10) GLYCEMIC INDEX
g) The Occasional High Glycemic "Splurge"
"It's only this one time"; "I can't let food go to waste"; "Everyone is having some"; "It's a special occasion"; "I'm doing really well so I can afford to splurge"; "It's my favorite food"; "It's free"; etc. Great excuses … but we are all human, if we don't draw a firm line and stick to it, we'll get on that slippery slope and the exception will rapidly become the norm: …………"just once a month, …..just once a week, …….just twice a week, ………just three times a week, …….etc." Diabetes seems to be a lot like alcoholism; even the best of us have slips and go on binges. The experts disagree on the effects of slips. Some feel that one becomes addicted to "the white stuff" and that any slip is just like an alcoholic slip, it can set an individual with diabetes back months. Others feel that a once weekly splurge won't upset the applecart.
Even though endocrinologists and the literature don't worry too much about an occasional high glycemic splurge, there are reasons to avoid splurges: 1, the "sugar addiction", 2, beta cell mortality 3, keeping triglycerides under control and 4, avoiding kidney damage. Note that the "occasional splurge" doesn't just cover cake at the office birthday party or a donut in a meeting; it also covers a baked potato, French fries, Spanish rice, or the bread in a sub.
There is recent research that shows that high glycemic foods and sugar are much like heroin, cocaine and nicotine; for many people the result of eating high glycemic index foods in any amount is a rise in certain neurotransmitters in the brain, one "feels good". And the "feels good" is addicting because as soon as the blood sugar level drops the neurotransmitter level drops and one get depressed. Unfortunately, just as in heroin, cocaine and nicotine, the result of giving in to the blood sugar addiction is a major decline in health, especially for a person with diabetes! The research is not conclusive at this point but, if the person with diabetes likes their "sweets", they may well be "addicted" to high glycemic index foods and they need to avoid them in any amount.
If a person with diabetes has craved sweets their entire lives and has difficulty passing the candy in the checkout line without buying a snack, they may well consider this addiction model. Note that addiction to heroin and nicotine are unusual in that an estimated 70% of the USA population will become addicted if they consume them regularly. This is in contrast to the 10% of the USA population that is genetically programmed to become an alcoholic (I.E. addicted to alcohol). It is conceivable that 70% of the USA population is addicted to sweets.
Beta cell mortality is a subject of debate. But one theory of beta cell mortality is that there is a threshold of glucose and or insulin below which the mortality rate is minimal and above which the beta cell death rate increases very rapidly. If this is the case, the occasional splurge can be damaging, it can kill the few beta cells in the pancreas of a person with type 2 diabetes.
There is another concern with "splurges". The rise in blood sugar might well be transient, lasting only one to two hours. But the rise in glucose can result in hardening of the arteries out of proportion to the rise in blood sugar. Research by Dr. Michael Brownlee of Albert Einstein College of Medicine has shown that a single high glycemic splurge by a person with diabetes can result in 24 hours of artery hardening. There is also the Harvard Nurses Study which showed high glycemic index carbohydrates degrade heart health.
When an individual with diabetes eats a lot of carbohydrates at once, i.e. they "splurge", this spike is excreted as glucose by the kidneys. The kidneys are not made to excrete glucose and they will be damaged in the process. This is one of the major causes of kidney failure and needs to be taken into account when contemplating a high glycemic index splurge.
Current Chapter: 10) GLYCEMIC INDEX
a) Introduction
b) Types of Common Carbohydrates
c) Glycemic Index and A1c
d) Glycemic Index and Losing Weight
e) Glycemic Index Controversy
f) Using Bad Statistics to Judge the Glycemic Index
g) The Occasional High Glycemic "Splurge"
h) Glycemic Load
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