T1D and your liver

[Steve14]

I wanted to ask if improving your liver functions would affect your blood sugar in a positive way? For example: you have high cholesterol and thus benign fatty liver, but not clinically relevant yet so your doctor shrugs it off. Would "tuning" up your liver through lifestyle and diet give you better control of the severity of hypos or even lessen the occurences? I'm talking about food related hypos and not artificially (injecting insulin) induced ones. Or does liver improvement only benefit those with Type 2?
Sorry I meant overall including using insulin. Having a high BS moment here.

Thank you!

 

[catapillar]

I'm not sure what you mean by food related hypos? Do you mean not eating enough/miscalculating carbs (I'm sure that happens to all of us). If you are type 1 and not making any insulin, the only hypos you get are going to be caused by artificial injected insulin. That's not to say they are "induced" sometimes we don't eat quickly enough or the macros in the food don't let the carbs absorb quick as expected or we miscount the carbs or we did exercise and didn't reduce the bolus enough or, or, or, or the list goes on...

Fatty liver is, I think, associated with insulin resistance. So if you improve that (if you have insulin resistance) you could reduce the amount of insulin you need to inject and thus reduce the margin of error that can sometime lead to hypos.

A glucose dump from the liver is what happens in response to a hypo. But I'm not sure to what extent that is related to liver function. It's caused by glycogen release in response to the hypo so I think that the trigger itself might be more related to hypo awareness rather than liver function, then the response to the trigger (the glucose dump caused by the glycogen) is a part of liver function. I'm not sure whether that bit of liver function is adversely effected by fatty liver. But really, unless you are going very severely hypo, you shouldn't be relying on the liver to bring you round with a glucose dump.

 

[Daibell]

Hi. Yes I'm also not sure what you mean by food-induced hypos. Hypos occur normally when you have excess insulin beyond the carbs you eat. Hypos can occur rarely even if not diabetic. Fatty liver (and the rest of the body) generally occurs thru excess carbs plus some genetics. Everyone benefits from getting rid of excess body fat. With less fat you may be able to use less insulin and blood sugar swings should be less meaning fewer if any hypos.

 

[Steve14]

I'm not sure what you mean by food related hypos? Do you mean not eating enough/miscalculating carbs (I'm sure that happens to all of us). If you are type 1 and not making any insulin, the only hypos you get are going to be caused by artificial injected insulin. That's not to say they are "induced" sometimes we don't eat quickly enough or the macros in the food don't let the carbs absorb quick as expected or we miscount the carbs or we did exercise and didn't reduce the bolus enough or, or, or, or the list goes on...

Fatty liver is, I think, associated with insulin resistance. So if you improve that (if you have insulin resistance) you could reduce the amount of insulin you need to inject and thus reduce the margin of error that can sometime lead to hypos.

A glucose dump from the liver is what happens in response to a hypo. But I'm not sure to what extent that is related to liver function. It's caused by glycogen release in response to the hypo so I think that the trigger itself might be more related to hypo awareness rather than liver function, then the response to the trigger (the glucose dump caused by the glycogen) is a part of liver function. I'm not sure whether that bit of liver function is adversely effected by fatty liver. But really, unless you are going very severely hypo, you shouldn't be relying on the liver to bring you round with a glucose dump.

Thank you! I'm still learning a lot. I usually wake up to 5.5 - 7.0, give myself 8 units of insulin and eat 1 medium and 1 small sandwhiches for breakfast (whole wheat bread). My blood sugar goes up to 10-11 after an hour and a half, but two and a half hours later I suddenly get hypo and often go down to 3.0. It's like the insulin is not doing it's job, but then it suddenly starts working and no matter what I do I cannot avoid going hypo.

 

[Steve14]

Hi. Yes I'm also not sure what you mean by food-induced hypos. Hypos occur normally when you have excess insulin beyond the carbs you eat. Hypos can occur rarely even if not diabetic. Fatty liver (and the rest of the body) generally occurs thru excess carbs plus some genetics. Everyone benefits from getting rid of excess body fat. With less fat you may be able to use less insulin and blood sugar swings should be less meaning fewer if any hypos.

Thanks for the reply. I was diagnosed T1D last year at the age of 26. Well, actually the doctor still didn't say which type, but classified me as "likely type 1". I had lots of hypos even 10 years before diagnosis. As a child I often starved myself and had days where I lived off on a single chocolate bar the whole day. Even back then I had times of hypo where I started shaking, jittery and severe hunger and remember going to the pantry and ate everything I saw to make me feel better. My mom always told me I'm not eating enough and get so hungry. So I had the symptoms a decade prior the diagnosis, but hyperglycemia only started last year with the unquenchable thirst. I had sugar of 23 at diagnosis. Still I didn't have frequent urination. My urination is normalish, 3-6 times a day.

 

[noblehead]

Thank you! I'm still learning a lot. I usually wake up to 5.5 - 7.0, give myself 8 units of insulin and eat 1 medium and 1 small sandwhiches for breakfast (whole wheat bread). My blood sugar goes up to 10-11 after an hour and a half, but two and a half hours later I suddenly get hypo and often go down to 3.0. It's like the insulin is not doing it's job, but then it suddenly starts working and no matter what I do I cannot avoid going hypo.

Looks like you need to inject earlier to give your insulin a head start on your food digesting, most of us here bolus ahead of our food to reduce the postprandial spikes, but if you do reduce the spike you may also have to adjust your I:C ratio if you find your still going hypo two & half hours later.

The following is a good article which explains why pre-bolusing before food can reduce postprandial spikes:

http://www.diabetesselfmanagement.c...blood-glucose-management/strike-the-spike-ii/

 

[Steve14]

Looks like you need to inject earlier to give your insulin a head start on your food digesting, most of us here bolus ahead of our food to reduce the postprandial spikes, but if you do reduce the spike you may also have to adjust your I:C ratio if you find your still going hypo two & half hours later.

The following is a good article which explains why pre-bolusing before food can reduce postprandial spikes:

http://www.diabetesselfmanagement.c...blood-glucose-management/strike-the-spike-ii/

Thank you! My diabetic doc told me to inject and wait 20 minutes to eat, so I'm doing just that. I tried 10 units, I tried 4 units etc. but my sugar after breakfast always stays at 200-220. Should I increase time with 5-10 minutes everyday and see if it helps? So tomorrow I could try 25 minutes until I eat?

 

[noblehead]

Thank you! My diabetic doc told me to inject and wait 20 minutes to eat, so I'm doing just that. I tried 10 units, I tried 4 units etc. but my sugar after breakfast always stays at 200-220. Should I increase time with 5-10 minutes everyday and see if it helps? So tomorrow I could try 25 minutes until I eat?

Entirely up to you, I bolus around 20-25 mins before breakfast which keeps my bg levels within my bg target range, others pre-bolus a lot longer and some less, I'm afraid it's a case of trial & error.

 

[donnellysdogs]

It may be that your basal is wrong.... Too much.

Do you use 1/2 unit pens? Have you been on carb counting / dose adjusting course or are you just doing fixed amounts according to the advice from your clinic?