#78 - Food, exercise and glucose "spikes": should everyone wear a CGM? Glucose spikes are normal physiology!! With Dr Guess and Prof Little
Feb 2, 2024
auto_awesome
Dr. Nicola Guess and Professor Jonathan Little discuss the importance of managing glucose 'spikes' after a meal or intense exercise. They explore the difference between glucose spikes and chronic hyperglycemia in diabetes, the relationship between carbohydrate intake and blood sugar control, the pros and cons of continuous glucose monitoring, understanding pre-diabetes glucose levels, and the role of beta cells in type 2 diabetes and exercise.
Continuous glucose monitors (CGMs) have benefits for individuals with diabetes but may be unnecessary for those without the condition.
Glucose spikes in individuals with type 2 diabetes are a normal physiological response, rather than a cause for concern.
The use of CGMs can potentially impact food choices and contribute to the development of eating disorders.
Deep dives
CGMs and the Concerns Surrounding Them
Continuous glucose monitors (CGMs) are devices that estimate blood glucose levels by measuring glucose every five to ten minutes. While they can provide a snapshot of glucose levels, their usefulness in individuals with normal blood glucose levels is still uncertain. CGMs can lead to anxiety and an uncomfortable relationship with food, causing people to cut out certain foods and develop disordered eating patterns. Additionally, CGMs do not necessarily improve long-term health outcomes, as glucose alone is not the sole contributor to cardiovascular disease. It is important to consider individual circumstances and whether the benefits of CGMs outweigh the potential risks.
The Value of CGMs for Diabetes Management
CGMs have proven to be valuable tools in managing diabetes, both for individuals with type 1 and type 2 diabetes. In type 1 diabetes, CGMs are essential as they provide continuous information about blood glucose levels, enabling individuals to adjust insulin dosage accordingly. For type 2 diabetes, CGMs can help individuals monitor their blood glucose levels and make informed decisions about their diet and lifestyle. However, the usefulness of CGMs in the general population without diabetes is still uncertain, and their potential benefits must be weighed against the potential risks.
The Importance of Differentiating Between Glucose Spikes and Chronic Hyperglycemia
Glucose spikes, or glucose excursions, after consuming a meal are normal physiological responses. The concern lies in chronic hyperglycemia, which is observed in individuals with diabetes. It is essential to differentiate between the two, as chronically elevated glucose levels lead to complications, while glucose spikes are a normal part of the digestive process. Glucose alone is not the primary cause of cardiovascular disease; other risk factors, such as high blood pressure and cholesterol levels, play more significant roles.
Understanding the Implications of CGMs on Food Choices and Eating Disorders
The use of CGMs can potentially impact food choices and contribute to the development of eating disorders. The constant monitoring and focus on glucose levels can lead to anxiety and the restriction of certain foods. There is a concern that CGMs may encourage individuals to avoid carbohydrates, including healthy options like fruits and vegetables, which are essential for overall health. It is important to provide individuals with proper guidance and education when using CGMs to prevent the development of disordered eating patterns.
Importance of glucose spikes in type 2 diabetes
Glucose spikes in individuals with type 2 diabetes are a normal physiological response, rather than a cause for concern. While chronic elevated glucose levels are associated with negative health consequences, brief spikes in glucose after meals or intense exercise are considered normal. In fact, high-protein diets may stimulate insulin secretion and lower glucose levels in individuals with type 2 diabetes. Understanding the distinction between chronic hyperglycemia and acute glucose spikes is crucial in managing diabetes effectively.
Limitations of continuous glucose monitors (CGMs)
Continuous glucose monitors (CGMs) have benefits for individuals with diabetes but may be unnecessary for those without the condition. CGMs primarily measure glucose levels, which alone do not provide comprehensive insights into an individual's metabolic health. Additionally, constantly monitoring glucose levels can be mentally and emotionally draining, potentially detracting from the overall enjoyment of life. Instead, a focus on maintaining a healthy weight, exercising regularly, and consuming a balanced diet can have a more significant impact on overall metabolic well-being.
Dr Glenn McConell chats with Dr Nicola Guess from Oxford University, England and Professor Jonathan Little from the University of British Columbia, Canada. Nicola is a dietitian researcher with many years of expertise including the importance or otherwise of glucose “spikes” or excursions and the pros and cons of continuous glucose monitor use. Jonathan is an expert on exercise metabolism who is coming onto the podcast for the second time after speaking previously about keto diets and exercise. A major point is the difference between having chronically elevated blood glucose levels such as in diabetes (pathology) versus having normal increases in glucose ("spikes") in response to a meal. Also increases in glucose before and during very intense exercise is normal physiology and not a concern. There was also a clear message that the use of continuous glucose monitors (CGMs) have both pros and cons and that need to be considered. A very interesting chat. Twitter: @DrJonLittle 0:00. Introduction and welcome 3:20. What are glucose “spikes”/excursions 4:45. Hyperglycemia in diabetes is very different to “spikes” 6:20. Glucose spikes in type 2 diabetes 7:19. Why is chronically elevated glucose a problem? 12:20. Confusion about glucose levels 2hrs after a meal 15:29. Underlying insulin resistance the problem not spikes 19:08. Fasting glucose and insulin measures 21:10. Meal tests and oral glucose tolerance tests 24:55. Be careful not to make the underlying pathology worse 26:15. Keto diets: T2D, weight loss, exercise 32:10. Glucose even in diabetes is not as important as we think 35:00. Are CGMs useful? 38:30. Too much focus on glucose than more important things 41:00. CGMs very important for people with T1D 42:05. CGMs and anxiety 43:25. CGMs and higher cholesterol 44:00. Misunderstanding of pre-diabetes re CGMs 46:00. Metabolic flexibility 47:40. “Nervous normals” 49:42. Is how loses weight important? 53:41. What about CGMs in type 1 diabetes? 54:15. CGMs, diabetes, diet, behaviour change and exercise 57:40. Glucose metabolism during exercise 59:55. Exercise and insulin sensitivity 1:02:15. Effect of exercise on glucose spikes from a meal 1:04:10. Intense exercise can increase blood glucose levels 1:07:10. Normal to have elevated glucose after intense exercise 1:09:50. Influencers misinterpreting data re glucose spikes etc 1:12:10. Misunderstanding glucose cut offs 1:13:10. Takeaway messages etc 1:14:00. Weight loss diet strategies 1:17:50. Amino acids and insulin secretion 1:24:40. Should everyone use CGMs? 1:26:30. Keep it simple re diet and exercise 1:27:40. Outro Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all. The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University. He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.1007/978-3-030-94305-9). Connect with Inside Exercise and Glenn McConell at: Twitter: @Inside_exercise and @GlennMcConell1 Instagram: insideexercise Facebook: Glenn McConell LinkedIn: Glenn McConell https://www.linkedin.com/in/glenn-mcconell-83475460 ResearchGate: Glenn McConell Email: glenn.mcconell@gmail.com Subscribe to Inside exercise: Spotify: shorturl.at/tyGHL Apple Podcasts: shorturl.at/oFQRU YouTube: https://www.youtube.com/@insideexercise Anchor: https://anchor.fm/insideexercise Google Podcasts: shorturl.at/bfhHI Anchor: https://anchor.fm/insideexercise Podcast Addict: https://podcastaddict.com/podcast/4025218 Not medical advice
Remember Everything You Learn from Podcasts
Save insights instantly, chat with episodes, and build lasting knowledge - all powered by AI.
