When Sugar Management Goes Awry

Digestible carbohydrates are broken down in the intestine into their simplest form, sugar, which then enters the blood. As blood sugar levels rise, special cells in the pancreas churn out more and more insulin, a hormone that signals cells to absorb blood sugar for energy or storage. As cells sponge up blood sugar, its levels in the bloodstream fall back to a preset minimum. So do insulin levels.

In some people, this cycle doesn't work properly. People with type-1-diabetes (once called insulin dependent or juvenile diabetes) don't make enough insulin, so their cells can't absorb sugar. People with type-2 diabetes (once called non insulin dependent or adult onset diabetes) usually start out with a different problem - their cells don't respond well to insulin's "open up for sugar" signal. This condition, known as insulin resistance, causes both blood sugar and insulin levels to stay high long after eating. Over time, the heavy demands made on the insulin making cells wears them out, and insulin production slows, and then stops.

Insulin resistance isn't just a blood sugar problem. It has also been linked with a variety of other problems, including high blood pressure, high levels of triglycerides, low HDL (good) cholesterol, heart disease, and possibly some cancers.

Genes, a sedentary lifestyle, being overweight, and eating a diet filled with foods that cause big spikes in blood sugar can all promote insulin resistance. Data from the Insulin Resistance Atherosclerosis Study suggests that cutting back on refined grains and eating more whole grains in their place can improve insulin sensitivity.

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