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Glucose homeostasis

Discussion in 'Prediabetes' started by Sapien, Jul 11, 2019.

  1. Sapien

    Sapien Prediabetes · Well-Known Member

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    I have seen it mentioned frequently that the fasting glucose level is the last thing to improve on a low carb diet. It seems that managing to avoid glucose spikes is almost an immediate effect which greatly helps lower average glucose, but fasting glucose seems to not drop so quickly.

    Is it correct to think of fasting glucose as a set point to which the body wants to return to when glucose is higher or lower?

    There are many factors that influence blood sugar levels at any point in time - diet, exercise, pancreatic function, hormones, etc.

    What has the most influence on regulating the set point? What is the ideal set point? (Dr Bernstein targets 83 mg/dL or 4.6 mmol)
     
  2. Sapien

    Sapien Prediabetes · Well-Known Member

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  3. Caeseji

    Caeseji Type 2 · Well-Known Member

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    I think you are indeed right, once the liver is used to being at that level for so long it will desperately attempt to dump stored glycogen to push the levels back up to that. It’s a good marker for metabolic health all in all due to getting rid of the dawn phenomenon it means your body is used to that constant level or at least that is how I understand it.
     
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  4. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    Wayward dawn phenomenon after fasting (in T2 insulin resistance) is more to do with the liver frantically trying to deflate itself. That’s my understanding of the basic mechanism according to Jason Fung. Eating usually arrests the process, but really the best strategy long term is to let it do what it needs to do, and continue the fast into the day as long as is comfortable.
     
    #4 Jim Lahey, Jul 13, 2019 at 4:22 PM
    Last edited: Jul 13, 2019
  5. Lamont D

    Lamont D Reactive hypoglycemia · Master

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    I have got a lot of information from this paper, some I knew and understood, other more scientific knowledge and definitions, were a different view of how the body develops diabetes, especially NIDDM, as a description of non insulin dependent diabetes mellitus. The cause as I understand it is hyperinsulinaemia because of insulin resistance and the cycle of imbalance in the hormones. The number of hormones that influence the response to food, the glucose derived and the high amount of circulating insulin that has no effect on the glucose, glucagon response.
    As the author suggests, the insulin/glucagon integral rein control by the hypothalamic-pituitary axis, with the growth hormone hGH, also the hormone somatostatin-28. I have read this called, the gut brain trigger.
    In simple terms, how your hormonal response to food is triggered and the imbalance in amounts of the numerous hormones is why T2 diabetes happens.
    Again, he quotes, the stimulus for the secretion of the incretins hormones- is food in the gastrointestinal tract, it anticipates and enhances the insulin response to glucose absorbed from the gut.
    And importantly for those like me, any under or overshoot of anticipatory response is soon corrected by the integral rein control. The overshoot of insulin is why I hypo after a carb meal. Reactive Hypoglycaemia is resultant from the same causes and imbalance in response to food.
    Homeostasis for me, is why I can live my life, in good health. My body is attuned to being in or just above normal levels, it has to be like this for me, the rollercoaster ride of blood sugar levels is the cause of the numerous symptoms. To be symptom and hypo free, I have to be in homeostasis.
    Another point the article refers to is exercise and why despite exertion, people don't go hypo because of vigorous exercise. In my case, I cannot exercise in such manner, because I have found that the function that corrects my blood glucose levels as described in the article, does not apply to me, the glucose necessary for me from a liver dump would have the same effect as a carb laden meal and would trigger the onset of an overshoot of insulin as a response, which would mean an episode of hypoglycaemia.
    As I said previously, it is a very good paper and the information I gleaned from it, has improved my understanding.
    Thanks
     
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  6. Cocosilk

    Cocosilk Gestational · Well-Known Member

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    Hi, could I ask for your advice? Do you eat small meals more often to deal with reactive hypoglycaemia? If you fast for, say 14h, does your dawn phenomenon rise enough to cause a hypo later?
    I'm unsure exactly if I have glucose intolerance or not as I wasn't officially diagnosed despite having a bit of a high 1h after a GTT. My results were:
    Fasting 4.4 mmol (but 5.0 on my metre when I woke a couple of hours earlier and usually anywhere from 4.8 - 5.3 is typical.)
    1h 12.1 mmol (13.8 on my metre)
    2h 6.5 mmol
    3h 3.6 at home on my metre - I had the shakes and had to pee way more often after the 1h spike.
    My labs just had a note saying "may be glucose intolerant. Check again in one year". So they wait for you to get sicker before they help you I think.

    I had gestational diabetes but I half expected I might have been prediabetic before the pregnancy.

    I had an insulin test too though and it came back at 6.3. Classed as normal in Australia but I think in the UK I would be warned that it's slightly higher than optimal. Is that right? I think the HOMA is 1.2.

    I started eating low carb /keto for about 5 months. Was good until I was getting too dehydrated (I'm breastfeeding a 3 month old) and I was getting heart palpitations and couldn't get them to settle enough (more salt, less salt, electrolytes, quit caffeine,I tried a few things). So this week I've reintroduced some carbs but I'm 2kg heavier straight away (fluid I imagine but I need to lose about 6kg eventually) and hungrier. The carbs make me think I'll end up eating larger portions than will be good because the spikes end up in the high 7s pretty fast.
    Just not sure whether to just go back to keto and have small meals whenever I need to or keep up a few more carbs.
    If your fasting level is in the 4s but goes up to the 5s with extended fasting, that's the liver emptying itself? Or is it always able to just make more glucose anyway?
     
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