In the unit on hyperglycemia, patient handout does not include the instructions on increasing the carb serving on the third day’s lunch as was discussed in the lecture. Could you please review why this is needed and when you include it in the blood sugar testing with the glucometer? Also in that same unit while discussing protein-sparing modified fast, you mentioned the patient should be medically monitored. Who would that be? Me or medical doctor? If me, what would I be watching for?

Chris Kresser:  We must’ve somehow uploaded an older version of that handout because the newer version does have that instruction. So Lauren, maybe make a note to ask Jill to remind me about that and we’ll upload the new handout. And the reason for that is that the first two days you’re looking at how their post-meal blood sugar responds to normal meals that they eat. And then on the third day you’re trying to sort of simulate the effects of an oral glucose tolerance test. But rather than using pure glucose, you’re using white rice, which has a higher actually a higher, if it’s jasmine white rice, it has a higher glycemic index than white rice, to see what happens to their blood sugar in response to a carbohydrate challenge. I think this way of testing post-meal blood sugar more closely mimics the real-world circumstances and what a patient is eating. Even if they never do eat just plain white rice, it would be closer to what they might experience if they ate ice cream or something like that. And it’s certainly easier and better tolerated in most cases than doing the actual oral glucose tolerance test.