Liver dump

[Frodo27]

Hi All,
A bit of advice please.
My BS would be very good if it wasn't for Liver dump. A rise of 3-4 mmol/l between 3-5am.
It means my low is pre dinner, my bedtime ids down to 6 or 7, at 3am a bit lower, but by 8am it can be over 10, and it takes a few hours to get it down again. This destroys my A1C. I eat 30-50g carbs a day only it is simply frustrating. i'm 65 but exercise at least 90 mins a day. I only eat one meal a day, on an evening.
I wondered if insulin pumps could be used at night to nullify the liver dump. If I could start the day similar to my bedtime reading I'm sure everything would fall into place.

Here is an interesting thought. Liver dump may be a result of childhood abuse or trauma such as war. Continual abuse may lead to such fear that the liver dumps to allow enough energy for survival. Perhaps.

 

[sunburst69]

I have posted regarding this previously in another thread...This is a problem for many diabetics including myself. Two things that can contribute/cause high BG #'s upon waking are the 'dawn phenomenon' and the Somogyi effect. They both involve the body raising BG. The dawn phenomenon is associated with the body's normal ramping up to meet the day and the Somogyi effect is a mechanism which triggers liver dumping when BG goes low at night. Many times adjusting nighttime meds and/or what you eat and how late can affect your body's response to these phenomena. I am not a medical professional, so please do some research and discuss this with your doctor/team.

 

[Juicyj]

Hi Frodo - you've posted in the Insulin Pump section - would you like me to move this into the Type 2 section for better visibility ?

 

[Frodo27]

My question relates to using an insulin pump to counter liver dump, nothing more, so it should remain here.

 

[Frodo27]

I have posted regarding this previously in another thread...This is a problem for many diabetics including myself. Two things that can contribute/cause high BG #'s upon waking are the 'dawn phenomenon' and the Somogyi effect. They both involve the body raising BG. The dawn phenomenon is associated with the body's normal ramping up to meet the day and the Somogyi effect is a mechanism which triggers liver dumping when BG goes low at night. Many times adjusting nighttime meds and/or what you eat and how late can affect your body's response to these phenomena. I am not a medical professional, so please do some research and discuss this with your doctor/team.

Thank you Sunburst69, I have studied diabetes for three decades and am aware of these common answers, yet despite hundreds of experiments based upon advice from many consultants and websites there appears to be no answer. The insulin pump may be an answer, but what is really needed is a drug that stops the liver dump. I have not come across one. In fact in my experience concentration is on the pancreas functions, and insulin resistance, none relating to liver functions.

 

[sunburst69]

DPP-4 inhibitors act on insulin production by the pancreas and glucagon production by the liver. However, I am not aware of any information relating to their effect on morning highs. Anecdotally, I can say my use of a DPP-4 inhibitor has coincided with stabilizing and slightly improving my morning BG #'s. I look forward to any further light you can shed on the subject.

 

[Bluetit1802]

Our livers dump whenever it detects our levels are low. We all know this.
In normal healthy people hormones trigger the pancreas to secrete insulin to regulate the dumped glucose and also tells the liver to stop dumping.

In T2 diabetics with insulin resistance this system breaks down. The liver dumps, the pancreas secretes, but the insulin doesn't work properly because it is resisted by the liver cells. The glucose levels remain high and the liver continues dumping, the pancreas panics and secretes more and more insulin until enough is produced to stop the liver dumping more glucose and push the glucose into the cells for energy/storage.

(I have no knowledge about pumps or injected insulin, but imagine that if there is insulin resistance then this artificial insulin will also be rejected and will need extra in order to regulate the dumped glucose and stop the liver from dumping more.) Maybe insulin/pump users can help more with this.

 

[Frodo27]

Our livers dump whenever it detects our levels are low. We all know this.
In normal healthy people hormones trigger the pancreas to secrete insulin to regulate the dumped glucose and also tells the liver to stop dumping.

In T2 diabetics with insulin resistance this system breaks down. The liver dumps, the pancreas secretes, but the insulin doesn't work properly because it is resisted by the liver cells. The glucose levels remain high and the liver continues dumping, the pancreas panics and secretes more and more insulin until enough is produced to stop the liver dumping more glucose and push the glucose into the cells for energy/storage.

(I have no knowledge about pumps or injected insulin, but imagine that if there is insulin resistance then this artificial insulin will also be rejected and will need extra in order to regulate the dumped glucose and stop the liver from dumping more.) Maybe insulin/pump users can help more with this.

Thanks Bluetit, as you say it is an imaginary concept and the rejection you mention is certainly a possibility. I guess if nobody else has tried it out then experiment may be a good way forward. I too have no experience of the insulin pump, but if devices such as the Accu-check combo system https://www.accu-chek.com.au/insulin-delivery-system/combo-system can be programmed and used for regulation during the night it may be worth a go. I have no idea how easy the pump is fitted, and if night only use is feasible. I have not used insulin for over 18 months but the low carb diet and exercise that took me off insulin is gradually less effective as I age, with arthritis slowing me down I am looking for some hope.

 

[Bluetit1802]

I have not used insulin for over 18 months

Sorry. I assumed you were on insulin because that is what it says in your profile. It may stop confusion if you could bring it up to date.

As far as I understand from what I have read, 3 things can cause unregulated/badly regulated liver dumps
1. insulin resistance especially in the liver
2. a failing pancreas that produces less insulin than is required.
3. wonky hormones ( growth hormone, glucagon and others that regulate everything)

 

[Sarahstar82]

Hi Frodo27 I’m a type 1 diabetic who is also insulin resistant, I’ve been on a pump for 4 years and still suffer with occasional high blood sugars in the early hours due to a liver dump. Often they are caused by hormonal changes (got quite a few when I was pregnant and up to a year after) I think also they may be influenced by what I’ve eaten at dinner. The pump won’t as you say nullify these liver dumps, just give you the ability to bring down your blood sugars quicker, I often wake when one is happening and adjust my basal rate accordingly and usually by the time I’ve woken up they are back to normal, there have been times this has not been the case and I’ve had to run a temporary basal for a few more hours. For me taking metformin as well helps, since going back on metformin I’ve not had high blood sugars during the night. I think it stops the liver releasing glucose ( happy to be corrected if I am wrong). It may be worth speaking to a pump specialist nurse, they may be able to give you more information on if you would benefit from a pump.