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Tue, 25 May 2004 21:32:11 -0400 |
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On Tue, 25 May 2004 21:03:26 +0000, [log in to unmask] wrote:
> > Eating earlier
> > leaves a longer time with no insulin and thus greater glucagon levels
> > leading to higher blood glucose in the morning. >
> > Wade
>
<snip!>
> In a type 1 diabetic, the absence of insulin creates a complication:
> insulin is needed to push glucose into the cells where it's needed. So
> without insulin, even though the blood is flooded with glucose, the cells
> are still starving for it, so more cortisol triggers more glucagon to make
> still more glucose...
<snip!>
> Todd Moody
I hate snipping out parts of posts, but I understand the need :)
Something important that I left out... Insulin is a potent inhibitor of
glucagon, probably the most potent. There are other regulatory loops that
include somatostatin and various peptides. (likeswise, glucagon is a potent
inhibitor of insulin production) In a 'normal' person between meals small
amounts of insulin are being released keeping glucagon in check. For a type 1
diabetic (or any diabetic not secreting ANY insulin) glucagon production runs
'open loop' flooding the body with large amounts of glucagon most of time
except of course during peridodic shots of exogenous insulin around meal times.
In the uncontrolled diabetic, it is this high level of glucagon that is
largely responsible for the body wasting, it is very catabolic. I'm suggesting
that minimizing between meals with the accompanying bolus of insulin would tend
to keep glucagon production muted and blood glucose lower. There are lots of
types of insulin also, and I'm not that familiar with the different types, but
there may be kinds of 'long lasting' insulins that may persist in the
bloodstream longer that may yield better control also. In the olden days I
think it was more common to use a dose of a long lasting insulin once a day
them supplement with bolus shots around meal times but now I think most take a
single type of insulin just around meal time. Anyway, good luck with whatever
you decide to do :) If your H(A1c) is excellent and you morning BG is under
150, I personally think you are doing super-fantastic and you can avoid most if
not all of the diseases prevalent among less controlled diabetics.
Wade
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