FAT STOPS ABSORPTION OF GLUCOSE

[prancer53]

Hi
I am new to the forum but have had diabetes (type 1) forever!! I am just wondering if anyone else has been told, as I was by practice diabetes nurse 2 days ago, that the reason I had an unexplained hypo was because I had eaten high carbohydrate food which contained fat which stopped glucose being absorbed by my body (at the risk of sounding facetious, could eating chocolate replace insulin injections in the future)?

My understanding is that fat (like protein) will only slow down absorption and that is why balanced meals, containing foods from all food groups, should always be eaten (unless ill or have no appetite).

Nurse also told me I should eat GI diet. When I looked it up I discovered that I eat a GI diet anyway but call it a low carbohydrate, balanced diet!!!!

GP told me that blood sugar came down rapidly because I ate sugary food however my understanding is that, because I inject insulin, my blood sugar would have gone up rapidly and stayed up for longer. If I was not diabetic my body would have produced more insulin to bring blood sugar back to a lower level and so possibly cause a rebound effect with the possibility of a hypo.

In my area, as in most I believe, care has been passed from hospital consultants to GP s; when this happened I was asked what I thought about it. My answer was indicative of my recently received responses as indicated above.

Has anyone else been advised that a) fat in food STOPS absorption of glucose and b) that eating high carbohydrate food. whilst taking insulin as a type 1, will induce or result in an episode of hypoglycaemia?

 

[phoenix]

I think that you are right in that fat can delay absorption rather than stop it but this can cause hypos. This is the well known pizza effect. The large amount of fat causes a long delay in the absorption of carbs. Pizzas also often have large amounts of carbs. The relatively large bolus insulin that you need for the carbohydrate starts to work quicker than the rate of carb absorption . This can result in a hypo at the 1-2hour point and a rise in levels later.
Gary Scheiner discusses it here.
http://diatribe.us/issues/32/thinking-like-a-pancreas
Actually pizzas and other such foods are a bit extreme. Rapid insulin isn't really that rapid compared to natural insulin. I normally aim for lower GI meals and find that the insulin profile matches this better than higher GI meals. Nevertheless, I still occasionally find that a meal is absorbed too slowly compared with the insulin with a consequent hypo at 2hours.

Personally, I don't find chocolate is as low as it's GI implies (a couple of pieces of peppermint aero isn't the advised treatment for mild hypos but woks well for me).
I suppose that a larger amount of high fat, high sugar choc might have an effect similar to a pizza effect . :?:

 

[mrman]

Yep, good old pizza effect. Lasagne has the same effect with me. Interesting point phoenix, about using choc to raise sugar levels. always been a bit confused with gi ratings. I have have found often certain foods which should be good gi are not and vice~ versa. Obviously there is science behind it, longer to breakdown/digest etc, but thinking that would apply if everyones metabolisms were identical. now use my results as my own gi index lol.

Sent from the Diabetes Forum App

 

[noblehead]

Has anyone else been advised that a) fat in food STOPS absorption of glucose and b) that eating high carbohydrate food. whilst taking insulin as a type 1, will induce or result in an episode of hypoglycaemia?

A) No, fat only slows down the absorption it doesn't stop it altogether, experience may tell you that a split dose of insulin will work well to cover such meals.

B) No again, if you don't get the insulin to carb ratio right or exercise soon after without reducing the dose then it will result in a hypo, my tea last night was 90g of carbs and I didn't go hypo afterwards.

 

[Yorksman]

There are many tales like lining your stomache by drinking a glass of milk before going out for a night's drinking. There is a bit of truth in many of these but it is far from the whole story.

The order in which you eat various foods can make a difference because the various, and many, digestive enzymes start to work on those eaten first and others foods wait. It will all get digested eventually, unless it is woody, ie cellulose based or consists of some oligosaccharides, which are broken down by bacteria in the intestine and not by enzymes in the stomache. Obviously, if you eat pulses after a lot mof other fod, it takes longer to pass through the stomache than if eaten on an empty stomache. Exercise too plays a part with activity release hormones which trigger the production of enzymes which work on various foods eaten. There are few rules which are as simple as the nurse suggests.

A good guide from Oxford Journals is:

Carbohydrates, Proteins, and Fats and Oils: the building blocks of nutrition
http://www.oxfordjournals.org/our_journ ... _chap3.pdf

and note the importance of fatty acids. Hardly anyone ever seems to talk about triglycerides and the fatty acids and yet there is much complexity of these intermediate stages between energy consumed and energy stored.

 

[phoenix]

Yorkman, that looks a very interesting resource, though not necessarily applicable to those of us with weird T1 metabolism. I've only scanned it and I can't find a date on it. Any ideas on that?
As a textbook, I tend to use Frayn's book plus notes . http://bcs.wiley.com/he-bcs/Books?actio ... 1405183594

 

[Yorksman]

Yorkman, that looks a very interesting resource, though not necessarily applicable to those of us with weird T1 metabolism. I've only scanned it and I can't find a date on it. Any ideas on that?

No, it's a chapter from from something entirely different, Mother and Child Nutrition in the Tropics and Subtropics but it's a good intro into how foods are digested in general. The other chapters are more pertinent to the specific subject:

http://www.oxfordjournals.org/our_journ ... e/mcn.html

 

[phoenix]

Thank you

 

[prancer53]

I found research on this one by Joslin Centre for Diabetes USA dated June 2013: it records exactly how research was carried out and it came to the conclusion that fat, rather than inhibiting absorption of glucose in type 1, requires more insulin for glucose metabolism. Therefore how did diabetes nurse arrive at conclusion that eating fat caused my unexplained hypo?

 

[phoenix]

If you read the link in my previous post Scheiner attributes the earlier rise to delayed absorption and the later to insulin resistance caused by fat. The Joslin research demonstrated the need for more insulin. In the discussion section of the paper they also suggest insulin resistance.
This (amongst other things as it got a bit off topic) was discussed in more detail on the thread about Spaghetti spiking glucose after 3-7 hours

 

[noblehead]

I found research on this one by Joslin Centre for Diabetes USA dated June 2013: it records exactly how research was carried out and it came to the conclusion that fat, rather than inhibiting absorption of glucose in type 1, requires more insulin for glucose metabolism. Therefore how did diabetes nurse arrive at conclusion that eating fat caused my unexplained hypo?

Fat, as explained earlier slows down the absorption of food and can cause postprandial hypo's if the full dose of insulin is given, the reason being the insulin works much faster than the stomach in these incidences, of course it depends on the amount of fat in the meal as to whether you give your full dose of insulin upfront or split into two doses.

 

[tomersn]

Patients with diabetes due to insufficient insulin secretion, if not "Taboos", so eat as usual, there will be blood glucose increased, go down for a long time, due to the high blood sugar caused a series of complications. Diabetes is often associated with obesity, high blood lipids, fatty liver, hypertension, coronary heart disease, gout and other diseases, these diseases are commonly known as "metabolic syndrome". So in order to health, must be.