Every time when I asked my patients and friends to be vigilant on carbohydrate consumption, most of them would proclaim that they were not diabetic, because they had a normal reading of fast blood sugar (or glucose) test or glucose tolerance test, or both. They thought that they were healthy. But they might not!
Diagnosis with diabetes mellitus (DM) is made only when either the patient’s fasting blood glucose (FBG) is 126 mg% and over or his two-hour glucose tolerance test (GTT), after drinking up to 75 grams of glucose in water, was 140 mg% and over. He would be told that he was pre-diabetic when his fasting blood glucose was in the range between 100 mg% and 125 mg%. Very few physicians and academicians are concerned about the magnitude of blood glucose after each meal inside the window of two hours, so long as both the FBG and GTT are within normal limits. However, with my intensive literature review and careful personal experimentations, I have concluded that the magnitude of blood glucose after each meal is the most important key to our health. Part of my conclusion that is cited in my book, Carbohydrates Can Kill, is independently underscored by a recent study, by Koichi Node and Teruo Inoue, “Postprandial hyperglycemia as an etiological factor in vascular failure.” Cardiovascular Diabetology 2009, 8:23doi:10.1186/1475-2840-8-23 http://www.cardiab.com/content/8/1/23
In my literature review, I have learned the following: An increase of inflammatory factors, including C-reactive proteins (CRP), closely follows the rise of blood glucose level that is usually from carbohydrate foods, and also from intravenous glucose solution when the individual receives medical attention. An increase of blood glucose and/or inflammatory factors can trigger premature cellular death and cellular mutations. Consequently, organs including the pancreas are inflamed and damaged or become cancerous. Because an increase of blood glucose causes inflammation, the inflamed intima attracts deposition of cholesterol from VLDLs and some lower density lipoproteins. I suspect such deposition might be a natural defense mechanism for covering the inflamed intima with cholesterol. An increase of blood glucose suppresses the production of nitric oxide, Nitric oxide is an important factor produced by the inner layer of the artery for dilating the artery. Thus, hyperglycemia constricts the vessel and increases the blood pressure. Besides, high blood glucose can facilitate glycation, which is a combination between sugars and either fats or proteins or both, with or without an enzyme. Gycation is a potential cause for cancers and neurological diseases such as Alzheimer’s disease, ALS, and others. In my other articles, I have also mentioned the links between the complications during pregnancy and the maternal high blood glucose level. (Read my book, Carbohydrates Can Kill.)
The damages by repeated episodes of high blood glucose could be accumulated. Therefore, diseases could be either acutely or slowly developed, depending the magnitude of the rising blood glucose after each meal. With the understanding of the grave impacts on the health by the blood glucose level, no one should allow himself naively thinking he is “healthy” because of normal FBG and GTT. Keep in mind that by the time when diabetes mellitus is diagnosed, the patient has lost about 50% of his (pancreatic) beta cells. FBG and GTT do not predict the ill impacts of repeated episodes of high blood glucose after meal until the disease or diseases are in the advanced stage.
With all the information, everyone should have at least an annual series of glucose tests from the time before meal and the next two hours after starting to eat the meal. (View my video, “A Series of Blood Glucose Tests On Foods”, at www.carbohydratescankill.com .) The test results will help the individual understand the relationship between the amount and types of consumed carbohydrates and the level of rising blood glucose; and help discover abnormal blood glucose readings sooner for preventing and managing diabetes mellitus and other diseases.
Robert Su, Pharm.B., M.D.
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