Conscious Consumption: Sugar

I grew up in Trinidad, developing the taste for coffee from a very young age. My grandmother — rest in power — would give my brother and me a small, partially filled cup every time we spent the weekend with her, which was fairly often. It was always the first thing we had in the morning with her. Ever since, I have craved the taste of not the coffee itself, but the specific way she would make it. No person or establishment has ever been able to replicate that taste or, better yet, the feeling her cups of coffee would elicit.

I have never been able to replicate the formula over the years, though I have tried at length. Unlike most Caribbean and Latin American coffee, hers incorporated minimal milk, yet was still on the sweeter side. As a working adult, I began buying and making my own coffee. One spoon of sugar was never good enough; even two or three spoonfuls couldn’t give me the flavor I craved.

There was always a little voice in my head advising me that three spoonfuls of sugar in a cup of coffee was excessive and not sustainably healthy. I had a very cursory grasp of the effect sugar intake had on my organs courtesy of a pre-med undergraduate degree, but I honestly didn’t know the long-term effects it would have on my day-to-day life. It wasn’t until my career transitioned into the pharmaceutical industry — placing me in the metabolism division of one of the largest drugmakers in the world, where my focus was on insulin — that I began to truly digest and grasp how the body works and, in turn, the effects of consistently dumping excess sugar into our systems.

My tenure in the metabolism division put me at the forefront of the fight against type 2 diabetes in primary care doctor offices across NYC, opening my eyes to a few things:

● The staggering number of people with type 2 diabetes

● The staggering number of people who had no real clue what the disease meant for them

● The staggering number of people who were willing to live with it untreated until it was too late.

Type 1 diabetes is generally genetically linked and developed at a young age. These diabetics have no control in the onset of the ailment

Type 2 diabetes comes about over time and is as a result of diet. These diabetics can have some form of control over whether the disease presents itself and also in reversing it’s progression. I will only be discussing Type 2 diabetes in this article.

I won’t inundate you with stats, as those don’t seem to communicate the true impact of the actual actions taken by a diabetic, but I think breaking down the dysfunction that occurs may resonate with persons that need to “watch their sugar.”

The main players in diabetes are:

● The pancreas (an organ that releases hormones)

● Insulin (a hormone)

● Glucagon (a hormone)

Normal Functioning Body

When we consume “carbs,” the body breaks them down to basic sugar units that are passed into the bloodstream, raising our blood sugar as a result. This rise in blood sugar levels triggers the release of insulin from our pancreas. Insulin does a number of things, including:

● Allowing cells in the body to absorb the sugar units to be used for energy (glycogen)

● Triggering the conversion of extra glucose into fat

Dysfunction occurs when we consistently consume too much sugar over time. The pancreas is overworked and, at a point, becomes unable to produce sufficient insulin to remove the sugar from the blood. The concentration of sugar in the blood rises as a result. This tends to take years; there isn’t a specific episode that causes diabetes. Think of it as a slow leak from a car tire, where air leaks for days or even weeks until you finally realize you have a flat tire. In terms of diabetes, that leak comes from years of unchecked consumption of processed foods that are high in sugar.

What does “high sugar” look like?

Because it takes time for the pancreas to lose its effectiveness and because there is no singular painful episode to alert us along the way, we are generally not aware that our sugar levels are rising. There are some signs, however, that could indicate rising sugar; one of the major determinants is the hemoglobin A1c test — or, for short, the HgbA1c or A1c test. I cannot stress enough that you should be needling your doctor on the following questions if they are not already educating you.

● What exactly is my hemoglobin A1c?

● What does hemoglobin A1c stand for?

● What does the range of good to bad look like?

● How can I keep it in check?

● How often should I be monitoring?

Here are the very broad and simplified answers to the above questions:

● Hemoglobin is a protein found in our red blood cells.

● The A in HgbA stands for “adult”.

● There are different types of adult hemoglobin. The majority is Type 1 — hence, it’s called HgbA1.

● There are different types of HgbA1 (a, b, and c among others). C is the most common kind that binds to sugar — hence, it’s called the hemoglobin A1c test.

● When sugar enters our bloodstream, it becomes attached to the hemoglobin. The higher the amount of glucose molecules found in the blood (rather than being shifted into your cells and muscles by the pancreas), the higher the “sugared hemoglobin” levels or, in medical terms, the higher your A1c levels.

● Note! Once hemoglobin is “sugared,” it remains that way until it dies, which is roughly three months — the lifespan of a red blood cell.

● Because blood cells have a life span of three months, your A1c level is a rough three-month snapshot of your blood sugar levels.

● Normal A1c levels are 5.7% and below.

● Prediabetic A1c levels range from 5.8% to 6.4%.

● Diabetes is diagnosed at 6.5% and above.

What does that percentage mean?

● That percentage refers to the percentage of your hemoglobin that is sugared.

Another key biomarker that indicates the presence of diabetes is your fasting blood sugar level, which is the amount of sugar in your blood after not eating anything for at least eight hours. This test can be carried out with at-home testers bought over the counter at your local pharmacy or as part of your regular check-up by your doctor. They both involve a blood draw — the at-home being a pinprick and the doctor version involving a traditional needle and vial collection process.

● Regular fasted blood sugar levels are between 70–100 mg/dl.

● 100–125 mg/dl means you are trending with prediabetes.

● 125 mg/dl and above diagnoses you with diabetes.

Unless directed by a doctor, you should not really buy at-home blood sugar testers and use them on yourself. The above are all valid questions and concerns we should be asking our doctors. That is their role, to guide you to the healthiest version of self.

What does consistent high blood sugar mean for you on the ground level and in your day-to-day life if you can’t even feel it rising? We already discussed the pancreas being overworked and ultimately burning out and losing function. What else can occur?

● Increased blood sugar levels strain the kidneys. The two major roles of the kidneys are to remove waste and drugs from the body as well as regulate the body’s fluids. When the kidneys are unable to process the extra sugar, they do what they do with all other toxins, they flush the excess out of your system. As a result, excess urination begins to occur, which triggers excessive thirst.

● The body begins to suffer from consistent dehydration issues. Constantly chapped lips and less saliva being produced can result in an increased risk of oral infections. Skin becomes dry and itchy, especially in the extremities — elbows, feet, hands. Over time, loss of feeling in these extremities due to nerve damage can occur. I can’t tell you the number of amputees and people with bandaged legs I have chatted with in endocrinologist waiting rooms over the years.

● Extreme water loss can lead to vision issues, as the eyes also rely on a certain level of hydration.

● Consistent high levels of sugar in the blood negatively affect the lining of blood vessels, triggering the deposition of plaque along the inner lining of arteries and tiny capillaries, which causes them to lose their healthy elasticity. This opens up the diabetic to a host of blood flow issues, including heart disease, erectile dysfunction, nerve damage, kidney failure, and poor blood circulation in the hands and feet.

● Because the sugar is not being shuttled from the blood to cells for energy use, you always feel fatigued.

● There are a number of other complications that can arise, but these are the top-level macros.

Thus, the longer my tenure in the metabolism division stretched on, the more I met and surpassed my insulin sales quotas, the more diabetic patients I encountered in doctor’s office waiting rooms, hospitals, and dialysis centers the less and less sugar I put in my coffee among other dietary changes. I beg you to do the same.

The follow up piece to this will be less scary as I will outline what you can do on a daily basis to counter whatever issues you may have with type 2 diabetes.