There are many things that effect blood sugar and we have a handle on most of them... I think. Food, fiber, exercise, insulin... all play a part and all worth paying attention to.
Yet, lately, I've come to think stress plays a far more important role than was thought. Even if not for the masses, then perhaps for me. I've noticed while food has a predictable and transitory effect on blood sugar, stress has a less predictable but much longer term effect. A stack of breakfast toast might boost BS for a few hours, but a stressful day can take a week to recover from.
If this is true then days, years, even decades of living with high stress could explain much.
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