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  #1   ^
Old Thu, Jul-26-18, 06:01
JEY100's Avatar
JEY100 JEY100 is offline
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Default Diabetic-level glucose spikes seen in healthy people

New Stanford University study using a CGM.

Quote:
Diabetic-level glucose spikes seen in healthy people, study finds
July 24, 2018, Stanford University Medical Center

A device that keeps extra-close tabs on the ups and downs of blood glucose levels reveals that most people see only a partial picture of the sugar circulating in their blood, according to a study by researchers at the Stanford University School of Medicine.

It turns out that the level of sugar in an individual's blood—especially in individuals who are considered healthy—fluctuates more than traditional means of monitoring, like the one-and-done finger-prick method, would have us believe. Often, these fluctuations come in the form of "spikes," or a rapid increase in the amount of sugar in the blood, after eating specific foods—most commonly, carbohydrates.

"There are lots of folks running around with their glucose levels spiking, and they don't even know it," said Michael Snyder, Ph.D., professor and chair of genetics at Stanford and senior author of the study. The covert spikes are a problem because high blood sugar levels, especially when prolonged, can contribute to cardiovascular disease risk and a person's tendencies to develop insulin resistance, which is a common precursor to diabetes, he said.
"We saw that some folks who think they're healthy actually are misregulating glucose—sometimes at the same severity of people with diabetes—and they have no idea," Snyder said.

The insight came to him after he and collaborators at Stanford gave study participants a continuous glucose-monitoring device, which superficially pokes into the surface layer of the skin and takes constant readings of sugar concentrations in the blood as it circulates. With the constant readouts providing more detailed data, Snyder's group saw that glucose dysregulation is more common than previously thought; they also used the data to start building a machine-learning model to predict the specific foods to which people spike. The goal is to one day use the framework to compile data from an individual and, based on their continuous glucose readout, direct them away from particularly "spikey" foods.

Most people who periodically check their blood sugar levels do so with a quick lance to the finger and a device that reads out the blood glucose concentration. The problem with this method is that it captures only a snapshot in time. The amount of sugar in a person's blood is not a constant; it ebbs and flows depending on what the person has eaten that day, down to the specific kind of carbohydrate. (For instance, rice, breads and potatoes are all different kinds of carbohydrates and people often digest them differently.)

To get a better read on glucose levels, Snyder fitted 57 people with a device that continuously took blood glucose readings over about two weeks. Most of the participants were healthy or showing signs of prediabetes, and five had Type 2 diabetes. Data sent back to the lab showed that there were multiple types of spikers, which were classified into three overarching "glucotypes." The glucotype categories—low, moderate and severe—are basically rankings of spike intensity.

"We're very interested in what it means to be 'healthy' and finding deviations from that," said Snyder, who holds the Stanford W. Ascherman, MD, FACS Professorship in Genetics. These glucotypes, he said, are subject to change based on diet. The researchers ultimately have two goals for their work: When people spike, catch it early; and understand what makes a person spike, and adjust their diet to bring the glucotype into the "low" range.
Often people who are prediabetic have no idea they're prediabetic. In fact, this is the case about 90 percent of the time. It's a big deal, Snyder said, as about 70 percent of people who are prediabetic will eventually develop the disease.
"We think that these continuous glucose monitors will be important in providing the right information earlier on so that people can make changes to their diet should they need to," he said.

Blame it on the cornflakes

In getting at the subtleties of spiking, Snyder conducted a sub-study in which 30 participants using the continuous glucose monitor alternated between three breakfasts: a bowl of cornflakes with milk, a peanut butter sandwich and a protein bar.

The trio of tests yielded some fairly startling results: After eating one or more of the meals, more than half of the group—whose prior blood sugar tests showed that they were "healthy"—spiked at the same levels as those of people who were prediabetic or diabetic.

What's more, nearly everyone spiked after eating the cereal.
"We saw that 80 percent of our participants spiked after eating a bowl of cornflakes and milk," Snyder said. "Make of that what you will, but my own personal belief is it's probably not such a great thing for everyone to be eating."

Still, the variables that elicit spikes in an individual—genetics; the population of microbes that live in our bodies; and epigenetics, or changes to gene expression—are critical to understanding glucose dysregulation and the foods that cause glucose spikes. Those parameters are not set in stone, which is why Snyder encourages everyone—including those who think of themselves as healthy—to check their blood sugar with continuous glucose monitoring about once a year.

"Right now we have information about people who do and don't spike, or are super-spikers, but we need to get smart about why it's happening," Snyder said. "I think understanding the microbiome and manipulating it is going to be a big part of this, and that's where our research is headed next."

The work is an example of Stanford Medicine's focus on precision health, the goal of which is to anticipate and prevent disease in the healthy and precisely diagnose and treat disease in the ill.

Explore further: New device could mean end of the jab for people living with diabetes
More information: Hall H, Perelman D, Breschi A, Limcaoco P, Kellogg R, McLaughlin T, et al. (2018) Glucotypes reveal new patterns of glucose dysregulation. PLoS Biol 16(7): e2005143. doi.org/10.1371/journal.pbio.2005143.


https://medicalxpress.com/news/2018...thy-people.html


"Right now we have information about people who do and don't spike, or are super-spikers, but we need to get smart about why it's happening," Snyder said. "I think understanding the microbiome and manipulating it is going to be a big part of this, and that's where our research is headed next."

What? Manipulating the microbiome? First, tell everyone to stop eating cornflakes.
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  #2   ^
Old Thu, Jul-26-18, 06:33
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cotonpal cotonpal is online now
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Quote:
In getting at the subtleties of spiking, Snyder conducted a sub-study in which 30 participants using the continuous glucose monitor alternated between three breakfasts: a bowl of cornflakes with milk, a peanut butter sandwich and a protein bar.


How about a breakfast of sugar free bacon and eggs?
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  #3   ^
Old Thu, Jul-26-18, 06:45
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Squarecube Squarecube is offline
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Wow! This is the kind of science Nobel prizes were created for. I wonder what they could discover if they started to study ulcers and bacterium?
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  #4   ^
Old Thu, Jul-26-18, 07:05
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teaser teaser is online now
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With glucose tolerance tests, if you don't take frequent enough measures, and the test isn't long enough, you can miss a lot. Continuous glucose monitors could certainly help with that. Being able to just send patients home and having them upload their data later on makes the whole thing a lot less cumbersome than a five-hour in office glucose tolerance test. Nothing earth shattering here, but maybe a way to get a clearer picture.
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  #5   ^
Old Thu, Jul-26-18, 07:09
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Ms Arielle Ms Arielle is online now
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Co-insidence.... watched this just an hour ago. RE ulcers ad bacterium.

Dr Berman on GERD and Leaky Gut.
https://www.youtube.com/watch?v=iq4mvgFIUb8
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  #6   ^
Old Thu, Jul-26-18, 07:32
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Squarecube Squarecube is offline
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Quote:
Originally Posted by teaser
SNIP.......Nothing earth shattering here, but maybe a way to get a clearer picture.


Yeah, sorry to sound so cynical, I think it was the mention of corn flakes which which triggered me. I hadn't even thought of them in years. In the early 1970s, I would stay at my friend's farm and we'd get up early so we could ride the giant corn DDT sprayer in the 5am mornings. Corn flakes were for breakfast, and there as a sugar bowl on the table. Dinner was five or six ears of the best corn you ever tasted...worm free of course.
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  #7   ^
Old Thu, Jul-26-18, 07:58
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GRB5111 GRB5111 is offline
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There is so much BS here, I'm not sure where to start:

Invoke the name "microbiome" and the transparent quest for research funding becomes clear. Yes, let's better understand and eventually manipulate the microbiome to solve this perplexing problem. That way, we can string the funding along and ignore the most important parts of solving the problem.

BG spiking needs to be studied? How about insulin spiking due to the food ingested?

Epigenetics has become the other big thing discussed, as scientists are finally agreeing that rapid gene mutation is not possible, but environmental factors influence health to a great degree. Ok, Sherlock, how about looking at lifestyle and referencing some of the current clinical practices that are having great success in reversing the symptoms of metabolic syndrome/ insulin resistance/ T2 diabetes.

Continuous glucose monitoring is informative and better than periodic BG testing? No kidding! But until we understand one's insulin response to diet, we're only managing one of the symptoms and not managing the root cause.

Forget the microbiome and look at how people ate before the food pyramid.

Last edited by GRB5111 : Thu, Jul-26-18 at 08:03.
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  #8   ^
Old Thu, Jul-26-18, 08:00
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Squarecube Squarecube is offline
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Quote:
Originally Posted by Ms Arielle
Co-insidence.... watched this just an hour ago. RE ulcers ad bacterium.

Dr Berman on GERD and Leaky Gut.
https://www.youtube.com/watch?v=iq4mvgFIUb8


Thanks for the video I just came off two weeks antibiotics, grrr..
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  #9   ^
Old Thu, Jul-26-18, 11:51
Zei Zei is offline
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Agree with the above comments. One thing of value I see coming from this is a lot of regular people who don't think they're at risk need to be alerted to the fact that it is happening to them. Known diabetics told to test a couple of hours after their meal to see if their glucose is back near normal? Well, how high was it at 40 minutes? An hour? Through the roof? That's when the harm is happening. And also to all those apparently normal people who haven't a clue that it's happening to them too. I found out on my own by testing at times intended to catch the sugar rise at its peak. Cheapo store-brand single reading meter does the trick. Just see how the different kinds of foods affect you. No guessing based on glycemic charts of other people's averages. Test yourself and know.
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  #10   ^
Old Thu, Jul-26-18, 12:05
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deirdra deirdra is offline
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"Normal" people typically have one 12-hr fasted BG test and if the result is normal, there are no more tests until their weight soars or they are exhibiting other signs of diabetes.

We need to see a comparison of cornflakes vs bacon & eggs. And you need to control for diet before you can study the biome or epigenetics, which vary based on diet.
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  #11   ^
Old Thu, Jul-26-18, 12:14
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OK so lets say it spikes but comes back down within about an hour, is that normal? OR Is BS never supposed to spike?
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  #12   ^
Old Thu, Jul-26-18, 13:50
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deirdra deirdra is offline
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Quote:
Originally Posted by Meme#1
OK so lets say it spikes but comes back down within about an hour, is that normal? OR Is BS never supposed to spike?
It is supposed to rise and fall, but a spike is an abnormally fast rise beyond the normal range, which spikes insulin release, followed by a quick drop in BG. All this spiking can cause insulin resistance and if BG falls quickly a person can get into the hypo range, where they can fall & hurt themselves or pass out or merely eat more sugar for "energy" and if they overdo it, the spiky roller coaster continues.
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  #13   ^
Old Thu, Jul-26-18, 14:34
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Ms Arielle Ms Arielle is online now
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I question how "Healthy" was defined for this study model.
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  #14   ^
Old Thu, Jul-26-18, 16:22
Zei Zei is offline
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If consuming a lot of carbs in a meal the blood sugar is going to rise, but my understanding is anything over about 140 (American measurement) is toxic. Possible damaging effect has been observed I think at maybe even as low as 120 in some studies. So if it goes up say beyond 140 and later comes back down, as far as I understand bad stuff happens during that high time even though it's later low again. And 12 hour fasting blood sugar is the very last thing to go wrong as diabetes develops, so by the time fasting sugar is elevated, the damage has been going on a long time. So my take on this is to try not to ever let my blood sugar take excursions that high even if it comes back down later on. Which for me with my present state of insulin resistance means very little carbohydrate consumption. Ideally I personally don't like to see it rise much, period. If it does, no more of that food in that amount. Incidentally I think I got the 140 and 120 ideas from Jenny Ruhl's Diabetes 101 website several years ago. Had lots of valuable eye-opening information there.
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  #15   ^
Old Fri, Jul-27-18, 07:02
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JEY100 JEY100 is offline
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We have read a lot of newly found information about Dr. Joseph Kraft and his 5 hour Insulin tests, but he was at the same time, also testing the glucose rise. He used a point system to assign importance to X Bg reading at X hour after the OGTT.

http://meridianvalleylab.com/wp-con...le-Re-type1.pdf
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