We know blood sugar is controlled when fasting blood glucose levels are less than 5.7mmol/L (Less than100mg/dL). When your fasting blood sugar is between 5.7mmol/L (100mg/dL) to 7.0mmol/L (126mg/dL) you are considered prediabetic.

However, if your fasting blood glucose is more than 7.0mmol/L (126mg/dL) then you are considered diabetic.

N.B In the medical community when we consider fasting, we are referring to no meals after midnight, with the blood sample being taken somewhere within the vicinity of eight hours after the initiation of the fast.

By the time it would have reached the anus, most of the nutrients and water are reabsorbed. It is a complex system of enzymatic activity, that only a mastermind, the creator of all science, the creator of the world we are living in, could put together.

There are three (3) basic types of macronutrients:

• Carbohydrates
• Proteins
• Fats

You may hear of vitamins, minerals and phytonutrients. These are just atoms, molecules or elements that facilitate proper functioning of enzymes and reactions.

Proteins

Proteins are broken down into amino acids which are further broken down into nitrogen products, as seen in Figure 1.9. These products can either be converted to acetyl-CoA, which in turn can be passed through the Citric Acid Cycle or Kreb Cycle for energy production. However, this is only a last resort. Proteins are generally used for the structure of cells and tissues.

Fats

Fats are broken down into fatty acids and glycerol. Fatty acids can then be converted to acetyl-CoA, and which in turn can pass into the Citric Acid Cycle or the Kreb Cycle for energy production. However, this is only a last resort. Fats are usually used for the structure of cells and tissues, and the storage of energy. It should be noted that more than double the amount of energy is achieved when fats are broken down, as compared to carbohydrates and protein.

Glucose is converted to acetyl-CoA which can now be converted to ATP (Adenosine triphosphate), which is the only energy unit recognized by cells. So even though glucose can be stored when it is converted to acetyl-CoA, the preferred pathway is energy production.

So to sum that all up, basically, proteins and fats are used for cells, tissues and structures. Carbohydrates are used for energy production for the daily function of cells and tissues.

You may recall that I mentioned “balance is everything”, this is the way the body reacts to excess foods. Ultimately, excess of any macronutrient or micronutrient, will result in storage.

The state of equilibrium is only attained when the exact amount of matter reacts in the appropriate proportions. I say that to emphasize that too much of anything shifts that equilibrium causing instability. This is the reason why scientist postulate that too much of any type of food is bad for you.

Now let’s switch gears and talk a bit about diabetes. After your doctor would have made the diagnosis of diabetes, there are three (3) forms of therapy:

• Diet and exercise
• Oral Hypoglycemic Agents
• Insulin Therapy

The goal is to keep the glucose level between 6.0mmol/L and 7.5mmol/L (100mg/dL and 135mg/dL).

We doctors have a great challenge in trying to attain these goals with diet, oral hypoglycemic agents and insulin therapy. It is often so easy to tell patients what to do but doing it is much more cumbersome.