Study: Blood sugar spikes in healthy people could signal prediabetes risk 

26 Jul 2018 --- Healthy individuals are likely experiencing rapid blood sugar spikes, sometimes at the same severity of people with diabetes, a study at the Stanford University School of Medicine has found. The research identified that the level of sugar in an individual's blood – especially in individuals who are considered healthy – fluctuates more than traditional means of monitoring, like the one-and-done finger-prick method, would have us believe. Such spikes can contribute to diseases that are common precursors for diabetes. 

“There are lots of folks running around with their glucose levels spiking, and they don't even know it,” says Michael Snyder, Ph.D., Professor and Chair of Genetics at Stanford and senior author of the study. “The covert spikes are a problem because high blood sugar levels, especially when prolonged, can contribute to cardiovascular disease risk and a person's tendencies to develop insulin resistance, which is a common precursor to diabetes,” he said.

“We saw that some folks who think they're healthy are misregulating glucose – sometimes at the same severity of people with diabetes – and they have no idea,” Snyder says.

The insight came to him after he and collaborators at Stanford gave study participants a continuous glucose-monitoring device, which superficially pokes into the surface layer of the skin and takes constant readings of sugar concentrations in the blood as it circulates. With the continuous readouts providing more detailed data, Snyder's group saw that glucose dysregulation is more common than previously thought; they also used the data to start building a machine-learning model to predict the specific foods to which people spike. 

The amount of sugar in a person's blood is not a constant; it ebbs and flows depending on what the person has eaten that day, down to the specific kind of carbohydrate. For instance, rice, breads, and potatoes are all different kinds of carbohydrates and people often digest them differently. Therefore, the common way in which people periodically check their blood sugar levels only captures a snapshot in time and not all the fluctuations. 

The goal is to one day use the framework to compile data from an individual and, based on their continuous glucose readout, direct them away from particularly “spikey” foods.

“We're very interested in what it means to be 'healthy' and finding deviations from that,” said Snyder, who holds the Stanford W. Ascherman, MD, FACS Professorship in Genetics. These glucotypes, he said, are subject to change based on diet. The researchers ultimately have two goals for their work: When people spike, catch it early; and understand what makes a person spike, and adjust their diet to bring the glucotype into the “low” range.

Often people who are pre-diabetic have no idea they're prediabetic. In fact, this is the case about 90 percent of the time. It's a big deal, Snyder says, as about 70 percent of people who are prediabetic will eventually develop the disease.

“We think that these continuous glucose monitors will be important in providing the right information earlier on so that people can make changes to their diet should they need to,” he said.