Glucose Variability: Not just a sweet nothing

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tl;dr

1. Glucose variability (GV) is a measure of day-to-day fluctuations in blood sugar levels and is associated with an increased risk of complications in diabetes and obesity.
2. GV can be managed with combined improvements to diet, lifestyle, and sleep habits.
3. GV is one of several biomarkers related to diabetes, obesity and metabolic disorders. To better understand your bio-individual risks and advantages, book a batch of blood biomarker assessments + personal consultation with me by clicking here.

Longevity Lesson

Glucose variability, often abbreviated as GV, is a term that's gaining traction in the world of diabetes management. While glycated haemoglobin (A1c) remains the standard for assessing long-term blood sugar control, it doesn't capture the day-to-day fluctuations in glucose levels. These fluctuations, collectively known as GV, include both high and low blood sugar episodes and have been increasingly recognised for their impact on health outcomes.

GV encompasses a range of fluctuations, from within a single day to variations between different days. It's been associated with a higher risk of complications in diabetes, such as cardiovascular issues and nerve damage, as well as an increased likelihood of experiencing hypoglycemia. Moreover, studies have shown that individuals with obesity, especially those with type 2 diabetes, tend to have higher GV compared to those at a healthier weight.

The relationship between obesity and insulin resistance further underscores the importance of GV. Insulin resistance, a condition where the body's cells become less responsive to insulin, is more prevalent in overweight and obese individuals. This resistance impairs the body's ability to regulate blood sugar effectively, leading to greater fluctuations in glucose levels throughout the day.

While A1c remains crucial for assessing long-term glycemic control, GV management is becoming increasingly important too. This all-around approach to diabetes management allows us to address average blood sugar levels while minimising the fluctuations that can contribute to complications and reduce overall quality of life.

Why care about GV?

Glucose variability shares an intricate relationship with diabetes, insulin resistance, and body mass index (BMI). Diabetes, whether it's type 1 or type 2, is closely linked with BMI—a measure of body weight relative to height. People classified as obese tend to have higher levels of various substances in their bloodstream, such as nonesterified fatty acids, glycerol, hormones, cytokines, and proinflammatory markers. These compounds contribute to insulin resistance, where your cells become less responsive to the effects of insulin, a blood sugar-regulating hormone.

Insulin resistance plays a central role in the development of diabetes. In type 2 diabetes, which is the most common form of the condition, insulin resistance typically precedes the onset of high blood sugar levels. When your cells resist insulin's attempts to regulate blood sugar, glucose builds up in the bloodstream, leading to hyperglycemia. Over time, if this condition persists, it can cause damage to various organs and tissues throughout the body.

In both types of diabetes, defective β-islet cells in the pancreas also contribute to the problem. These cells are responsible for producing insulin, and when they don't function properly, the body struggles to maintain normal blood sugar levels. This dysfunction, combined with insulin resistance, creates a perfect storm for the development of diabetes.

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Moreover, increased glucose variability has been linked to oxidative stress, a condition characterised by an imbalance between free radicals and antioxidants in the body, and poor vascular health, which can contribute to cardiovascular diseases.

Fortunately, there's hope. For instance, exercise has been shown to improve vascular health and reduce oxidative stress, potentially mitigating the adverse effects of increased glucose variability associated with obesity. Regular physical activity can help protect cardiovascular health and manage blood sugar levels effectively.

GV is one of several biomarkers related to diabetes, obesity and metabolic disorders. To better understand your bio-individual risks and advantages, book a batch of blood biomarker assessments + personal consultation with me by clicking here.

A multi-pronged approach to GV management

It might seem like a lot at first, but managing glucose variability is highly achievable with surprisingly simple nutritional and lifestyle strategies. Like most healthy habits, it comes down to being committed and consistent with your efforts to make positive changes in your life. Here are some sustainable strategies to get you going on the path to better glucose variability.

Fuelling:

1. Prioritise Healthy Fats and Whole Foods: Incorporate foods rich in unsaturated fatty acids, such as nuts, seeds, avocados, and olive oil, into your diet. Aim for a balanced intake of fruits, vegetables, whole grains, and legumes. These foods provide essential nutrients, antioxidants, and dietary fibre, which can help regulate blood sugar levels and improve overall metabolic health.

1. Monitor Carbohydrate Consumption: Keep track of your carbohydrate intake; focus on high-quality sources like vegetables, fruits, whole grains, legumes, and dairy products. These foods have a lower glycemic index, meaning they cause less fluctuation in blood sugar levels compared to processed carbohydrates. Limit intake of carb-rich foods with added fats, sweets, or salt, as they can contribute to glycemic variability.

1. Optimise Your Meal Timings: Consider the timing of your meals, as research suggests that eating in the evening may exacerbate postprandial hyperglycemia. Aim to eat larger meals earlier in the day when insulin sensitivity is higher and metabolic reactions are more efficient. Additionally, prioritise protein and vegetable consumption before carbohydrates to help lower post-meal glucose levels.

1. Choose Healthy Protein Sources: Include lean protein sources such as fish, poultry, tofu, beans, and legumes in your meals. Protein does not significantly raise blood sugar levels and can help you feel fuller for longer, aiding in weight management and glucose regulation.

1. Choose Whole Grains: Whole grains contain bran, germ, and endosperm, providing more fibre and nutrients than refined grains, which only contain the starchy endosperm. Go for options like brown rice, quinoa, whole wheat bread, and oats for sustained energy and improved glycemic control.

1. Consider a Plant-Based Diet: Plant-based diets have been associated with reduced risk of diabetes and improved blood glucose management. They are low in saturated fat and cholesterol, making them beneficial for insulin sensitivity and weight management. Incorporate a variety of fruits, vegetables, whole grains, legumes, nuts, and seeds into your meals to support metabolic health and overall well-being.

Lifestyle:

1. Exercise Regularly: Engaging in various forms of exercise, including aerobic, resistance, and high-intensity interval training (HIIT) can help reduce glucose variability. Studies indicate that exercising for at least 150 minutes of physical activity per week, coupled with weight management strategies, can lower your risk of developing diabetes by as much as 58% in as little as 3 years. Even a single moderate-intensity workout can significantly enhance glucose absorption by cells, thus improving glycemic control.

1. Select Appropriate Exercise: Choose activities that suit your individual circumstances and capabilities, especially if you have type 2 diabetes or obesity. While exercise is vital for managing diabetes, it's crucial to avoid injury/discomfort and minimise the risk of hypoglycemia. Opt for moderate aerobic or stretching exercises, and ensure that the intensity and frequency align with your health goals.

1. Prioritise Quality Sleep: Strive for consistent and adequate sleep duration, aiming for at least 7-8 hours per night. Poor sleep quality and inadequate duration have been linked to increased insulin resistance and poorer glucose control, especially among people with type 1 diabetes. Sticking to a regular sleep schedule can help stabilise your glucose levels and improve overall health.

1. Manage Stress: Practice stress management techniques to regulate cortisol levels and mitigate its impact on glucose metabolism. Chronic stress can contribute to insulin resistance, exacerbating glucose variability and increasing your risk of metabolic disorders like obesity and diabetes. Incorporate relaxation techniques such as meditation, deep breathing exercises, or yoga into your daily routine to promote overall well-being and glycemic stability.

Navigating glucose variability requires a multifaceted approach that covers dietary adjustments, lifestyle modifications, and even your sleep habits. Simple measures like adding more nutrient-rich foods like healthy fats and whole grains to your meals, getting some regular physical activity, promoting your sleep quality and reducing stress can optimise your metabolic health and reduce your risk of diabetes and obesity-related complications. Remember, small changes can yield significant results on your journey to longevity.?

GV is one of several biomarkers related to diabetes, obesity and metabolic disorders. To better understand your bio-individual risks and advantages, book a batch of blood biomarker assessments + personal consultation with me by clicking here.

Sources

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