The Diabetes–Breathing Connection

The Diabetes–Breathing Connection

May 24, 2023


The article discusses the impact of breathing patterns on insulin levels and blood sugar response, highlighting the potential role of diaphragmatic breathing in managing diabetes.

The Connection Between Diabetes and Optimal Breathing

Did you know diabetes is a widespread health concern affecting millions in the United States alone?

According to the National Diabetes Statistics Report, an estimated 7.3 million individuals in the country are currently living with diabetes, which accounts for approximately 11.3% of the total population.

Even more concerning, 96 million people aged 18 years or older have prediabetes, which represents a staggering 38.0% of the adult US population.

Defining Diabetes and Prediabetes

The International Diabetes Federation defines diabetes as “a chronic disease that occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces.”

Insulin, a hormone synthesized by the pancreas, plays a crucial role in converting glucose from food into energy. Glucose from all carbohydrate foods is converted into glucose in the bloodstream, and insulin facilitates its transportation into the cells.

However, the inability to produce or effectively use insulin leads to high glucose levels in the blood, a condition known as hyperglycemia. This can result in long-term complications, such as damage to your organs and tissues.

The Centers for Disease Prevention and Control(CDC) defines prediabetes as a condition in which your glucose levels are higher than normal but not high enough to be diagnosed as diabetes.”

Types of Diabetes

The following table shows the 3 types of diabetes:

TypeDescriptionOnset Age GroupPrevalence
Type-1-Your body cannot produce insulin.
-Requires lifelong insulin therapy

--Increased thirst
--Frequent urination
--Extreme hunger
--Unintended weight loss
--Blurred vision
Mostly diagnosed in:
--Young adults
5-10% of all diabetic cases
Type-2-Your body is unable to utilize the insulin it produces.
-Symptoms are hard to spot.

--Increased thirst
--Frequent urination
--Blurred vision
--Tingling or numbness in hands and feet
--Slow healing wounds
--Recurrent skin infections
Typically diagnosed in middle-aged or older adults, but can occur in children and young adults as well.90-95%of all diabetic cases
Gestational Diabetes-Occurs due to high blood glucose levels during pregnancy.
-Usually goes away after the baby is born.
-Typically doesn’t have any symptoms.
Pregnant Women, usually during the 2nd or 3rd trimester.2-10% of all pregnancies

Interpreting Your Diabetes Numbers

Here is a list of some important diabetes tests.

  • A1C Test: Measures average blood sugar levels over the past 2 or 3 months to assess diabetes control.

  • Fasting Blood Sugar Test: Measures blood sugar levels after fasting to evaluate diabetes risk.

  • Glucose Tolerance Test: Assesses how the body processes sugar after consuming a liquid containing glucose.

  • Random Blood Sugar Test: Measures blood sugar levels at any time to diagnose or monitor diabetes.

ResultA1C TestFasting Blood Sugar TestGlucose Tolerance TestRandom Blood Sugar Test
Diabetes6.5% or above126 mg/dL or above200 mg/dL or above200 mg/dL or above
Prediabetes5.7-6.4%100-125 mg/dL140-199 mg/dLNA
NormalBelow 5.7%99 mg/dL140 mg/dL or belowNA


Factors Influencing Insulin Levels and Blood Sugar Response

1. Artificial Sweeteners

Artificial sweeteners, commonly used as sugar substitutes in various food and beverage products, have gained popularity due to their low-calorie content. However, research suggests these non-caloric sweeteners may still affect insulin levels and blood sugar response. Some studies indicate that artificial sweeteners may alter gut microbiota composition, impacting insulin sensitivity and glucose metabolism. Here are some nutritive sweetener options:

  • Stevia: Stevia is an FDA-approved low-calorie sweetener that has antioxidant and antidiabetic properties.

  • Aspartame: Aspartame is also an FDA-approved low-calorie sweetener that is 200 times sweeter when compared to table sugar.

2. Dehydration

Dehydration occurs when the water losses in your body are higher than your water intake. When you are dehydrated, it leads to a reduction in the water content of the bloodstream, resulting in a higher concentration of blood sugar. This does not indicate an increase in the actual amount of blood sugar but rather an elevated ratio of blood sugar to water, leading to an upward trend. 

Dehydration can trigger both mild and substantial spikes in blood sugar levels, potentially resulting in hyperglycemia (high blood sugar levels) if the increase is significant. It is important to stay adequately hydrated to support optimal insulin function and blood sugar control.

3. Medications

 Certain medications, such as corticosteroids, antipsychotics, beta-blockers, thiazide diuretics, and statins, can influence insulin levels and blood sugar response. It is crucial for individuals taking these medications to work closely with their healthcare professionals to monitor their insulin levels and blood sugar response and make any necessary adjustments to their treatment plan.

4. Irregular Sleep Patterns

Disrupted sleep patterns, such as inadequate sleep duration or irregular sleep schedules, can increase insulin resistance. Multiple studies have shown that frequent nighttime awakenings, inadequate sleep duration, excessive sleep, and irregular sleep patterns are associated with an increased risk of glucose intolerance.

5. Caffeine

The impact of caffeine on blood sugar levels is a question of interest. Habitual high-caffeine consumption over a four-week duration has demonstrated a detrimental effect on insulin sensitivity among individuals diagnosed with type 2 diabetes. However, this doesn't mean you should avoid caffeine altogether. While caffeine's effects may last longer for those with insulin resistance, moderate caffeine consumption is generally safe for most people when not excessive.

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Know These Facts

  • Do you know what causes diabetes? You might be thinking about high blood sugar now. But that’s not the actual condition of diabetes. Excessive insulin is the underlying cause of diabetes, not excess blood sugar. So, explicitly speaking, lots of blood sugar is the symptom, not the root cause of diabetes.

  • Fluctuations in blood sugar levels occur throughout the day, and observing patterns of rises and falls can provide important and practical information about your metabolic health.

  • The process of fat burning is intricately linked to insulin levels, which are strongly influenced by, or closely associated with, blood glucose.

  • The first crucial step is to attain an acute awareness of your glucose levels. Glucose monitoring is a beneficial, initial step that can provide significant insights into fluctuations and glucose variability.

The Link Between Breathing and Glucose Metabolism

Insulin, a hormone produced by the pancreas, acts as a key, allowing glucose to enter our cells. Once inside, glucose undergoes chemical reactions facilitated by enzymes and proteins to release stored energy. This process is crucial for cellular respiration.

Without sufficient insulin, glucose remains in the bloodstream, becoming more concentrated over time. In response, the pancreas releases glucagon, which prompts the liver to release stored sugar or glycogen. This interplay between glucagon and blood sugar maintains stable levels in our body and brain.

However, individuals with insulin resistance struggle to respond effectively to insulin, leading to elevated blood glucose levels. Lack of oxygen in cells can trigger inflammation and further insulin resistance. Conversely, increasing oxygen concentration lowers the glucose level at which insulin is released.

Breathing plays a vital role in glucose metabolism. It involves the movement of air between the lungs and the atmosphere. Inhalation brings air to the lungs, while exhalation removes it. The brainstem houses the respiratory center responsible for regulating this process.

Breathing differs from other bodily functions as it can be consciously controlled. You have the power to voluntarily adjust your breath, especially before exertion or effort. Being aware of your breathing patterns and intentionally modifying them to achieve various goals helps you tap into the transformative potential of your breath to support overall health and well-being.

How Your Nervous System and Glucose Metabolism are Connected?

Your nervous system plays a vital role in regulating various responses, including the sympathetic and parasympathetic branches of the autonomic (automatic) nervous system. The sympathetic nervous system is responsible for the fight-or-flight response, while the parasympathetic nervous system induces a relaxation response.

One key hormone involved in the stress response is cortisol, often referred to as the body's alarm system. It influences blood pressure, blood sugar levels, sleep-wake cycles, and the utilization of proteins, fats, and carbohydrates. Cortisol is closely linked to the fight-or-flight response.

When we encounter stress or perceive a threat, the amygdala in our brain processes visual and auditory stimuli, sending an SOS signal to the hypothalamus. This signal sets off a cascade of events through the autonomic nervous system, particularly the sympathetic branch.

Activation of the sympathetic nervous system prompts the adrenal glands to release catecholamines, including adrenaline and noradrenaline. These hormones increase heart rate, blood pressure, and breathing rate, redirecting blood flow to vital organs and the large muscle groups. This response prepares the body for a fight-or-flight scenario.

During this heightened state, cortisol levels rise, causing a temporary increase in insulin resistance. This stress hormone also impacts glucose levels by elevating circulating glucose, providing immediate energy for combat or escape.

After the initial surge of epinephrine subsides, the hypothalamus initiates the activation of the HPA axis (hypothalamus-pituitary-adrenal axis). Through a series of hormonal signals, the HPA axis modulates the sympathetic nervous system. If the perceived threat persists, adrenocorticotropic hormone (ACTH) is released, stimulating the adrenal glands to produce cortisol. This sustains the body's heightened state of alertness and inhibits insulin to prevent glucose storage.

Once the threat passes, cortisol levels decrease, triggering the parasympathetic side of the autonomic nervous system and its relaxation response. However, repeated spikes in cortisol and subsequent glucose surges can make individuals more susceptible to metabolic syndrome.

If left unchecked or occurring frequently, this pattern of cortisol release can keep blood sugar levels consistently elevated, leading to obesity, hypertension, dementia, type 2 diabetes, and depression.

Fortunately, by reducing cortisol levels, we can shift our body's response toward the parasympathetic nervous system. Research indicates that conscious alteration of breathing patterns can send a signal to the brain, activating the parasympathetic branch. This, in turn, slows heart rate, aids digestion, and promotes a sense of calm. Moreover, it can help regulate the release of stress hormones like cortisol by influencing the sympathetic system.

The Role of Diaphragmatic Breathing in Glycemic Control

Following Optimal Breathing Techniques that help you utilize the maximum potential of your diaphragm offers a range of benefits, including the regulation of cortisol levels, which in turn helps to reduce stress and stabilize glucose levels.

Diaphragmatic breathing has been associated with positive effects on body mass index, waist-hip ratio, and post-meal glucose levels.

Moreover, diaphragmatic breathing serves as a valuable therapeutic tool in achieving an optimal balance between antioxidants and free radicals, thus combating oxidative stress—an important factor in glycemic variability.

Research indicates that regular practice of diaphragmatic breathing exercises has been shown to effectively lower both fasting blood sugar levels and post-prandial blood sugar levels (blood sugar level after a meal)[23].

The Bottom Line

Incorporating deep, slow, intentional, and diaphragmatic breathing techniques into your routine can yield significant benefits for your body's functioning. This includes maintaining a balanced glucose production by the liver and preventing excessive blood sugar spikes, particularly in challenging and stressful situations.

Optimal breathing practices improve the effectiveness of insulin, allowing cells to efficiently utilize glucose as an energy source. This helps prevent the buildup of glucose in the bloodstream, mitigating the potential risks associated with sustained high blood sugar levels.

Additionally, the enhanced oxygenation resulting from optimal breathing promotes better nutrient absorption, leading to improved metabolic health. And who knows? Maybe decades of shallow or poor breathing helped to contribute to low oxygen levels and a pre-diabetic disposition in the first place!

By optimizing various physiological processes, optimal breathing fosters overall well-being and supports the body's optimal functioning.

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