Blood glucose and Insulin threshold

[finsit]

So this is again a dilemma that i am not able to figure out despite all the literature and experiments i have done so far in the last 2 years. So here is the case. When i eat a heavy protein/fat meal, my glucose stays elevated for 3-4 hours (in the range of 6.5-7 mmol). Now if i eat less protein with some carbs, it may rise to 7.5 but will be back to close to 6 mmol in 2 hours. Now my question is, if i am producing enough insulin that can take care of high surge to 7.5 to bring it down to 6 in 2 hours, why doesn't it take care of slow and gradual sustained spike of 6.5-7.5?

Please note i am talking here of endogenous basal/bolus insulin. My theory is that there must be a threshold (different for everyone) where we release bolus insulin (1st phase)? So i am assuming as long as i am staying below 7, only my basal insulin (2nd phase) is working? and as soon as i hit a threshold of 7.5 or 8 then i have some sort of bolus insulin releases that brings BGs down fast?

Or there could be some other explanation to this? Also in both above cases, which spike do you prefer?

 

[NicoleC1971]

I don't know but you are only at looking at this through the paradigm of blood glucose because that's the only thing you care measuring.
For example if you did a Kraft test (glucose and insulin measurements taken regularly through the day) you might well find that a lot of insulin is being released to deal with the 7.5 spike and that eventually this will cause more visceral fat storage and more insulin resistance than you already have.
OR that you do have a glucose tolerance level wherein only a small spurt of insulin is needed for this which doesn't cause disease but if you are already type 2 then it is likely you don't tolerate carbs too well.
The different patterns are described here if you haven't already come across this:

 

[Yulkuy]

I noticed kind of the same thing in my thread https://www.diabetes.co.uk/forum/threads/multiple-insignificant-spikes-after-some-meals.189734/ and Ronancastled left an interesting graph out there. My spikes are kind of similar to you, from 4.x fasting to 5-6 mmol for a few hours, and yours I guess are from 5.x fasting to 6-7 mmol for a few hours.

Could it be that your body is still digesting protein for 3+ hours? I felt some meat-tasted burps a few times when I was measuring those reactions, don't know if it means something.

Plus, if we think what a totally healthy person should spike to, let's say, to 8 mmol three times a day 1 hour after meal and be back at the baseline in 2 hours, with baseline 4.8 mmol, if I calculated everything correctly, that would result only in 5.2 average daily glucose and 30 HA1C.

If we take 3 meals a day, spikes up to 8 mmol again (tho protein or fat heavy meals shouldn't spike that high), "trails" for 3 hours after each meal with average glucose of 5.5 mmol, and baseline glucose of 4.8 will result in 5.54 average glucose, 32 HA1C.

I think using those calculations it is possible to deduce that either some people spike very high and get reactive hypos, or actually do remain slightly elevated for some time after balanced meals.

Difference between 6 mmol, and 7+ mmol, I guess, is that being at 7+ you are a in a small spike away from reaching lower kidney limit and your body may know that and do more job to bring you down fast. Clean carbs are also released relatively fast and maybe pancreas can't release insulin as fast, but for more balanced meals pancreas can keep up to keep you in a tight range.

 

[Yulkuy]

I also think stuff like this from type 1 diabetics is useful to see that high fat and proteins meals do give significant spikes in an insulin-deprived body even after dealing with first initial spike https://www.reddit.com/r/diabetes/c...only/?utm_medium=android_app&utm_source=share

 

[AndBreathe]

So this is again a dilemma that i am not able to figure out despite all the literature and experiments i have done so far in the last 2 years. So here is the case. When i eat a heavy protein/fat meal, my glucose stays elevated for 3-4 hours (in the range of 6.5-7 mmol). Now if i eat less protein with some carbs, it may rise to 7.5 but will be back to close to 6 mmol in 2 hours. Now my question is, if i am producing enough insulin that can take care of high surge to 7.5 to bring it down to 6 in 2 hours, why doesn't it take care of slow and gradual sustained spike of 6.5-7.5?

Please note i am talking here of endogenous basal/bolus insulin. My theory is that there must be a threshold (different for everyone) where we release bolus insulin (1st phase)? So i am assuming as long as i am staying below 7, only my basal insulin (2nd phase) is working? and as soon as i hit a threshold of 7.5 or 8 then i have some sort of bolus insulin releases that brings BGs down fast?

Or there could be some other explanation to this? Also in both above cases, which spike do you prefer?

Are you testing your sugars by Libre, or another continuous monitor or finger prick tests?

 

[finsit]

Are you testing your sugars by Libre, or another continuous monitor or finger prick tests?

Both CGM and finger testing and they tally mostly.

 

[finsit]

I don't know but you are only at looking at this through the paradigm of blood glucose because that's the only thing you care measuring.
For example if you did a Kraft test (glucose and insulin measurements taken regularly through the day) you might well find that a lot of insulin is being released to deal with the 7.5 spike and that eventually this will cause more visceral fat storage and more insulin resistance than you already have.
OR that you do have a glucose tolerance level wherein only a small spurt of insulin is needed for this which doesn't cause disease but if you are already type 2 then it is likely you don't tolerate carbs too well.
The different patterns are described here if you haven't already come across this:

So what you are saying is that its better to have a more sustained spike of less than 7 because it will release less insulin and will avoid the damages of hyperinsulenmia ?

 

[AndBreathe]

Both CGM and finger testing and they tally mostly.

It was more catching any multiple rises you might experience with protein and fatty meals.

 

[NicoleC1971]

So what you are saying is that its better to have a more sustained spike of less than 7 because it will release less insulin and will avoid the damages of hyperinsulenmia ?

Yes but some people (about 25%) just have a high carb meal, brief spike and NO hyper insulinemia which could be non pathological. They are the lucky ones who stay the same weight and do not get diabetes and other metabolic disease.

 

[NicoleC1971]

I also think stuff like this from type 1 diabetics is useful to see that high fat and proteins meals do give significant spikes in an insulin-deprived body even after dealing with first initial spike https://www.reddit.com/r/diabetes/c...only/?utm_medium=android_app&utm_source=share

U type 1s may be insulin free but that means we are vry glucagon dominant meaning our livers spike our glucose during fasting, illness, stress both physical and emotional. You cannot infer conclusions just from what is eaten.

 

[LaoDan]

I still find the subject quite interesting. Insulin is slightly anabolic to both muscle and adipose tissues. Without it, I assume it’s catabolic to both as well.

Bodybuilers purposefully spike their insulin levels post workout by adding dextrose to their post workout drinks. I guess it’s to force feed muscle with nutrients and drive protein synthesis. Yet they are not adding of adipose tissue in the process.

Now take a person with hyperinsulenmia, we tell them they need to reduce their insulin levels so they can lose muscle tissue, the main glucose disposal site. I know I’m kind of twisting things, but to make a point.

the hard thing is to have a lifestyle that’s anabolic towards muscle and catabolic to adipose, and how we can use hyperinsulenmia as an advantage. At least in the short term, obviously it won’t last for ever.

sorry for my post coffee yapping