two questions my books don't answer!

DaveDisco

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Hi guys, wonder if you can help

have two questions that I can't find answer to in my 4book diabetes library! :D

1) is the effect of insulin directly proportional to blood sugar level or constant
For example, all other things being equal (exercise, CHo etc) if 1 unit takes me from 15 to 10 mmol
does that mean that 1 unit would also take me from 8 to 3 ?

2) had a weird occurence the other day. checked my sugar before tea- ok. had my meal and insulin, then checked 2 and a half hours after tea. I was at 6.2. I ate nothing more and was feeling fine the rest of the night, but when I went to bed and tested then about 3 hours after the 6.2 reading I was 11.2 ! thought this must be a misread so tested twice more, got 10.9 and 11.4. I have no idea at all what caused this rise? any ideas?
 

Useless Pretty Boy

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Not sure about the first question, but I'd assume it is constant. Don't quote me though.

As for the second question, I had something similar happen just before my last check and asked my doctor. Apparently you can occasionally inject into a blood vessel or a damaged pervious injection site, which will make the insulin blast straight into your bloodstream and act much more rapidly than it's designed to. The reason we inject into skin pockets is to slow the absorbtion.

So basically what happened is that the insulin had completely absorbed into your system before all the food had been absorbed. You checked your level, it was fine, but then it went back up as your meal continued to be metabolised.

Apparently it's just something that occasionally happens and with the best will in the world there's no way to predict or stop it. It'll be less common if you rotate your injection sites more frequently and make use of more areas (buttocks, thighs, arms, etc).

So don't worry about it, unless it becomes really common, which might mean you're not injecting enough basal insulin in the evenings.
 

rkeane

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Answer to secod question. This happened to me for a while about six months ago. 2 hrs after dinner I would be a around 5. Then check 2 hrs after that before bed nd was between 10-15. Decided to half my background insulin as I felt it had stopped working after 12 hrs. So I now take background insulin in morning and evening. Levels are fine now. Between 5-8 all night. Maybe try that?
 

Dillinger

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Hello,

1st question - the higher your blood sugar levels the more insulin in general you'll need to bring it down, and vice versa.

2nd question - could be what you ate; fat tends to delay the absorption of carbohydrate so one gets a delayed rise in sugar if you eat a cheesy pizza for instance, alternatively if you are eating a low GI carbohydrate then it will take longer to get into your blood stream, and lastly if you are low carbing and eat protein about 60% will convert into glucose but very slowly so that may explain it?

All the best

Dillinger
 

SophiaW

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I've noticed what Dillinger pointed out about fat content, high fat and carb content in the meal causes an initial drop and then a climb in BS. If we have fish and chips from the local chippy or pizza from a restaurant then this type of reading can happen. Homemade pizza it doesn't happen, but I think that's because I use much less cheese than the restaurants.
 

NickW

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For question 1, I definitely find that it takes more insulin to reduce my blood glucose when it's high - e.g. at 5mmol/L, 1 unit might drop it by 1 point; at 10mmol/L 1 unit might only drop it by 0.7 points. As you say this doesn't seem to be covered in much of the literature, but it's a very noticeable phemonenon to me.
 

Jen&Khaleb

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After a conversation with my scientist sister I would like to ask Dillinger how eaten protein turns into Glucose.

Dillinger said:
if you are low carbing and eat protein about 60% will convert into glucose but very slowly so that may explain it?

As far as I can tell this isn't possible but if the body is starved of carbohydrate it will break down lean muscle tissue and it will be processed through the liver and that is how glucogen will enter the bloodstream. Please correct me if you have facts available. I think turning protein into carbohydrate would be like turning straw into gold.

Jen
 

NickW

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Jen&Khaleb,

I'm not Dillinger, but the process you're looking for is called gluconeogenesis - the generation of glucose from non-carbohydrate sources, including protein (and certain fats). It absolutely works on dietary protein; in fact the body will only start metabolising lean tissue when there's a lack of both dietary carbohydrate AND protein. Why would the body possibly want to cannibalise itself when there's a perfectly good source of fuel available to it?

The body breaks down all of the food you eat into simpler structures before it can consume them as fuel. The various carbs you eat aren't glucose; the body breaks them down into glucose via a series of chemical reactions. Some carbohydrates take fewer steps (i.e. less effort) to convert into glucose, which means they raise blood glucose levels faster - and this is where the glycemic index comes from. But the body also breaks down fat and protein for fuel when it needs to. It's an even more complex process and so it won't do this unless it has to (i.e. when there isn't enough carbohydrate available), but it certainly can and does happen.

If you're really interested, a quick google of the term "gluconeogenesis" should explain things properly - or maybe you or your sister could read up on the basics of human metabolism - it's interesting stuff!
 

timo2

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For the sake of my bank balance, I'd much rather talk about turning straw into gold. :D

I can provide the straw. Lots of straw.

Just so long as this ain't a scam. :|

It has happened before. I give them the straw, then they bale. :x
 

Jen&Khaleb

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NickW

I looked and looked only to still find that you can't eat protein and turn it into blood glucose. The only place that mentioned what was written was in a low carb diabetes post. All the documents I googled said that protein went to the muscles and tissues and the body could extract that to make glycogen and the body could store it in the liver.

Maybe a new topic should be posted on this subject to find how many people see spikes in bsl's from eating protein. I have never seen this with my son. I imagine if you are low carbing this process would start because the brain needs glucose and if it is not available from food it will get it from other places.

Starting new topic. This is not disrespectful of people who low carb.

Jen
 

cugila

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Hi Jen.

Nick gave the correct answer to your question to Dillinger. I think you may not have been looking in the right place when you did a search. There is much evidence out there to support what Nick has stated here about Gluconeogenesis.
 

Dillinger

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timo2 said:
For the sake of my bank balance, I'd much rather talk about turning straw into gold. :D

I can provide the straw. Lots of straw.

Just so long as this ain't a scam. :|

It has happened before. I give them the straw, then they bale. :x

:D - comedy gold right there.... :D
 

IanD

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DaveDisco said:
Hi guys, wonder if you can help

have two questions that I can't find answer to in my 4book diabetes library! :D

1) is the effect of insulin directly proportional to blood sugar level or constant
For example, all other things being equal (exercise, CHo etc) if 1 unit takes me from 15 to 10 mmol
does that mean that 1 unit would also take me from 8 to 3 ?
Its more likely to be a % reduction, so if a drop of 15 to 10 is 33%, a 33% reduction from 8 will be 5.4.

However, test measurements will show what actually happens.