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. To learn more about Type I diabetes, and Type II diabetes, visit our Health articles and Pharmacy news section today! The graph above shows VA medical center scores compared with non-VA hospital scores for blood sugar control for individuals with diabetes. What is this measure?The level of glycosylated hemoglobin (HbA1c) in an individual’s blood indicates the amount of glucose, or sugar, in his or her system over the past two to three months. What are we measuring?It is recommended that individuals between 18 and 75 years old with diabetes be tested for HbA1c levels at least once a year. Why is this important?By carefully controlling glucose levels in the blood, receiving regular HbA1c tests and practicing other healthy habits, diabetic patients may prevent or delay diabetes complications such as nerve, eye, kidney and blood vessel damage. 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. Identify your HbA1c test score, mean blood and glucose level to know if your blood glucose is in the optimum level. The percentages represent the number of patients with diabetes whose blood sugar levels were higher than normal when last tested. High levels of HbA1c in the blood indicate a high level of glucose in the blood, which can worsen diabete's effects on eyes, kidneys and cardiovascular functioning. The graph above shows the percentage of diabetics in this age range who had HbA1c levels higher than 9% when last tested.
For this measure, a LOWER percentage indicates a higher quality of care, with 0 percent being the target.
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.



Criteria for 3 hour glucose tolerance test
Glucose blood sugar levels symptoms
Hypoglycemia caused by drugs


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