michael raiti wrote:
> Wht is a liver dump?
>
Just as the pancreas secretes insulin to attempt to keep blood glucose
below a certain level, the liver *produces* glucose to keep BG from
falling too low. Severe hypoglycemia can kill you faster than an
equivalent hyperglycemia. This is why diabetics carry glucose tablets,
in case they inject too much insulin and BG falls too low. If they
don't act quickly they can go into a coma within minutes. Anyway, when
BG drops, the liver produces glucose in two ways: by converting stored
glycogen (in the liver) back to glucose and releasing that, and by
gluconeogenesis, i.e., making glucose from amino acids.
There is something known as the "dawn phenomenon," which is a rise in BG
in the morning, even though one has eaten nothing since the previous
evening's dinner. As far as I know, this is a natural phenomenon, and
it probably provides a good evolutionary purpose, so that when we wake
up and face the day we have a little extra fuel on hand for vigorous
exertion. This dawn phenomenon is a "liver dump." In an insulin
resistant person, however, the DP, like any influx of glucose, will tend
to cause a higher rise in BG, that takes longer to drop back to
baseline. That's because even though the liver is putting out glucose,
the cells are not getting it quickly, and so the liver thinks there's
not enough glucose in circulation and puts out more. So an IR person
can get some fairly high readings in the morning, and diabetics (T1 or
T2) are very familiar with this. If you're IR and do a *short* burst of
intense exercise first thing in the morning, you can push it even
higher, because the exertion sends a fire alarm to the liver that you
*really* need glucose. I once did a set of 25 pushups and then tested
and got a reading of 125 md/dl. I guess the moral of the story is: If
you're going to do exercise in the morning, do enough so that you not
only trigger a liver dump but also use up the glucose produced.
Now for an actual update....
I'm almost through my third week of very lowcarb, pretty nearly paleo,
intermittent fasting. As I mentioned recently, I've been unhappy with
my BG readings. At my last physical in the fall, my Hba1c was 5.2,
which indicates an *average* BG (including times after meals etc.) of
108. My actual readings on my home glucometer tended to be about 90-93
fasting, and 105 two hours after a meal. But these numbers were
whole-blood based. Lab results are plasma-based, and there's a 12%
difference. So to get a true picture I'd have to add 12% to my
readings, which would indeed suggest an average of about 108. So, okay,
I'm overweight and have been eating SAD so I shouldn't be too shocked.
However, even in the past when I was pretty strictly paleo and 30 or so
pounds lighter, the lowest reading I *ever* got was 84, and with the
added 12% that would really be a 94. And that was only once. One other
time I got an 88 (plus 12% = 98.6). My doc considered these numbers
fine, but I don't, for reasons I've already explained.
First, I decided to upgrade to a new meter. You can get them for free
from various places; I used http://onetouch.orderpoints.com/. This one
is plasma-calibrated, so I'm getting plasma-based readings now,
comparable to the numbers in lab reports. I carefully calibrated it
with the control solution and started testing. To my surprise, my
fasting BG (mid-afternoon) is 78-80, which is a respectable HG level,
and definitely the lowest I've ever tested in 3 or 4 years of having a
meter. And I'm still significantly overweight (10 lbs. down since Jan.
15, but 30+ to go). My morning reading is 88, and my 2-hour
postprandial readings, after my big evening meal, are 84-86. Assuming
the meter is reasonably accurate, these are good readings, especially
considering that I've known I've been IR for years and have been unable
to get those numbers down by manipulating the *what* of my diet.
The only plausible conclusion is that the intermittent fasting has
already improved my insulin sensitivity significantly, in just under
three weeks. I also had one "bad" meal, with a lot of stuff that I
shouldn't be eating, and when I tested 2.25 hours later, it was 90. I'm
happy with the weight loss too but these BG readings were really
unexpected, but are good motivation to keep doing what I'm doing.
Todd Moody
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