Breathing, stress and metabolic mastery

For the last five years or so, I’ve experienced a significant improvement of my diabetic control as measured by my CGM time in range, CGM glucose variability and A1c performance. I’ve been aware of this improvement but I’m just now realizing what is going on and where much needed improvements still need to happen.

Back in the late fall of 2019, I called 911 due to an alarming shortness of breath. I had not experienced this symptom before. I felt an air hunger that was new to me. Spending eight hours overnight in the ER revealed no medical insight into my condition. The shortness of breath symptom moderated and then disappeared during my stay.

The medical reason for my ER visit remained a mystery to me until today. I finally put two and two together and made a conclusion after watching a YouTube video by Patrick McKeown. I’ve been aware of all the key facts but it took the simple unifying explanation of his video to make it clear to me.

Since 2018 I’ve been explicitly aware of the importance of balancing the sympathetic (fight vs. flight) side of the nervous system with the parasympathetic (rest and digest) side. Only one can be present at a time; when one dominates, the other steps aside. I used meditation and breathing exercises to elicit the calming effect of a parasympathetic response.

It’s interesting that it’s the vagus nerve that serves as the key piece of anatomy in our sympathetic vs. parasympathetic nervous system balance. The vagus nerve connects our brain to all of our digestive organs. When good balance is struck, we enjoy good digestion, less cortisol release, and more well-being. I now realize that we also can control our blood sugar levels better!

Don’t get me wrong, I fully realize that good blood sugar control is a complex balance that involves good diet choices, exercise and many other factors. But I now can fully realize that explicit and daily repetition of breathing exercises play a critical role in our diabetic control.

Hyperglycemia, hypoglycemia and the swing between the two puts us on a stressful edge. This often too-regular metabolic excursion keeps us on the fight or flight trajectory and reduces our ability to bring balance and relaxation to us.

While I’ve been using breathing exercises to help me, I now have a greater appreciation for its potent effects. This on-again, off-again habit will now go to the top of my daily priorities.

I also have more appreciation for my practice of taping my mouth each night to enforce nose breathing during sleep. This may alarm some here but I encourage people to consider this practice. Not everyone breathes through their mouth during sleep but waking up with a dry mouth is a good indication of unhealthy mouth breathing.

I believe that restoring balance between the sympathetic and parasympathetic nervous system plays a key role in diabetic control. Daily breathing exercises are an accessible and potent tool to strike that balance.

Another resource to check out is Nick Heath, PhD and T1D, The Breathing Diabetic. He has found breathing exercises as a way to improve metabolic health.

I encourage you to give consideration to reducing stress and making the control of your blood sugar markedly better.


I totally agree, great to read all this. I was also going to mention Nick Heath and his work, glad you did.
There’s another great resource which I’ve been participating in over the last year: Diabetes Sangha - a group that offer free, live meditation practices over zoom, nearly every day. It’s a lovely community and no experience with meditation is necessary. Nick Heath has been a guest presenter there.
I’ve also been a reiki practitioner for over 20 years, and I believe this, combined with breathing exercises, has helped me have a more relaxed approach to living with T1d, while still maintaining excellent TIR and overall well being.

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He is the presenter ths Sunday, October 1st, 8 pm eastern time. All are welcome: there is a Zoom link on the Diabetes Sangha home page.

James Nestor, author of the book Breath, participates as a test subject in a month-long mouth vs nose breathing experiment. The cognitive, motor, and metabolic deficits of prolonged mouth breathing are mind-boggling!


Thank you for expressing your thoughts, Lucia, about an often under-appreciated factor of a healthy metabolism. I was beginning to think that I had raised an esoteric diabetes topic that most did not think was comment-worthy. My early impression was wrong!

I will check out your link and learn to learn more about meditation and also intend to google “reiki meditation” to expand my knowledge.

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Thanks for your comment. Nice to see that others here have preceded me in finding Nick Heath as a resource for stress relief as a deliberate diabetes tactic for blood glucose management.

I will add your suggestion of James Nestor’s book to my Audible list.

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At the risk of this thread becoming a discussion with myself, I just want to provide a useful article that I thought people would find interesting. It is an NPR Terry Gross 2020 interview with James Nestor, an author referenced by @SophieCat above. I found it a very interesting read and explanation of how the simple act of breathing plays an important role in our health and well-being.


Yoga therapist Evan Soroka also discusses the importance of breath practice in T1D management.


Thanks for starting this conversation - so good to have more resources and learn more. I’m a big believer in a truly holistic approach - including our mental, emotional and physical well being when working with T1d or anything else…I have some info on my website here (this page is about Reiki classes, but gives some explanation of Reiki), if you’re interested… hope it’s ok to link to it?

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Not to mention that mouth breathing at night is bad for ur teeth. I don’t struggle with this, as I normally keep my mouth closed while sleeping. Tape would give me anxiety.

I am able to reset my sympathetic/ parasympathetic nervous system by fasting. It really does wonders. I was taught early on thst I should be constantly eating every 2-3 hours to keep my sugars steady, but really my sugar is in perfect control when I fast, even when I’m exercising. Hiking and walking is also an exercise in rhythmic breathing, so I feel like I get both in one activity.

@Timothy, yeah, I’ve read that mouth breathing upsets the mouth microbiome or bacterial balance and that can lead to bad dental health.

Not everyone breathes through their mouth at night but I’ve read estimates of 50% that do. I had some anxiety when I first started taping my mouth for sleeping. I got used to it fairly quickly and use a good medical paper tape. I learned that you don’t need to cover the entire mouth to get the benefit, just enough to keep the lips together. I would not do it if I wasn’t a mouth breather.

Fasting has much to recommend it. Before I started fasting for health reasons, I noticed for many years that my blood sugar levels were always easier to control when I had to fast for a blood draw or a medical procedure.

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I’ve noticed this too. Whenever possible, I try to exercise first thing because my blood sugar is so much easier to control than it is later in the day after I have eaten and taken insulin.