"Beyond Insulin".

Guzzler · Mar 20, 2019

A fascinating presentation by Catherine Croft pertaining to Glucagon secretion in relation to Insulin. Covers such things as the insulin to glucagon ratio, protein, excercise and ffa's etcamong other things. Catherine speaks on T2 but also mentions T1.

@Jim Lahey I thought you might be interested in this esp wrt to hypoglucagonaemia. About 23 minutes.

Member496333 · Mar 20, 2019

Very interesting. Thanks for the tag. Only recently did I start to become more aware of the relationship between insulin and glucagon. The complexity of everything never ceases to fascinate me.

Tophat1900 · Mar 20, 2019

I will check this out when I'm awake enough to watch it, sounds very interesting.

Guzzler · Mar 20, 2019

Jim Lahey said:
Very interesting. Thanks for the tag. Only recently did I start to become more aware of the relationship between insulin and glucagon. The complexity of everything never ceases to fascinate me.

It could explain why some with T1 and T2 react differently to excercise, stress, protein etc. and it could explain why the timing of injections of insulin can sometimes be such a tricky thing for some on exogenous insulin. Interesting stuff, I think.

Guzzler · Mar 20, 2019

Tophat1900 said:
I will check this out when I'm awake enough to watch it, sounds very interesting.

Glucagon is definitely one thing that crosses over the different types. Enjoy the presentation.

Member496333 · Mar 20, 2019

I think also I mentioned recently about glucagon dysfunction as a possible contributory factor in hypoglycaemic episodes in individuals not using exogenous insulin or oral hypoglycaemics.

Guzzler · Mar 20, 2019

Jim Lahey said:
I think also I mentioned recently about glucagon dysfunction as a possible contributory factor in hypoglycaemic episodes in individuals not using exogenous insulin or oral hypoglycaemics.

This would make sense for those few who feel low when others would be completely unaware at the same level. Definitely merits more research.

KK123 · Mar 20, 2019

Thank you for posting this @Guzzler, just watched it. It's the sort of thing where you need to watch it ten times and take notes to fully understand (for me anyway) but it is fascinating as you said. For me (as a type 1), it seems to be saying that if I were to eat no carbs (or extremely low) but were to eat something high in protein, my glucagon et al, glucose levels would be stimulated into rising (which I've noticed they do) and I'd then have to take insulin to combat this? The only way to counteract this and prevent the body going through this glucogen process in the first place would be to eat carbs?. This seems like a vicious circle then, eat an amount of carbs to stop the glucagon rising in the first place or eat protein and then have to eat carbs when the glucose rises or stop eating carbs and protein? A low(er) carb diet generally means using less insulin but the downside is you may end up with glucose levels rising anyway if you eat protein! My head hurts. Hope someone comes along to explain it.

Guzzler · Mar 20, 2019

KK123 said:
Thank you for posting this @Guzzler, just watched it. It's the sort of thing where you need to watch it ten times and take notes to fully understand (for me anyway) but it is fascinating as you said. For me (as a type 1), it seems to be saying that if I were to eat no carbs (or extremely low) but were to eat something high in protein, my glucagon et al, glucose levels would be stimulated into rising (which I've noticed they do) and I'd then have to take insulin to combat this? The only way to counteract this and prevent the body going through this glucogen process in the first place would be to eat carbs?. This seems like a vicious circle then, eat an amount of carbs to stop the glucagon rising in the first place or eat protein and then have to eat carbs when the glucose rises or stop eating carbs and protein? A low(er) carb diet generally means using less insulin but the downside is you may end up with glucose levels rising anyway if you eat protein! My head hurts. Hope someone comes along to explain it.

I have no answer to that one and I'm not even embarrassed to say that! As Catherine says, Glucagon then may be influenced by GLP1, GIP, Leptin etc etc etc.. It is so tantalisingly and exquisitely complex.

Member496333 · Mar 20, 2019

KK123 said:
Thank you for posting this @Guzzler, just watched it. It's the sort of thing where you need to watch it ten times and take notes to fully understand (for me anyway) but it is fascinating as you said. For me (as a type 1), it seems to be saying that if I were to eat no carbs (or extremely low) but were to eat something high in protein, my glucagon et al, glucose levels would be stimulated into rising (which I've noticed they do) and I'd then have to take insulin to combat this? The only way to counteract this and prevent the body going through this glucogen process in the first place would be to eat carbs?. This seems like a vicious circle then, eat an amount of carbs to stop the glucagon rising in the first place or eat protein and then have to eat carbs when the glucose rises or stop eating carbs and protein? A low(er) carb diet generally means using less insulin but the downside is you may end up with glucose levels rising anyway if you eat protein! My head hurts. Hope someone comes along to explain it.

Glucagon signals the liver to secrete glucose in order to maintain glucose homeostasis in the absence of food energy, but exogenous carbohydrate is not necessary for this. The liver can manufacture glucose from amino acids and fatty acids. It’s obviously very much more complicated than that, but that’s the nuts & bolts as I understand it.

Brunneria · Mar 20, 2019

The glucagon/insulin relationship has always been something that I have speculated may affect some of us with RH - certainly in myself. Unfortunately there are many other causes too. And I would go further and postulate that my personal food intolerances have an impact, as well as other hormones such as leptin, etc.

Will watch this with interest @Guzzler, but not, unfortunately, today.

Guzzler · Mar 20, 2019

Brunneria said:
The glucagon/insulin relationship has always been something that I have speculated may affect some of us with RH - certainly in myself. Unfortunately there are many other causes too. And I would go further and postulate that my personal food intolerances have an impact, as well as other hormones such as leptin, etc.

Will watch this with interest @Guzzler, but not, unfortunately, today.

Leptin is in the list that Catherine speaks to wrt to hormones that may be influenced by or indeed influence glucagon among others like oestrogen and cortisol. Hope you find it as interesting as I did.

Tophat1900 · Mar 21, 2019

So... how to find that magical balance? Great post @Guzzler all very interesting.

Member496333 · Mar 21, 2019

Tophat1900 said:
So... how to find that magical balance? Great post @Guzzler all very interesting.

Eat real food your whole life

Tophat1900 · Mar 21, 2019

Jim Lahey said:
Eat real food your whole life

Thanks Jim, I may just consider that

kokhongw · Mar 21, 2019

Amy Berger's latest blog is a timely addition to this complexity
http://www.tuitnutrition.com/2019/03/insulin-glucagon-pancreas.html#more

“Contrary to popular belief, insulin is not needed for glucose uptake and utilization in man.” (Source)

She is also trying to make some sense of this insulin/glucagon ratio

Also

Prof. Roger Unger, Type 1 & Type 2 Diabetes

Much of what I’m about to share comes from Dr. Roger Unger. He’s co-author on the paper, Glucagonocentric restructuring of diabetes: a pathophysiologic and therapeutic makeover, and his video lecture from 2014 is absolutely, 100% a must-watch. I’ve watched it 5 times and I learn something new every time.

If we think of insulin as an anabolic hormone, then we can also think of it as anti-catabolic. It prevents things from being released and broken down. In this sense, insulin doesn’t lower BG by clearing glucose out of the blood; it does it by signaling the liver to stop releasing glucose.

“Impaired insulin-mediated suppression of hepatic glucose production (HGP) plays a major role in the pathogenesis of type 2 diabetes (T2D).” (Source)

Separately, what I had found interesting from the FGF1 injection to the brain is that they have recently concluded that the sustained glucose clearance that resulted is likely insulin independent ...

So it is not always about GLUT4 (Insulin dependent)...GLUT1(insulin independent) is coming into focus...

kokhongw · Mar 21, 2019

KK123 said:
Thank you for posting this @Guzzler, just watched it. It's the sort of thing where you need to watch it ten times and take notes to fully understand (for me anyway) but it is fascinating as you said. For me (as a type 1), it seems to be saying that if I were to eat no carbs (or extremely low) but were to eat something high in protein, my glucagon et al, glucose levels would be stimulated into rising (which I've noticed they do) and I'd then have to take insulin to combat this? The only way to counteract this and prevent the body going through this glucogen process in the first place would be to eat carbs?. This seems like a vicious circle then, eat an amount of carbs to stop the glucagon rising in the first place or eat protein and then have to eat carbs when the glucose rises or stop eating carbs and protein? A low(er) carb diet generally means using less insulin but the downside is you may end up with glucose levels rising anyway if you eat protein! My head hurts. Hope someone comes along to explain it.

There is a section in Amy's blogpost that might be relevant, injected insulin will not reach the same level of concentration in the pancreas where it is needed to stop the glucagon actions...

KK123 · Mar 21, 2019

kokhongw said:
There is a section in Amy's blogpost that might be relevant, injected insulin will not reach the same level of concentration in the pancreas where it is needed to stop the glucagon actions...

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Wow, thank you for this!

NicoleC1971 · Mar 21, 2019

Guzzler said:
Glucagon is definitely one thing that crosses over the different types. Enjoy the presentation.

Came across this presentation via YouTube feed and watched it thrice just to get my head around the new hormone I hadn't heard of (the one that is made by the delta cells that calms both insulin and glucagon down).
Anyway my question is why do my diabetologists never mention any of this stuff when I tell them that despite trying to minnimise insulin by eating low carb, I get weird spikes probably due to my very uninhibited alpha cells! I truly have learnt more from this lady and Ben Bikman (sic) and may even consider the pharmacological solutions she suggests.
Also I think the process diagram she was hoping somebody would make about how all of these hormones interact would be a great project for Ivor Cummins (Fat Emporer)!

Guzzler · Mar 21, 2019

NicoleC1971 said:
Came across this presentation via YouTube feed and watched it thrice just to get my head around the new hormone I hadn't heard of (the one that is made by the delta cells that calms both insulin and glucagon down).
Anyway my question is why do my diabetologists never mention any of this stuff when I tell them that despite trying to minnimise insulin by eating low carb, I get weird spikes probably due to my very uninhibited alpha cells! I truly have learnt more from this lady and Ben Bikman (sic) and may even consider the pharmacological solutions she suggests.
Also I think the process diagram she was hoping somebody would make about how all of these hormones interact would be a great project for Ivor Cummins (Fat Emporer)!

I reckon a diagramn for this would make the picture of the Krebs Cycle look simple.

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