- Messages
- 4,253
- Type of diabetes
- Type 2
- Treatment type
- Tablets (oral)
- Dislikes
-
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
I'm being very strict on the low carbohydrates at the moment and also wearing a self funded Freestyle Libre.
In general my usual Extended Dawn Phenomenon [EDP] (start to rise at 06:00, rises until 12:00, then drops steeply) has been muted and in general all the numbers look good.
I have in the past noticed that if I take strenuous exercise in the morning my EDP goes higher and longer.
However the trace above is interesting if quite alarming.
The ride was roughly 10:30 - 11:45 to the coffee stop, then about 12:30 after coffee back to base.
The return ride was less strenuous (following wind) but still had a short sharp hill which had me puffing and grunting a lot.
So it isn't the riding per se which is pushing my BG up.
There seems to be something going on in the mornings where my liver insists on dumping glucose into my bloodstream where it is not being removed.
I can see that if I am in ketosis and my muscles are converted to running on ketones then the glucose won't be burnt as energy.
However there seems to be a broken mechanism where my liver keeps dumping glucose into my bloodstream even though the levels are far higher that normal.
This combines with not enough insulin being produced to remove the glucose.
I have talked about this in the past, with my current theory being that the Alpha cells in my pancreas are producing glucagon which does two things. Stimulates release of glucose from the liver and inhibits the release of insulin by the Beta cells in my pancreas. For some reason the glucagon production is not throttled by rising BG.
https://en.wikipedia.org/wiki/Glucagon
This is an interesting description.
It also contains the alarming statement:
"Glucagon production appears to be dependent on the central nervous system through pathways yet to be defined. In invertebrate animals, eyestalk removal has been reported to affect glucagon production. Excising the eyestalk in young crayfish produces glucagon-induced hyperglycemia"
Erk!
So although not an invertebrate (despite some unkind comments from friends and acquaintances) this may point to a CNS issue (though possibly not my eyestalks).
Further:
"
Secretion of glucagon is inhibited by:
- Somatostatin
- Amylin [21]
- Insulin (via GABA)[22]
- PPARγ/retinoid X receptor heterodimer.[23]
- Increased free fatty acids and keto acids into the blood.[24]
- Increased urea production
- Glucagon-like peptide-1
which raises some interesting questions.
(1) is the effect due to slow release of insulin?
(2) could ketone fuelled exercise be taking the ketones out of my blood and thus removing an inhibitor?
(3) I note that rising glucose levels don't seem to be listed as an inhibitor to glucagon production - which could explain a lot
Whatever, something somewhere is broken.
Probably in my pancreas.
If the pandemic ever subsides I might get to talk to an endocrinologist who understands this stuff.
Also, in the context of T1 diabetes:
"As the beta cells cease to function, insulin and pancreatic GABA are no longer present to suppress the freerunning output of glucagon. As a result, glucagon is released from the alpha cells at a maximum, causing rapid breakdown of glycogen to glucose and fast ketogenesis.[29] It was found that a subset of adults with type 1 diabetes took 4 times longer on average to approach ketoacidosis when given somatostatin (inhibits glucagon production) with no insulin"
Hmmmm....again.
I can see that when exercising strenuously in ketosis, fast ketogenesis might be a very good thing. However this seems to logical.
I need to look at somatostatin though.
What I could do with is a fast acting short duration pill which I can take just before a morning bike ride.
Edit:
https://en.wikipedia.org/wiki/Somatostatin
"Somatostatin inhibits insulin and glucagon secretion"
Oh, {bother}!
I need something that just inhibits glucagon production.
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