearls Publishing. Updated September 20, 2021. https://www.ncbi.nlm.nih.gov/books/NBK545201/
3 Mergenthaler P, et. al. Sugar for the brain: the role of glucose in physiological and pathological brain function. Trends Neurosci. 2013;36(10):587-597. doi: 10.1016/j.tins.2013.07.001
4 Carbohydrates. Cleveland Clinic. Updated February 8, 2021. Accessed August 22, 2022. https://my.clevelandclinic.org/health/articles/15416-carbohydrates
5 Controlling Blood Sugar. Diabetes Education Online. Accessed June 29, 2022. https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/controlling-blood-sugar/
6 Glucagon. Cleveland Clinic. Updated January 3, 2022. Accessed June 29, 2022. https://my.clevelandclinic.org/health/articles/22283-glucagon
7 Insulin Resistance and Diabetes. Centers for Disease Control and Prevention. Updated August 10, 2021. Accessed June 29, 2022. https://www.cdc.gov/diabetes/basics/insulin-resistance.html
8 Oral Medication: What Are My Options? American Diabetes Association. Accessed June 29, 2022. https://www.diabetes.org/healthy-living/medication-treatments/oral-medication/what-are-my-options
9 Imran AS, et. al. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Targets for Glycemic Control. Can J Diabetes 2018:42(S42–S46). doi: 10.1016/j.jcjd.2017.10.030
10 Beck RW, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: The DIAMOND randomized clinical trial. JAMA. 2017;317(4):371-378. doi: 10.1001/jama.2016.19975
11 Welsh JB, et al. Accuracy, Utilization, and Effectiveness Comparisons of Different Continuous Glucose Monitoring Systems. Diabetes Technol Ther. 2019;21(3):128-132. doi: 10.1089/dia.2018.0374
12 Vigersky RA, et al. The Relationship of Hemoglobin A1C to Time-in-Range in Patients with Diabetes. Diabetes Technol Ther. 2019;21(2):81-85. doi:10.1089/dia.2018.0310
2 Hantzidiamantis PJ, et. al. Physiology, Glucose. StatPearls Publishing. Updated September 20, 2021. https://www.ncbi.nlm.nih.gov/books/NBK545201/
3 Mergenthaler P, et. al. Sugar for the brain: the role of glucose in physiological and pathological brain function. Trends Neurosci. 2013;36(10):587-597. doi: 10.1016/j.tins.2013.07.001
4 Carbohydrates. Cleveland Clinic. Updated February 8, 2021. Accessed August 22, 2022. https://my.clevelandclinic.org/health/articles/15416-carbohydrates
5 Controlling Blood Sugar. Diabetes Education Online. Accessed June 29, 2022. https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/controlling-blood-sugar/
6 Glucagon. Cleveland Clinic. Updated January 3, 2022. Accessed June 29, 2022. https://my.clevelandclinic.org/health/articles/22283-glucagon
7 Insulin Resistance and Diabetes. Centers for Disease Control and Prevention. Updated August 10, 2021. Accessed June 29, 2022. https://www.cdc.gov/diabetes/basics/insulin-resistance.html
8 Oral Medication: What Are My Options? American Diabetes Association. Accessed June 29, 2022. https://www.diabetes.org/healthy-living/medication-treatments/oral-medication/what-are-my-options
9 Imran AS, et. al. Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Targets for Glycemic Control. Can J Diabetes 2018:42(S42–S46). doi: 10.1016/j.jcjd.2017.10.030
10 Beck RW, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: The DIAMOND randomized clinical trial. JAMA. 2017;317(4):371-378. doi: 10.1001/jama.2016.19975
11 Welsh JB, et al. Accuracy, Utilization, and Effectiveness Comparisons of Different Continuous Glucose Monitoring Systems. Diabetes Technol Ther. 2019;21(3):128-132. doi: 10.1089/dia.2018.0374
12 Vigersky RA, et al. The Relationship of Hemoglobin A1C to Time-in-Range in Patients with Diabetes. Diabetes Technol Ther. 2019;21(2):81-85. doi:10.1089/dia.2018.0310