Blood Sugar Spikes - what is the big deal?
"But I don't have diabetes. Why should I care about blood sugar?"
As we discussed in the previous post, not having a formal diabetes diagnosis does not mean that everything is ok. Blood sugar dysregulation can start a long time before it is picked up by conventional blood tests and so does the damage.
Many many people live in a state of metabolic ill health and do nothing about it, until things go really wrong.
My job as a nutrition counsellor is to give you "a kick in the back side" to be proactive and to never arrive at a diagnosis.
Consider this post such a "kick in the back side" - it will give you knowledge which you can use as motivating force 💪
Here is what happens in your body when your blood sugar stays too high, too often:
1. You "break" from the inside (a.k.a Oxidative Stress)
For a glucose molecule to turn into energy, it is a fairly long multi step process.
Imagine a conveyor belt where the raw material (glucose) enters at the start and along the way many things happen to it. Eventually at the other end you get ATP - the energy currency of the cell.
The "conveyor belt" (the cell's mitochondria) - can only deal with so many glucose molecules coming in at once. If you try to put more, things fly off the belt.
Those "things" (lose electrons which react with oxygen and hydrogen to form Reactive Oxygen Species) cause damage. They steal electrons from the proteins, DNA and lipids that make up You. Flooding the cells with more glucose than they can safely handle, quite literally breaks your building materials from the inside. This happens mainly in the cells where glucose can enter without the need for insulin, found in the retina, the kidneys and the nervous system.
2. Your cells close the door to glucose (a.k.a Insulin Resistance)
Muscle cells and fat tissue cells, which make up the majority of You, require insulin in order for glucose to enter.
If they are already "full", when they see more glucose wanting to come in they will "close their doors" to insulin. This will result in glucose remaining longer in the blood, signaling to the pancreas to make even more insulin to force the glucose in. This is a state of insulin resistance, a precursor to diabetes and the route cause of many chronic metabolic diseases.
As the cells begin to struggle with turning glucose into energy, insulin resistance can manifest itself with symptoms like fatigue, constant hunger and cravings, brain fog, difficulty losing weight and weight gain around the belly.
The occasional glucose spike is not going to cause this, but the more frequent and the higher the spikes the faster this will happen.
3. You get "cooked" (a.k.a Glycation)
When glucose floats around, it sticks to things. When glucose sticks to proteins, DNA and lipids it changes them irreversibly. Molecules called Advanced Glycation End products (AGEs) accumulate on them. This is called "glycation" - it is the same chemical process that happens to your steak when you BBQ it at a high temperature and it browns. While this makes the steak tasty, the resulting AGEs in the browned part are not good news for your body.
AGEs, whether you make them internally from eating too much sugar, or get them from the food you eat, cause damage.
They can cross-link proteins, leading to structural and functional changes. For example, when collagen and elastin proteins in blood vessels become stiff and lose elasticity, you get heart disease. When this happens in the skin, you get wrinkles.
AGEs also bind to specific receptors on cells, known as RAGEs (Receptors for Advanced Glycation End Products), which sends the message to the immune system to "send in the troops" a.k.a inflammation results. This inflammation damages cells and also causes … insulin resistance.
Again, one doughnut is not going to kill you, but the more often and the higher your blood sugar spikes, the more "cooked" you get. This process is irreversible. It is a sure way to speed up aging. Rather than spending money on Botox, it is more effective to just ditch the doughnut.
4. Your blood vessels become more "leaky" and plaque develops
Like your intestines which are coated with a mucus layer that protects them, your blood vessels have their own equivalent. This unsung hero is called the "glycocalyx". It is a gel-like lining, made up of molecules that contain glucose and its job is to protect the lining of your vessels, the endothelium. The glycocalyx is kind of a shield, a barrier that makes the endothelium less permeable.
High blood sugar damages the glycocalyx.
This leaves the vessels more exposed and more prone to things getting through the endothelial lining. These things, such as molecules which carry cholesterol, called LDLs can get through the lining more easily. If those molecules are "oxidised" (as happens during glucose spikes) the immune system sends "the troops" (macrophages) to clean them up. These macrophages "eat" the oxidised LDLs but then stay there in the endothelium gradually building up as plaque which can block the vessel.
All in all, you have a good reason to look after your glycocalyx by not spiking that blood sugar too often, too much.
While none of the above is ideal, the good news is that
- it all is within your control
Your food choices will largely determine how much and how often your blood sugar will spike.
The idea is not to avoid all sugar spikes. The idea is to reduce the "area under the curve". The way to do that is by eating foods that your body can deal with well.
The general rule is to eat real, whole foods and avoid things that have been processed and highly processed.
The devil, however, is in the details. The best diet for you is personal to you, depends on your genetics and your metabolism and most of all must be "do-able" and compatible with your lifestyle.