A new study into the development of diabetes suggests that individuals – even those who consider themselves healthy – might need to pay more attention to their blood sugar.
Stanford University researchers continuously monitored individuals’ blood glucose level over two weeks. This methodology varies from the more traditional monitoring and diagnosis methods of repeated finger-prick measurement or oral glucose tolerance tests. The study was published in PLOS Biology.
This measurement revealed that fluctuations in everyday blood sugar are more extreme than previously thought, and “spikes” of high blood sugar in individuals who classify themselves as healthy reach the same heights as diabetic patients.
Diabetes is a disease which is affecting a rapidly growing population of patients – the authors highlighted in their paper than whilst 30 million people in the USA are classed as diabetic, 84 million are prediabetic – where physiological measurements are below diabetes thresholds, but at significant risk of progressing to diabetic levels (up to 70% of that 84 million may eventually develop type 2 diabetes).
To better explore the physiological relationship between “healthy”, prediabetic and diabetic people, the authors developed an analytical framework that analyzed 57 study participants by their “glucotype”, a reflection of how much their blood sugar fluctuated over a period of 2-4 weeks.
These glucotypes were grouped into three categories – low, moderate and severe, based on the variability the researchers saw in blood glucose. 24% of patients that would have been traditionally classed as normoglycemic had a “severe” glucotype, indicating high variability. Over the period of continuous monitoring, the “severe” group had prediabetic levels of blood glucose over up to 15% of the monitoring duration and tipped into diabetic levels 2% of the time.
Thirty of the study participants were then given standardized meals to determine how different foods affected blood sugar. The majority of participants that ate a meal of cornflakes and milk caused glucose elevation that reached the prediabetic range, whilst there was a smaller glucose response to eating protein and fat-rich foods.
In a Stanford press release, Michael Snyder, PhD, professor and chair of genetics at Stanford and the study’s senior author said, “There are lots of folks running around with their glucose levels spiking, and they don’t even know it. “We saw that some folks who think they’re healthy actually are misregulating glucose — sometimes at the same severity of people with diabetes — and they have no idea.”
Snyder went on to highlight the competing factors at play in glucose spiking, including our genetics, gut bacteria, and the epigenome of subtle chemical modifications which varies between every individual. Those last two factors change throughout our lifetime, and Snyder said in the release that he encourages annual continuous glucose monitoring even for individuals who think they have healthy blood sugar levels.
The authors stress that their glucotype classification systems need longer-term validation, but they may prove to be a useful tool for prediction and prevention of this growing societal issue.