By Dr Joe
Are “non-diabetic blood sugar spikes” an actual phenomenon or not? Let’s talk about it, shall we. Something millions of people don’t realize is that non-diabetics do experience blood glucose spikes after meals.
Yes, non-diabetics get blood sugar highs, believe it or not. They just don’t know it and this phenomenon has implications for your health.
Your doctor won’t tell you how important your blood glucose control is as a non-diabetic. I will.
The reason your doctor fails to tell you this is mainly because it is generally thought that until a diagnosis of diabetes is made, you are assumed to be metabolically competent.
But that is not always the case.
In actual fact, this is the reason why a lot of prediabetes cases are missed. Prediabetes is the abnormal metabolic stage before type 2 diabetes actually bites.
And before the prediabetes stage, you also develop insulin resistance which is largely silent as well.
Doctors don’t pay enough attention to metabolic health in a run-of-the-mill consultation even if the consultation is for a wellness overview.
There are so many individuals with insulin resistance, prediabetes and frank type 2 diabetes walking around totally unaware they have any of those conditions.
If only we paid just a little attention to our metabolic health, we could prevent millions of cases of type 2 diabetes raging around the globe like a wild summer forest fire.
Do non-diabetics have blood sugar spikes?
I often get asked about whether non diabetics have blood sugar highs i.e blood sugar spikes. The short answer is,; Yes, they do. Blood sugar spike after eating in a non-diabetic is real, but there is a caveat here. Not every non diabetic does.
It all depends on what I call metabolic competence along with other variables.
Before I talk about the variables involved, let me draw your attention to this study carried in Ulm University in Germany.
They recruited 24 healthy volunteers into the study and made them eat similar meals in the first 3 days of the study and then allowed them free eating under daily real life conditions for the rest of the study.
The operative word there is healthy. The study participants were thoroughly examined to confirm they were truly non-diabetic by a variety of tests including blood insulin levels, c-peptide levels, HbA1C and oral glucose tolerance test.
You don’t have to know the ins and outs of those tests if you are not familiar with them. All you need to know is, if a combination of all those tests are normal, then you are definitely not diabetic.
They were young men and women, 24 in total (12 males and 12 females) with a mean Body Mass Index of 22.6. They were well within normal body weight by all accounts and young too. Mean age was 27 years.
Participants were fed 50gm carbohydrate meals for the first 3 days of the study and allowed home to eat freely for the rest of the study.
The participants had continuous glucose monitoring for 24 hours a day during the study period, so every tissue glucose fluctuation was registered and analysed to give a fuller, clearer picture.
What the study found.
They found glucose excursions (or glucose fluctuations if you will), to vary between 59mg/dl – 168mg/dl (3.3mmol/l – 9.3mmol/l) during the day. Night time glucose was fairly stable.
What does this tell you – How high can a non-diabetic’s blood sugar go?
This study clearly shows that even non diabetics do show fluctuating high blood sugar levels when they eat. If you take it one step further and would like to know how high can a non-diabetic blood sugar go, that study gives you an answer right there.
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In that cohort of healthy non diabetic individuals, their blood sugars were hitting a high of 168mg/dl (9.3mmol/l).
In answering the question of how high can a non diabetic’s blood sugar go, it will vary between individuals.
168mg/dl (9.3 mmol/l) was the peak blood sugar level in those non-diabetics in the study.
Don’t forget though that these were young men and women with an average age of 27 years.
In real life as we know it though, how high your blood sugar will go will depend on your metabolic competence and of course, the type of foods you eat.
In those non diabetic individuals in the study, they also found that breakfast was the worst culprit of the meals.
So, don’t be fooled into thinking your blood glucose levels are always normal after a meal just because you don’t have a diagnosis of diabetes. A lot of normal non diabetic people do swing their blood glucose levels.
The nearer you are to the diabetes door, the higher your blood glucose excursions when you eat.
What is normal blood sugar levels after eating for non-diabetics?
It would be remiss of me, if I left you hanging without letting you in on what normal blood sugars should be after eating if you are non-diabetic.
What’s the point of telling about blood sugar spikes in non-diabetics if I don’t reveal what normal blood sugars should be after eating.
The essential point here though is; the importance of non-diabetics having a control on their diet. What you eat has either a positive effect on your health or a negative one.
Let me repeat that.
Non-diabetics are obliged to take control of their food choices, if they are to avoid the health implications of blood sugar highs. This is the whole point of this exercise.
You may want to use the figures below as your non-diabetic blood sugar chart if you like. It works just the same way.
So, below is your non-diabetic blood sugar or glucose chart and this is what is recommended by the American College of Clinical Endocrinologists.
Of particular interes,t are the values there that represent what you, as a non-diabetic should be aiming for at 1 hour after eating and 2 hours post meal. They represent what should be normal blood sugar levels after eating your meal.
As you can see; it is anticipated that your blood sugar should peak 1 hour after you have eaten but some foods may swing either way.
For instance, an oatmeal may peak just beyond the 1-hour mark compared to a bagel, doughnut or potato fries which might peak much earlier.
In fact, in the study above, they actually found that blood glucose peaked around about 45 minutes after the subjects ate.
However, for standardisation purposes, the 1 hour after eating blood glucose value of 140mg/dl (7.8mmol/l) for non-diabetics has become a reference point that doctors would recommend you aim for.
Just as a non-diabetic is expected to have blood sugar levels of 100mg/dl (5.5mmol/l) after fasting overnight.
One very important point is that these set values for non-diabetics are target figures. They should represent your top value. Indeed, you should be aiming for less than the top value. The further away you are below the top set values, the better.
How long after eating does blood sugar return to normal?
I get asked often how long after eating should blood sugar return to normal. Well, the simple answer to that question is; blood sugar should return to normal within about 2 hours of eating.
Ideally, blood sugar should be back to normal values at 1 hour and half. That is if you are metabolically competent. Of course, if it’s taking longer, then your metabolic competence is being called to question.
To fully understand this, I have to explain how this whole blood sugar regulation shenanigan works when you eat. Brace yourself…
Here we go…
Your pancreas has some some cells scattered inside it called beta cells. These beta cells manufacture, store and release insulin when needed. You will always have some insulin in your blood circulation at any point in time in the 24 hours of the entire day.
You will never have zero insulin level at anytime. This is called Basal Insulin release.
When you eat, your pancreas is called into action straightaway. Eating causes a rise in blood sugar. A blood sugar rise is a clarion call for the beta cells of the pancreas to release insulin over and above the usual basal insulin release.
A blood sugar rise over 100 mg/dl, (5.5 mmol/L) would trigger a release of the stored insulin to bring back the blood glucose to normal levels. This is called First Phase Insulin Release.
The 1st Phase Insulin Release is triggered within a couple of minutes of commencing your meal.
And in normal metabolically competent individuals, this first phase insulin release is enough to prevent any significant blood sugar rise which should peak 45 minutes after you start eating.
If there is failure to return the blood sugar back down to below 100 mg/dl, (5.5 mmol/L), the beta cells will push another round of insulin into the circulation to get the glucose level down. This is called Second Phase Insulin Release.
It is expected that this second phase insulin release should complete the job of regulating the blood sugar to normal. And this should happen within an hour and half after eating. Certainly 2 hours max.
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Why is it important for non-diabetics to know about controlling their blood sugars after eating?
As you can see from those non-diabetic blood sugar chart values, the highest blood sugar you mustn’t exceed is 140mg/dl (7.8mmol/l).
That number or value wasn’t plucked from thin air. It was based on research. It is thought blood sugars above the 140mg/dl (7.8mmol/l) is the level at which cell damage by the excess blood sugar in circulation begins to occur.
There are 2 main reasons why controlling your blood sugar after meals is important:
- Unrecognized type 2 diabetes
- And the number 1 killer disease the world over – Heart disease
I do not want to scare you in any way but a lot of damage does occur beneath the surface, so to speak, in individuals with undiagnosed type 2 diabetes and those who are not frankly diabetic but fall into the category of impaired glucose tolerance.
More or less the impaired glucose tolerance individuals are the prediabetics.
The danger here is; a lot of people who are pre-diabetic or insulin resistant are totally unaware they are. For practical reasons, we consider these people as being “normal” or “non-diabetic” even though in truth they are not.
What’s your risk of death from undiagnosed high blood sugar?
This DECODE European Study old it may be, did demonstrate that the relative risk of death from heart disease and strokes increases by 1.5 times when your blood glucose after 2 hours post 75gms glucose test is between 140mg/dl (7.8mmol/l) – 200mg/dl (11.1mmol/l). See Red arrow in Chart below.
I want that figure to sink in for a moment. People who have a result between 140mg/dl (7.8mmol/l) – 200mg/dl (11.1mmol/l) are not considered diabetic but prediabetic. That piece of research is telling us the risk of death of prediabetics is already high.
The sad thing is that millions of people like you and I are walking around not knowing that we may have pre-diabetes simply because we have not been tested.
…and also because we do not show any symptoms.
Worse still is, that same research does tell us if you your blood sugar is above 200mg/dl (11.1mmol/l) your relative risk of death actually doubles.
John Fuller several years ago also did a classic piece of research where he gave 18,403 British men aged between 40 – 60 years of age 50gm of glucose load. John secured the results of the test and just simply followed the individuals up for 7.5 years to see what their mortality risk was over time.
He wanted to know if increases in blood glucose after 2 hours of the 50gm glucose load would be a risk factor for heart disease or death.
John and his colleagues found the men who had 2-hour blood glucose levels below 96mg/dl (5.3mmol/l) did not suffer any significant mortality.
However, mortality doubled in those whose 2-hour blood glucose were between 98mg/dl – 200mg/dl (5.4mmol/l – 11.1mmol/l) as the follow up years rolled by. See Red Arrow in chart below.
What do these 2 studies tell us?
I did not mean to scare you with those statistics but to make a point. The main conclusion from those 2 studies is that you can use the 2-hour glucose test to predict mortality from what I call metabolic incompetence.
Metabolic incompetence that you may not be aware of because you do not have any symptoms. So to all intents and purposes, you are disease-free. But in truth, you are not.
Shall we then agree that until you have had a rigorous test to check that you are not insulin resistant, pre-diabetic or actually have type 2 diabetes, you may well do your body serious favours by managing your diet.
Even if you have had tests that prove you are not diabetic, you still need to watch what you eat to avoid blood sugar spikes when you eat. Because non-diabetics do spike blood glucose after having regular everyday popular foods.
The kinds of foods you eat play a huge role as to whether you get blood sugar spikes after your meals or not.
For instance, that pasta, that rice, that pastry, that white potato, that high fructose corn syrup you had yesterday or this morning may have rocketed your blood sugar levels to those levels recognized in those researches I mentioned above.
That means you could be doing the same damage to your heart without realising you are…simply because you are not diabetic.
You would have noticed earlier that even in healthy non-diabetic young men and women with an average age of just 27, they experienced glucose excursions hitting 168mgdl (9.3mmol/l).
How much more do you think your blood glucose excursions will be after a meal if you are older, say over 40 and have other risk factors such as being overweight and sedentary. I will discuss the risk factors for diabetes in another article.
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Your Take Home Message
But for now, your take home message here is this.
Not being a diabetic does not mean you are immune from diabetes-like blood glucose levels after your meal especially when you eat high glycaemic index foods. This is more likely to occur as we get older.
You need to start taking precautions and how do we do that?
By simply watching what we eat and the portions we eat.
Your first victory when you avoid the blood sugar spiking foods and limiting your food portions is that you avoid the after meal glucose highs.
That in itself stops you from developing insulin resistance which in turn prevents type 2 diabetes. Ultimately by so doing, you automatically are lowering your heart attack risks by a mile.
My friend, Mike gives some guidance about some of the foods that may be spiking you and they are in your kitchen right now. His article is more like a follow up to what I have been talking about here. It’s a good read that bolts on to this piece. Read Full Story Here.