HNF-4α controlling many genes involved in liver function such as the GLUT2 and L-PK genes. Evidence on the mode of action of metformin shows that it improves insulin sensitivity by increasing insulin receptor tyrosine kinase activity and enhancing glycogen synthesis in hepatocytes, and by increasing recruitment and transport of GLUT4 transporters to the plasma membrane in adipose tissue.
In addition to its effects on hepatic glucose and lipid homeostasis and adipose tissue lipid homeostasis, metformin exerts effects in the pancreas, vascular endothelial cells, and in cancer cells. Diabetes blood sugar levels chart: what is a normal blood, Keep in mind that the blood glucose level before a meal for a non diabetic person and a person with prediabetes may be very similar. Blood sugar – wikipedia, the free encyclopedia, The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal.
Blood glucose levels : testing and normal range, A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Blood glucose monitoring – wikipedia, the free encyclopedia, Blood glucose monitoring is a way of testing the concentration of glucose in the blood (glycemia). When your blood sugar is too high or too low, Sometimes, no matter how hard you try to keep your blood sugar in the range your doctor has advised, it can be too high or too low.
Home « blood sugar basics, Make your next conversation with your diabetes healthcare team count by asking these quick questions about blood sugar!. Diabetes, blurred vision, and high blood sugar levels, Blurred vision can also be a symptom of more serious eye problems. The final destination of a journey is not, after all, the last item on the agenda, but rather some understanding, however simple or provisional, of what one has seen.
In these modern times, with the plethora of blood-sugar-related diseases, we need tools like GI and GL to help us understand ways to control blood sugar. The self-testing, graphic approach to food testing developed in the balance of the newsletter is a less scientific but a more dynamic way to explore postprandial (post-meal) blood glucose levels (BGLs).
GI measures the blood glucose impact of foods eaten in isolation, yet we rarely consume foods this way. GI readings vary with the individual—blood sugar and insulin reactions are more extreme for diabetics, for example (See Charts 2A and 2B).
GIs are calculated in the science lab as the day’s first meal after a 12-hour fast and using a fixed serving that includes 50 grams of carbohydrate.  Most of our daily calories, however, are consumed in combination and throughout the day, when our blood sugar is affected by other foods that we have eaten earlier, as well as by our level of activity. Of the following numbered charts, the first three are based upon scientific research journal articles (Charts 1, 2A, 2B), while the last four (Charts 3-6) are constructed from my own self-testing of foods4 using a simple blood glucose monitor. Chart 1:  Blood Sugar Curves of White Bread Compared to Bread with Added Fiber, Sourdough, and Vinegar. Chart 3:  Instant Oatmeal, Whole Oats (Soaked and Not Soaked), and Whole Oats Combined with a Protein and Fat. To fully appreciate the impact of two back-to-back carbohydrate breakfasts please notice that the scale used for Chart 6 is twice that of Charts 3-5. Resetting the Table–to Control Blood Sugar (For a discussion of other strategies, see April 2011).
Ramekins filled with condiments like nuts and seeds (GI=0).  Nuts and seeds provide healthy fats, fiber, vitamins, minerals, and antioxidants, while they slow digestion and curb blood sugar. Sourdough bread or whole-grain bread with whole kernels; butter from grass-fed cows and organic nut and seed butters such as tahini and pumpkin seed butter. A pitcher of water and glasses for all—sometimes we mistake hunger for what is in fact thirst.  You might flavor the water with a little lemon juice or other flavoring.
Because 12-hour fasting, pre-meal blood sugar reading can vary, all data points at time zero prior to the first morning meal were indexed to zero in order to illustrate the change from a neutral starting point. I use the label “traditional” carbohydrates, just as we call unrefined fats, “traditional” fats. Ketosis is a metabolic state in which the liver produces small organic molecules called ketone bodies at “sufficient” levels, which I’ll expand upon later.  First, let’s get the semantics correct. So, if I’m deprived of a dietary source of glucose, I depend solely on my liver to release glycogen (a process known as hepatic glucose output, or HGO). Take home message #2: No glucose for 24-72 hours equals the need for something else the brain can use instead (that is not fat or protein, since neurons can’t oxidize fat and the last thing we want to do is start muscle wasting at a geometric rate). How, exactly, does our body take pyruvate (from glucose) or acetyl CoA (from fat) and generate so much ATP? To think of it another way, if you start with stored energy – glucose or fat, for example, which if burned in calorimeter will give off varying amounts of heat – and you’re willing to convert their carbon, hydrogen, and oxygen molecules into another form with less energy – water and carbon dioxide which, if burned, produce very little heat – it’s a fair trade!  The ETC is simply the vehicle that allows our body to make the switch. In the absence of acetyl CoA (several ways this can happen, including substrate shortage, as I’m describing here) we evolved a cool trick.  Our liver can make – out of fat or protein, though we much prefer to use fat so we can spare our protein and prevent severe muscle wasting – something called beta-hydroxybutyrate, one of the 3 ketone bodies I described above. B-OHB and acetoacetate (see figure below from this paper by Cahill and Veech, 2003) are produced by the liver from long and medium chain fatty acids and released into the bloodstream. Acetoacetic acid and B-OHB live in reversible equilibrium (on the left), but once acetoacetate is converted to acetone (on the right) there’s no going back. The reason a starving person can live for 40-60 days is precisely because we can turn fat into ketones and convert ketones into substrate for the Krebs Cycle in the mitochondria of our neurons.
The graph below, also from the Cahill and Veech paper, shows the blood chemistry of a person starving for 40 days.  Within about 3 days, a starving person’s level of glucose stops falling. Take home message #3: We evolved to produce ketone bodies so we could not only tolerate but also thrive in the absence of glucose for prolonged periods of time. In an earlier post I explained the difference between nutritional ketosis (NK) and diabetic ketoacidosis (DKA). In Part II of this post I’ll tackle the questions I know folks still have on their mind (below). What are the most important things you need to know about getting into (or staying in) ketosis? Related PostsThe interplay of exercise and ketosis – Part IIMy experience with exogenous ketonesKetones and Carbohydrates: Can they co-exist?
When not spending my days cavorting about in my size 9 Calvin Klein skirts and super-skinny True Religion jeans, I’m holding down a job as a tech executive, learning a foreign language, and spending time with one of my friends planning a book project about logic. Even if I hadn’t lost a lot of weight eating like this, I would do it again in a heartbeat solely for the mental benefits alone.


Like most Silicon Valley workplaces, we are very diverse and to comment on what other people eat would be extremely rude. TO: john pelley July 10, 2014 above If you want a paradigm shift in exercise and health, checkout Dr.
Have started with the cahill and veech paper, will have read it shortly, but I fear he may reject it because it’s on 40 day fasts and that seems to be a lot different to what we consider NK to be.
I know you justified this near the end (NK has similar physiology, just without the acidosis, correct?) but again, not sure he, and many others, would take that as good enough.
This mindset is pervasive…and oddly enough, I have only heard this rhetoric from physicians of at best average health and fitness levels admonishing their patients for being overweight on the exact same type of diet! Now that this research is beginning to see the light of day, not because it was in some textbook or learned in nutrition classes, or because the peer-reviewed journal entries made huge wide-spread public attention, but almost exclusively due to the number of common people who have looked at it’s science, tested it out on themselves, and have decided to follow it because of how well it worked and is working for them. Without all all of the common people benefiting and demonstrating the reality of this, it would still be considered pseudo-science by the leading scientific authorities of our day, and in fact, it sort of is.
Fortunately, the nutrition and anti-meat special interest groups are not as powerful as some others are, and they’re slowly giving way to the overwhelming abundance of evidence that is mounting up due to the everyday common people who are using this ketogenic idea. I imagine that inevitably, health classes in elementary, middle, and high schools all across the U.S.
If someone’s says this, you know they do not understand the least of how the body works, and they probably have never tried themselves to stay in ketosis state for a longer period. I’ve been running (nonprofessional) for 34 years, the last 5 years also marathons, I did about 20+ marathons, my body stayed the same since I was 18 years old (78 kg, ~10% fat), I experimented a lot with being in ketosis because I wanted to test my hypothesis that one can improve on a marathon by training in ketosis, because then you improve a lot of the mechanisms by training them already from the start of your work out, which otherwise would have started only after 32 kilometres of work out.
The most dangerous ones are the ones who are utterly convinced they are right, because they are not open anymore for arguments that prove the opposite. Jimmy Moore is a fine example of how eating this way will change your body composition, replacing fat with muscle easily.
Actually, I was reading somewhere online, you might have to google it, that doing 3 to 4 day fasts, like Biblical fasts, as in you eat nothing, is very possibly one of the most effective means of fighting cancer and preventing it. The article talked about the benefits to fighting and preventing cancer using a keto-dieting approach, saying that cancer survives best in a body with plenty of carbs, glucose, and proteins like glutamine found in many meats. It’s fascinating because much of science seems to indicate the reality of the what the Bible says. Well, interestingly enough, now it seems like there may also be a rather incredible health benefit from doing periodic fasting of a such magnitude, and that is the potential for making an inhospitable and deadly environment for any cells that happen to turn into cancers that perhaps we are unaware. I just thought that was fascinating and compelling enough to post along with the main idea of this post.
Will you by any chance be talking about the suitability of ketogenic diets for pregnant and postpartum women? Blood sugar regulation – wikipedia, the free encyclopedia, For homeostasis, insulin is the main hormone involved. Low blood sugar levels chart – buzzle, Low blood sugar levels chart like high blood sugar, abnormally low blood sugar also needs prompt medical attention. In the fasting state hepatic glycogenolysis produces most of the glucose and the remaining glucose is produced by gluconeogenesis.
Blood sugar, also known as glucose, is a monosaccharide and one of your bodya€™s primary sources of energy. If your blood sugar gets too low, also known as hypoglycemia, then there isna€™t enough glucose in your blood to feed your brain and other tissues. On the other hand, high blood sugar, also known as hyperglycemia, happens when too much glucose is circulating in your blood. Your blood sugar levels fluctuate depending on what you eat as well as your bodya€™s ability to metabolize sugar. Food that is high in simple carbohydrates digest quickly and are rapidly absorbed into your bloodstream.
Recall that the normal amount of sugar in your blood, the amount that results in normal blood sugar levels is approximately one teaspoon. After insulin comes to the rescue and shepherds the glucose out of your blood and into your cells, your blood sugar levels rapidly drop. There are many reasons that your body may not be able to maintain normal blood sugar levels.
Another exenatide-related drug is Bydureon® which is a once-a-week injectable form of exenatide. A more recent addition to the GLP-1 receptor agonist family of diabetes drugs is Trulicity® (dulaglutide) manufactured by Eli Lilly and Co.
Additionally, it has been shown that metformin affects mitochondrial activities dependent upon the model system studied. The latter effects of metformin were recognized in epidemiological studies of diabetic patients taking metformin versus those who were taking another anti-hyperglycemia drug. The second factor—the postwar shift from traditional to refined carbohydrates—is largely due to the growing role of the commercial food industry and processed, convenience foods.  Convenience foods must have a long shelf-life, so food companies rely upon refined flours and oils, which do not go rancid.
Visual pictures of postprandial blood sugar behavior, while less scientific than GI measurements, are nevertheless powerful learning tools, providing a real flavor for how our body reacts when we eat different kinds of foods. This chart illustrates the second meal effect– that what we eat at one meal affects postprandial blood sugar behavior at the next. What we do to our children when we give them a sugary cereal or a Pop-tart for breakfast extends beyond this first meal to affect their blood sugar, hunger, concentration, and desire to overeat throughout the rest of the day. One of the best herbs and spices to moderate blood sugar.  It can be sprinkled on hot cereals and desserts such as puddings, custards, and stewed fruits.
In part I of this post I will see to it (assuming you read it) that you’ll know more about ketosis than just about anyone, including your doctor or the majority of “experts” out there writing about this topic. The first confusing thing about ketosis is that ketone bodies are not all – technically — ketones, whose structure is shown below.
To put this comment in perspective consider the following: though our brain represents only about 2% of our body mass, it accounts for about 20% of our energy expenditure. Obviously our species wouldn’t be here today, blogging for example, if this were the end of the story.


This is another rendition of the figure above showing the Krebs Cycle, but here you can see where B-OHB and acetoacetate enter the picture. How to make a fat cell less not thin: the lessons of fat fluxKetosis – advantaged or misunderstood state?
I spent days and days making sourdough rye bread by hand to try to ferment out all the anti-nutrients.
He built a lot of impressive muscle doing the Total Immersion swimming at Stanford, eating right at 50 total carbs. We have Hindus, Sikhs, Muslims, Buddhists, Russian Orthodox Christians, Jains, Jews, vegans, Filipinos who eat pork skin, Cantonese & Taiwanese who eat duck feet. That explains why my performance in the gym doesn’t suffer that bad when I go extremely low on the carbs. Indirectly, though, it’s clear that even without any carbs, HGO is preserved, so there must still be some glycogen turnover in the liver. I know a lot of people are going to hate me for saying this, but it’s the left wing that has taken over most of our research and research labs.
And some are just comfortable with the life, and have become greedy and scared of losing it.
This is surprisingly difficult to do, the 90% part, because protein accompanies fat almost universally. It also talks about how the cancer can still survive in low-carb environment because of the glutamines and I think some other proteins that it can still use for energy. I do hope I have not offended anyone, but as I would tolerate anothers trying to relate this to Atheism and the benefits inherent in an evolutionary evaluation of our current diet, i.e. Always seek the advice of a qualified physician or health provider for medical diagnosis and treatment. Metformin has a mild inhibitory effect on complex I of oxidative phosphorylation, has antioxidant properties, and activates both glucose-6-phosphate dehydrogenase, G6PDH and AMP-activated protein kinase, AMPK.
Technically, the term ketone denotes an organic molecule where a carbon atom, sandwiched between 2 other carbon atoms (denoted by R and R’), is double-bonded to an oxygen atom. But, to understand how we survived requires one more trip down biochemistry memory lane.  In the figure below (also included and described in the video) I gloss over a pretty important detail. In fact, the late George Cahill did an experiment many years ago (probably would never get IRB approval to do such an experiment today) to demonstrate how ketones can offset glucose in the brain.
His clinical interests are nutrition, lipidology, endocrinology, and a few other cool things. I wonder if you’ve ever come across the use of a glucagon shot with high protein intake as a means for losing fat? At 5pm, I’m calm, ready to keep going, and want to finish the action items, whereas everyone else gets really cranky, complains how mentally tired they are and has to end the meetings so they can review the final numbers-based decisions the next morning. After the initial ketoadaptation period I’m performing pretty near my previous higher-carb levels. They are going to use their political allies influence and power over research funding and labs and schools to do whatever they can to prove themselves right, their opposition wrong, and to make their opposition sound as psuedo-science, bought-out, and brainwashed as possible. However, the article stated, I believe even quoted, (paraphrasing) that fasts like that make an almost impossible environment for cancer to thrive. Fasting was a part of the law that was finished and no longer necessary to be followed when the Messiah came. Christiansen found that the blood sugar levels in healthy individuals were quite a bit lower than those commonly recommended by doctors.
The importance of AMPK in the actions of metformin stems from the role of AMPK in the regulation of both lipid and carbohydrate metabolism (see AMPK: Master Metabolic Regulator for more details). This is why diabetes and obesity often go hand-in-hand (90% of diabetics are either overweight or obese).
David Ludwig regarding high-glycemic foods and overeating, cited in the Recommended Reading section at the conclusion of this newsletter. But, in a state of starvation we’ve only got about one to three days before we’re in trouble.  If our brain doesn’t get a hold of something else, besides glucose, we will die quite unceremoniously. Look throughout history, modern societies of the day are often full of people trying to subvert, in some way, science that they feel will affect their place and power in society.
I say only a few days because you could get into a state of muscle wasting if you go much longer. The article went on to explain more specifics like that this and that forms or prevents the formation of, but the general message there was that there is potential being shown that having fasts like that can actually both prevent and fight cancer.
That’s the idea as spoken of by Paul behind why Christians no longer follow the law as the Jews were required too.
In adipose tissue, metformin inhibits lipolysis while enhancing re-esterification of fatty acids. The activation of AMPK by metformin is likely related to the inhibitory effects of the drug on complex I of oxidative phosphorylation.
This helped me and some other people I know to break through what the Atkins people call a plateau. This would lead to a reduction in ATP production and, therefore, an increase in the level of AMP and as a result activation of AMPK.
However, the disciples who wrote the Bible after Christ ascended into heaven, they kept on with it and told all other Christians to continue fasting.
In fact, since the cells of the gut will see the highest doses of metformin they will experience the greatest level of inhibited complex I which may explain the gastrointestinal side effects (nausea, diarrhea, anorexia) of the drug that limit its utility in many patients. Don’t mind if I drift out of ketosis for a few days (social events, or just feel like eating a fat pile of sweet potato) but I mostly stay in it.



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