People who are wearing CGM devices may notice various types of graphs with different peaks, valleys, and curves. Some individuals may witness two particular kinds of graphs when they consume carbohydrates. They may either see a monophasic glucose spike or a biphasic glucose spike. But what do these terms mean and why are they important?
Highlights
- A Biphasic Glucose curve is defined as a curve that shows a peak around 30-60 minutes after a meal, which then decreases and is followed by another elevation, 90-120 minutes later,
- A glucose tolerance test is when individuals are tested on their blood glucose levels after consuming 75 grams of glucose,
- Biphasic curves that appear after a carbohydrate-rich meal are linked to better health outcomes.
What are Monophasic Glucose spikes?
A monophasic glucose spike is a blood glucose pattern with a single peak that emerges after a high carbohydrate dietary intake. It simply shows a singular peak, which is followed by a decline in the graph. This type of glucose spike may provide insight into the inner workings of your metabolic fitness.
What are Biphasic Glucose spikes?
A biphasic Glucose curve is defined as a curve that shows a peak around 30-60 minutes after a meal, which then decreases and is followed by another elevation, 90-120 minutes later. Studies suggested that individuals with monophasic curves had higher fasting and 2-h plasma glucose levels.
They also presented lower insulin sensitivity, beta-cell function (cells that make insulin), HDL cholesterol (this is considered good cholesterol), adiponectin (breaks down fatty acid and regulates blood glucose) and pancreatic polypeptide levels (impacts liver glycogen storage). The intensity of metabolic dysfunction was observed to be higher in subjects from the study with monophasic curves. These subjects seem to have a higher prevalence of metabolic dysfunction and disrupted glucose metabolism.
Monophasic Glucose Spikes vs Biphasic Glucose Spikes
A study showed that after a glucose test, obese individuals who experienced monophasic curves had lower insulin sensitivity and pancreatic beta function than individuals with biphasic curves. A glucose tolerance test is when individuals are tested on their blood glucose levels after consuming 75 grams of glucose. The monophasic individuals were also shown to be more likely to have an elevated risk for type 2 diabetes.
Another study assessing the shape of the glucose curve during an oral glucose tolerance test observed two groups – one with normal glucose tolerance and the other with impaired glucose tolerance. Then, the individuals were segmented into monophasic or biphasic groups. Not only did the individuals who displayed a biphasic curve have a stronger percentage of normal glucose tolerance but they also were found to be younger with a lower BMI, lower plasma glucose as well as haemoglobin a1c. They also had better insulin sensitivity than the monophasic group.
What is happening after Glucose spikes
Within the framework of the human body, it is important to understand the physiological processes that lead to a monophasic or biphasic response. In the biphasic group, insulin is secreted and deployed quickly from the pancreas to take up blood glucose. This takes place immediately after the glucose intake and continues for a shorter duration of time in the first phase. In the second phase, it occurs for a longer duration of time. In individuals that have a monophasic response with a singular peak after consuming glucose, insulin secretion seems to be diminished and disrupted.
People who exhibit the biphasic curve have better insulin secretion and stronger insulin sensitivity, thereby leading to early glucose regulation in the first phase, which is followed by an increase in glucose. This leads to the two peaks that you see in the curve. There may be certain other factors involved as well, such as how quickly the stomach unloads food and other hormone-related variables. Biphasic curves that appear after a carbohydrate-rich meal are linked to better health outcomes.
They are also associated with lower glucose levels, lower fasting insulin, lower BMI, lower rates of disrupted glucose tolerance and metabolic syndrome, and higher insulin sensitivity. Having said that, it is vital to note that you don’t need to eat in a particular way just to generate the biphasic response. When you consume food, the ideal response and pattern that should exist on the graph is a stable one, without a spike at all. A stable curve is better than a spike and is also ideal for health.
How does Glucose Spike affect you?
Monophasic or biphasic responses are one of many metrics that exist and narrate one chapter in the entire metabolic fitness story. Risk factors and poor health outcomes are associated with an individual whose blood glucose graph exhibits multiple spikes and crashes in the day, especially high glucose peaks post food consumption. Within the graph, the ideal scenario would be to have a blood glucose curve that is closer to being flat, with fewer crashes and spikes while maintained at a healthy target. There are various other factors apart from the type of dietary intake that can be instrumental in spikes such as lack of sleep, high-stress levels, intake of extra food, and exercise. A continuous glucose monitoring device may provide information on your dietary patterns, empowering you with the data required to improve your overall metabolic fitness.
Conclusion
A monophasic glucose spike is a blood glucose pattern with a single peak that emerges after a carbohydrate-packed dietary intake. A biphasic curve is defined as a curve that shows a peak around 30-60 minutes after a meal, which then decreases and is followed by another elevation 90-120 minutes later. A monophasic spike may mean lower insulin sensitivity, beta-cell function, HDL cholesterol, adiponectin, and pancreatic polypeptide levels. A biphasic spike is a good spike that occurs in two phases. A curve that is closer to being flat is the ideal pattern while maintaining minimal spikes and crashes throughout the day.
Disclaimer: The contents of this article are for general information and educational purposes only. It neither provides any medical advice nor intends to substitute professional medical opinion on the treatment, diagnosis, prevention or alleviation of any disease, disorder or disability. Always consult with your doctor or qualified healthcare professional about your health condition and/or concerns and before undertaking a new health care regimen including making any dietary or lifestyle changes.
References
- Distinct metabolic profile according to the shape of the oral glucose tolerance test curve is related to whole glucose excursion: a cross-sectional study – PMC
- Glucotypes reveal new patterns of glucose dysregulation – PMC
- Assessing the Shape of the Glucose Curve During an Oral Glucose Tolerance Test | Diabetes Care
- The Shape of the Glucose Response Curve During an Oral Glucose Tolerance Test Heralds Biomarkers of Type 2 Diabetes Risk in Obese Youth – PMC
