[sdo72]

I don't know why modern days we get so many problems wrong.

A -> B, then B -> A => incorrect

In a fire, we see firefighters, that doesn't mean firefighters cause fire. In diabetic patients, we see high glucose level. That doesn't mean eating high GI food causes someone to have diabetes.

If we look at the Blue Zone, many people eat mostly carb. So carb/high GI food definitely doesn't cause diabetes.

Devices like this will make other people fearful of high glucose and think they're getting diabetes. People without the disease shouldn't focus on monitoring the glucose level, focus on eating healthy instead. And of course eating healthy is another complex topic.

[462436347]

> If we look at the Blue Zone, many people eat mostly carb. So carb/high GI food definitely doesn't cause diabetes.

While obesity is known to be the greatest risk factor for T2DM, you can induce insulin resistance in weight-stable individuals just by shifting the macro composition of their diet towards saturated fat:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291812/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171936/

Sugar, amusingly, doesn't seem to have the same effect.

Given that the typical recreational CGM wearer (in my experience) is a low-carb/keto type (who ruined their insulin sensitivity), you should probably take the comments in this thread touting CGM use with a grain of salt.

[migro23]

> In a fire, we see firefighters, that doesn't mean firefighters cause fire. In diabetic patients, we see high glucose level. That doesn't mean eating high GI food causes someone to have diabetes.

This is correct but probably not in the way you think. It is not the glucose in and of itself that is the problem but the level of the hormone insulin circulating around your system that is at the root of Type II diabetes. Glucose and insulin are highly related. Insulin is released by the pancreas to help control the level glucose in our blood.

Virtually no insulin is required when metabolising fats, a small amount is required for protein and a larger amount of insulin is required when dealing with glucose dense carbohydrate based foods. The faster a carbohydrate is metabolised the greater the dose of insulin required to quell the resulting glucose rush in the blood.

What does the insulin do? As a hormone it has many functions. The presence of insulin in the blood signals to all cells to burn sugar (glucose) rather than fats (ketones) for their energy. It prompts the cells in the skeletal muscles to store up glucose in the form of glycogen for later use and it signals the liver to store excess glucose that is not immediately needed. Once the liver and muscles are full then the liver then converts any excess to triglycerides.

Where do the triglycerides go? They get stored as subcutaneous fat all over but largely in the belly (in men) and bum/upper legs (in women). What happens when subcutaneous stores are full? Then the triglycerides are shoved anywhere and everywhere. Fat is pushed into muscle cells as well as the cells in individual organs. The fat molecules present in cells in organs are particularly pernicious (visceral fat) but any cells that contain these triglycerides seems to disrupt the insulin signalling within the cell. This results in insulin resistance i.e., the ineffectiveness of insulin to signal to the cell to take up excess glucose.

When sufficient threshold of insulin resistance is reached, you will get higher blood sugar readings and a higher A1C at which point your doc will say you have prediabetes or full on type II diabetes.

Insulin is the master key variable that unlocks the type II diabetes puzzle. High blood sugar levels are just a symptom. The problem with modern day Type II diabetic care is they consider the high blood sugar as the root problem. So this is treated with meds such as metformin and eventually MORE insulin. Understanding type II diabetes as a disease of too much insulin sheds the disease in a very different light.

Anyway, you are correct, the high glucose level per se is not the cause, but high levels of insulin constantly circulating around your system is the big problem. Of course an effective way of doing that is to continuously eat foods dense in glucose and fructose that are metabolised very quickly e.g., cookies, ice-cream, orange juice etc.

> If we look at the Blue Zone, many people eat mostly carb. So carb/high GI food definitely doesn't cause diabetes

Blue Zone areas such as Okinawa, you do find people eating carb rich foods but they are also high in fibre e.g., root vegetables, sweet potatoes etc. look at books by Robert Lustig to learn more about the importance of fibre in relation to metabolism and diabetes risk.

[sdo72]

Thank you for the detail :). And yes, I do believe lacking of fibre is one of the key important factors causing many kinds of diseases, and the modern diet is totally missing lots of fibre.

[migro23]

You're welcome. I must add that I am not a doctor so take the above with the appropriate level of skepticism on your behalf. I am only summarising what I have learned from books and have omitted A LOT of detail.

Recommended further reading

- Pure, White and Deadly (John Yudkin)

- Fat Chance (Robert Lustig)

- Outlive (Peter Attia) contains an excellent and concise synopsis of the mechanisms behind metabolic disease

[ravenstine]

Glycemic index is only sort of useful for people who actually have diabetes, where blood sugar dysregulation makes insulin regulation equally as precarious. For anyone who doesn't have diabetes, GI doesn't really mean anything other than that their insulin may or may not spike in a short period of time related to a food. Glucose spiking, hence insulin spiking, is not something you want, but this also doesn't mean that something with a lower GI score is better for you and doesn't cause you to release as much insulin. Whether it's table sugar or whole grain pasta, they'll become glucose that the body will use or store in one way or another. Fasting glucose will still remain higher.

> Devices like this will make other people fearful of high glucose and think they're getting diabetes.

Elevated glucose is exactly what causes type 2 diabetes. Take away the glucose supply, and you don't have elevated insulin. Fear of glucose that is too high too often is entirely justified and is not something that should be going on if people can avoid it. Sugar molecules are damaging to cells and are related to other things like cardiovascular calcification.

> If we look at the Blue Zone, many people eat mostly carb.

So-called "Blue Zones" are not science. They are anecdotal, cherry-picked, uncontrolled, and can't be tested. Also, some of those zones, such as Okinawa, are mythical. Okinawans historically have eaten a lot of pork, and still eat a ton of pork. They also used to not keep much in the term of birth records, so there was really no way to know how old any of those people were back when they were studied.

> So carb/high GI food definitely doesn't cause diabetes.

Propose a model of type 2 diabetes that doesn't involve dysregulation of blood glucose and come back to us.

[462436347]

> Elevated glucose is exactly what causes type 2 diabetes. Take away the glucose supply, and you don't have elevated insulin. Fear of glucose that is too high too often is entirely justified and is not something that should be going on if people can avoid it. Sugar molecules are damaging to cells and are related to other things like cardiovascular calcification.

No, it doesn't: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602127/

[ravenstine]

Reread that article. It has literally nothing to do with cause and effect. The study finds an association between intramyocellular lipids and insulin resistance, and has absolutely nothing to say about whether diabetes is caused solely by glucose dysregulation or something else.

[sdo72]

Every response you have don't relate to my comment! and I believe you have incorrect info in your responses as well.

[ravenstine]

Surely you have a good example of what I am incorrect about instead of merely saying I am wrong?

[sdo72]

Your comments aren't the responses to my comments. Let's take an example, my comment is neither proposing a model for T2D nor saying CGM is part of any model.

You said Okinawa people eat a ton of pork, please compare with something.

You said they don't have birth record accuracy which is not totally true. In many asian culture, they use Zodiac and similar methods to keep track of age, the exact date may be off, but the year cannot be off because if it's off, that's 12 year difference. I cannot be a dragon and claim myself to be 84 when I am only 72 because all of my friends around know how old I am around.

When 1 or 2 persons say it, it may be mythical. But when most of population say it, there must be some truth. And it's also up to you how you believe it.