The Secret Life of Glucose
Section titled “The Secret Life of Glucose”Glucose Disposal - A Measure of Health
Section titled “Glucose Disposal - A Measure of Health”We usually equate good health with low blood pressure, low cholesterol, normal weight, and of course, the absence of illness. Let me introduce you to another measure of health -- glucose disposal. Glucose is blood sugar. Disposal refers to the efficiency with which your body takes carbohydrates and burns them for energy. If you are not burning glucose quickly and efficiently, it is possible to change that and improve you health.
How Blood Sugar Works
Section titled “How Blood Sugar Works”We've learned a lot about glucose disposal by studying type 2 diabetes. We used to call type 2 diabetes adult-onset diabetes, but unfortunately kids are getting fat enough early enough to get this, too. Type 2 diabetes occurs when the cells of the body become resistant to the action of insulin; blood sugar rises and causes a world of trouble.
Let's look at what's actually happening on a cellular level. When we consume carbohydrates, our body converts them to glucose, shunts the glucose into the blood, and then passes it into the space between the cells, called the intercellular space. The oily cell membrane (composed in part of lecithin, cholesterol, omega-3 and omega-6 fatty acids) will not allow glucose to pass into the cell by itself. Insulin's job is to tell a protein on the cell membrane, called the "insulin receptor," to start pulling in glucose.
When the insulin receptor doesn't work very well, the pancreas must make more insulin to stimulate the receptor enough to do its job. The pancreas can make more insulin for a while, but then two problems arise.
First, the pancreas may eventually lose the ability to make enough insulin to keep glucose levels down, resulting in type 2 diabetes.
Second, higher than normal levels of glucose and insulin - even short of full-blown diabetes -- damage the body. High levels of insulin trigger higher cholesterol and triglycerides, damage the lining of the blood vessels, cause fluid retention, increase C-reactive protein (much in the news these days as a risk factor for heart disease and stroke), increase fat production (we're talking love handles here, not fats in membranes or somewhere useful), raise blood pressure, and ... but let's stop. You get the idea.
On the other hand, if the insulin receptors are working well, we need make only small amounts of insulin. The carbohydrates we eat are promptly pulled into brain cells, muscle cells, and all other working cells of the system, and we avoid high blood pressure, diabetes, elevated cholesterol, weight gain, and so on.
How To Measure Glucose Disposal
Section titled “How To Measure Glucose Disposal”Blood glucose levels go up and down by the minute, so checking those even several times a day is not an accurate way of measuring our average exposure to excess glucose. Research scientists use sophisticated tests to measure glucose disposal, but these are too expensive for day-to-day use. In clinical practice, we can get good information by measuring hemoglobin A1c, or glycohemoglobin. Glucose is sticky stuff. It won't just stick to your hands, it'll also stick to the tissues in your body - nerves, eyes, kidneys, everything. It sticks to hemoglobin, that red protein that carries oxygen for us. That's handy, because it is easy to get a little blood and see how much glucose is sticking on to that hemoglobin. Usually about 5 percent of our hemoglobin has some glucose stuck on it. Since we make a whole new supply of red blood cells every 120 days, the percentage of glycohemoglobin gives us an idea of what our blood sugar has been averaging over the past couple of months. The lower your glycohemoglobin, the better your glucose disposal! If you would like to learn what your glycohemoglobin is, we can measure it.
How to Improve Glucose Disposal
Section titled “How to Improve Glucose Disposal”The best way to improve your glucose disposal is to exercise. There are many studies that show this to be true. In one, fully half of a group of people with diabetes type 2 returned to normal with diet and exercise. Remember the rallying cry, "Death has a hard time hitting a moving target!"
Now, you can find all kinds of studies showing that cinnamon, essential fatty acids, vitamin E, lipoic acid, vanadium, chromium, certain herbs, and so forth can improve glucose disposal, but don't kid yourself. If you have poor glucose disposal and really want to improve it, you need a major change in diet and exercise. If somebody looking at you from a distance can't tell that you've changed your lifestyle, you haven't changed your lifestyle. If you are interested in lowering your glycohemoglobin, check out our weight management services. Glycohemoglobin, weight, blood pressure, blood sugar, and cholesterol generally rise and fall as a group, so even though our page is titled "Weight Management Programs," the information applies to all conditions associated with glucose disposal.
No one is claiming that lifestyle change is easy, but it can be extremely satisfying and it will improve your health and your well being. The next time your friend or family member makes a comment about your weight, just smile and tell them "I have a glucose disposal problem, and I'm doing something about it."
We Get Mail
Section titled “We Get Mail”Dear Readers,
We received strong reader reactions to our article on American pharmaceutical companies. Several readers found the piece useful and informative; one thought it sounded like Fox News propaganda.
To open discussion, we're reprinting the reactions we received. We'd like to know what you think.
"Give us the straight goods."
Section titled “"Give us the straight goods."”"I appreciate your perspective on health, as I trust you, as my physician, to treat me with care and concern ... However, may I suggest that you confine your discussions to actual health and medical concerns and leave out the politics? Everyone is entitled to their opinion of course ... I personally find a few of your attitudes somewhat noxious, particularly when you feel compelled to defend big-pharma and trash personal injury attorneys. Not that these are black and white issues ... I actually enjoy debating the points at times, but when I read the health information which you generously provide, I'd rather not wade through the mini sermons which sound to me like Fox news propaganda.
I know you don't agree, but I think anything other than a universal health care system as enjoyed by every other western nation, is backward and barbaric. Many of the lawsuits you deride aren't allowed in other countries for the simple reason that they are perceived as unnecessary due to the guaranteed safety net for all patients.
Anyway, I'm not writing to debate, just point out that you'll probably reach me and others more effectively if you stick to the pure health issues which you obviously know a great deal about and I enjoy reading immensely. I also like you personally and don't see why you would want to cloud the waters. Some might react by simply deleting your email or getting removed from your list. I don't want to throw out the baby with the bathwater. Just suggesting you give us the straight goods.
Respectfully yours,
"David"
"Thoughtful"
Section titled “"Thoughtful"”"Excellent, very thoughtful, newsletter Douwe!
Thanks from Richard Lynn, MD"
"Re: No Drugs from Canada"
Section titled “"Re: No Drugs from Canada"”"I finally read your commentary. Par Excellence! Thanks for the Medicine for People emails, also.
Regards,
Judy A. Peterson"
LASIK, Risky or Wonderful?
Section titled “LASIK, Risky or Wonderful?”If you're considering LASIK, be sure to get the numbers from your eye doctor. Ask him what percent of his patients improve and how many need a second surgery to improve the improvement.
What LASIK Is
Section titled “What LASIK Is”Visual problems are often due to imperfections in the cornea. LASIK surgery uses a special laser to shave off some of the cornea, reshaping it to improve vision.
What You Need to Know
Section titled “What You Need to Know”According to a review in The Medical Letter Jan 19th, 2004, laser surgery improves vision in about 29 of 30 patients. Between 5 and 28 percent of those patients will require a second procedure to obtain an optimal result. What about that thirtieth patient? He or she will have lost "best spectacle-corrected" vision. That means their vision may have been 20/80, correctable to 20/20 with glasses. After surgery, they may see 20/40 without glasses, but even with glasses, will see no better than 20/40. So their "best spectacle-corrected" vision will have fallen from 20/20 to 20/40. Not good news if you are a pilot, professional driver, or surgeon.
What Would I do?
Section titled “What Would I do?”I have vision good enough not to need it, but if I did, I would research my doctor very carefully before I went ahead with this irreversible surgery.
Best Link: http://www.fda.gov/cdrh/LASIK/risks.htm
CJK January 23, 2006