individuals experience more ups and downs of blood sugar levels upon eating
- The study used a continuous glucose-monitoring device to
assess the sugar levels in the individuals
authors suggest that people use the continuous monitoring system as opposed to
the regular one-time test to prevent the onset of diabetes
continuous glucose-monitoring device connected to the body, researchers from
the Stanford University School of Medicine have found out that the sugar in an individual's blood (especially in
individuals who are considered healthy) fluctuates more often than thought
and that not all of these "spikes" might be picked up by traditional glucose
monitoring methods like the one-and-done finger-prick method.
The device keeps extra-close tabs on the ups and downs of
blood glucose levels thereby giving people a whole continuous picture rather
than a partial picture of the sugar circulating in their blood.
‘Continuous glucose-monitoring can help identify individuals who are prediabetic, better than the traditional method, and can help keep them from developing insulin resistance, which leads to diabetes.’
help of the device, the researchers have been able to find out that the blood sugar
level undergoes "spikes" or a rapid increase, after eating
specific foods, mainly carbohydrates
, especially in healthy individuals.
are lots of folks running around with their glucose levels spiking, and they
don't even know it," said Michael Snyder, PhD, 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
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 study is
published online on July 24 in PLOS Biology.
periodically get their blood sugar levels checked with a quick lance to the
finger and a device that reads out the blood glucose concentration. This method
of reading sugar levels captures the levels only momentarily. The amount of
sugar in a person's blood is not a constant; it ebbs and flows depending on the
food intake that day, down to the specific kind of carbohydrate. (For instance,
people digest rice, bread, and potatoes which are all different kinds of
Study - To get a
better read on glucose levels
his collaborators chose 57 participants, most of them who were healthy or
showing signs of prediabetes and five of them who had Type 2 diabetes
were all fitted with a device that continuously recorded blood glucose levels
for about two weeks. The device superficially poked into the surface layer of
the skin to take constant readings of sugar concentrations in the blood as it
circulated. Data was sent back to the lab; the results showed multiple types of
spikers, which were classified into the three basic rankings of spike
intensity, namely low, moderate and severe "glucotypes."
glucotypes are subject to change based on diet. The researchers ultimately had
two work goals: One was to catch the spike early and the second was to
understand what makes a person spike, and then adjust their diet to bring the
glucotype into the "low" range.
readouts are revealing the fact that glucose levels are not normal all the time
in the blood; in other words, glucose
dysregulation is more common than previously thought
is especially useful for people who are prediabetic since about 90 percent of
the time, these people do not know that they are prediabetic, and what's more
alarming is that about 70 percent of the prediabetic
people will eventually develop the
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," Snyder said.
Sub-study - Blame it
on the cornflakes
To get into
the subtleties of spiking, the researchers conducted a sub-study where they
chose 30 participants from the primary study and continuously monitored their
glucose while they alternated between three kinds of breakfasts: a bowl of
cornflakes with milk, a peanut butter sandwich and a protein bar.
- After having one or more of the meals, more than half of the group
whose blood sugar levels were in the "healthy" bracket in the main study,
showed glucose "spike" at the same levels as those of people who were
prediabetic or diabetic.
- 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."
other individual variables like genetics
population of microbes that live in our bodies (microbiome
changes in gene expression (epigenetics
), have a
role in glucose dysregulation and the foods that cause glucose spikes.
encourages everyone, including the healthy people to check their blood sugar
with continuous glucose-monitoring
about once a year.
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."
involve using the framework to compile data from an individual and, based on
their continuous glucose readout, make them stay away from particularly
- Heather Hall, Dalia Perelman, Alessandra Breschi, Patricia Limcaoco, Ryan Kellogg, Tracey McLaughlin, Michael Snyder., "Glucotypes reveal new patterns of glucose dysregulation" (2018) Journla PBIO https://doi.org/10.1371/journal.pbio.2005143