Continuous Glucose Monitoring (CGM) and defending your health

Before reviewing what follows, you might review this post on the Hormesis Health and Fitness Brand - pay particular attention to "defending your health", because what is mentioned next has everything to do with that.

Please read the label for what is in this coffee.

• Sugar free vanilla (no carbs)

• 2 Stevia (sugar free)

• Extra cream (very little lactose - if whole real cream)

So what would you expect my blood glucose readings to do given consuming that?

The intention in ordering with those ingredients - even though its an occasional indulgence of artificial ingredients - is to keep my blood glucose levels low and stable below 100 mg/dl.

Now here is what what happened:

The whole intent with the choice of ingredients was to avoid that! What drove the glucose up?

• It should not have been the ingredients!

• It wasn't increased "sympathetic stress" from caffeine causing increase cortisol and gluconeogenisis (liver production of blood glucose) because it peaked and dropped off. Stress would have sustained longer glucose!

The preparer of the drink was asked if there could have been any way the vanilla flavor could have had sugar and not be the sugar free version - they said no as the sugar version is on the upper shelf and the sugar free is on the lower shelf.

Do you know the answer is yet?

Now Ill give the answer. This vendor offers these dairy options:

• Whole Milk: Standard full-fat milk.

• 2% Reduced Fat Milk: A lighter alternative to whole milk.

• Nonfat Milk: Skim milk with no fat content.

• Half-and-Half (Breve): A mixture of half whole milk and half heavy cream, offering a richer texture.

• Heavy Cream: Provides a very rich and creamy addition to beverages.

When you order a coffee with “cream” with this vendor, the standard addition is half-and-half, which is a blend of equal parts whole milk and heavy cream.

If you prefer a different option, such as heavy cream or a non-dairy alternative, you can request it when placing your order. The vendor offers a variety of milk and cream options to cater to diverse preferences and dietary needs.

I thought "if I asked for cream" I would get "cream", not an option that includes "other nouns" in the description such as "half-and-half". I frequent this vendor on special occasions, and when I have asked for "cream", at no time did the server ever ask if I "really wanted cream" and not half-in-half"! (unbelievable)

So... Now you have the answer! That is what lactose does to my glucose levels.

Now here is the most important part: I was deceived and my health was compromised! Just ask me how I feel about that. If you did not review this post on the Hormesis Health and Fitness Brand at the beginning of this post - its time!

You may ask why the big deal. The glucose level went up and came down. Well, here is the BOOM!

Atherosclerosis!

In the comment that follows:

1. First you see just enough of the makeup of your arteries.

2. Then I will highlight the very first inner protection of your arteries.

3. Then I will show you why this high glucose level is a problem

This image shows the artery. Note the LDL particles in the bloodstream. The image is meant to convey 3 stages in the artery leading to activation of "proteoglycans".

When low-density lipoprotein (LDL) particles reach proteoglycans in the arterial walls, they can become trapped and accumulate. Proteoglycans are part of the extracellular matrix in the arterial intima, and their negative charge attracts the positively charged components of LDL particles.

Once LDL is retained, it is prone to chemical modifications, such as oxidation. Oxidized LDL (oxLDL) triggers an inflammatory response, attracting immune cells like monocytes. Monocytes differentiate into macrophages, which engulf the oxLDL, turning into foam cells. These foam cells contribute to the formation of fatty streaks, an early sign of atherosclerosis. Over time, this process can lead to plaque development, arterial narrowing, and an increased risk of cardiovascular events.

For the purpose of this post, the very first inner functional part of the artery will be emphasized: the "glycocalyx"

“Arterial glycocalyx dysfunction is the first step in the atherothrombotic process”. The atherothrombotic process refers to the progression and consequences of atherosclerosis, complicated by thrombosis (blood clot formation), which together contribute to cardiovascular diseases such as heart attacks and strokes. This process has two primary stages: first is atherosclerosis (plaque) and the second is thrombosis where the plaque becomes unstable and can rupture. For this post we will focus on the very first step of atherosclerosis and the role of the "gylcocalyx".

The glycocalyx is a highly specialized, gel-like layer that lines the luminal surface of endothelial cells in blood vessels. It plays a critical role in vascular health, serving as a protective barrier that regulates permeability, inhibits inflammatory processes, and prevents the infiltration of atherogenic particles such as LDL.

So.. if the glycocalyx plays a protective role in preventing the infiltration of atherogenic particles such as LDL, the "very first" protective stage, consider this:

High levels of blood glucose vill virtually eliminate that protective layer over 6 hours of exposure and not be back to "normal protective function" until 8 to 12 hours later! For most people, however, they have already had another high carb meal or snack to keep that protective layer difunctional!.

How Glycocalyx Prevents LDL Penetration

1. Physical Barrier: The glycocalyx forms a thick layer over the endothelial cell surface, creating a physical blockade that LDL particles cannot easily penetrate.

2. Charge Repulsion: The negative charge of the glycocalyx repels negatively charged LDL particles, preventing them from adhering to endothelial cells.

3. Regulation of Transcytosis: By modulating receptors involved in LDL uptake, the glycocalyx can influence LDL transcytosis across the endothelium.

Compromise of Glycocalyx and LDL Infiltration

Damage to the glycocalyx is a key factor in allowing LDL particles to reach the intima. Common causes of glycocalyx degradation include:

1. Oxidative Stress: Reactive oxygen species (ROS) degrade glycocalyx components like GAGs.

2. Inflammation: Cytokines (e.g., TNF-α, IL-1β) disrupt glycocalyx integrity, increasing permeability.

3. Hyperglycemia: High blood sugar reduces glycocalyx thickness and function.

4. Dyslipidemia: Elevated LDL levels can lead to glycocalyx damage, creating a feedback loop that allows further LDL penetration.

5. Mechanical Damage: High blood pressure and shear stress can physically disrupt the glycocalyx.

Clinical Implications

When the glycocalyx is compromised:

• LDL particles can more easily penetrate the endothelial barrier and accumulate in the intima.

• Oxidized LDL triggers local inflammation and recruitment of monocytes, leading to foam cell formation and plaque development.

Strategies to Protect the Glycocalyx

• Diet and Lifestyle: Low-inflammatory, nutrient-rich diets (e.g., Mediterranean or ketogenic diets) and regular exercise support glycocalyx health.

• Glycocalyx-Regenerating Therapies: Emerging therapies include supplementation with hyaluronic acid, antioxidants, and sulodexide (a heparan sulfate mimetic).

• Control of Risk Factors: Managing blood sugar, cholesterol, and blood pressure preserves glycocalyx integrity.

The glycocalyx serves as a critical barrier that prevents LDL particles from reaching the arterial intima. Its degradation due to oxidative stress, inflammation, or other factors allows LDL infiltration, setting the stage for atherosclerosis. Protecting the glycocalyx is essential for cardiovascular health and the prevention of atherogenic processes.