Post meal blood sugar spikes take years off your life. The pattern is reversed by inhibiting absorption or increasing excretion of glucose. We can leverage this information to take action now.
Basis For Action
You need not have a diabetes diagnosis. But we can look at interventions in this population for insights. Please keep in mind, damage from blood sugar (AKA glucose) excursions occur in people before any diagnosis of diabetes.
Eating sugar raises blood sugar. Eating refined grains raises blood sugar more. These blood sugar rises precipitate a release of insulin to coax glucose into the cells and out of the bloodstream.
Let’s look at the progression of our response to glucose toxicity. Below are various patterns of a standard dose of glucose. Normal first, ending with insulin resistance and diabetes.
Notice that most return to starting glucose numbers after 4 hours. Your doc typically tests after an overnight fast. You can spike glucose and your blood value won’t always show.
High blood sugar AND high insulin wreak havoc on our biology. Read more on insulin in this 20+page white paper and sugar destroying arteries here. More – and higher – blood sugar excursions produce compounding problems. Even though your blood glucose may return to normal, damage is being done. This damage is cumulative and builds with regular excursions.
Get this: MOST people with normal glucose tolerance have high insulin levels, independent of obesity2. Assume we all need to be on guard.
Let’s look at some impacts of diabetes drugs, to build the case for action.
Increasing Glucose Excretion
We have a newer diabetes drug class called SGLT2 inhibitors. They are gaining favor from evidence of life extension – up to 4.5 years in one study3. This although they raise “bad” cholesterol4 – read more about cholesterol (it may not be so “bad”) in this 100 page white paper.
SGLT2 inhibitors cause more glucose elimination via urination, so blood levels are lower.
But, like most drugs, there is a cost.
Adverse effects such as diabetic ketoacidosis, genital and urinary tract infection, cancer, bone fracture and foot and leg amputation5.
It’s not surprising that peeing a bunch of sugar out would lead to some infections in the equipment performing the task. Plus, it has already provoked insulin. So let’s look to preventing high blood sugar so we don’t have to reach for this tactic.
Blocking Absorption
Acarbose is an older diabetes drug that inhibits glucose entry into the bloodstream. It too can increase lifespan6, reduce body weight, and improve age related glucose dysregulation7. All this, by reducing the postal spike described in the title.
Side effects here are GI related, mainly a little gas passing.
So, if we can prevent the glucose/insulin spike, we don’t have to take drugs to pee it out, all for a chance of gas. Nice, this path seems helpful, now for a deeper dive.
Target Mechanisms
Acarbose
Acarbose works mainly on an enzyme in the intestinal lining called alpha-glucosidase (α-glucosidase). It is the final step in digesting carbohydrates.
By inhibiting α-glucosidase, we slow that post meal spike in blood sugar, in normal and diabetic people9.
Glucose Spike
A big glucose surge causes many problems, here are a few.
Blood Vessel Degradation
I wrote an article on this, please click here for more details, but here is a summary:
-High glucose decreased blood vessel lining significantly (called glycocalyx)
-This caused oxidative stress to the vasculature (essentially reactive oxygen exhaust from processing the glucose fuel)
-Increased clotting
-Impaired endothelial function (how well the vascular functions)
Inflammation
Reaching for ibuprofen regularly? Inflammation is contributory to most chronic disease processes.
Copious amounts of information exists in the literature tying high blood sugar to inflammation. Relevant to this post, post-meal blood sugar surge accelerates vascular inflammation10 and general inflammatory signaling mechanism11.
Vitamin C Depletion
I also wrote an article on this, please click here.
-glucose competes with Vitamin C
-as cellular Vitamin C availability decreases, so does immune function
-as cellular Vitamin C availability decreases, so does collagen formation
Cancer
Most cancers thrive by using high amounts of glucose, known as the Warburg. We see this trait used on a PET scan for cancer diagnosis and monitoring. The spots that light up are those consuming higher glucose than normal cells.
Having prolonged high blood sugar can help fuel pre-cancerous cells as well.
As normal cells lose functional capacity, they become zombies. The technical term is senescent. Senescent cells don’t function normally, but still consume resources. If they don’t get terminated, a potential conversion to cancer looms. High blood sugar fuels senescent cells12. On the flip side, fasting is a great way to knock out senescent cells. Or course, fasting helps reduce blood sugar.
Aging
Sugar binds to proteins in a reaction called glycation. We monitor diabetic risk via a metric called Glycosylated Hemoglobin (HbA1c). It is the percentage of glycated, or damaged, cells detected – higher worse. Glycation is also the process that browns meat during cooking. Resultant from this reaction is its leftovers called Advanced Glycosylated Endproducts (AGEs). We link AGEs to changes we see and associate with aging13.
Higher blood sugar, more glycation, more AGEs, more browning, more aging.
Mood
Depression, anxiety, and our reward system use neurotransmitters to send signals. Serotonin, norepinephrine, and dopamine are three, and we target these using prescription antidepressants (Prozac, etc). Problem is, these have side effects for many – weight gain and decreased libido, for example.
I recently read about a glucose-mediated interaction with these neurotransmitters in Brain Drain: How Highly Processed Food Depletes Your Brain of Neurotransmitters, the Key Chemicals It Needs to Properly Function by William Wilson:
“glucose spikes inside of the neurons cause an abnormal release of neurotransmitters from the cells into the synaptic space. The reuptake system that evolved to recycle these chemicals is incapable of handling this excessive load, so too many of these neurotransmitters wash out into the blood stream where they are picked up by the kidneys and excreted in the urine. It became clear to me that neurons dump excessive amounts of neurotransmitters in response to glucose spikes.”
Translation, glucose causes dysregulation of the chemicals governing how we feel and relate to others.
Consequential stuff.
The Landscape – Why We Need Guardians
Carbs are not bad. Massive, unnatural post meal glucose spikes from highly provocative, processed foods are terrible.
Whole foods, such as vegetables, fruits, and starches have natural fibers that hold back some glucose surge. Flours and sugar, however, enter with ease. The result is a blood sugar tidal wave.
The Food Around Us
We
If you are eating out of a package, or in a restaurant, odds are a blood sugar spike is just ahead.
Here are just a few examples:
-pasta
-bread
-desert
-cereal (Just. Don’t. Eat. Cereal.)
-oatmeal
-bananas
-juice
-chips
-tortillas
These all spike your blood sugar.
But I Don’t Have Diabetes?
Yet…
If you are on the blood sugar roller coaster, damage is being done. They estimate huge numbers of people are pre-diabetic and undiagnosed diabetes. But those classifications are
Don’t wait for a diagnosis to guard against damage.
Glucose Guardians
Since these foods are all around us, and many are tasty, here is the strategy I employ.
In general, I try to avoid blood sugar provoking foods. Especially if I haven’t worked out that day.
On days where these foods make it on the menu, I limit portions.
I also like to add a few guardians…
My glucose guardian stack is:
Alpha Glucosidase/Amylase Inhibitors
Slowing the absorption of starch by exploiting the mechanism above.
Grape Seed Extract (GSE)
GSE inhibits both α-amylase and α-glucosidase activity, better than acarbose – which is an approved diabetes pharmaceutical14.
Green Tea Extract
Green tea is a health food, via multiple mechanisms. One potentially is it is a potent inhibitor of α-glucosidase15. It also had anti-inflammatory and anti-cancer properties. But here, it helps slow glucose absorption.
N-acetylcysteine (NAC)
NAC is a sulfur-containing amino acid. It is a precursor to glutathione, the major antioxidant. Further, NAC supports liver detox (is even the main antidote for Tylenol (acetaminophen) overdose) and supportive in depression. On topic, the study cited in my previous post on blood vessel degradation from sugar, showed NAC prevented much of the damage. Including protection of the lining (glycocalyx), endothelial function, and clotting. Much of the stress from large sugar spikes results in high oxidative stress levels. NAC provides protection16.
Vitamin C
I mentioned in a previous post that glucose competes with Vitamin C. Therefore, if we are risking a glucose surge, it is reasonable to provide a surge of Vitamin C.
Bitter Melon
Bitter melon improves the response efficiency, in diabetics and non-diabetics, to post glucose surges17. In the event we consume, and absorb, enough carbohydrates accumulate to cause a surge, this supplement can aid our response.
Vanadyl Sulfate + Chromium
Again, assuming we still experience a surge despite alpha glucosidase inhibition, we can deploy a little insulin response support. Vanadyl sulfate and chromium both show usefulness in post meal surge support 181920. Personally, after a hair mineral analysis, found I was a little low in chromium – the only mineral in me to be out of range.
N-Acetyl Glucosamine (NAG)
Most know glucosamine as helpful for joints and arthritis – and it is. However, two distinct additional roles put it in my glucose guardian stack.
First, carb sources including grains (rice, wheat, corn), nightshades (tomatoes, potatoes, peppers, etc), and legumes contain lectins. Lectins are sugar binding proteins. This process can trigger inflammation and other complications, as I have written about previously. NAG binds to lectins so they don’t interact elsewhere in the body21. NAG is effective at preventing lectin induced headaches in my daughter – read her story here. And, by effective, I mean around 100% of the time. Lectin bomb (spaghetti and brown rice noodles) with NAG, no problem, without, headache an hour later. She is now a very compliant NAG consumer.
Second, NAG lowers blood glucose, increases the number of mitochondria (energy producing organelles – a good thing), and reduces mortality22.
Take Home
Spiking blood sugar is harmful – diabetic or not. The more you ride the glucose/insulin roller coaster, the more you damage your body, change your mood, and speed up aging.
With that uplifting thought, we must use a glucose guardian strategy.
First, the free interventions.
-Portion control. Pay close attention to serving sizes of glucose-provoking foods, especially in relation to how active you have been.
-Post meal activity. I know I can improve on this for sure, but simply going from table to couch is not ideal. Engaging in light physical activity, such as walking, improves the post meal glucose rise23.
If pizza or pasta ends up on your plate, you likely will want to supplement with at least some of the guardians above. Throw in beer and a desert? Definitely need some guardianship.
The whole stack provides solid support. If you want to start slow, at least one alpha glucosidase (green tea or grape seed), NAC, and NAG provide broad coverage.
- https://www.townsendletter.com/Jan2015/early0115.html ↩
- https://www.sciencedirect.com/science/article/abs/pii/S0168822716301577 ↩
- https://diabetes.medicinematters.com/empagliflozin/sglt2-inhibitors/up-to-4-5-years–life-gained-with-sgtl2-inhibition-in-empa-reg/16202898 ↩
- https://www.ncbi.nlm.nih.gov/pubmed/30354257 ↩
- https://www.ncbi.nlm.nih.gov/pubmed/29485006 ↩
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3954939/ ↩
- https://diabetes.medicinematters.com/empagliflozin/sglt2-inhibitors/up-to-4-5-years–life-gained-with-sgtl2-inhibition-in-empa-reg/16202898 ↩
- https://www.nature.com/articles/s41387-019-0092-y ↩
- _ Goodman, L. S., Gilman, A., Hardman, J. G., Gilman, A. G., & Limbird, L. E. (1996). Goodman & Gilman’s the pharmacological basis of therapeutics (9th ed.). New York: McGraw-Hill, Health Professions Division ↩
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688503/ ↩
- https://www.ahajournals.org/doi/full/10.1161/01.cir.0000034509.14906.ae ↩
- https://www.researchgate.net/publication/262879813_Hyperglycemia_causes_cellular_senescence_via_a_SGLT2-_and_p21-dependent_pathway_in_proximal_tubules_in_the_early_stage_of_diabetic_nephropathy ↩
- https://www.ncbi.nlm.nih.gov/pubmed/30184484 ↩
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356113/ ↩
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356113/ ↩
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301041/ ↩
- https://www.hindawi.com/journals/ije/2018/5257216/ ↩
- https://www.ncbi.nlm.nih.gov/pubmed/8366258 ↩
- https://www.uspharmacist.com/article/a-critical-review-of-chromium-picolinate-and-biotin ↩
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115436/ ↩
- https://doi.org/10.1016/j.cell.2018.07.044 ↩
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6267507/New Markdown file ↩
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