Waking up the pancreas & morning liver dump

[CherryAA]

I watched the most recent presentation by Prof Taylor

https://www.easd.org/virtualmeeting/home.html#!resources/33559

He explains in that why eating fat in the morning will help to control morning liver dumps, because the fat inhibits the level of insulin in your blood from creating glucose via glucogenesis.

Interestingly that would also be a good reason for following a keto style VLC diet in preference to a low fat shakes one

At an early stage in this process, I decided that I would not try to control that through eating because my first priority was to lose weight and I know that when I start eating I find it quite hard to stop.

I also believed that the size of the liver dump in the morning probably described how close to " normality" one was . Therefore if the diet was working what should happen is that the difference between overnight average glucose levels and the high point of the morning liver dump should get less until eventually in the event of a "cure" there would be no discernible difference because the system was working properly again.

In eating only one meal a day at 4.00 pm, this liver dump process has become obvious in my figures because it is not being distorted by food noise.

I've just checked back over the last few months of my libre recordings and there is a clear trend towards the gap between the overnight average and the morning liver getting smaller - it started off about 4mmol in November and is around 1.5 mmol now.
During that time my fasting insulin has come down from much higher than 20 iUI/ml to around 8.3 . In my own mind, despite the fact that I am already25 kg down, I am still not " baked" enough yet, because if I was the morning liver dump would disappear. - whether that actually constitues a " cure" or is merely the optimum position someone with diabetes can put themselves into. I have no clue .

The data is hard to spot without a libre, or similar because it involves comparing what the trend look like all night long, and what the high point was during the morning - even in the absence of food.

Others with a libre and a " zero " carb policy for breakfast, might like to take a look and see if they can spot any similar trends themselves.

 

[Bluetit1802]

I am a part time Libre user and test many times a day.

My overnight readings have always been low, my fasting levels have always been low to mid 5s since not long after diagnosis.

I would then start to rise without food, but not hugely. Generally no more than half a mmol/l but staying at that elevated level for 3 or 4 hours. So only a tiny liver dump, not significant, but annoying to me because it impacted on my pre-lunch level and therefore my post lunch level. Half a mmol/l is half a mmol/l !!

With any carbs the rise was higher and was out of proportion to the number of carbs.

I then hit on fat only for breakfast in the form of decaf coffee with plenty of double cream, no food, drunk within 10 minutes of getting up. I no longer have any liver dump and actually drop back to my fasting level or lower. My pre-lunch levels are significantly lower.

A fatty breakfast 10 minutes after getting out of bed has been wonderful for me. I have been doing this since 11th January. It is still working.

 

[DCUKMod]

Through all of my early finger prick testing, I would have sworn I had no liver dump, but once I used the Libre, that informed me differently.

I'm just one of those infuriating people who has never had much of a liver dump, unless my alarm rouses me from a deep, deep sleep, or I wake to a start, like the phone ringing, or if I realise I have over-slept and I have a morning appointment.

yes, I'm just one of those irritating people who seemingly has to be different!

 

[Fleegle]

I watched the most recent presentation by Prof Taylor

https://www.easd.org/virtualmeeting/home.html#!resources/33559

He explains in that why eating fat in the morning will help to control morning liver dumps, because the fat inhibits the level of insulin in your blood from creating glucose via glucogenesis.

Interestingly that would also be a good reason for following a keto style VLC diet in preference to a low fat shakes one

At an early stage in this process, I decided that I would not try to control that through eating because my first priority was to lose weight and I know that when I start eating I find it quite hard to stop.

I also believed that the size of the liver dump in the morning probably described how close to " normality" one was . Therefore if the diet was working what should happen is that the difference between overnight average glucose levels and the high point of the morning liver dump should get less until eventually in the event of a "cure" there would be no discernible difference because the system was working properly again.

In eating only one meal a day at 4.00 pm, this liver dump process has become obvious in my figures because it is not being distorted by food noise.

I've just checked back over the last few months of my libre recordings and there is a clear trend towards the gap between the overnight average and the morning liver getting smaller - it started off about 4mmol in November and is around 1.5 mmol now.
During that time my fasting insulin has come down from much higher than 20 iUI/ml to around 8.3 . In my own mind, despite the fact that I am already25 kg down, I am still not " baked" enough yet, because if I was the morning liver dump would disappear. - whether that actually constitues a " cure" or is merely the optimum position someone with diabetes can put themselves into. I have no clue .

The data is hard to spot without a libre, or similar because it involves comparing what the trend look like all night long, and what the high point was during the morning - even in the absence of food.

Others with a libre and a " zero " carb policy for breakfast, might like to take a look and see if they can spot any similar trends themselves.

I followed the KETO diet trying to have less than 10-20G carb a day and ended up with a massive liver dump every single day. My tolerance for carbs went down and down till even the 10 in one meal would cause a rise for a long time - I cut my protein and everything no joy. And that is what finally made my mind up that I needed to try a different path and the ND ensued.

Now I am on the ND with shakes and a ludicrous amount of carbs and hardly any fat and I get no liver dump at all in the morning - none at all. I have tested it by not having my first shake till 11am in the morning and my BG just flat lined at 4.5-5 until I have the shake.

I tried eating fat in the morning - cheese, coffee with cream to no avail. But we are all different.

 

[Fleegle]

I am a part time Libre user and test many times a day.

My overnight readings have always been low, my fasting levels have always been low to mid 5s since not long after diagnosis.

I would then start to rise without food, but not hugely. Generally no more than half a mmol/l but staying at that elevated level for 3 or 4 hours. So only a tiny liver dump, not significant, but annoying to me because it impacted on my pre-lunch level and therefore my post lunch level. Half a mmol/l is half a mmol/l !!

With any carbs the rise was higher and was out of proportion to the number of carbs.

I then hit on fat only for breakfast in the form of decaf coffee with plenty of double cream, no food, drunk within 10 minutes of getting up. I no longer have any liver dump and actually drop back to my fasting level or lower. My pre-lunch levels are significantly lower.

A fatty breakfast 10 minutes after getting out of bed has been wonderful for me. I have been doing this since 11th January. It is still working.

Hasn't it got to come out one way or another? It is sitting in the liver and came from somewhere. If it doesn't "dump" then will it not just get fuller of it. At some point the liver needs to give out the glucose it has stored - doesn't it or the liver will become saturated.

 

[Bluetit1802]

Hasn't it got to come out one way or another? It is sitting in the liver and came from somewhere. If it doesn't "dump" then will it not just get fuller of it. At some point the liver needs to give out the glucose it has stored - doesn't it or the liver will become saturated.

The liver will always dump in times of fasting, overnight, and between meals. It is just that in people with normal insulin production and no insulin resistance it isn't noticed because the pancreas drip feeds insulin 24/7 (basal insulin) which deals with the dumped glucose as soon as it rises to a level that becomes noticeable.

I believe the liver releases glucose when told to do so by the hormones. In times of fasting or between meals our hormones detect there is too low an amount of glucose in the blood stream for the body's needs, so the hormones trigger the liver to dump in order to keep us alive and make sure the brain and other organs have the glucose they need. This is why none of us ever see zero glucose and why normal non-diabetics don't hypo. In normal healthy people, once there is sufficient glucose in the blood stream for our needs the basal insulin gets to work to shift it to the cells that need it and the hormones tell the liver to stop dumping.
This is how the body is regulated as far as glucose is concerned (in the absence of food.)

For normal healthy people:
Insufficient glucose = liver dump = basal insulin dump = liver stops dumping = balanced glucose.

Sadly, in T2s this system breaks down to a greater or lesser extent, possibly because the basal insulin carrying the dumped glucose to the cells is rejected (insulin resistance). So we end up with too much insulin and too much dumped glucose. The greater the insulin resistance, the more noticeable the liver dumps will be.

I know what I mean! It is difficult to explain it.

 

[CherryAA]

I followed the KETO diet trying to have less than 10-20G carb a day and ended up with a massive liver dump every single day. My tolerance for carbs went down and down till even the 10 in one meal would cause a rise for a long time - I cut my protein and everything no joy. And that is what finally made my mind up that I needed to try a different path and the ND ensued.

Now I am on the ND with shakes and a ludicrous amount of carbs and hardly any fat and I get no liver dump at all in the morning - none at all. I have tested it by not having my first shake till 11am in the morning and my BG just flat lined at 4.5-5 until I have the shake.

I tried eating fat in the morning - cheese, coffee with cream to no avail. But we are all different.

That's very interesting. I also found that eating anything in the morning didn't seem to make much difference to the liver dump.I'm now eating all my calories in one meal a day including 40-50g carbs in one hit and that seems to cause about 2 mmol extra as a post prandial peak

 

[DavidGrahamJones]

this liver dump process has become obvious in my figures because it is not being distorted by food noise.

I've been struggling to identify spikes that I get during the night and I've got one theory. Getting up to go to the bathroom which can happen 3 times a night and if it's really bad every hour on the hour. It's annoying because my BG is not always so low during the night that I need a boost to wake up. Still work in progress.

 

[Robbity]

I've found for the most part that while I've been nicely keto/fat adapted that I've had far fewer and less obvious liver dumps. My theory is because I'm eating fewer carbs and because my body has now switched to burning (stored) fats as well it probably doesn't have the same needs to keep trying to top up with glucose from liver dumps as there's a steady continuous flow of fuel coming from this alternative fatty source.



Robbity

 

[Bluetit1802]

I still go with the theory that if our basal insulin is working properly and our insulin resistance is low, any glucose deposited in the blood stream by the liver in times of fasting and between meals will be dealt with accordingly and quickly by this basal insulin. Fast enough for it not to have any noticeable rise in BS levels, or at least nothing significant. This is exactly what happens in a healthy non-diabetic. The pancreas and the liver working in tandem to keep our BS levels in a narrow range throughout the day and night.

 

[CherryAA]

I'm currently trying to get rid of the circulating insulin in my body and at the same time identify what is actually going on by eating only once per day ( at 4pm) . This then isolates exactly what the liver dump is and what the effect of different foods are.

I'm blogging separately about the actual "low insulin " diet - down 5kg in 7 days,

Having put one of these monitors on a non diabetic friend eating a similar diet, I can see clear that the difference between us is the extent of the morning liver dump.
My goal at the moment is to leave the liver dump untouched ( it is after all now small) and see if the strict adherence to one meal per day for 2 months is enough to cause it to disappear or not.

My one meal a day will be different combinations of fat, carbs and proteins . I can already see that with 70% fats its close to zero, depsite eating 1600 calories in one sitting. ( and also losing 0.6 kg as a result - which was slightly surprising! )

Hopefully by the end of the 2 months I am going to know what my personal optimal space is.

 

[Bluetit1802]

@CherryAA

I believe your disappearing liver dump is a direct result of you getting rid of your IR and thereby allowing your natural basal insulin to offset any glucose delivered by your liver. Your current method of eating to keep insulin levels very low may well be the reason your IR has gone away, or almost gone away.

 

[CherryAA]

@CherryAA

I believe your disappearing liver dump is a direct result of you getting rid of your IR and thereby allowing your natural basal insulin to offset any glucose delivered by your liver. Your current method of eating to keep insulin levels very low may well be the reason your IR has gone away, or almost gone away.

Yes I believe this too, that is precisely why I adopted the Low Insulin diet based on the Food Insulin Index, but then did that via one meal per day, because I could see that not eating often would help. I have been astonished at the speed of the success and maybe it will all go pear shaped shortly, but currently 5 kg in a week, having been stalled for 6 months, AND eating substantial meals of lovely food without feeling hungry , at the same time having low blood glucose seems like the perfect storm which is not credible.

I feel like I should be doing one of those "infomercials " just send £xx here and I will give you the secret to eternal life lol

The real proof in all this will be - if my Hba1c goes down ( which i will be amazed if it doesn't - given I think tha is directly related to my weight loss) - what about the OGTT ? if the area under the curve reduces for the next one - then that will be a sign off true " recovery" as opposed to dietary control. I', already " inremission" apparently ... so the next one will be fascinating