A new study led by researchers at Stanford Medicine reveals that individual blood sugar responses to certain carbohydrates depend on a person’s metabolic health. The research could pave the way for more personalized approaches in preventing and treating prediabetes and diabetes.
The study highlights that people with metabolic conditions like insulin resistance or beta cell dysfunction show distinct patterns in how their blood sugar levels react to different foods. These conditions can lead to Type 2 diabetes. The findings challenge current dietary guidelines, suggesting that personalized food recommendations could improve diabetes care.
“Not all prediabetes patients are the same,” said Dr. Michael Snyder, a professor of genetics at Stanford. “This study shows that your metabolic health status could influence what foods are right for you.”
The research will be published in Nature Medicine on June 4, co-authored by Dr. Tracey McLaughlin, a professor of endocrinology, and Dr. Snyder. Other key contributors include Dr. Yue Wu, postdoctoral scholar, Ben Ehlert, graduate student, and Dr. Ahmed Metwally, now a research scientist at Google.
Blood Sugar Responses Offer Clues to Metabolic Health
There are many paths to diabetes, which is currently diagnosed by high blood sugar levels, or hyperglycemia. Beta cells in the pancreas produce insulin, which helps cells convert glucose into energy. When beta cells malfunction or insulin resistance occurs, the body struggles to manage blood sugar, leading to conditions like prediabetes and Type 2 diabetes.
In this study, 55 participants without a history of Type 2 diabetes were tested for insulin resistance and beta cell dysfunction. They also underwent multi-omics profiling, which measured factors like triglycerides, liver function, and gut microbiome data. About half of the participants had prediabetes, in line with the current statistic that one in three U.S. adults is affected.
Participants wore continuous glucose monitors and consumed portions of different carbohydrates delivered to their homes. The foods tested included jasmine rice, buttermilk bread, shredded potato, pasta, canned black beans, grapes, and a berry mix. After fasting overnight, participants ate each food twice, and researchers tracked their blood sugar responses for three hours.
Food Choices and Blood Sugar Spikes
Results showed that most participants experienced a blood sugar spike after eating rice or grapes, regardless of their metabolic health. However, the response to foods high in resistant starch—like potatoes and pasta—varied based on the participant’s metabolic condition.
“Starchy foods aren’t the same for everyone,” said Dr. Wu. “The blood sugar spikes they cause vary a lot depending on individual metabolic health.”
Those with insulin resistance had the highest blood sugar spikes after eating pasta, while participants with either insulin resistance or beta cell dysfunction saw the biggest spikes after eating potatoes. Further analysis showed that those with potato-induced spikes also had higher levels of triglycerides and fatty acids, common markers of insulin resistance.
Blood sugar spikes after eating beans were linked to metabolism patterns that use fat for energy, while bread-induced spikes were more common in those with hypertension.
Potential Biomarker for Insulin Resistance
The study suggests that the ratio of blood sugar spikes from eating potatoes versus grapes could become a practical biomarker for insulin resistance.
“Insulin resistance is treatable through lifestyle changes and medication. However, there’s currently no easy way to diagnose it in a clinical setting,” said Dr. McLaughlin. “This ratio could help doctors identify insulin resistance in patients, improving early intervention.”
Strategies to Manage Blood Sugar Spikes
The research team also tested whether eating fiber, protein, or fat before carbohydrates could reduce blood sugar spikes. Participants consumed pea fiber powder, egg whites, or crème fraîche 10 minutes before eating rice.
Eating fiber or protein before rice successfully lowered blood sugar spikes, while fat delayed the spike’s peak. However, this effect was seen only in participants who were metabolically healthy. Those with insulin resistance or beta cell dysfunction did not experience significant changes in their blood sugar responses from these foods.
Dr. McLaughlin and Dr. Snyder believe that further research is needed, especially on how different meal timing and food combinations might help mitigate blood sugar spikes.
“Eating carbs later in a meal is still a good idea, even though we don’t know yet whether fiber, protein, or fat is the best choice,” Dr. Snyder advised. “Try eating your salad or burger before your fries.”
Collaborative Effort
This study also involved researchers from Johns Hopkins University, Ultima Genomics, Amrita Vishwa Vidyapeetham University, University of Bergen, and Cairo University.
By revealing how metabolic health shapes our blood sugar responses to food, this study opens new doors for personalized care in managing diabetes and prediabetes.
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