Retrospective #232: “A spoonful of sugar”

“A spoonful of sugar” is the title of a 14-year old and still popular blog post of Dr. Michael R. Eades. Eades, in his own words, is a “sort of traditional M.D. with an eye to what works to get patients well whether it is traditional or not.” He and his physician wife, Mary Dan Eades, are the authors of “The Protein Power LifePlan” and before that “Protein Power,” two of the best books I have read on the subject of optimal health, low carb eating and Type 2 diabetes.

The one-teaspoon-of-sugar metric refers to the amount of “sugar” (glucose) that is dissolved in the 5 liters of blood in the circulatory system of a typical human. In the article Dr. Eades explains that a blood glucose reading of 99mg/dl, “the highest fasting blood sugar you can have and not be diagnosed as pre-diabetic,” means that you would have just 4.95 grams of grams of sugar in your blood. One teaspoon of sugar is equivalent to, i.e., weighs just 5 grams.

The American Diabetes Association established the current Type 2 diabetes diagnostic thresholds in 2009. They are 70-99mg/dL being a “normal” fasting blood glucose, 100-125mg/dL being prediabetic, and ≥126mg/dL being diabetic.

Quoting Dr. Eades: “If you run the calculations for 126 mg/dl, the amount of sugar in the blood of someone just over the line into the diagnosis of diabetes, you find out that it is 6.25 grams, or 1 1/4 teaspoon. So, the difference between having a normal blood sugar and a diabetic blood sugar is about a quarter of a teaspoon of sugar.” He continues:

“What really gets kind of scary is when you look at the amount of carbohydrate in, say, a medium order of McDonald’s fries compared to the sugar in your blood. Remember, it is the job of your digestive tract to breakdown the starch and other complex carbohydrates, which are nothing more than chains of sugar molecules, into their component sugars so that they can be absorbed into the blood. An order of medium fries at McDonald’s contains 47 grams of carbohydrate*. 47 grams of carbohydrate converts to about 47 grams of sugar, which is almost 10 teaspoons. So, when you eat these fries you put 10 times more sugar into your blood than that required to maintain a normal blood sugar level. If you figure, as we did above, that one quarter of a teaspoon is all the difference between a normal blood sugar and a diabetic blood sugar, the 10 full teaspoons would be 40 times that amount.”

And if that isn’t scary enough, Dr. Eades then hits you with his coup de grâce:

“Since your metabolic system has to work very hard to deal with the sugar load from an order of fries, imagine what it has to do when you add a large soft drink, a hamburger bun, and maybe an apple turnover for dessert.”

I have to admit I never thought about my pancreas and its declining ability to make insulin, and my body’s declining ability to process that insulin, and the “sugar” attached to it in my blood, when I drove up to McDonalds and ordered my large order of fries, as a side order. For 16 years, before my doctor suggested I try very-low-carb eating to lose weight, I just relied on him to deal with my progressively worsening type 2 diabetes. I didn’t know any better!

Boy, what a difference eating very-low carb made, both in my weight (at one point I had lost 188 pounds) and in my diabetes status. Although I have since regained some of that 188 pounds (I continue to maintain at least a 150-pound weight loss), I am still able to stay off almost all the diabetes meds I had been taking. I had been maxed out on two orals (Metformin and glyburide) and had been started on Avandia. Today, I just take one small dose of Metformin a day. And my blood sugars are now “non-diabetic.” My A1cs are in the low to mid 5s, once even reaching 5.0%

The takeaway? In a person with a “healthy” metabolism, your body gives itself a shot of insulin the moment you see or even think about eating. A metabolism compromised by enough Insulin Resistance to give you an impaired glucose tolerance (IGT) can no longer do that. Then, when something starchy or sweet (carbs) contacts your saliva, the brain signals the pancreas to immediately secrete more insulin… but for some of us it’s too late. Your damaged or clogged pancreas can no longer make as much insulin as it did before, and the insulin that it does make is not “taken up” by the cells as it circulates around your body. The “not taken up” is the Insulin Resistance (IR) part.

The result: Your body is overwhelmed by the sugar (glucose) circulating in your blood after digesting the carbs (starches and sugars) you just ate, and your blood sugar rises above healthy levels, and the silent damage to your organs and your Microvascular and Macrovascular systems continues…

 * The McDonalds table has been updated. A medium French fries is now 44g of carbs. A large French fries is 67 grams.