Episode 109 Summary
- Blood Glucose vs Blood Insulin - There is a lot of confusion with people about the difference between, the relationship between and individual significance of blood glucose and blood insulin. Or you may have heard about this before, but it is important to revisit this important information repeatedly, as a form of insulation against the messaging from big food companies.
- What is blood sugar? When we refer to blood sugar what we are actually referring to is the concentration of glucose present in the blood. When we eat a high carbohydrate meal our bodies will have a resulting elevation in the blood glucose level. However just because your blood sugar is within range doesn’t mean you are metabolically healthy.
- What is insulin? Insulin is a hormone produced by the pancreas. When blood glucose increases, insulin signals the cells in the body to store the extra blood glucose as glycogen in the muscles or as fat in the fat cells. This is very important as elevated blood glucose levels over time are very harmful to the body. High blood glucose levels damage the lining of our arteries, and increase our risk of cardiovascular disease. They also cause damage to our kidneys and brain cells. This is why blood sugar levels are tightly regulated by the body.
- But they both spike! Doesn’t this mean they are the same thing? No, actually blood glucose will rise rapidly or “spike” following the ingestion of a high carbohydrate meal. Glucose is a molecule, an energy substrate which is absorbed into our bloodstream from food. Shortly afterwards our bodies secrete insulin, a hormone, “insulin spike” as a response to the increased blood glucose, to signal the cells to take up the glucose and return the blood glucose to a safe level. So they are related but completely separate biochemical processes.
- Which foods increase our blood glucose? Glucose can be ingested in the form of sweet sugars, such as table sugar or as savoury sugar, so for example starch in potatoes, rice, bread and cereals.
- What is insulin resistance and why does it happen? Over time when following a standard, typical western diet, our fat cells can become inflamed. They become resistant to the signals from insulin to take up the extra glucose from the blood, but as it is essential for the blood glucose to be tightly regulated the body will continue to produce more and more insulin, effectively “yelling” at the fat cells to continue to take up this onslaught of glucose from the blood. As they become more and more resistant the body starts to take up insulin and store it in the liver and the pancreas and we end up with fatty liver and fatty pancreas. This process can continue to escalate for years before the blood glucose levels will measure out of range.
- Why are some people more prone to insulin resistance and weight gain than others? Unfortunately the simple answer here is genetics and epigenetics. Some people are more genetically prone to insulin resistance and weight gain than others, even when consuming the same diet and living a similar lifestyle. The truth is however that in the long term MOST humans are prone to insulin resistance if they continue to consume a modern western diet.
- What can you do right now to set your blood glucose and blood insulin on the path back to balance? The best thing you can do is to decrease your consumption of both sweet and savoury sugars. Most people don’t realise that their cereal and their wholemeal bread and their orange juice might be leading to insulin resistance, not just the lollies, cakes and icecream. This way your body can naturally lower insulin. As your body naturally lowers insulin you are able to burn your own body fat stores and lose weight in a sustainable and healthy way.
- Sign up to our $7, 7 day no sugar challenge - Learn more about sugar in an achievable week long block. Discover all of the secret marketing tricks and hidden sugars in our foods, and get fabulous help, support and advice along with two masterclasses from Dr Mary Barson and Dr Lucy Burns.
Show notes:
The difference between Glucose and Insulin
Dr Mary Barson: (0:11) Hello, my lovely listeners. I'm Dr. Mary Barson.
Dr Lucy Burns: (0:15) And I'm Dr. Lucy Burns. Welcome to this episode of Real Health and Weight Loss. Gorgeous ones, Dr. Lucy here. And guess who's back! I'm so, so happy to be recording with Dr. Mary today. Gorgeous girl. Welcome back to the podcast!
Dr Mary Barson: (0:36) Hello. I'm back.! Hello, everybody. It's great to be here. My mom is holding the baby. And I'm here talking to you, Lucy.
Dr Lucy Burns: (0:47) I know it's so wonderful. So if for some reason you have been under a rock, you may have noticed that Dr. Mary has not been featuring heavily in the podcasts because she was off busy making, delivering and now looking after a baby.
Dr Mary Barson: (1:04) And they are time consuming. Didn't know if you knew that. But babies, they take up time.
Dr Lucy Burns: (1:10) Absolutely. So the other sort of wonderful, wonderful thing that we would love to celebrate. You know, while we're both here is the fact that our podcast is two years old.
Dr Mary Barson: (1:23) Wow. Yes, it's our second birthday. Hooray, hooray.
Dr Lucy Burns: (1:26) And we have just hit a quarter of a million downloads, which for us. I mean, we never ever thought that would happen. It is truly amazing. And we are humbled to everybody that listens, that takes the time to listen to our podcast and shares the podcast. It's so truly wonderful.
Dr Mary Barson: (1:46) This is truly one of - I think - my proudest achievements. Being part of this podcast, part of Real Life Medicine, spreading the word and being able to help people, empower people. So thank you to all you beautiful, lovely listeners. We are so grateful.
Dr Lucy Burns: (2:07) Absolutely, absolutely. And in fact, as one of our momentum members, who was featured in our podcast early on, Elané, has mentioned many times, “You cannot hear the message often enough”. And the reason for that is not that you're you know, stupid and you can't remember it. But it is to unpack the stories that have been in, you know, that you've been conditioned to believe over decades. And also as insulation against the barrage of subliminal and overt messaging from big food companies.
Dr Mary Barson: (2:48) Yes, you have to swim upstream a little bit to have a healthy low carb, real food lifestyle in this high carb high inflammatory world.
Dr Lucy Burns: (3:00) Absolutely. Absolutely. So Mares, one of the things that we have been asked a number of times, and I thought would be a great topic to just remind people about today is talking about the difference between insulin and glucose. I think there's a lot of confusion out there. You know, people get, I guess, mixed up with the term “spikes”. We talk about an insulin spike, we'll talk about a glucose spike. And I thought being the biochemist, as well as medical doctor that you are, that this would be an excellent topic for us to unpack.
Dr Mary Barson: (3:34) Excellent. I'll put on my doctor and biochemist hat. I'll put on two hats. And it's a great topic to talk about. There is confusion, Lucy, I hear people who frequently believe that because their blood sugar is okay, therefore everything is okay. So they've been told perhaps you've got some pre-diabetes, or you've got insulin resistance or you've got fatty liver. But there's this idea that they measure their blood sugars. Their blood sugars are fine, that everything is fine. So it's not necessarily the case.
Dr Lucy Burns: (4:13) Not at all. Not at all. And it's interesting because I recently did a CGM experiment. And a CGM is a continuous glucose monitor. And you wear it, it's like a little device you wear on your arm. And you then have to connect your phone or reader to it and you sort of scan it. The one I use does rely on you remembering to scan it, but I did it for two reasons. One, my morning blood glucose was a little higher than I would like. And two, I have recently just tweaked some of my low carb lifestyle because I realised some of the things I was doing were not particularly helpful. So Mary, I think part of the confusion these days comes between, you know the difference between insulin and glucose. People talk about a glucose spike, people talk about an insulin spike. Some people don't care about either of those, some people don't care about insulin, they're only interested in blood sugar, can you just give us a little definition on what they all mean?
Dr Mary Barson: (5:17) Okay, let's do it. So, sugar, let's start there. So sugar, obviously, we've got our table sugar, the sweet things that we eat. They are related, but a bit different to the blood sugar that we're talking about. So, blood sugar, we are talking about blood glucose, glucose being a simple form of sugar. When we eat carbohydrates, whether that be table sugar, or whether that be starches in the form of potatoes, rice, and bread, all of those carbohydrates are broken down when we eat them. And most of it ends up in our blood as elevated blood sugar. So after you eat a high carb meal, your body will get an elevation in blood sugar, which is blood glucose. That's what we're talking about. When we're talking blood sugar, we're talking blood glucose.
(6:17) And look, that can be absolutely fine. Because when the system is in balance, and everything's working well, after you've eaten a carb meal, along comes insulin. And Insulin is the hormone made by our pancreas. And Its job is to deal with blood glucose. And what the blood and how it deals with the blood glucose is it allows that glucose in our blood to go inside all the cells of our body. In particular, it allows it to go into the muscles where we can use it for fuel or the muscles can store it as glycogen/ It allows it to go into the liver where the liver can store it short term as glycogen and it also very importantly, allows the sugar to go into our fat cells and be stored as fat. And that is how our body stops us from having high blood sugar for long periods of time.
Dr Lucy Burns: (7:16) Which is helpful, isn't it? Because we know that actually high blood glucose over prolonged periods of time is harmful.
Dr Mary Barson: (7:26) Very bad, high blood sugar, high blood glucose over time is very harmful to our bodies, it damages the lining of our arteries in particular, it's not the only thing it does, but that is one of the most damaging things that it does and can set us up for, you know, cardiovascular disease and increased risk of heart attacks and strokes in particular. That is one of the dangerous things about high blood sugar over time. It also damages our kidneys and damages our brain cells and it ain’t good, we don't like it.
Dr Lucy Burns: (8:04) It's interesting, isn't it? It's, I think there's this sort of disconnect in our society between, you know, sugar that we eat, and then blood glucose that causes the damage. Like I think if you did a survey of just, you know, random people, most people would go, “Oh yeah diabetes is not good. It's bad for you, it causes, you know, disease, feet fall off all of those things.” Most people have some level of understanding and possibly recognise that it's due to high levels of blood glucose. But then there's this complete disconnect between the food that we eat, and it causing those glucose levels.
Dr Mary Barson: (8:42) Yes. Particularly with the starches. It's an obvious mental jump to take, that somebody who has diabetes has got a problem with that blood sugar, which is blood glucose, therefore, they should reduce their sugar. Yes, that's easy. However, we also get glucose in our bloodstream from starches, bread, rice, potato, pasta.
Dr Lucy Burns: (9:15) I love this phrase called Sweet sugars and savoury sugars. Sweet sugars, obviously, you know, table sugar, anything that is sweet. Then the savoury sugars are the pasta, rice, bread, potato, and a few other little sneaky things in there.
Dr Mary Barson: (9:33) The carbohydrates. If you are someone who is, you know, gaining weight overweight, got problems with insulin resistance. The wonderfully fabulously good news is that you can reduce all the problems associated with insulin resistance by reducing your carbohydrate intake. This is why we are passionate advocates for low carb, real food.
Dr Lucy Burns: (10:04) Okay, so can you just tell me again, about insulin resistance?
Dr Mary Barson: (10:10) Yes, I will. So I'm going to talk about the natural history, I suppose you could say, of type two diabetes. And why just because your blood sugars are normal doesn't mean that everything's okay. As I mentioned before, insulin's job, one of its main jobs, is to take the glucose out of our blood and allow us to use it and store it as fat. And that for many of us, our bodies, this beautiful system is getting completely overwhelmed by the sheer volume of carbohydrates in a pretty standard modern diet. And how your body copes with this is very clever. However, over time, it causes serious issues. So high blood glucose is bad, very, very bad, your body really does not want you to have high blood glucose. And it has a whole range of mechanisms to ensure that the blood glucose is very, very tightly controlled. And the main mechanism by far is insulin.
(11:22) So say you are eating more carbs than your body is naturally able to deal with, the first thing your body will do is to create more insulin. So it makes more insulin to tell your fat cells look, you gotta do a better job. I know I'm asking a lot of you but you need to take, every time I have toast and orange juice and cereal for breakfast, you've got to deal with these guys. And so your body makes more insulin to start yelling at your fat cells to store this. And your fat cells can get a bit sad and unhappy and inflamed. And they can want to hide their insulin receptors because they just can't do it anymore. But they have to do it because you're still eating toast and orange juice and cereal for breakfast. So your body will then make even more insulin and will scream even louder. And your fat cells. Yeah, they'll take it but they're like, “Oh man, I can't do this”. And they'll hide it even more. And then your body will be like, “Okay, I need to do something with this glucose that we keep having to deal with”. So we'll start putting it inside your liver and storing it in your liver and in your pancreas. And you'll get fatty liver and fatty pancreas. And that is not good for you. But your body is just doing its absolute best to deal with this constant onslaught of carbohydrates.
(12:37) And then what happens is that as your body becomes less and less able to cope with all of the carbs that you're eating, your tissues get resistance to the insulin, and then your body, it needs to make more insulin, and then you get more insulin resistance and your body makes more insulin, you get more insulin resistance. On and on it goes. And this actually goes on for years before it can be picked up. This could be happening to you right now. And you might have absolutely no idea. Possibly even for up to maybe even 20 years, there are signs that a person is on their way to developing type two diabetes with high insulin before the system gets so completely overwhelmed that the body is no longer able to keep blood glucose within a tightly controlled range, and then the blood glucose starts to rise. But by the time that has happened, there are all of these, this entire process has been going on for years and just getting worse, silently, worse and worse and worse and worse and worse. So blood sugar, elevated blood glucose is actually quite a late sign that your body ain't coping with your particular diet.
Dr Lucy Burns: (13:54) Interesting, isn't it? Now, can you explain to our listeners why some people can seem to eat, you know, quite high carbs. And other people seem to you know, they have a certain amount of carbs that might be really, really much more moderate, but they're having trouble with their insulin and the glucose. How does that work?
Dr Mary Barson: (14:13) Yeah, so this comes down to luck, genetics and how well you chose your parents. Some people are just not prone to getting insulin resistance. Some people can cope with their, you know, wholemeal bread, cereal and orange juice for breakfast and maintain good health and not gain weight and be perfectly fine. I'm going to make a generalisation here, but quite often the people who can eat a regular normal standard modern high carb diet and stay thin. They often can be health professionals who tell you that if you just eat the way that they do, you'll be fine. Look at me, I'm fine. Obviously, there's something wrong with you. So just do what I'm doing, and it'll work for you too. However, we are all different. And indeed, most humans are prone to insulin resistance on a modern Western diet, because the actual working majority of adults in Australia and in other developed nations across the world have got metabolic disease and metabolic disease at its heart, is due to elevated insulin.
Dr Lucy Burns: (15:31) I think it's super fascinating. And again, this is to, you know, I really want to just to hammer home the point to our listeners, that none of this is your fault. You know, you have no control over the genetics that you've been given. And for a lot of them, you know, there can be things like, how high the mother's blood glucose was when there was a baby in the womb. And again, that then can switch on genes. We know about epigenetics, which then make that baby more prone to insulin resistance. That baby is fed a standard Australian diet and everyone says, “Why is this child so fat?” Or “Why is this person so fat, they must eat too much.” and “It's all their fault!” and all that stuff. And that's just garbage.
Dr Mary Barson: (16:17) I've felt that way my entire life. I have got a perfect storm of insulin resistant genetics, if you like. So both my parents have type two diabetes, I've got polycystic ovarian syndrome. Quite possibly, my mum had gestational diabetes, when I was little, I don't really know. But she may well have. It seems quite likely. And I had gestational diabetes, absolutely everything. So I am just as genetically primed as a person can be to be insulin resistant, and suffer from being overweight, and metabolic syndrome and all of those things. My whole life and I can very distinctly remember a time in medical school, where I was able to very, very accurately compare my lifestyle as a 20 something year old university student to other 20 something year old university students because I lived in the Rural Clinical School, which was extremely fun. I lived in this hostel with all these other uni students or medical students together. And we just lived right on top of each other, we ate all our meals together, we were there all the time. And I could see these thin 20 something year olds having cakes and chips, and all of this junk food and being really slim. And even as a 20 something year old, if I ate that food, I gained weight, like nothing else. And I can remember being struck by the sheer injustice of it all. Still feeling it today. And it's just the way it is, you know, my body is the way that my body is. And I have found a way to work with my beautiful body that is healthy, fun, delicious, sustainable. And you can too.
Dr Lucy Burns: (18:06) Absolutely, I mean, you know, you can't change your genes, but you can manage your physiology, you can manage your psychology, and you need to be able to do both for long term permanent health and weight loss.
Dr Mary Barson: (18:21) Yes. Coming back to what you said Lucy, before about the glucose spike and the insulin spike. I think I could elaborate on that a little bit. So I did mention that when we eat a meal containing carbohydrates, be that sweet sugar or savoury sugar, then, our body will process that meal, we will absorb those carbohydrates into our bloodstream, and that causes a spike in blood glucose. And then after that has happened, very shortly afterwards, our body is like ah, high blood sugar, and it will then secrete insulin to deal with that. So an insulin spike will follow a blood sugar spike. They are related but separate biochemical processes.
Dr Lucy Burns: (19:14) Yes, and I think that's important for our listeners. And it's hard. Don't worry, it took us a long time to get onto this. But glucose is a molecule that you can either ingest or our body can make, which works as a fuel substrate. And insulin is a hormone. It's a hormone that's made by our pancreas. A lot of people go, “Oh, surely we should just have something to block the insulin, that would be good, rather than having these high levels of insulin”, but if we did that, then glucose would just run rampant and it would be completely out of control. So that's not a viable option.
Dr Mary Barson: (19:50) The best thing you can do is find ways to lower your insulin requirements. So that your body can naturally lower your insulin. And when your body naturally lowers your insulin, lots of great things happen. Not least of which is that you are able to burn your own fat stores and lose weight sustainably and healthfully.
Dr Lucy Burns: (20:19) Absolutely. Now Mares, we know that you and I love talking about glucose and sugar. And we know that for some people, it all feels very hard. And there's little stories their brain tells them about not being able to do it, or how could you ever do this forever, and all of those things. So we have on offer a very small window, a very small challenge, if you like, on reducing your sugar in your diet. Would you like to tell our listeners about that?
Dr Mary Barson: (20:50) Oh, I would love to. So it is called the seven day no sugar challenge. It is happening November 21, with an optional two date prep, starting November 19. Where we will give you lots of fabulous help, advice and coaching to reduce your sugar consumption, to help get your head in the right space. To help heal your body. To detox - to use that word - from sugar, savoury sugar, and sweet sugar, if you like in your life in a beautiful, lovely supportive online community with excellent coaching from Lucy and myself. Two fabulous masterclasses included. It's a wonderful doable week, where you'll gain lots of wisdom.
Dr Lucy Burns: (21:41) Absolutely. So I think lovelies, it's a challenge that we promote as being family friendly. There's three levels. If you've got a family and you're worried about your family's sugar consumption, you actually have every right to be worried. We know that the current recommendations are that people really shouldn't have more than six teaspoons of added sugar per day on, you know, on average, but on average teenage boys have 38 teaspoons of sugar. Like that's average, every day. It's an enormous amount of sugar. And for lots of people, it's unclear as to where those sugars are. Will we help you unpack all of that. All the marketing mischief that happens. And it's a total bargain at seven bucks, seven bucks for seven days. We've got a link in the show notes. Or you can go to our website, https://www.rlmedicine.com/nosugar. Sign up. See you there.
Dr Mary Barson: (22:40) We'd love to see you there.
Dr Lucy Burns: (22:43) Alright, gorgeous ones. That's it for Dr. Mary and myself today. And I think we'll see you next week.
Dr Mary Barson: (22:48) Bye bye.
Dr Lucy Burns: (22:55) So my lovely listeners that ends this episode of Real Health and Weight Loss. I'm Dr. Lucy Burns,
Dr Mary Barson: (23:02) and I'm Dr. Mary Barson. We’re from Real Life Medicine. To contact us, please visit our rlmedicine.com.
Dr Lucy Burns: (23:13) And until next time, thanks for listening. The information shared on the Real Health and Weight Loss podcast, including show notes and links provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
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