You answered my questions I had after watching your video and I have clearer understanding now of the steps I can take to better effect my diabetic responses to what and how I eat. Thank you!
It's not that you didn't explain well enough in your last video, but some concepts were so novel and mind-blowing that we'll need a second take on it! ☝🏻New fan here! You are doing great!
This literally is the best information on the internet regarding the physiology of processing carbohydrates and how they effect your blood sugar . Just excellent . Thank you
Professor (Dr) Mario, You are a true medical educator, especially enlightening the diabetics. You are sharing objective and scientific information.❤🎉❤🎉
Love this channel. It is so madenning when one finds a ton of conflicting information and can never know what is reliable and what not.... Finally i can feel safe that the information shared is not overblown or cherry-picked or misleading in other ways.... Thank you!
This may be one of my favorite comments of all time, because this is exactly what I am trying to create here. It's an ambitious goal, as we all have our biases, but I guess it's worth a try, and wonderful if people appreciate the effort. Thank you! Cheers Mario
This channel is by far the most informative source of the science of glucose in the body I have ever come across. I´ve been wearing a CGM every now and then for a year (with the Veri app) and it´s so helpful to learn that "spikes" up to 140 mg/dl are nothing to worry about at all. I do though wonder that the landscape of my post meal "spikes" often are "Twin Peaks" where the second peak is lower but substantial. I would love to here Dr. Marios take on that 🙂
Thank you, Gunnar, for the kind words. Regarding your twin towers, here's a nice article about that from the Veri website: www.veri.co/learn/biphasic-curve-metabolic-health Cheers Mario
It's very useful to wear for a month or so to learn how you are responding to different foods. Much longer is probably not necessary for people without diabetes.
@@nourishedbyscience I have read the article you linked, but they are for people with diabetes and prediabetes. Would a lean and metabolic healthy individual have biphasic spike ? If i remembered correctly didn't see them in those profile from Kraft test's pattern ? I think there was a clinical study on healthy Japanese Women and there wasnt any biphasic spike if I remembered corrrectly ?
@@zhuhaibaker7816 What do you mean with "they are for people with diabetes and prediabetes?" The article says very clearly that a biphasic pattern is a sign of good glucose tolerance, and a monophasic pattern a sign of a lacking first-phase insulin response. Overall, I wouldn't worry too much about it. In real life, when we eat very differently from a clean OGTT, the pattern isn't to obvious anyways when using a CGM. I would mostly pay attention to the amplitude, not the shape of the curve. Cheers Mario
This is exactly what I was looking for. I was diagnosed prediabetic at 5.8 but got it down to 5.5 in six months. My doc gave me a CGM to try and I noticed that, despite my fasting numbers being acceptable (90-100), i keeeeep spiking to 150-180 regularly. I've seen it go into the 200s a few times during extenuating circumstances, but my endocrinologist is not concerned because my a1c is fine. But man these spikes make you feel like shit! I've been looking for answers because I keep seeing conflicting evidence. Thank you so much.
Please have your doctor do a fasting insulin or C-peptide test. Chances are your pancreas is working overtime to keep your blood sugar level at a normal level but at the same time giving you hyperinsulinemia which is just as dangerous as high blood sugar. These tests can let you know if you're at risk for diabetes 5 to 10 years ahead of time. I wish I had this done before I became diabetic 4 years ago. Fortunately I have reversed my symptoms by restricting the carbs. Good luck to you,
17:09 - blood sugar spike is caused by slow pancreas reaction in producing insulin, or as it is explained in this video an absence of stored insulin. Some sources say it is a result of fructose overconsumption, and then it becomes vicious circle, because glucose spikes trigger conversion glucose to fructose which causes less and less ability to handle carbs. There is a way to go somewhat around this issue, it's described in The CR Way book - using a tease meal - an hour before eating breakfast you eat a very small amount of carbs (page 38), it will stop fasting and turn on your pancreas, and an hour later it will be ready to handle your breakfast with much smaller spike of blood sugar.
I really like your suggestion to combine hi-carb foods with fats and proteins so as to lower the spike. It allows me to eat staple foods like bread; now, I just have to refine the combinations and do the groceries with that in mind. Very practical.
How I do appreciate your work and your videos. You are clearing up so many questions for me. I am pre diabetic, and 15# overweight. I consistently eat 1600 - 1700 calories per day. I seem stuck at my current weight, and am afraid to drop calorie intake further because I am very active. At one time in my life I almost ruined by health with a too restrictive diet for too long. My metabolism dropped with every calorie decrease, and I was not getting adequate nutrition. I try now not to obsess about food and to have a good relationship with my food. It appears that if I keep carbs under 125 per day, this has the best effect on blood sugar. With the information you have provided, my numbers are so much better and I am hoping my weight will begin to slowly drop too. Thank you for your work. You truly seem like a dedicated, kind and humble person. Refreshing to see!
Oh … my … goodness. I watched your previous video again and then watched this one three times. I could never understand why the same meal caused widely fluctuating blood sugar readings at different times. Now I understand. It’s like someone finally raised the blind and let the light in. Oh how I wish someone had explained all of this to me a long, long time ago. I can’t wait for your next video!
Thanks so much for this kind feedback. I still feel like there must be a more elegant way to explain the second meal effect ...! I almost re-recorded that section of the new video ... Cheers Mario
@@nourishedbyscienceIt was very easy to understand! Everything is really making sense. Had I known what was happening, I could have started adjusting a long time ago. Sadly, it was never explained to me before you explained it. You can’t imagine how much you’ve helped me. Thanks so much!!
In my mind, I see it as priming the lawnmower carburetor. After it's primed and I turn the key to start the engine the fuel has a much easier time making it up to the carburetor to be combusted. @@nourishedbyscience
An excellent education on this topic. Thank you, doctor. I don't have diabetes or prediabetes, but up to 80% of us still get blood sugar spikes. I do. But they are waning in frequency and strength and becoming more stable. But I still act to prevent diabetes. Shotgun pellets may hit what a bullet misses. What I mean is that a combination of methods is surely better that only one. So, I have learned to take a teaspoon or two of vinegar in a cup of water within 30 minutes before eating. Rinse your mouth afterward to protect tooth enamel. Then eat veggies first, protein second and minimal carbohydrates last. Drinking a glass of water is also said to lower blood sugar. I wait for 1 hour after a meal before having coffee, as it can otherwise deplete iron, which only induces fatigue and compounds the fatigue caused by a blood sugar spike. I add a half teaspoon of cinnamon to the coffee as well instead of sugar. It is known to lower blood sugar. Some 30 minutes after a meal I do 40 squats, 40 push-ups and 40 pull-ups on a 45-degree machine I have. Or I sometimes just run on the spot (stationary running) for a few minutes instead. I have read that blood sugar is beneficially taken from the blood for the muscles when we exercise. I have also noted some simple acupressure moves that are featured for diabetics here on RU-vid by a Japanese lady. RU-vid search 'acupressure diabetes' to find it. Magnesium is also reported to be helpful in quelling blood sugar spikes. But since magnesium has multiple health benefits, I also take it. I am also looking at berberine. Cooking, refrigerator cooling, and then reheating rice and potatoes also lowers their glycemic index. Or, the cooled potatoes can be eaten with salad instead of reheating. Bread can also be put in the refrigerator and then toasted. Both cooling and toasting bread lowers its glycemic index. Feeling great. Get proactive and prevent diabetes. Or lower your condition into reverse in only a few months. Win yourself that prize!
Thanks so very much for sharing! I just found out that I’m pre-diabetic and a bit scared. I thought that I was doing fine eating a Mediterranean diet and also living Italy, over 20 years, loving my plate of pasta for lunch. Then, bam! Now, I’m seeking strategies to stay healthy. So, thanks again.
Provided value? If i had a doctor even remotely knowledgeable and attentive to detail like you when i was starving my body and messing up my metabolism i wouldn't be in the condition I'm in now 😢😢. I can't thank you enough and it could be my thyroid that i have tears in my eyes right now but I'm truly thankful. Thanks to your information it's the second day that I'm maintaining a one-kilo loss and i feel so good. I had not had lost a kilo and kept it off for two years 😢😢
Thank you, Mario! It's very informative and helpful and the fact that your videos are based on scientific evidence is worth watching. I agree with you completely on the influencers in social media. Some tend to fearmonger, and some tend to dramatise for the sake of getting views sometimes as far as stating as if everyone is diabetic and everyone should not be eating cereals and white bread. Looking forward to more videos!
Praise God - thank you for all you share! So refreshing, practical, and helpful. And life-giving!! Instead of restrictive and leading to eating disorders!
Great video again. I really appreciate how you deliver your information in very clear, and respectful manners. I learn a lot from a single video of your channel than multiple videos from others. Thank you!
You can reverse diabetes, fasting no Carbohydrates whole plant based diet buy book diabetes code Ssecond book obesity code by dr Jason Fung, my Indian builder reversed his diabetes but very strict to say in remission education diabetes is ametabolic disease intolerance of carbohydrates. I am asurgeon passionate about health longevity all healthy life styles sleep stress exercise water clean breathing social connection meditation all
Thanks a lot man. My graph is like the 2nd graph at timestamp 3.29. I was searching for an explanation and answer everywhere on the internet. Your video helped answer. Really appreciate
Thank you Mario, I totally understand. BTW I am a physician. I know you are right as far as losing weight being most important in this conundrum… Looking forward to more videos!
Great work Doc'! I just found your channel and I really appreciate the way you describe the subject matter with obvious consideration/awareness of the practical application of the average person's dietary needs/habits.
Best, most straightforward explanations and advice about blood sugar that I've heard, out of at least a hundred videos on the topic! 👏👏 I'll be sharing with friends who would want to know about this.
Honestly the most informative video I've watched on this topic and nutrition in general. Seems to be a very engaging video, judging by the amount of comments! I'm really looking forward to the videos about exercise, stress and sleep on blood sugar regulation.
Hi, Mario! I'd like to thank you very much for taking the time to make these videos, as well as answer people's questions. I've just recently discovered your channel, and it's been so helpful to learn about blood sugar and what I can do to regulate it. I have a family history of diabetes, and am pre-diabetic and obese myself, so I've been working to reduce my weight to healthy levels as well as manage my blood sugar levels. I'm very grateful!
I’m so happy to hear about a more realistic and scientifically-backed value of what constitutes a glucose spike. I’m using a subscription app and CGM here in the US that defines a spike as >30 mg/dl rise and glucose level at 110 mg/dl or higher. That has proven pretty difficult for me as a mild prediabetic with a 5.8 A1C.
Yes, I honestly don't know where the 30 mg/dL increase = spike idea ever came from. I do think that blood sugar spikes can be a problem, even among healthy people without diabetes or pre-diabetes, but what the rationale is for calling an increase from 90 to 120 mg/dL a spike is totally unclear to me. I am glad you found the content helpful. Best, Mario
Considering Levels link to research on their site where they argue for the 30mg/dl it would be interesting to see a video where you comment on their rational and sources. Search levels and: What should your glucose levels be? What is blood sugar spike and why does it matter.
Here is some number that could help others Every two months I carry out full blood test, four months ago my HbA1c was 8 and few days ago was 7.4 thanks to the CGM My C-Peptide was 661 and few days was 626 Triglyceride was 0.93 and few days ago was 0.94 All liver and kidney functions are normal including my TSH, T3 and T4 are all within range My LDL was 4.3 and few days ago 5.3 My HDL was 5.92 and few days ago 5.33 AST (GOT) was 17 and few days ago 20 ALAT (GPT) was 17 and few days ago 20 Bilirubin total well within normal range Bilirubin indirect well within normal range Homocysteine was 9.9 and few days ago was 8.35
Thank you so much. It's all starting to make sense. I watch and re watch your 'videos'. I am currently on a low carb diet which I eat in a 6-10 hour window. When my BMI and waist circumference are acceptable then I think the hard work will begin.
Thank you for such valuable content, Mario! Informative yet easy to follow. As for other questions I would be interested in hearing the answer to, I have one: how does sleeping and napping relate to blood sugar? In particular, how does a 20-30 min nap after lunch affect the spikes? (in another video you did say that walking after a meal helps lowering blood sugar, which already suggests the answer to my question, but I would still be interested in hearing an actual explanation from you). Cheers from Italy!
Big fan of naps myself ;-) However, in terms of the immediate impact on blood sugar levels, taking a nap is just as bad as sitting down at a desk or on the couch right after a meal. So, I'd say, as far as blood sugar is concerned, exercise/walk > inactivity, incl. naps ...:-( There is an exception though: if someone chronically gets too little sleep at night, that has major negative effects on blood glucose control, and taking a nap will partly mitigate that negative effect: pubmed.ncbi.nlm.nih.gov/29530368/ Cheers Mario P.S.: Thanks for your kind feedback!
I'm still watching, I'm less than 3 minutes in, but I had to stop to say that you are the first person that I have ever seen address this specific data directly. There is a lot of talk around it. There is mention of what the concerning levels are, but rarely, and generally on vaguely is there any other data for contrast. Thank YOU! 🙂
Have been wearing a CGM for a few weeks now and have been trying to learn more about diabetes, carbs, etc, but this video was the most informative of any that I’ve seen. Appreciate the excellent information.
I would greatly appreciate your insights on other types of diabetes besides type two. While I acknowledge that about 90% of people have type two diabetes, there are still many individuals with type one and other forms of diabetes who could greatly benefit from your expertise. Thank you for your efforts in creating these informative videos; I have learned more from you than nearly anyone in the medical field, including other RU-vid videos that I have watched. Once again, thank you for your time and dedication.😄😄😄😄😄
Diabetic on Metformin 500mg twice b4 meals, average FB average100; PPBS 140. Body fitness training 9hrs/wk under supervision. I appreciate all your suggestions. Looking forward to more information from you as I'm over 70yrs a doctor by profession.
Great video, I learned many new things. I ordered my own glucose tolerance test with insulin for under $200. Because glucose control is so important, I don’t think you should downplay getting this test based on cost alone if someone feels they are having issues with glucose. What I found was that my initial insulin production was low followed by a spike. My glucose went from 96 @fasting ; 171 @ 1hr; 125 @ 2hrs. 57@ 3hrs. So I may have reactive hypoglycemia. This is new info for me, I haven’t anyone discus this previously. Again thank so much for this video. I’m looking forward to next weeks video and what is the best diet to follow?
Thank you, William. Appreciate the kind feedback. These are interesting data you share. That reactive hypoglycemia came in quite late. Usually, we are seeing it sooner than at 3 hours. Cheers Mario
Thank you for your advice about a low carb diet. I don't believe in a low carb diet. I am so grateful for all your advice. I have been following your recommendations about reading labels and limiting processed foods. I do understand the second meal you described. I am doing well following what you say. Since changing my eating habits I am finding I don't crave sugars as much. My cravings and appetite have seemed to decrease. My b/p is stable. My energy level is up. I believe that by continuing on this path I will be able to get some of the inflammation down that can be aggravating my arthritis. Had to have surgery on my right hand last week due to arthritis. Thank you for doing such a great job explaining everything.
Interesting and most importantly practical advise and recommendations. I personally could manage my 26 years diabetes much better after I went low carb. A1C 9 to 5.7 and dropped 50 lbs and cut many meds and insulin. Of course it could be only me getting good response but it has been 18 months my bg has been in between 90 and 160 all time. According my CGM.
Forgot to mention in my previous comment that you explained the symptoms of reactive hypoglycemia perfectly! That’s exactly what happens to me. It generally takes all day to fully recover from. Not a pleasant experience for sure. Can’t wait to hear how the person in your next video handled it!
I’ve just figured out wearing a CGM that I’ve been getting these spikes for years. Instant oatmeal has been my worst trigger. Seems to make the whole day bad as you say.
Thank you for this very valuable information. I feel it’s our responsibility to ensure our health. By the time you get sick, the doctors have only pharmacy meds to rely on. I always thought I was informed about blood sugar but am learning so much and will make adjustments as needed.
I wear the monitor as a healthy person. Saw the spike with potatoes meal. This is the very best video explaining risks and strategies to deal with it for better well beeing based on science!
Thanks for sharing your knowledge! Much appreciated! 1. For the second meal effect - does it mean it's best to eat, say - carb with protein/fat/fiber for both breakfast and lunch, while maybe cutting out carbs for dinner? 2. My second question is: if my sugar is 135 fasting before breakfast around 10, while my sugar 2 hours after a meal is under 140 (118 or so) , what does that mean? My fasting sugar is higher than norm yet is normalized after I eat? I researched the dawn affect and don't think it applies in my case as it's not middle of the night level. I use strips to check sugar level.
If you have a very low-carb dinner, then the next meal is breakfast the next day, and your glucose tolerance will be reduced. My general suggestion is to either always eat at least a bit of carbs or all meals as low-carb meals. Including some high-carb meals in a low-carb diet may trigger some major spikes. Fasting glucose >=126 is indicative of diabetes, even if the 2-hour time point after a standardized OGTT (or a meal) is relatively low, so I would certainly discuss this with a doctor. Best, Mario
A very scientific response to the blood sugar spike issue. I often used to think when many influencers talk about blood sugar spike they say it is so bad to have spikes and must have portion control and the like. What is interesting in your response is that from scientific evidence as long as we stay below 10 mmol/l we should not be too concerned. I have another fundamental question on how the medical fraternity decides what is the level of blood glucose [HbA1C] is considered diabetic? Why 6.5% and why not 8%? What is the basis of determination? Can you provide some scientific basis please?
I just came across your video (thanks to my RU-vid algorithms 🙂), and it is so refreshing that you are not contributing to the fear-mongering content in social media that is out there. I actually feel like a normal person now and that I am not going to die tomorrow! When I see my BG at 120, I panic, but now maybe not so much! I was wondering if you could give your take on what a normal hba1c should be. Thank you, and I have subscribed. 👍🏼
Thank you so much for taking the time! I think my last check was 5.4. I don't know what it was before because I have never had it tested, but I was just curious because my fasting glucose tends to run in the low 90s. It is something that I am working on improving. Thank you, again. 🙂
Thank you Mario. I am much clearer now after watching the video you suggested earlier in reply. I did experience all the signs of Hypoglycemia. It was a scary episode as I had never experienced something like that. It happened when I skipped my breakfast and lunch after having a carb-rich dinner the night before. I believe the way your body processes glucose changes as you age. I had no problem skipping meals before.
You give us incredible information. Indeed. Please keep the videos coming. This topic is so confusing to tons of people because of the various presenters. You are wonderful
FWIW, my blood sugar will go up 20-25 points eating a salad for breakfast. At 5pm, that same salad will barely raise my glucose level. Even eggs for breakfast will raise my sugar 20 points. Coffee with half and half (no sugar) will raise my BG level 10 points. Usually 20-30 minutes after my meals, I go on my exercise bike for 15-30 minutes and it will keep me at a lower spike, than if I didn't exercise. I'm in the early stages of pre-diabetes. 5.7-6.0 A1C levels. I get blood work every 3 months. Twice within the past 5 years, after the holidays, I had a 7.0 A1C, when I didn't do any exercise.
@@Jack_Schularick that would definitely do it, but I check my BG before I eat as well. It's usually in the 80s and low 90s. I don't suffer from the dawn phenomenon effect with elevated levels. They also say cortisol levels will rise if you skip breakfast.
@@titaniumismagical8643 Very thought provoking. Probably a combination of both, or more: There is also that insulin independent glucose uptake in the muscle during exercise. Perhaps you just sit down in front of the computer after your breakfast, like the rest of us :) A brisk walk after breakfast on a Saturday would resolve the question, perhaps.
@@Jack_Schularick thanks, I appreciate your input. I do go on my exercise bike, usually after every meal. I begin a 15-30 minute exercise approximately 25-30 minutes after my meals. It definitely lessens a spike. Those BG numbers I posted, happens if I don't exercise. I have to be careful because I'm going into pre-diabetic A1C levels. I'm just putting my numbers out there for others. There's not much data out there yet with people who exercise after a meal and its effects. It definitely works for me.
I've been wondering about the effects of coffee/tea/caffeine on blood sugar. I read that if you drink coffee before eating breakfast it can negatively impact your blood sugar, but if you drink it during or after a meal, it is beneficial. Would be nice for more clarification on how and why caffeine affects blood sugar.
Ah, you are the second person today who has that question. And I am sorry to say that I don't know and need to do some research before I can respond to it. Will include some information about this in a future video, or make a separate video about this topic if there are enough data to make it worthwhile. Cheers Mario
Glucose goddess made a post about that and as far as I remember it’s true, you’d better eat the coffee after the meal (it was a cappucino though, i’m not sure this applies to plain coffee)
Hi Mario, I really like your channel, you do an awesome job! You base the information on science but also you apply common sense and avoid the “purist” approach 👏🏼
Excellent and very helpful information. These videos have been the most helpful, detailed, and easy to understand information regarding blood sugar and its corrolating causes and possible complications.
Excellent Video, Mario!! I’ve studied a lot and have heard new information, here. Thank you for providing education the average person cannot get elsewhere, particularly from their medical practitioner. Bravo!👏👏
That can mean you had a blood glucose spike, which then crashed quickly at the 2 hour mark. Usually a person's blood sugar peaks between 1-1.5 hours after a meal.
I would agree with Titanum is Magical: there isn't much solid research on this, but I think this may be a less severe version of reactive hypoglycemia.
I liked the strategies to reduce blood sugar spikes, I think thats helpful for people who are not always low carb, or who carb cycle. I'm going to do more reheated rice and potatoes. I wonder if having a small carb snack maybe 20-30 minutes before your high carb meal would blunt the insulin response for the second meal effect, or whether it would all be considered one high carb meal.
Mixing a carb food with fat before refrigerating or freezing prevents or impairs retrogradation, I've read. Which would mean that frozen ready to eat foods may contain low(er) amounts of resistant starch. Any comment?
I really like this…. Professional, Informative but easy to digest… and maybe the most important thing is you dont’t try to feed us with you next top selling book… or your idea of next big mega trend with fancy words which simply means little But I would suggest to do some writing and publish some because that would help us
You can find a write-up of each video on my website, along with all references and often a more detailed discussion of the science. You can find the link to each blog post in the video description below each video. Thank you for your kind words. Cheers Mario
Hi Mario, thanks again for your incredible videos. You mentioned an insufficient first-phase insulin response can be responsible for spikes, and a resulting strong second phase insulin response can cause reactive hypoglycemia. What I'm curious about is whether anyone else has a seemingly "0th phase" response to eating, where glucose drops before it spikes? Much of my non-exercising postprandial CGM data looks this way: 1. Eat 2. Immediate (within minutes) Drop in CGM blood sugar (-5 to -40 mg/dl, depending) 3. Delayed Surge in CGM blood sugar (110-180mg/dl) 4. Reactive hypoglycemia (50mg/dl) 5. Repeat 3 and 4 several times (polyphasic glucose response) 6. Eventually stabilize several hours later (2-6 hours, depending on many factors)
If I'm exercising (e.g. uphill walking) while eating, everything changes, and I get a much more stable blood sugar level until digestion is fully complete. However, if I stop exercising before digestion is complete, I'll see 3 and 4 occur almost immediately in response. Then I have another "mode" where I have textbook perfect glucose tolerance... but this mode shows up periodically, but many things reliably throw it off - a poor night of sleep, vaccination, infection, stress, too much rest, the list goes on... This all remains quite a complex mystery - I've yet to see several of the peculiarities of my phenotype described in the literature, or elsewhere... Does any of this align with anything you've seen in your practice or read about in the literature? Thanks again! P.S. There are many more peculiarities, but this is already far too long and complex!
Hm, that is indeed curious, and not common. Thank you for sharing. I assume you have discussed this with a doctor? Also, could you share what you have tried to remedy this, other than walking? Does lower-carb help? Cheers Mario
Hi, Could you at some point address the Dawn Phenomenon and what strategies might work to bring these high morning blood sugars under control. Thank you!
Had baked ,cooled & reheated potato based breakfast My readings after every 30 minutes [125 ,130 135 &110] At end of 2hour I am prediabetic Thousand thanks
@saramenda9473, I am afraid that is incorrect. Hand-held glucose meters that directly measure blood glucose in a drop of blood are (a) an actual measurement of glucose in blood (rather than in the interstitial fluid, which is what a CGM sensor measures); (b) more reliable, with less variation from measurement to measurement and much lower likelihood that you'll get an extremely faulty reading. I am not against CGMs at all, and think they are extremely useful, but they are not more accurate than even a cheap hand-held glucose meter. Best, Mario
This is a great video! I know about the resistance starch effect and it really does work. I didn’t know about freezing bread, but that makes sense too. So glad I watched this and subscribed.
Great video! I’m just getting interested in sugar and insulin levels so I mostly have limited knowledge. You’ve made me question several of the things I assume are true about carb intake.
Thank you Mario. At a certain point eyes glaze over. I want food I love. After your videos I changed my diet in the past four months to mostly meat with a vegetables, reducing carbs considerably. This lowered by A1C from 6.7% in December to 6.1% in May, 2023. I am a type two diabetic. Your information is very helpful. I want to avoid the health problems of my elders. On the other hand, we are all going to die. I am drinking too much alcohol since covid 19 lock down crisis. How does alcohol effect type two diabetes? Thank you for your videos.
Dear Jack, Alcohol tends to be converted to fat in the liver, and so too much alcohol can lead to too much fat in the liver over time. Having too much fat in the liver makes the liver insulin resistant, and so this could increase the demand for insulin, and potentially contribute to glucose intolerance. Aside from this, some alcoholic beverages, beer in particular, have a very high glycemic index. Particularly to someone on a low-carb diet, this alone could lead to major spikes and keep the HbA1c elevated. I realize this is easier said that done, but cutting back on the alcohol could be a big boon for the liver, and improve both insulin sensitivity and glucose tolerance. And reducing fat in the liver has other benefits for the liver in the long run (fatty liver disease is a major risk factor for cirrhosis). We'll cover fatty liver disease and what to do about it sometime soon, so hopefully that content will be useful to you. Warm wishes, Mario
@@nourishedbyscience Thank you. After your response I have been sober for nine days and it does feel like the right thing to do. You help many people. Thanks for your efforts.
@@jackgoldman1 Hi Jack. How is it going. Did you manage to stay sober (or substanially reduced your Alc intake)? Try to inform yourself about the newcastle diet (Roy Taylor). T2D is reversable.
I was waiting for this video and I am so happy to see it.Only positive response for the inhold 👍 👏. I have rather strange question: do you have any of your videos in German language?I have some german friends,who would love to see and hear you ,but in German,because they can't speak English ...blessings ❤ 🙏
Currently, I have no German videos and no plans to make any. It's just too much work to produce each video in two languages. However, you can wait for a few days, and then RU-vid will automatically provide subtitles translated into many languages, including German. I've checked a few of them; they are really good. Cheers Mario
Thank you very much for your excelent explanations of blood sugar controle. Still some questions: 1. Why is the first phase insulin response blunted in type 2 diabetes. Is the insulin not stored, or does is the insulin not released with high blood sugar? Or are the betacells not quick enough to make insulin? Or all of the above? And is it true that sometimes protein consumption can activate the first insulin response where carbs can't do it? 2. Does the second meal effect extend to many hours later? Most days I eat only two meals a day. The last at about 3 p.m. would that affect my meal next morning at 8 am?
Hi Jan, The first-phase insulin response is blunted whenever there is not enough pre-formed insulin stored in the beta-cells. There could also be a reduction in beta-cell mass (i.e., fewer beta-cells) in advanced type 2 diabetes. The reasons for this in type 2 diabetes are probably several, and thought to be partly related to genetic predisposition, higher age, toxic effects of chronically elevated free fatty acids and glucose, inflammatory processes etc. Pre-loading a meal with protein can enhance the first-phase insulin response to a high-carb meal eaten a bit later, so this is one of the mechanisms how adding protein to a meal can be helpful. Regarding the second meal effect: it's usually not been tested with meals very far apart. Most studies compare the glycemic impact of dinner when lunch contained vs. did not contain carbs. My best guess would be that it still matters somewhat even if the meals are further apart, as in intermittent fasting. Cheers Mario
I think deep frozen food does not undergo lots of retrigradation because the process is very fast, as opposed to the slow cooling in that happens in common kitchen fridges.
Thank you for these informative and interesting videos. I wear a CGM and find my blood sugars are running around 140-150 mg while taking Jardiance and Ozempic. I am trying to follow a low carb diet and would be interested in learning some other strategies to getting my blood sugar down in addition to losing weight… Thanks so much!
I am sorry, but it would be inappropriate for me to provide any specific individual guidance beyond the general scientific information I share in the videos. All I will say is that with the weight loss you are likely to experience, your blood sugars will very likely get better over time. Whether adding additional measures, such as a low-carb diet, is suitable or advisable to you, I suggest you discuss with a nutritionist or physician. Cheers Mario
By the way, Jorden, you were also interested in the mechanism through which the second meal effect works, right? It mostly has to do with preparing the beta-cell to be able to trigger a solid first-phase insulin response. I explain this later in the video. Cheers Mario
Hi Dr Kratz (Mario), Greeting from Europe! Many thanks for another valuable and “Real lecture” on Blood Sugar spikes! Regarding your first point and looking at your first demo graph it is very much my graph when I wake up in the morning! Regardless of what I had the night before! I always start with a range of 170-180! Soon after breakfast which is usually two eggs and some cheese with a cup of tea, the BSL goes to around 200-210. Few hours later drops to160. Here is the crazy part; yesterday just before lunch, I placed my CGM (Continuous Glucose Monitor) on and started with an avocado followed by some nuts! I started with 180 and the sugar reading almost within few minutes started to drop digitally to around 150, I had some chicken and salad with some olives. I never snack between meals! My BSL continues to drop till it reached 140 and sometime 136. On the next comments I will write my latest blood test result. I ALWAYS start the day with FULL TANK 180 to 200! Usually the rise starts around 4-5 am. My BSL pattern trends high in the morning and continue to drop till I go to sleep and continue to drop during my sleep till Dawn! I know for sure, whenever I eat carbohydrate, my blood sugar level spike’s just to give you an idea, I had Butternut pumpkin soup with some chick peas, following that I had TWO DRY FIGUES! This pushed my BSL from 150 to 240 with 10 minutes! It took three hours to drop to around 145! Question Number 3, I can say without any doubt that retro gradation doesn’t work for me! I wash, soak, cook the starchy food and place in the refrigerator for 24 hours and when I heat it prior to eat, It still spike my BSL! Maybe it works for others. Your point on should a diabetic person give up carbs completely having the chance of becoming carb intolerance has great deal of truth! To give you an example; Few years back I used to eat pretty much anything from rice to cake to bread along with salads, chicken and meat and all my HbA1c were 7 to 7.2! The day I changed my diet to almost 90-95 percent low carb food my BSL started to get higher ESPECIALLY when I am fasting! Even when I fast for 20 hours my BSL goes to 10-12 but as soon as I eat it drops to around 140-150 and some time to 130! BUT my recent HbA1c level was around 7.4 despite all the morning high BSL! I usually eat two meals a day at most. Now I am using my CGM I can pretty much test my food at any time and see how I react to the food I eat. Mind you I NEVER eat junk food, never snack between meals, I do not smoke or drink alcohol, reasonably active and walks 3-4 KM a day! Also when I am under severe stress my BSL goes as far as 250 and eventually drops down to around 150 few hours later. On point four, I just experimented with a big bowel of salad mostly green leaves and small amount of feta cheese, I also used apple cider Vinegar as you suggested followed by two very small pieces of 85% dark chocolate and here is the result; I started with 160 and as soon as I started eating, my CGM started to drop almost digitally within few minutes, it continue to drop till it reached 152. After 15 minutes I just checked and my BSL now is at 182 and few minutes to 178!!! By the way I totally agree with you on fermented food effect on lowering diabetes, It does absolutely nothing for me with ZERO effect. But I eat them anyway because they are food for my friendly gut bacteria!! Which brings me to your very MOST important point (#6) that you raise in today’s Video! By the way NO ONE has raised this point before you in all the hundreds of videos that I watched on this subject! I think this case applies to me, because when I watch my CGM during my meals, I can see the immediate changes in my blood sugar level. I think the two conditions you mentioned which is the fast emptying of food and slow insulin response applies to me for sure. I can see my reading goes changes almost within minutes of consuming certain foods let alone 15-30 minutes! Well done Dr Kratz! I will write my C-Peptide test on the other comments and you will see it is within range! I would like to add another observation from my own experience; when I am fasting my BSL goes up as far as 12, the moment I eat it drops to 135-150. That proves your analysis is correct! Also when I eat any small amount of honey or small amount of Gelato after meals, it seems to encourage the secretion of insulin to bring my BSL down!? Often my reading in that instant around 126 (7)! Please feel free to use my info by sharing it if it helps in any way
Thank you for sharing, and thank you for the kind words. It does seem like you are someone where not all of the strategies work. For example, retrogradation. It does work, i.e., the cooling will cause some resistant starch to form. However, for someone who is glucose intolerant, there is still too much digestible starch in the food even after retrogradation. Hope my future videos about how to improve glucose tolerance will be useful to you. At the same time, I would encourage you to discuss your morning blood sugars with your doctor if you haven't already. Warm wishes, Mario
@@nourishedbyscience By the way what is Type 1.5 or Type three diabetes?? I forgot to mention in my last reply that I never use any medications! Thank you
@@galaxywanderer5945 Are you a diagnosed T2D? Your values are skyrocket high! I recommend you to inform you about the newcastle diet (Roy Taylor, there is an interesting interview with him on the yt channel from Gil Carvalho).
Great Channel and videos Dr.Mario. As I have insulin resistance I loved your videos alot and they are really to do the point and accurate. I have one more question which couldnt find the answer in your videos yet, ma be I missed it. My question is eating frequently(Which means Breakfast in the morning, then 2 hours later a healthy snack, then lunch, 2 hours later a snack then dinner) good or bad for us? I'm also using using CGM for a week now and my blood sugar levels is in the okay range, when I eat according to your recommendations, however eating snacks causes small waves(not spikes) naturally, should we continue with healthy snacks or try to stick with 3 meals only? Thanks a lot for all those great videos.
Thank you for the kind feedback, Talat. Good question, and I may make a separate video about eating frequency at some point. For now, let me just share two recent review articles about the topic: www.ahajournals.org/doi/10.1161/CIR.0000000000000476 www.ncbi.nlm.nih.gov/pmc/articles/PMC7490164/ One bigger point though: make sure that the snacking does not shorten the overnight fasting period. In other words, if the snacking continues until well after dinner, then there could be some disadvantages associated with this for metabolic health. This is because some trials show that the opposite, i.e., an extended fasting period over night, as in time restricted eating, has metabolic benefits. Cheers Mario
NbS - The best channel on nutrition I have ever seen. And a question: How come that a little bit of acetic acid or citric acid slows glucose absorption in the light of tons of hydrochloric acid in the stomach? It would be like a drop in the bucket. Is this about neutralizing the amylase in saliva?
Thank you for your kind words. The effect of vinegar could partly have to do with inhibition of amylase in the mouth, but there is also evidence of additional effects, such as vinegar causing a delay in gastric emptying, which may also be mimicked by citric acid. Admittedly, though, this is a somewhat more complex issue than I wanted to get into in the video. Acetic acid and also citric acid may well have other effects that explain their overall impact on glucose metabolism.
@@nourishedbyscience Thanks for the reply Mario. I hope lactic acid in my sauerkraut does the same, in which case Sauerkraut would be a triple superfood: lower BS, provide fiber and - enrich microbiome with lactobacilli. 😄
