How to Improve Immunity when you have Diabetes or High Blood Sugar


Now more than ever, it’s important to ensure your blood sugar is managed. This blog article was inspired by the recent peer reviewed paper published in the Journal of Diabetes Science and Technology that

looked at 1,122 people hospitalized with COVID-19 in the US from March 1st-April 6th. They found that patients with hyperglycemia (high blood sugar) had a 4x greater risk of having negative outcomes from COVID-19. People with type II diabetes have a higher susceptibility to infections. One of the reasons for increased infections is that having elevated blood sugar inhibits several parts of our immune system including neutrophils, phagocytosis, superoxide production and microbial killing.


If you already understand blood sugar control skip to the next paragraph for action steps. In most cases type II diabetes develops slowly, starting with insulin resistance. There are almost no symptoms, which is why it can take so long for a diagnosis to happen. Our blood sugar is regulated by the release of a hormone called insulin. We make insulin in our pancreas in response to consuming foods with sugar or carbohydrates. Insulin is the signal that many cells need to open their doors and allow the sugar inside to be used as fuel. The trouble happens when we over consume carbohydrates and/or sugar and we have excess fuel. Excess consumption leads to high blood sugar. If we do this on occasion, such as indulging in birthday cake, it’s not a big deal. But, if we chronically over consume carbohydrates and sugar, the cells start to take in more glucose than they need. Overfed cells stop responding to the insulin signal causing more and more insulin to be produced. This phenomenon is called insulin resistance. If this condition persists, we end up with too much insulin, an inflammatory hormone, and eventually the pancreas can become fatigued and unable to keep up the insulin production. At this point, a person develops type II diabetes.


So we know that having elevated blood sugar is an issue for our immune health and ability to recover from a COVID-19 infection. What can we do about it?


  1. Get screened. I run fasting insulin and glucose as well as an A1c regularly on patients. Just a fasting glucose is not enough of a screening tool, especially when you are trying to catch insulin resistance early.

  2. Work with a provider: If you are diagnosed with type II diabetes, I recommend working with a provider. Look for an ND, MD, or DO in your area.

  3. Change your diet: Most information around high blood sugar focuses on dietary changes, so I won’t put too much emphasis on that here. In a nutshell, eat less processed foods, eat more vegetables and reduce your intake of simple carbohydrates and sugars. Easy right?

  4. Reduce your stress! This is very important for glucose control. When we are stressed or anxious our body releases hormones called cortisol and adrenaline. Both of these hormones cause your liver to make sugar and dump it into the blood stream. A not so fun fact: when the body develops high blood sugar in response to sympathetic signals (stress), adrenaline actually inhibits pancreatic insulin secretion prolonging how long the blood sugar stays elevated. It’s a brilliant design if you are stressed because you need to escape or fight, but not great when you are stressed and inactive.

  5. Sleep. A lack of sleep not only raises blood sugar levels but it also reduces your ability to process glucose leading to hyperglycemia. We don’t know all the reasons why sleep is so important for blood sugar control. Some theories include sleep increasing growth hormone and allowing for the deactivation of cortisol. Aim for 7 hours per night and try to get into bed before midnight.

  6. Exercise. Exercise is a quick way to reduce your blood sugar, especially muscle building workouts. Our muscles have a transporter called GLUT-4 that rapidly brings glucose into cells. We can increase the activity of GLUT-4 with strength training. Just 30 minutes 3x per week can lower your blood sugar levels over time.


Knowledge is power. Now you understand that elevated blood sugar can have negative consequences on your immune system and that there are action steps you can take to improve your health.


PMID: 26897277 PMID: 30533447 PMID: 350523


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