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Blood sugar rises for different foods compared

Nov 9, 2025Oct 8, 2025 kaitiscotlandLeave a comment

Adapted from BMJ 28 June 2025

Our individual metabolic response to different foods types may influence our risks of developing diabetes and cardiovascular disease. Californian researchers decided to test 55 members of the general population after they had consumed various carbohydrate foodstuffs to see what the blood sugar response was over time.

Glucose levels typically peaked at about an hour and were highest for rice, potatoes and grapes. They noted that responses varied considerably between individuals however. Eating fibre, protein or fat before the carbohydrate reduced the size of the peak blood sugar compared with eating the carbohydrate on its own. This of course won’t be news to insulin users who need to check their blood sugar regularly.

Fastest peaks in order:

Grapes – 40 minutes after eating

Potatoes – Berries 50 mins

Bread – Rice – Pasta – Beans 60 mins

Highest peaks in order:

140 -160 mg dL glucose – Rice- Grapes-Potatoes-Bread

120-140 Berries – Pasta

100-120 Beans

Longest lasting blood sugar rises over 100 minutes Pasta-Potatoes-Bread-Rice

Shortest lasting blood sugar rises under 100 minutes Berries-Grapes-Beans

What can we make of this?

If you have a low blood sugar, grapes could be a good option if you don’t have juice or glucose tablets. Otherwise keep them for eating after a meal or with cheese.

In terms of diabetes control, both beans and berries are good options because they don’t raise your blood sugars very much and in addition the levels fall quickly too.

Pasta could be a good option if you are undertaking planned prolonged exercise as it raises the blood sugar moderately and lasts the longest in your system.

Rice, potatoes, and bread produce high blood sugar spikes, so if you like eating these, it is preferable to eat them with some sort of fat, and eat them after the protein component of your meal.

Alternate day fasting may help weight loss on the short term

Nov 3, 2025Oct 7, 2025 kaitiscotland1 Comment

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Adapted from BMJ 28 June 2025 Intermittent fasting as a nutritional tool by Semnani-Azad et al.

A study aimed to find out what effect intermittent fasting diets had on cardiometabolic factors compared to unrestricted diets or continuous energy restriction.

99 RCTs involving over six thousand people were examined. Compared to no restriction in food intake (no dieting), both continuous energy restriction and intermitting fasting led to reduced body weight.

The only type of intermittent fasting diet that produced more weight loss than continuous food restriction ( eg traditional calorie counting) was the alternate day fasting method. Otherwise, whatever method was adopted, the cardiometabolic improvements were similar for the other dietary types.

Some people find it easier and more simple to stop eating certain meals entirely rather than count calories or undertake other forms of food limitation. For caloric restriction, a deficit of 30% was usually able to be maintained in the first three months, when motivation was high, but fell below 10% after 12 months.

This study looked at differences between no dietary restriction, overall calorie restriction, fasting on alternate days, time restricted eating, and whole day fasting. Although alternate day fasting produced the most weight loss after 24 weeks, the amount was only 1.29kg more per participant. Fat lost from the viscera is particularly helpful for people who have fatty liver disease. People with type one and two diabetes, overweight, obesity, metabolic syndrome and metabolic dysfunction such as fatty liver, were included in this study.

This study does not establish any particular dietary strategy as being superior, but does suggest that alternate day fasting be considered as a worthwhile option. The best diet for an individual is one that they can stick to and so widening the options may be helpful.

Obituary: Judith Steel

Oct 28, 2025Aug 5, 2025 kaitiscotland1 Comment

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Adapted from BMJ 14 June 2025

Judith Steel was responsible for establishing the first pre-pregnancy unit for type one diabetic women in the UK.

Judith Steel was born in 1940 and died of a chest infection due the effects of a spinal tumour on 8th January 2025.

In 1976 she and obstetrician Frank Johnstone set up a diabetic clinic for type one women in the Simpson Memorial Pavilion Edinburgh. They recognised that high blood sugars greatly influence congenital abnormalities which occur in early pregnancy, and that early intervention, before pregnancy occurs is necessary.

Women between the ages of 14 and 40 were advised on dietary changes to improve their chances of having a normal baby. Of the 143 births at the unit by 1990, only 2 babies had congenital abnormalities. In comparison, of 96 women who defaulted from the clinic, 10 babies with malformations were born.

Worldwide, such clinics were set up, improving the outlook for countless families. Now, these special clinics are mainstream.

Judith wrote many academic papers and also Personal Experiences of Pregnancy Care in Women with Insulin Dependent Diabetes in 1994.

Judith unfortunately developed a spinal cord tumour in the 1980s. This gave her mobility problems in her legs. She had two operations but was not able to be cured, and had to use a wheelchair.

Judith was born in West Yorkshire. She entered Edinburgh University and qualified in 1965. At the time, men greatly outnumbered the women who were admitted to the medical degree course. She particularly enjoyed the lectures of Leslie Duncan who was a diabetologist and veterinary surgeon. He would bring patients to lectures including dogs. After qualifying she joined his diabetology team.

She met her future husband Michael Steel at anatomy lectures. He was initially on crutches after a motorcycle accident. They married in 1962. After graduation they worked together in Nigeria. They then worked together at Edinburgh’s Western General Hospital and then in Kenya in a diabetology unit.

In 1983 Judith was appointed to an associate specialist position and started working with adolescents with eating disorders associated with diabetes. She was awarded an MBE in 1992.

Michael moved to St. Andrews University and Judith moved to the Victoria Hospital Kirkaldy. She studied the development of blindness in diabetes and found that this could be prevented if eye screening was done every 1-2 years.

Both Judith and Michael travelled around the world to share knowledge with other diabetologists. She spent her retirement in Edinburgh and is survived by her husband, three children, and six grandchildren.

My comment: I had never heard of Dr Steel till I read this obituary in the BMJ. She certainly was a trailblazer and improved the outlook for diabetics worldwide. She contributed to improvements in pre-pregnancy and pregnancy care for type one women, eating disorders, and reducing blindness. Much of her work was copied and is now a part of regular care. She did much of her work from a wheelchair and managed to bring up three children. Thank you Judith.

Anaemia is more common than usual in diabetes

Oct 22, 2025Jul 31, 2025 kaitiscotlandLeave a comment

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Adapted from BMJ 14 June 2025

Diabetes increases the likelihood of anaemia of various types. Iron deficiency, vitamin B12 deficiency, and anaemia of chronic disease were three to five times more common in people with diagnosed diabetes than those with normoglycaemia.

Renal complications and decreased erythropoietin production may be part of the explanation.

The study was part of the UK Biobank Study.

Another longitudinal study of apolipoprotein in the development of cardiovascular disease found that blood glucose levels are also linked to the development of aortic stenosis.

As blood levels rise, so does the risk. After 25 years of having diabetes, the average onset of aortic stenosis doubles compared to those with normal glucose levels.

My comment: Because diabetics get many more regular blood tests than the usual GP population, one would imagine that even if you do get anaemia, that this can be detected and treated earlier.

Supported exercise significantly improves life expectancy after colon cancer

Oct 16, 2025Jul 30, 2025 kaitiscotlandLeave a comment

Adapted from BMJ 14 June 2025

Observational studies have shown that colon cancer patients who increase their physical activity after treatment have a lower risk of recurrence and death compared to those who don’t. Now, a randomised controlled trial, the first of its kind, has shown the same thing.

A three year programme of structured exercise reduced the relative risk of disease recurrence, new primary cancer, or death, by 28% in patients with stage III and high risk stage II colon cancer. The magnitude of the benefit is on a par to many standard drug treatments.

The Challenge Study randomised 889 patients with resected colon cancer and adjuvant chemotherapy to either the structured exercise group or a health education group. The exercise group had face to face coaching sessions and behavioural support every week for the first six months and then once a month. The health education group were given information about healthy eating and exercise but not the personal coaching.

The exercise group managed to get people to do the equivalent of 40-60 minutes brisk walking or 25-30 minutes of jogging, three or four times a week.

After 8 years follow up, disease recurrence, new primary cancer, or death had occurred in 93 of the 445 people in the exercise group, compared with 131 of 444 people in the education group. 90% of the exercise group were still alive, compared to 83% in the education group.

Vicky Coyle, consultant medical oncologist at Queen’s University Belfast, who led the research, hopes that exercise will be embedded in future treatment plans for patients.

It is thought that exercise works by regulating hormone levels, reducing inflammation and strengthening the immune system.

One of the commonest questions patients ask their doctors is what they can do to reduce their risk of a cancer recurrence. A vigorous, structured exercise programme fits the bill.

The link between poverty and poor health is complex

Oct 10, 2025Sep 19, 2025 kaitiscotlandLeave a comment

Adapted from BMJ 26 July 2025

Mothers and children in low income households have poorer health than those from high income households. A trial in four cities in the USA compared results when monthly unconditional cash transfers were made. In theory, those given more money should see an improvement in health.

A total of 1,000 mothers were randomised to receiving either $333 dollars or $20 a month until their child was six years old.

After four years, no difference between the groups was found n maternal mental health, maternal or child BMI, or maternal report of the child’s health.

My comment: I would have thought that an extra $333 would have led to some improvements in diet, house heating, clothes and shoe provision. It could also have led to less paid work being necessary for the mother to do, which I would also have expected to help. I am surprised that health outcomes didn’t improve at all. Perhaps, much more money is needed? Or is it being spent on things that don’t improve health?

Weight loss drugs have unintended side effects

Oct 4, 2025Jul 27, 2025 kaitiscotland1 Comment

Adapted from BMJ 14 June 2025

Weight loss drugs have considerable advantages but as use grows unexpected side effects are occurring too.

For the child bearing years, usually 15-45 years of age, weight loss drugs seem to render oral contraceptives less effective.

Therefore, should you wish to delay or prevent conception, it is best to add a barrier method such as condoms or a diaphram to the combined or progestogen only pill.

Should a pregnancy occur, the weight loss drugs need to be stopped because there is insufficient knowledge about how these drugs can affect a developing baby. Animal studies indicate that there could be adverse fetal outcomes.

For those in older age groups, it has been found that people with diabetes have twice the likelihood of developing neovascular age related macular degeneration, than diabetics not on weight loss drugs.

Dr Rangan Chattergee: Baked salmon fishcakes

Sep 28, 2025Jul 24, 2025 kaitiscotlandLeave a comment

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Adapted from Dr Rangan Chatterjee’s website.

Baked Salmon Cakes

These fishcakes are an easy way to nourish your body and enjoy a flavourful meal.

1 tablespoon avocado or olive oil

6 oz can of wild salmon or 6 oz of cooked salmon

1/2 medium red onion finely chopped

1 large egg, beaten

1/4 cup finely chopped almonds

1/2 teaspoon of salt

1/4 teaspoon finely ground black pepper

1 cup ground almonds

one lemon cut into wedges (optional)

finely chopped parsley leaves (optional)

Mayonnaise (optional)

Method

Pre-heat the oven to 425 degrees. Grease a baking sheet with oil and put it in the oven to heat.

In a medium bowl, shred the salmon into small flakes with two forks. If you are using canned salmon add the liquid into the bowl.

Add the onion, egg, chopped almonds, salt and pepper and mix well.

Stir in the almond meal. If you are using canned salmon, the mix could get a bit slushy, and if this is the case, add additional ground almonds.

Form two large patties.

Put in the oven on the top rack. Bake for 10 mins. Then take out and turn over the patties. Bake for a further 10 minutes.

Serve immediately with lemon wedges and parsley garnish or mayonnaise.

Falling is the main cause for excess injuries in people with diabetes

Sep 22, 2025Jul 23, 2025 kaitiscotland1 Comment

Adapted from BMJ 24 August 2024

An Australian study has shown that people with both type one and type two diabetes are hospitalised for injury more often than the general population.

Most of these injuries happened due to falls.

People using insulin have 60% more chance of being hospitalised for injury. Type two diabetics who take sulphonylureas have also a raised risk.

My comments: These findings tend to indicate that hypoglycaemia is a cause of falls. There could also be other reasons. I recall visiting a woman who had two broken wrists. She had fallen in the street and had fallen off the kerb. I asked why she thought she fell. She said, “I can’t feel my feet.” As a fractured hip in older age is a major reason for losing independence it is important for diabetics to aim for as best blood sugar control as appropriate for them, but also to take care to reduce hypoglycaemia.

Marks and Spencer now supplying stoma underwear

Sep 16, 2025Jul 21, 2025 kaitiscotland1 Comment

Adapted from BMJ 24 August 2024

Marks and Spencer has partnered with Colostomy UK to launch an underwear line design for people with a stoma.

About 100,000 women in the UK have a stoma, but many find that underwear options were very limited to specialist online retailers.

They have produced a more affordable, accessible panty range that can keep a stoma bag in place by day and night.