One of the tenets of chiropractic care is to manage the health of and restore function to the patients entering our office, not limited to any one system of the body but rather THE WHOLE PERSON. With this primary care responsibility, knowledge and understanding of the patient who presents with either controlled or uncontrolled blood sugar abnormalities is necessary, as it is a very important aspect of their health and well-being. How does the blood sugar level affect the body, and what can chiropractic do in the management of the patient with blood sugar abnormalities?

Glucose (sugar) is the primary source of energy for our body’s cells, and the level that exists in the blood is tightly regulated by insulin produced by the pancreas. Essentially, when we eat carbohydrates (simple or complex), the blood sugar level goes up and triggers insulin to increase, which in turn lowers the blood sugar level to keep it in a fairly tight range (usually within 80-110 mg/dl, with a mean of 100). Your blood sugar level is typically lowest in the morning before you’ve eaten breakfast, which makes it the best time to check the level (called “fasting” blood sugar or FBS). Your blood sugar level will elevate after eating for an hour or two and then gradually normalize. It can dip down below the “fasting” level usually in the third to fourth hour after eating, at which time symptoms of low blood sugar or “hypoglycemia” can occur (tired, difficulty concentrating, light headed, rapid heart rate, etc.). In a “normal” person, the peak of blood sugar after eating usually reaches a maximum of 140 mg/dl (with 125 being the limit in a non-fasting sample) vs. the “controlled” diabetic who peaks out <180mg/dl, above which glucose will start showing up in the urine and is detectable with a urinalysis (dip sticks can be purchased at any pharmacy). When the blood sugar is high, the term “hyperglycemia” is used (too low = “hypoglycemia”). In general, we can tolerate levels that are too high better than levels that are too low, so IF you ever find a person passed out and they are wearing a bracelet indicating diabetes, you must ASSUME that they are hypoglycemic first as levels below 40 mg/dl can be life-threatening and a sugar-rich drink or food is appropriate (if they are conscious, of course—if not, call 911!). Diabetes mellitus is diagnosed when the fasting blood glucose level is persistently high (the fasting range allowed for a “controlled diabetic” is 90-130 mg/dl) and is the most common cause of hyperglycemia.

In patients with diabetes mellitus, the blood sugar literally makes the blood thicker (think of molasses) making it hard for it to pass through the smaller blood vessels (called capillaries). This is why the eyes, kidneys, and the toes / feet are so susceptible to damage, as blood can’t get through the small vessels in these locations. Though larger scaled studies are needed, numerous case studies have been published that report success in reducing A1C levels, blood glucose levels, and the amount of insulin needed in both type 1 and type 2 diabetes mellitus in patients of various ages, including a four-year-old type 1 diabetic. There are several published case reports showing that chiropractic adjustments applied to the upper neck and mid-back regions, the areas where nerve supply to the pancreas, have benefited diabetics. Nutritional recommendations have also been reported as beneficial in many case reports. The authors of these case studies have recommend larger studies to investigate the efficacy of these treatments.