#19 How is digestion related to blood sugar?

In this episode Dr. Donohoe and Dr. Panno discuss digestion, post-prandial (post-meal) glucose, and how they each affect one another.  We go over several studies that assess gastric emptying time (rate of digestion) and its impact on post-prandial glucose spikes and stability. We cover the various things that can change gastric emptying time and how you can use this information to better control your blood sugar.

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Time Stamps

• 2:11 - Why Carbs are not the only factor for dosing a meal?
• 4:20 - Defining Post-Prandial Glucose and Gastric Emptying (GE)
• 6:05 - Common Symptoms for Digestive Issues for Non-Diabetics, Type 1’s and Type 2’s
• 9:52 - The 3 Main Factors that affect the Postprandial response
• 14:40 - You can get Neuropathy on your stomach? Autonomic Neuropathy and Digestion
• 22:25 - More Accurate (Nerdy) Definition of Gastric Emptying 
• 23:45 - The 3 Main Factors of Macronutrients and their Impact on Gastric Emptying
• 27:00 - Blood Sugar’s Impact on the Motility of Food in Non Diabetics and Diabetics 
• 34:51 - Meal Characteristics with the macronutrients (Carb/Protein/Fat)
• 43:16 - Cholecystectomy (Removal of Gallbladder), and its impact on Digestion and therefore Blood Sugar
• 50:03 - Different Insulin Dosage Strategies for different macronutrients 
• 57:56 - SO WHAT? How can we use GE in the future to manage blood sugar?
• 1:10:41 - Applying GE to specific diets (Keto/Vegan/Low Carb, etc) and other health conditions 
• 1:14:39 - Bursts My Beta cells

 

Resources/Links Discussed in the episode:

Lupoli, Roberta, et al. “Gastric Emptying Impacts the Timing of Meal Glucose Peak in Subjects With Uncomplicated Type 1 Diabetes.” The Journal of Clinical Endocrinology & Metabolism, vol. 103, no. 6, 2018, pp. 2269–2276., doi:10.1210/jc.2017-02811.

Lupoli, Roberta, et al. “Postprandial Glucose Control in Type 1 Diabetes: Importance of the Gastric Emptying Rate.” Nutrients, vol. 11, no. 7, 2019, p. 1559., doi:10.3390/nu11071559.

Marathe, Chinmay S., et al. “Hypoglycaemia and Gastric Emptying.” Diabetes, Obesity and Metabolism, vol. 21, no. 3, 2018, pp. 491–498., doi:10.1111/dom.13570.

Smart, C. E. M., et al. “Both Dietary Protein and Fat Increase Postprandial Glucose Excursions in Children With Type 1 Diabetes, and the Effect Is Additive.” Diabetes Care, vol. 36, no. 12, 2013, pp. 3897–3902., doi:10.2337/dc13-1195.