#78 - Glucose spikes are normal physiology!!! Drs Nicola Guess and Jonathan Little

Dr Glenn McConell chats with Dr Nicola Guess from Oxford University, England and Professor Jonathan Little from the University of British Columbia, Canada. Nicola is a dietitian researcher with many years of expertise including the importance or otherwise of glucose “spikes” or excursions and the pros and cons of continuous glucose monitor use. Jonathan is an expert on exercise metabolism who is coming onto the podcast for the second time after speaking previously and ketone diets and exercise. This is the first time there has been a double header in the podcast. A major point that came out is the difference between having chronically elevated glucose levels such as in diabetes versus having normal increases in glucose in response to a meal. Having chronically elevated glucose is indicative of underlying pathology, while normal increases in blood glucose (spikes) after a meal is normal physiology and not of concern. Also increases in glucose before and during very intense exercise is normal physiology as well and not of concern. There was also a clear message that the use of continuous glucose monitors (CGMs) have both pros and cons and that need to be considered. A very interesting chat. Twitter: @DrJonLittle. Instagram: dr__guess. Glucose spikes are normal physiology! 0:00. Introduction and welcome to Nicola and Jonathan 3:20. What are glucose “spikes”/excursions 4:45. Hyperglycemia in diabetes is very different to “spikes” 6:20. Glucose spikes in type 2 diabetes 7:19. Why is chronically elevated glucose a problem? 12:20. Confusion about glucose levels 2hrs after a meal 15:29. Underlying insulin resistance is the problem not spikes 19:08. Fasting glucose and insulin measures and the liver 21:10. Meal tests and oral glucose tolerance tests 24:55. Being careful not to make the underlying pathology worse 26:15. Keto diets: type 2 diabetes vs weight loss vs exercise 32:10. Glucose even in diabetes is not as important as we think 35:00. Are continuous glucose monitors (CGM) useful? 38:30. Too much focus on glucose than more important things 41:00. CGMs very important for people with T1D 42:05. CGMs and anxiety 43:25. Some people on CGMs have higher cholesterol 44:00. Misunderstanding of pre-diabetes re CGMs 46:00. Metabolic flexibility in response to what eat 47:40. “Nervous normals” 49:42. Is how one loses weight important? 53:41. What about CGMs in type 1 diabetes? 54:15. Do CGMs result in favorable changes in behavior in T2D? 56:33. CGMs, diet, behaviour change and exercise 57:40. Glucose metabolism during exercise 59:55. Exercise and insulin sensitivity 1:02:15. Effect of exercise on glucose spikes from a meal 1:04:10. Intense exercise can increase blood glucose levels 1:07:10. Normal to have elevated glucose after intense exercise 1:09:50. Influencers misinterpreting data re glucose spikes etc 1:12:10. Misunderstanding glucose cut offs 1:13:10. Takeaway messages etc 1:14:00. Weight loss diet strategies 1:17:50. Amino acids and insulin secretion 1:24:40. Should everyone use CGMs? 1:26:30. Keep it simple re diet and exercise 1:27:40. Outro Inside Exercise brings to you the who's who of research in exercise metabolism, exercise physiology and exercise’s effects on health. With scientific rigor, these researchers discuss popular exercise topics while providing practical strategies for all. The interviewer, Emeritus Professor Glenn McConell, has an international research profile following 30 years of Exercise Metabolism research experience while at The University of Melbourne, Ball State University, Monash University, the University of Copenhagen and Victoria University. He has published over 120 peer reviewed journal articles and recently edited an Exercise Metabolism eBook written by world experts on 17 different topics (https://link.springer.com/book/10.100.... Connect with Inside Exercise and Glenn McConell at: Twitter: @Inside_exercise and @GlennMcConell1 Instagram: insideexercise Facebook: Glenn McConell LinkedIn: Glenn McConell   / glenn-mcconell-83475460   ResearchGate: Glenn McConell Email: [email protected] Subscribe to Inside exercise: Spotify: shorturl.at/tyGHL Apple Podcasts: shorturl.at/oFQRU YouTube:    / @insideexercise   Anchor: https://anchor.fm/insideexercise Google Podcasts: shorturl.at/bfhHI Anchor: https://anchor.fm/insideexercise Podcast Addict: https://podcastaddict.com/podcast/402... Not medical advice