Lowering blood glucose

Lowering blood glucose without the use of drugs is a fascinating new domain of research; T2D can be put completely into remission^[1].

This is a highly complex subject; I will endeavour to make it simpler for you to understand. Nevertheless expect to have those brain cells stretched. Every obese person and all diabetics should have an understanding of these matters.

I would suggest that those enjoying a naturally high fibre diet and low refined-starch foods need have few concerns on the subject. They are unlikely to suffer from T2D and can give this page the miss; but they are few and far between.

Nuts and seeds are particularly rich in natural dietary fiber; so are whole-grains such as grits and sourdough breads.

For those who are insulin-resistant lowering blood glucose must be kept in focus; in this 100% wholegrain stone-ground grits we add a little cheese, cream and parsley. The glycemic index is low; less than 50. The berries are the cherry on top.

Incretin hormones and DPP-4

There are two hormones produced in the stomach and small intestine that naturally lower blood glucose; they are secreted within minutes of swallowing food.

• GIP delays the emptying of the contents of the stomach into the small intestine where starches are digested; and the glucose formed is absorbed into the blood stream.
• GLP-1 on the other hand stimulates the pancreas to increase the production of insulin and reduce the secretion of glucagon; this lowers the levels of sugars in the blood stream. Its effectiveness is greatly impaired in those suffering from T2D. It also plays an important role in satiation signalling when we've eaten enough.
  

Allowed to continue functioning, these two hormones could dangerously lower blood glucose to the extent that the brain and other organs would run out of energy; coma would soon follow. So they are degraded within minutes by an enzyme called DPP-4; this is normal physiology within our bodies.

DPP-4 is rendered ineffective in various disease states such as obesity, cancer and generalised inflammation^[3]; the action of the incretin hormones continues for too long. Hypoglycemia is likely; low blood sugar. 

DPP-4 is depleted in those consuming highly glycemic snacks and meals; sugar, refined grains and ultra-processed foods.

Anti-inflammatory effect of DPP4

DPP4 also has a powerful anti-inflammatory effect beyond reducing the half life of the incretin hormones; it helps to break down the overly exuberant cytokines that have such a destructive effect in viral infections.

DPP4 is also depleted by inflammatory foods and during a viral infection; the body is then unable to break down these cytokines associated with the destructive storm affecting the lungs and other organs.

DPP4 also helps prevent the consistently raised hormone called cortisol produced by chronic stress; that spikes blood glucose and can lead to T2D.

The amino acid called proline

Proline residues play an important role in the proper functioning of DPP-4. Having a ring structure makes it difficult for enzymes in the stomach and small intestine to digest them completely. Should short chains of amino acids be absorbed into the blood stream they set up powerful inflammatory reactions.

Proline is the only amino acid having a ring structure.

It is particularly high in the plant proteins found in grains, known collectively as prolamines; gluten is one such example.

Almost without exception people find sourdough far more digestible; and DPP4 can function normally sending satiety messages to the brain. It's no coincidence that in the five Blue Zones where longevity is the norm^[6] that all breads are baked by this method.

The gluten is predigested by bacteria and yeasts in the culture even before it is consumed.

Proline is also very high in broths made with bones and the skin from chickens^[4] and various animals; best is from those that are grass-fed.

This is all profoundly important for the normal functioning of these hormones and enzymes such as DPP-4. It's all about lowering blood glucose; reducing inflammation in the body and not succumbing to viruses like HIV and Covid^[3].

Gliptons

Gliptons are a class of drugs that inhibit DPP-4, prolonging the influence of the incretin hormones GIP and GLP1; that would promote the lowering of blood glucose in diabetics.

Unfortunately Gliptons have quite serious side effects; upper respiratory and throat infections, and of the urinary tract. Patients are also more likely to suffer from joint pains and swelling of the heart muscles; pancreatitis and hypersensitivity to bee-stings resulting in anaphalaxis.

There are better ways of lowering blood glucose than interfering with the normal hormonal cycles with medications like Gliptons.

Gluten

Complete avoidance of gluten-rich breads, either because of indigestibility associated with proline or their high starch content is not necessary for those who enjoy only sourdoughs made from wholegrains; nor is it advisable.

Many nutritionists have pointed out that those avoiding gluten very often turn instead to highly refined foods to their great detriment. Anti-inflammatory DPP4 is reduced and processed starches raise blood glucose; cytokines have a field day setting up anger in our joints, muscles and capillaries. Raised cortisol further raises serum sugars.

Numerous studies have shown that gluten that has been hydrolysed by the enzymes in the sourdough method of baking has many beneficial virtues such as less muscle injury during exercise; and resistance to a hepatitis infection^[5].

The tripeptides produced, rich in proline and glutamine, both of which we may have difficulty with in gluten that has not been predigested, have a significant inhibitory activity on DPP-4; this means that lowering of blood glucose by the incretin hormones continues for longer causing hypoglycemia and wild swings in serum sugars.

Sourdoughs tend to be expensive; consider baking them yourself. The loaf above takes just five minutes to prepare, including grinding the flour. The taste, texture and digestibility are astounding; as is the price tag if you are willing to purchase a mill and source the wheat directly from a farmer. It costs around half a dollar to make.

But one slice of real bread is enough. A second may make you feel stuffed and give you indigestion.

Freshly-ground 100% wholemeal flour is almost impossible to purchase; from your own mill it costs less than a quarter of the retail price. For those who bake sourdough bread themselves daily, the cost is paid off in around one year.

Ginger and turmeric

Researchers have found that an enzyme in ginger is particularly efficient in hydrolising gluten. Currently it is being used orally in herbal medicine for enhancing immune function and stimulating insulin release for lowering blood glucose; via its inhibition of DPP-4.

Whilst pharmaceutical companies are looking to use this property for novel new medications, you can simply grate fresh ginger and turmeric daily in your cooking.

It has long been known that fresh ginger has many benefits, especially for the diabetic. It is not however a substitute for avoiding refined carbs.

South African Indians eat prodigious amounts of ginger, turmeric and garlic; but the prevalence of T2D is extremely high because of their love of polished precooked rice and cake flour for making soft rotis.

Exercise

Even a brisk ten minute walk after a starchy meal makes a very significant contribution to lowering blood glucose.

Test yourself

In short lowering blood glucose is a highly complex and controversial subject. If you are obese, have diabetes or know that you are insulin-resistant with a high HbA1_c it is imperative that you test yourself regularly. Exactly how do unrefined high fibre carbs affect you personally? Can you enjoy sourdough bread? What about new potatoes?

Continuous Glucose Monitors are coming down in price and have become very user-friendly. Measuring your blood sugar every few minutes, and recording it via blue tooth on your cellphone gives you immediate feedback on the response of your body to these carbs.

Use one periodically for two weeks.

New potatoes have far less digestible starch; in moderation even diabetics can probably enjoy them but should test the response of their blood glucose.

The obese alas should drastically reduce all starches, even the good ones like new potatoes, butternut and sourdough bread; until they have shed those unwanted pounds.

Obesity

Is obesity a disease? The researchers have not made up their minds; it certainly predates the modern "industrial diet."

It is my conviction that the obese should not in the main feel guilty about their affliction. They have been lured by food companies into consuming the offering found in today's supermarkets; and many of the lies peddled about starches. Lowering blood glucose and keeping it down has become an arduous affair for the majority; it need not be so.

For those enjoying a high fibre and low refined-starch diet it's not difficult at all; these foods supply satiety and slow gastric emptying.

But it does mean indulging in cake flour and sugar products only on high and holy days; cookies, delectable scones and slices of sponge cake.

On the other hand the obese know perfectly well what happens when they accept that second slice of chocolate cake; each has over ten teaspoons of sugar and about 110g of refined starch. Like all disease states, obesity is 10% genetic but mostly to do with lifestyle. We can reply "no thank-you; I have enjoyed elegant sufficiency."

You will feel stuffed after a meal like this; one slice of true wholegrain bread is enough. The berry jam contains about 1 tsp of sugar; and many important phytonutrients. One has little inclination for dessert; the incretin hormones are at work "mediating satiety via central pathways to the brain^[8]."

Continuous glucose monitors

The continuous glucose monitor (CGM) is an amazing new device that will give important insights into lowering blood sugar; it enables you to see your levels in real time. Whilst designed for the diabetic, both types 1 and 2, it would have huge benefits for the obese and in fact for all of us who are insulin resistant; nearly 50% of the population.

A tiny disposable sensor placed simply under the skin measures glucose levels in the body; and then transmits the information wirelessly to your cellphone.

The device enables you immediately to see which foods are spiking your blood glucose, the affect of exercise and any medications you are taking. The savings would be vast; every diabetic would simply and easily be able to reduce the insulin and other drugs that have been described.

Whilst they are expensive, if every person with elevated blood glucose had been able to monitor during the recent pandemic, millions of lives would have been saved. More than half of those who died were obese or diabetic.

There are two types.

• Intermittently scanned continuous glucose monitors (isCGM)
• Real-time continuous glucose monitors (rtCGM)

Whilst the diabetic really should have this device indefinitely, we all could benefit by using a CGM for say a month or two; it would hugely reduce the comorbidities like heart and kidney disease. The immediate feedback on how an indulgence could threaten one's very being would give massive impetus to meaningful lifestyle changes.

The IMMEDIATE study^[7] gave cogent support for the use of CGMs.

Lowering blood glucose

Lowering blood glucose can be done naturally by our food choices and walking after starchy meals.

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