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Type 2 Diabetes
How low is too low for an HbA1c?
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<blockquote data-quote="Caleb Murdock" data-source="post: 223199" data-attributes="member: 37907"><p>Correct me if I'm wrong.</p><p></p><p>Your pancreas stores up insulin in the form of granules, and when you first start to eat, it squirts this stored insulin into your blood (there may be more than one squirt, a squirt when you start to eat and then a squirt or two later in the meal). That's called the phase I insulin response. Once the stored insulin is used up, your pancreas has to manufacture any more insulin that it releases as it is needed. That's the phase II insulin response. The phase I response is larger and more sudden than the phase II response, and that larger response is needed to cover the surge in blood sugar during a high-carbohydrate meal. A type-2 diabetic can't release that initial surge of insulin, and so the blood sugar goes up and stays up for hours, while the phase II insulin dribbles into the system and gradually brings it down. Eventually the phase II insulin response isn't enough to EVER get the blood sugar to normal, and the diabetic's blood sugar remains permanently high. That leaves the diabetic with a few choices: reduce carbs drastically so that not so much insulin is needed, or take insulin, or take some medication that decreases insulin-resistance or stimulates the pancreas to make more insulin. Eventually, if the diabetic doesn't make dietary improvements, any medications that are taken won't be enough, and the diabetic will be forced to go on a low-carb diet, or to take insulin.</p><p></p><p>All these changes take place gradually, of course. Initially your phase I response may be only slightly stunted, so that your blood sugar rises to, say, 140 (7.8) instead of 120 (6.6), and then takes an extra couple hours to get down to 90 (5.0) instead of getting to 90 rapidly.</p><p></p><p>Fast-acting insulins are designed to replace the phase I response, while long-acting insulins are designed to replace the phase II response. A type-1 diabetic who produces no insulin at all may need both long-acting and short-acting insulins, while a type-2 diabetic who is still producing phase II insulin may only need to take fast-acting insulin to cover meals. Also, you should be aware that many type-2 diabetics produce more insulin than many non-diabetics do, but it just isn't enough to overcome the insulin-resistance that has developed in their bodies.</p></blockquote><p></p>
[QUOTE="Caleb Murdock, post: 223199, member: 37907"] Correct me if I'm wrong. Your pancreas stores up insulin in the form of granules, and when you first start to eat, it squirts this stored insulin into your blood (there may be more than one squirt, a squirt when you start to eat and then a squirt or two later in the meal). That's called the phase I insulin response. Once the stored insulin is used up, your pancreas has to manufacture any more insulin that it releases as it is needed. That's the phase II insulin response. The phase I response is larger and more sudden than the phase II response, and that larger response is needed to cover the surge in blood sugar during a high-carbohydrate meal. A type-2 diabetic can't release that initial surge of insulin, and so the blood sugar goes up and stays up for hours, while the phase II insulin dribbles into the system and gradually brings it down. Eventually the phase II insulin response isn't enough to EVER get the blood sugar to normal, and the diabetic's blood sugar remains permanently high. That leaves the diabetic with a few choices: reduce carbs drastically so that not so much insulin is needed, or take insulin, or take some medication that decreases insulin-resistance or stimulates the pancreas to make more insulin. Eventually, if the diabetic doesn't make dietary improvements, any medications that are taken won't be enough, and the diabetic will be forced to go on a low-carb diet, or to take insulin. All these changes take place gradually, of course. Initially your phase I response may be only slightly stunted, so that your blood sugar rises to, say, 140 (7.8) instead of 120 (6.6), and then takes an extra couple hours to get down to 90 (5.0) instead of getting to 90 rapidly. Fast-acting insulins are designed to replace the phase I response, while long-acting insulins are designed to replace the phase II response. A type-1 diabetic who produces no insulin at all may need both long-acting and short-acting insulins, while a type-2 diabetic who is still producing phase II insulin may only need to take fast-acting insulin to cover meals. Also, you should be aware that many type-2 diabetics produce more insulin than many non-diabetics do, but it just isn't enough to overcome the insulin-resistance that has developed in their bodies. [/QUOTE]
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