Sugar, Starch, Glucose, and Insulin

Starch and Sugar cause High Levels of Glucose and Insulinsugar-starch-glucose-insulin-spoonfu-of-sugar

Sugar and starch are eaten in abundance in the Western diet. The body is not equipped to deal with this, and cannot thrive with this excess present. Here we explain how they interact, and how they can be measured and controlled. Sugar and Starches are directly converted to glucose by the digestive process. Glucose is a simple form of sugar. High blood glucose levels, and the high insulin levels associated with them are a major causative factor in most degenerative disease. So why is a high level of glucose bad?

Glucose seems to be a major player in most degenerative disease. The plaque that gums up arteries, causing atherosclerosis, typically has some glucose components in it. Excess sugar raises triglycerides, a major heart risk factor. Excess glucose leads directly to insulin resistance, weight gain, and if carried far enough, adult onset diabetes. The brain damage seen in Alzheimer’s tends to have glucose products present. Non-Alzheimer’s dementia is also associated with higher blood glucose. Finally, glucose is a cancer promoter. Cancer cells usually can only survive on glucose, and they need a lot of it.

Sugar, the way the term is loosely used, usually consists of a 50-50 mix of glucose and fructose. This is true for table sugar and high fructose corn syrup and roughly true for most fruit. Starches, however, are converted by the intestine to 100% glucose. Once clear of your stomach and intestine, both fructose and glucose go first to the liver, but after that, their fates diverge markedly.

Glucose from food you ate passes mostly through the liver and then directly into the bloodstream. The body then generates insulin, which acts as a delivery service, carrying the glucose through the blood stream and delivering it to waiting cells. The muscle, brain, and other cells have first shot at this, but if there is glucose left over, it’s stored as fat in the fat cells. So excess glucose makes you fat!

Fructose doesn’t make it out of the liver in one piece. The liver first uses it to replenish its glycogen, a high density form of sugar the liver builds and stores for later use. Once this is topped up, the liver converts the remaining fructose to triglycerides, the basic molecule of fat. It then packs lots of these little fat molecules into VLDL particles along with cholesterol and other stuff, and sends them off into the blood stream. VLDL stands for Very Low Density Lipoprotein, and is a fluffy wad of triglycerides and cholesterol. As the VLDL floats by, cells can snatch a triglyceride and use it for energy. Muscle cells, fat cells, and in some cases brain cells can do this. As the triglycerides are stripped off, the VLDL particle shrinks, eventually becoming LDL, the infamous ‘bad’ cholesterol. So excess fructose makes you fat and increases your LDL!

Sugar-Starch-glucose-insulin-DandelionFor these reasons, there is currently a lot of press suggesting that fructose is worse than glucose. This is like comparing Genghis Kahn to Attila the Hun.

Fructose isn’t really needed at all. The ever versatile liver can replenish its glycogen storage from glucose alone if need be. Glycogen is a massive molecule made up of perhaps as many as 30,000 little glucose molecules very precisely strung together and packed in an elaborate and complex topography. It looks like a dandelion about to be blown. If the liver is building glycogen by using fructose, it converts it to glucose before attachment. After a meal is digested and there is no blood glucose available from food, the liver will supply it by disassembling the glycogen-dandelion back into individual glucose molecules and letting them loose into the bloodstream. Quite versatile, the liver.

The muscles also store glycogen, actually more than the liver. They make it from the arriving blood glucose. The muscle glycogen is rapidly consumed in exercise.

The amount of circulating glucose is tiny compared to the glycogen store, 5 grams (about a teaspoon) versus 100 grams in the liver and 400 grams in the muscles.

Young cells can metabolize glucose more efficiently than old cells. It is for this reason that children can get away with a sugar/starch intake that would rapidly get stored as fat in many adults. However, this obviously has its limits too as we are reported to be in the midst of a childhood obesity epidemic. The obesity is the visible effect, but arterial plaque is developing, cellular stress is developing, along with insulin resistance, the hallmark of adult onset diabetes. If for some macabre reason you wanted to jumpstart degenerative disease, excess sugar and starch in childhood would be very effective.

The Sugar/Starch Management Report Card

Do you know your sugar and insulin levels? Glucose is measured in the blood test that accompanies a typical physical. Fasting insulin is almost never measured. Ask your doctor for Sugar-Starch-glucose-insulina fasting insulin. Additionally you should ask for an A1C test, which is a measure of average glucose level over 90 to 120 days.

If you have these numbers, you can see what ‘grade’ you made. You get an ‘A’ if fasting glucose is below 80 mg/dl, A1C is less than 5%, and insulin is between 3 and 6µu/dl. Fasting means 12-14 hours after your last meal. Circulating sugar from that meal should be long gone and the hypothalamus should be regulating to your ideal reference point somewhere below 80. At this point, it’s adding sugar to the blood by directing the liver to dump glucose from the glycogen that was stored earlier. There should be little need for the insulin escort, so its level should be below 6, effectively turned way down.

A1C is an indirect measure of average sugar. The average includes the fasting level as well as the higher levels that occur right after a meal. A score of 5 on A1C means an average level of 110 mg/dl. This in turn means either your body rapidly took up all the sugar and starch you ate, or that you aren’t eating much of it in the first place.

Otherwise, if your A1C is less than 5.5, fasting glucose less than 90 and the insulin less than 10, give yourself a ‘B’ for now, but if any of these three are near these limits, you are not on very solid ground and should make a dietary change, and cut sugar or starch. If you are over any of these limits, you get a ‘C’ and are showing signs of insulin resistance and on your way to early diabetes unless you change course. You definitely need to cut sugar and starch in this case. This will have to be a lifetime decision, so cut it in a way you can live with. This isn’t always easy, especially at first, however, it is imperative to reverse this.


…in a nearby parallel universe…

If you have been eating a lot of starch and sugar, your cells have ‘programmed’ themselves to run on this. They will take anywhere from 2-3 months to switch to fat metabolism, which is the healthy route. You will crave sugar and carbs during that time, but there is a light at the end of the tunnel. After the adjustment period has passed, you will won’t crave starch and sugar as desperately ever again.

Once you drive your numbers to an ‘A’, or at least a ‘B+’, you can experiment with adding some of your favorite carbs back in. But only through careful calibration. In other words only by employing the technology of Quantitative Medicine.

  5 comments for “Sugar, Starch, Glucose, and Insulin

  1. Jim
    February 22, 2015 at 5:04 am

    Another great post. I can say from experience too that after cutting added sugars out of my daily eating, and once adjusted, I didn’t seem to crave them as much. I can also say that after adjustment, trying to add some back can be a slippery slope, so be careful not to thwart any progress. Many need to understand that “treats” are just that – reserved for once in a great while, and not a staple – if you can tolerate them.

  2. Sri
    February 22, 2015 at 8:37 pm

    Thanks for the Report Card Doc.

  3. February 23, 2015 at 2:08 pm

    Hi Jim,

    I agree. I believe St. Augustine had it right: “Complete abstinence is easier than perfect moderation.”

    So ‘add-back-ins’ introduce a very slippery slope.

    Charlie, who seems capable of ‘perfect moderation’ is more sanguine about this than I am.

    Thank you, Jim, and Sri for your comments,

    Dr. Mike

  4. Pat
    January 10, 2018 at 8:57 am

    Really helpful and interesting stuff!

    Is it ok for someone (me) who has a score of “A” to have a bowl of oatmeal or some Ezekiel bread for breakfast? (I still eat grains and some processed foods so this would be a grain reduction for me).

    • January 11, 2018 at 9:44 am

      Hi Pat,
      I am not a fan of soy and most versions of Ezekiel bread include soy as the other bean; the lentils would be fine for you. So, of the two choices you offer – The Lady or The Tiger – I would go with the occasional oatmeal. ‘”…grain reduction for me..” Great, Dr. Mike

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