Goal: precision nutrition
There are many good reasons to know how one’s blood glucose levels vary over 24 hours. Reasons linked not only to diabetes: measuring blood glucose dynamically and continuously, in fact, means accessing a myriad of information about important factors that influence our health and our aging process.
What are glucose, blood glucose and insulin?
Let us begin by saying what glucose and blood glucose are. The first is the sugar used by cells to produce energy (many of the foods we eat are transformed into glucose). Blood glucose is its value in the blood, generally expressed in mg/dl. For glucose to enter the cells, however, insulinHormone produced by Langerhans island cells of the pancreas. It stimulates the entry of glucose into the cells, subtracting it from the blood and thus lowering blood sugar. It induces the use of glucose both to produce energy and for the synthesis of glycogen and fats. is needed, a hormone secreted by the pancreas.
We do, however, have a good right arm supporting the pancreas, namely muscle: when stimulated, it is able to let glucose in even without the direct action of insulin, one more reason to keep it trained.
Are “glucose spikes” always dangerous?
Here it is important to remember that glucose spikes or, more precisely, rises in blood glucose and rises in insulin after meals are entirely physiological (the level of sugars in the blood obviously rises depending on the food consumed and, in healthy people, returns to baseline levels within a couple of hours precisely thanks to insulin production). When, on the other hand, insulin is not produced in sufficient quantity or when the body is unable to use it appropriately, a large and/or prolonged rise in blood glucose occurs, which, in the long run, represents a health risk.
In general, a good glucose curve is one that shows low fluctuations after a meal and quickly returns to stability.
What is glycated hemoglobin for?
Usually, blood glucose is measured while fasting, and a value that is too high is a warning sign of a condition of prediabetes or diabetes. But a single spot value is of little use: just like blood pressure, it can in fact be influenced by a great many factors. More indicative measurements are the glucose curve (after taking a glucose solution) and glycated hemoglobin, which makes it possible to assess the average trend of blood glucose over the last 3 months: these tests are normally prescribed by the physician precisely when diabetes or prediabetes is suspected.
SoLongevity Clinic
Measuring blood glucose with the patch
The average value (glycated hemoglobin), however, does not account for how blood glucose fluctuates at different times of the day (an expression of glycemic variability). And it is exactly from here that SoLongevity wants to start, to offer a precision nutrition service that aims not only at weight loss, but that has a significant impact on the prevention of diabetes and other pre-pathological and pathological conditions.
The SoLongevity Precision Nutrition Program involves a period of blood glucose monitoring for about 2 weeks, dynamically and continuously, through a patch, that is, the CGM sensor (Continuous Glucose Monitoring, normally used in patients with diabetes): a small device that is applied to the arm, painlessly and non-invasively.
The data are analyzed by an expert dietitian, and compared with information on meals and daily activities. It is as if, instead of snapshots, we could have a film that allows us to see how different behaviors, different food choices and different lifestyle habits — including physical activity, sleep, stress management and so on — influence endocrine and metabolic parameters, individual by individual.
Monitoring blood glucose with the CGM sensor is certainly not intended to eliminate fluctuations in blood glucose, something that would not be possible to achieve, also because it is not compatible with life: the aim is to increase awareness of one’s own lifestyle and of its effects on one’s metabolic health.
What is metabolic health?
It is now well known that the habitual consumption of sugars, refined flours, processed and ultra-processed products leads to real endocrine, metabolic and inflammatory stress.
As explained by Ilaria Bertini, a dietitian who collaborates with SoLongevity, what we eat and our lifestyle can generate and fuel endocrine-metabolic-inflammatory dysfunctions at both the microscopic (molecular) and macroscopic (phenotypic) level. Most of these dysfunctions “work” insidiously for years before damage or disease appears, and they accelerate aging.
Unfortunately, they are very difficult to detect with conventional diagnostics: “Metabolic health, that is, the ability to manage energy as well as possible, is fundamental for healthy aging. Wide, continuous fluctuations of hypoglycemia and hyperglycemia overlap, in fact, with oxidative stress, chronic inflammation, glycation, hyperinsulinemia and insulin resistance, which then, in a cascade, can lead to actual metabolic syndromethe metabolic syndrome is characterized by the simultaneous presence of at least 3 metabolic and haemodynamic alterations that represent a high risk factor for the onset of cardiovascular diseases and tumors., to neurodegenerative and cardiovascular diseases, and can also contribute to profoundly altering hormonal and immune system balance”.
Interpreting blood glucose monitoring
As we anticipated, glycemic variability is a relatively new parameter that is not part of conventional diagnostics. The CGM sensor measures interstitial glucose, that is, the sugars that pass from the capillary to the cell. What can we observe? For example — Bertini explains — how much blood glucose rises in the post-prandial state, but also how quickly it returns to baseline values and the difference from pre-prandial values. In this way it is possible to establish, among other things, person by person, the correct ratio between macronutrients such as proteins and carbohydrates.
The quality of food can also influence blood glucose, as can eating in company in a relaxed atmosphere or after stress at work, being outdoors or indoors. Again: a sleepless or restless night can alter the glycemic response to the first meal of the day. Finally, of course, the positive effect of physical activity (that is, of using the muscles) on the rise in blood glucose after meals is well known.
In women: how does the menstrual cycle affect blood glucose?
In women, there are also differences linked to the hormonal phase. For example, generally in the follicular phase (in the first two weeks of the menstrual cycle), women have better insulin sensitivity and better resilience to stress, and handle fasting very well. In the luteal phase, that is, when menstruation approaches, insulin resistance increases and they tolerate stress and fasting with great difficulty. Being aware of this allows us to intervene with tailored approaches.
What happens during monitoring with the CGM sensor?
For the first 4-5 days of monitoring, those taking part in the program must continue to behave normally, according to their usual habits: working days and weekends, outings with friends, dinners, aperitifs, and so on. In the other 10 days, on the other hand, the dietitian gives instructions: changing the time of a meal or changing the proportion between nutrients, modifying the quantity of an ingredient in a recipe. Day after day, small improvements are implemented that represent a real action of prevention and health optimization.
Ilaria Bertini was among the speakers at SoLongevity’s “In-Clinic Meetups”. Find out what they are, relive the events and register to take part free of charge in the next meetings.
