I, Ronan Kelly have been a type 1 diabetic for 14 years so have seen the effects of unregulated blood glucose levels first-hand. Personally, my quality of life decreased significantly when my blood glucose levels were unregulated. I experienced low energy, constant mood swings and, honestly, I wasn't happy.

However, since regulating my blood glucose levels, my life has changed. I have unbelievable energy, my athletic performance has increased exponentially, my body fat level has decreased and, most importantly, I am happy again!

My goal is to share the habits and principles that have helped me regulate my blood glucose levels and have turned my life around to non-diabetics. I know there are many members of the general population with poor blood glucose levels that are experiencing the same daily problems that I experienced.

There is a huge misconception in the general public domain that one simply transfers from having normal blood glucose levels to being diagnosed as type 2 diabetic. However, there is a period in the middle called "pre-diabetes". Pre-diabetes is a serious health condition where blood glucose levels are higher than normal, but not high enough to be diagnosed as type 2 diabetic.

Approximately 88 million American adults - more than 1 in 3 - have pre-diabetes. Of those with pre-diabetes, more than 84% don’t know that they have it, which is a highly concerning figure. It could also be present for up to 13 years before the diagnosis of diabetes.

It is known that the condition puts you at increased risk of developing type 2 diabetes, heart disease, and stroke. It is highly likely that the hyperglycemia (high blood glucose levels) are damaging the person's health and increasing their risk of chronic disease. Our goal is to reduce this risk for the general population and improve overall health through specific nutrition habits and principles.

Here at Regulate, we seriously disagree with the weight loss principle of calories-in minus calories-out. We believe this is a gross oversimplification of an extremely complex and individual experience. Everyone's body is so different, and factors like gut health, muscle mass, genetic profile, stress and hormonal health affect everyone's weight loss journey differently.

For example, a randomised control trial was conducted on a group of 800 people that analysed their blood glucose responses to 46,000 identical meals. They found that there was extremely high interpersonal variability in post-meal blood glucose levels to identical meals. Factors that affected this variability were genetics, lifestyle, insulin sensitivity, insulin and glucose transporters, activity levels, and possibly the gut microbiome. The conclusion from the study was that general dietary guidelines and principles like the "calorie in-calorie out" have little-to-no utility and a personalised approach will yield successful results in weight loss.

This is what we aim to achieve at Regulate and have full confidence that a personalised approach will improve our clients body composition and overall health.

As previously mentioned, there are millions of people worldwide in a pre-diabetic and diabetic state. This means that their fasting blood glucose levels are often outside the normal range and elevated. Fasting blood glucose levels are those which are measured at least two hours after eating. These should be lower than your postprandial blood glucose levels, which are those measured within two hours of eating.

A non-diabetic should have a fasting blood glucose level of between 4.0 and 5.5 mmol/L Anything above this range is classed as a level of pre-diabetic/diabetic and metabolic dysfunction.

In simple terms, this is your post-meal blood glucose increase. Everyone, whether diabetic or non-diabetic, experiences these increases and they typically peak 1 hour after eating a meal. If excessive, they can negatively affect your health for numerous reasons.

For example, blood glucose elevations cause oxidative stress, which is an imbalance of free radicals and antioxidants in the body. Although this imbalance does occur naturally as an ageing process, an increased imbalance can cause cell and tissue damage; affecting the normal functioning of the body.

Glycemic variability refers to blood glucose changes that occur throughout the day, including hypoglycemic (low blood glucose) periods and postprandial increases, as well as normal changes that occur in the day (e.g. during exercise).

In recent studies, the importance of glycemic variability for our health has been truly realised. Firstly, it is thought to be an independent risk factor for diabetes complications, such as retinopathy, independent of the level of hyerglycemia. This suggests that even if blood glucose levels are relatively normal, if changes are frequent and intermittent hypoglycemia occurs, it is damaging for our health.

Secondly, the extent of glycemic variability is thought to be the biggest contributor to cardiovascular events, such as stroke and heart attack, seen in diabetes. Therefore, minimizing hyper and hypoglycemic events will minimize the risk of these events.

Finally, decreased glycemic variability has been shown to improve death rates in non-diabetic critically-ill patients.

This demonstrates that glycemic variability is a key metric we should be monitoring in blood glucose control. Here at Regulate, we want to see our clients to show relatively flat blood glucose graphs, avoiding hyper- and hypo- glycemia.

Body mass index is a metric that is commonly used to determine whether a person is underweight, normal weight, overweight or obese. It takes into account your weight and height, and is displayed as one of the most informative metrics for body composition and health.

However, at Regulate, we believe this is extremely flawed as BMI does not take into account body components such as lean muscle mass and fat mass. As lean muscle mass is much heavier than fat, those with high muscle mass often come up as having a high BMI and being overweight/obese. This is seen, for example, in professional rugby players. It, therefore, gives the incorrect and inappropriate impression that they are 'unhealthy'.

Body fat percentage is the proportion of your body mass that is made up of fat. It can be found relatively accurately using methods called bioelectrical impedence analysis (BIA) or dual x-ray absorptiometry (DXA), however an estimate can be found by using a device called a skin-fold calipers.

Unfortunately, unlike BMI, body fat percentage goals and cut-off points for over-weight and under-weight categories are not well-defined. One report by the World Health Organisation from 1995 suggests that a body fat percentage of over 25% in men and 35% in women indicates obesity, however recent reviews report that there is not enough evidence to confirm this

There are a range of benefits for your health if your body fat percentage was too high and you reduce it, especially if it coincides with increased skeletal muscle mass. Some of these benefits include...

Your waist circumference is the diameter of your waist (located directly above the hipbone, usually in line with the belly-button), which can be found using a tape measure. It is in indicator of the amount of fat there is in and around your abdomen, also known as visceral fat. It has been shown that men at are increased risk of health problems, such as cardiovascular disease and diabetes, if their waist circumference is above 102cm, and women are at increased risk if their waist circumference is above 88cm.

Despite decades of indisputable evidence that waist circumference provides both independent and additive information to body mass index (BMI) for predicting health outcomes, this measurement is not routinely obtained by healthcare professionals. Recently, an expert group criticised this and stated that the correct measurement of waist circumference is vital include in health assessment and management.

Based on this, here at Regulate, we want waist circumference to be a key metric for our clients to focus on, rather than weight.

Sarah is a CORU registered dietitian who graduated from
Technological University Dublin and Trinity College Dublin in 2021. Back in
2017, she chose her degree, Human Nutrition and Dietetics, based on her strong
beliefs that food and nutrition underpin the concept of health in our population.

Throughout her time in university this belief has grown and evolved, and her main goal of practicing as a dietitian is prevention. Sarah agrees with the widespread viewpoint in health systems that ‘Prevention is better than Cure’ – that modern medicine needs to focus on preventing diseases rather than curing them. This is why she is excited to work with Regulate, a company that exclusively focuses on controlling blood sugar levels in the general population. Not only will this reduce the incidence of pre-diabetes and type 2 diabetes, but, based on the wealth of evidence that suggests a causal relationship between high blood sugar and chronic disease, it will improve the overall health of our population.