Of refeeds and diet breaks
Replies
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collectingblues wrote: »Nony_Mouse wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
My Goo (cat) was also insulin sensitive. Try measuring a 0.1 unit of insulin
She was also the first cat in NZ on Lantus, I got it for her when it was still on human trials here.
I've been compared to a cat before, but never quite like that. I appreciate your making me sit in my office and giggle.
She was pretty damn awesome, so it's definitely a complement to be compared to her!! I'm also mighty glad of the mad injecting skillz I acquired because of her. Injecting a cat with pain meds is so much easier than trying to squirt it into their cheek pouch. Over 11 years since she left this realm, and I can still give a shot like a pro
1 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
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Nony_Mouse wrote: »collectingblues wrote: »Nony_Mouse wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
My Goo (cat) was also insulin sensitive. Try measuring a 0.1 unit of insulin She was also the first cat in NZ on Lantus, I got it for her when it was still on human trials here.
I've been compared to a cat before, but never quite like that. I appreciate your making me sit in my office and giggle.
She was pretty damn awesome, so it's definitely a complement to be compared to her!! I'm also mighty glad of the mad injecting skillz I acquired because of her. Injecting a cat with pain meds is so much easier than trying to squirt it into their cheek pouch. Over 11 years since she left this realm, and I can still give a shot like a pro
Abby was having some issues earlier this year, and diabetes was one of the considered diagnoses (she ended up being totally fine -- just a picky little girl who has her mama's eating quirks). The vet was surprised at how totally nonplussed I was with that one. She asked, and I explained that well, I've been type 1 for 35 years, and no one's had to put me down, so I was pretty sure that I could figure out the cat.4 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
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collectingblues wrote: »Nony_Mouse wrote: »collectingblues wrote: »Nony_Mouse wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
My Goo (cat) was also insulin sensitive. Try measuring a 0.1 unit of insulin She was also the first cat in NZ on Lantus, I got it for her when it was still on human trials here.
I've been compared to a cat before, but never quite like that. I appreciate your making me sit in my office and giggle.
She was pretty damn awesome, so it's definitely a complement to be compared to her!! I'm also mighty glad of the mad injecting skillz I acquired because of her. Injecting a cat with pain meds is so much easier than trying to squirt it into their cheek pouch. Over 11 years since she left this realm, and I can still give a shot like a pro
Abby was having some issues earlier this year, and diabetes was one of the considered diagnoses (she ended up being totally fine -- just a picky little girl who has her mama's eating quirks). The vet was surprised at how totally nonplussed I was with that one. She asked, and I explained that well, I've been type 1 for 35 years, and no one's had to put me down, so I was pretty sure that I could figure out the cat.
Yup, in terms of the usual suite of senior cat issues to deal with, I'd pick hyper thyroid first (though Mario is proving tricky on that, so I'm rethinking that one, for any normal cat it's just get radio iodine treatment and done), then the Dire Beasties. Feline diabetes is generally more similar to Type 2 than Type 1, and with the gentle insulins now available if you get a diagnosis early enough and can get them tightly regulated, you can often get them off insulin. Goo probably would have been a good candidate for that had we had Lantus available from the start, but alas that wasn't the case. If your cat suddenly stops needing insulin three years post-dx, she's probably got cancer![:\](https://community.myfitnesspal.com/en/resources/emoji/confused.png ":\")
. 0 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
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So, this week's weight drop could just be more that was masked by the pred, and water shedding took longer than I assumed, right?3
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Nony_Mouse wrote: »So, this week's weight drop could just be more that was masked by the pred, and water shedding took longer than I assumed, right?
I would think it's reasonable to assume that after a whoosh there might be a certain amount of water remaining that would release more slowly.2 -
Nony_Mouse wrote: »So, this week's weight drop could just be more that was masked by the pred, and water shedding took longer than I assumed, right?
Yes, I'd think so. I'd maybe give it a week or so -- I usually "allow" 10 days for hormonal weight, so I'd say pred could be similar -- and see how things stand then, before getting nervous that you need to up calories even more.0 -
I do like to worry over nothing! But, y'know, I've dropped 1.6 kg since switching to maintenance 5 weeks ago (taking the glass of water I had before weighing this morning into account), and obviously some of that was eczema-related, but that averages out at my body behaving like it's still at a 500 cal a day deficit ffs.
On the bright side, I have a mighty Christmas Day buffer!! Just got to eat/drink an extra 3700 cals to make up that additional 1/2 kg!4 -
collectingblues wrote: »Nony_Mouse wrote: »So, this week's weight drop could just be more that was masked by the pred, and water shedding took longer than I assumed, right?
Yes, I'd think so. I'd maybe give it a week or so -- I usually "allow" 10 days for hormonal weight, so I'd say pred could be similar -- and see how things stand then, before getting nervous that you need to up calories even more.
Yeah, hormonal weight for me is gone in a day, two max.
I need to up cals regardless, and I can use my pre-flare data as a base for that because it's pretty solid. I have a little wiggle room before I go need to go 'no, really, too thin', but not much. Let's just hope all of this is coming off my thighs and lower belly!2 -
Wow, haven't seen a thread since one of mine that hit 100 pages and started new one To Be Continued.
If they even do that anymore.6 -
collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
I have to commend you. I've never met anyone that had both damaged alpha and beta cells. I'd love to be on the research team that helps your case because this is something new for me. Overactive glucagon response and impaired insulin is the usual case for many T1s and beta cell damaged T2s.. they're also generally insulin resistant so insulin doses are ungodly high, which does nothing to keep adding more insulin since they generally feel "saved as long as they have their insulin to save them" .. until it stops working and pancreatitis is prevalent with CKD, etc...
At this point, it's almost the extreme of what happens when you're insulin sensitive and dosing must be precise. I'm barely familiar with Dr. Bernstein and I know he is T1 and works with many T1s to control the stereotypical postprandial excursions to cover their bolus intake and overnight, but I haven't interacted in his group long enough to know the nuances.0 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
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In just to see if I get to flip it over to page 100
Nony hopefully it is all coming off where you want it to come off of ;-)
2 -
collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
I have to commend you. I've never met anyone that had both damaged alpha and beta cells. I'd love to be on the research team that helps your case because this is something new for me. Overactive glucagon response and impaired insulin is the usual case for many T1s and beta cell damaged T2s.. they're also generally insulin resistant so insulin doses are ungodly high, which does nothing to keep adding more insulin since they generally feel "saved as long as they have their insulin to save them" .. until it stops working and pancreatitis is prevalent with CKD, etc...
At this point, it's almost the extreme of what happens when you're insulin sensitive and dosing must be precise. I'm barely familiar with Dr. Bernstein and I know he is T1 and works with many T1s to control the stereotypical postprandial excursions to cover their bolus intake and overnight, but I haven't interacted in his group long enough to know the nuances.
The alpha cell thing is ... fascinating, and simultaneously annoying. Basically, it means that I have no natural response to hypos, which in turn leads to really bad hypos, with then delayed spikes. I'll get a glucose dump once the adrenaline hits, but not when it's actually useful.
It's part of why when people start talking about beta cells as a treatment route, I just sort of turn it off -- because for me, that would just be a disaster, since there still wouldn't be anything to control the glucose release.
I side-eye Bernstein. He's low-carb preachy, and frankly, I don't need to demonize food groups. I'm sure he's helpful for many, but I can't stand him. My typical carb intake is usually around 200 gm or less -- so not low carb, but also not Standard American Diet carbs.3 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
-
In just to see if I get to flip it over to page 100
Nony hopefully it is all coming off where you want it to come off of ;-)
No, no, my announcement that @livingleanlivingclean mention of pumpkin and pumpkin soup is bringing to mind that I've enjoyed thickening my soups with canned pumpkin in the past and I am thinking of making something like that for tonight doesn't have anything to do with me trying to flip the thread to page 100!
3 -
In aggravated assault triggering news: I loathe... absolutely loathe loud open mouth lip-smacking food chewers. There's one here in my office as I type this and I'm very much wishing for a fly to enter between the open mouth concert sessions.4
-
In aggravated assault triggering news: I loathe... absolutely loathe loud open mouth lip-smacking food chewers. There's one here in my office as I type this and I'm very much wishing for a fly to enter between the open mouth concert sessions.
I see what you tried to do there @anubis609 and arguably, given your contributions to @Nony_Mouse 's thread, you probably SHOULD be featured in the first post of page 100! 3 -
collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
I have to commend you. I've never met anyone that had both damaged alpha and beta cells. I'd love to be on the research team that helps your case because this is something new for me. Overactive glucagon response and impaired insulin is the usual case for many T1s and beta cell damaged T2s.. they're also generally insulin resistant so insulin doses are ungodly high, which does nothing to keep adding more insulin since they generally feel "saved as long as they have their insulin to save them" .. until it stops working and pancreatitis is prevalent with CKD, etc...
At this point, it's almost the extreme of what happens when you're insulin sensitive and dosing must be precise. I'm barely familiar with Dr. Bernstein and I know he is T1 and works with many T1s to control the stereotypical postprandial excursions to cover their bolus intake and overnight, but I haven't interacted in his group long enough to know the nuances.
The alpha cell thing is ... fascinating, and simultaneously annoying. Basically, it means that I have no natural response to hypos, which in turn leads to really bad hypos, with then delayed spikes. I'll get a glucose dump once the adrenaline hits, but not when it's actually useful.
It's part of why when people start talking about beta cells as a treatment route, I just sort of turn it off -- because for me, that would just be a disaster, since there still wouldn't be anything to control the glucose release.
I side-eye Bernstein. He's low-carb preachy, and frankly, I don't need to demonize food groups. I'm sure he's helpful for many, but I can't stand him. My typical carb intake is usually around 200 gm or less -- so not low carb, but also not Standard American Diet carbs.
I think anything less than SAD amounts counts as "low carb" in the sense of that it's not ad lib and rampant. And not that I look to Bernstein, he just sort of popped up first in my mind as a T1 practitioner lol. In your case, you may actually require the carbs since glucagon isn't assisting at all in hypo episodes. And I'm not one to demonize macros at all either, regardless of the way I actually eat.
However, I am interested to know how alpha cell therapy works. It's really a new aspect for me. And I do wish you a lot of success since you living alone isn't optimal.. though I do wonder if having a continuous glucose monitor might be of use to you for timing doses for bolus and exercise, as well as be able to act as a kind of medical alert sent to your device and notify any emergency contacts.0 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
-
In aggravated assault triggering news: I loathe... absolutely loathe loud open mouth lip-smacking food chewers. There's one here in my office as I type this and I'm very much wishing for a fly to enter between the open mouth concert sessions.
I see what you tried to do there @anubis609 and arguably, given your contributions to @Nony_Mouse 's thread, you probably SHOULD be featured on the first post on page 100!
But it's you @PAV8888!!! Your persistence has paid off
Hey!! Guess what's back?? Yep, not PMS hunger after all. *Lots of swearing*. Hoping I can stave it off with a potion bath and jumping back up to uber topical steroid. Did I say *kitten* yet?? If not, *kitten*.
But, I have two fabulous new dresses from my morning exploits. I shall put on and photograph to show you before I turn fully into a bright red mess.
*kitten*.
ETA: whoa, editing my post to kittenify a word the swear filter didn't pick up made ALL the bad words appear! I have been good and kittened them myself 3 -
In aggravated assault triggering news: I loathe... absolutely loathe loud open mouth lip-smacking food chewers. There's one here in my office as I type this and I'm very much wishing for a fly to enter between the open mouth concert sessions.
I see what you tried to do there @anubis609 and arguably, given your contributions to @Nony_Mouse 's thread, you probably SHOULD be featured in the first post on page 100!
Haha, you may have the 100th page @PAV8888. Aside from trying to bump it into the triple digits, I really was excreting the thought process as it was happening.. it's actually STILL happening. I regret having a candy bowl here2 -
In aggravated assault triggering news: I loathe... absolutely loathe loud open mouth lip-smacking food chewers. There's one here in my office as I type this and I'm very much wishing for a fly to enter between the open mouth concert sessions.
I see what you tried to do there @anubis609 and arguably, given your contributions to @Nony_Mouse 's thread, you probably SHOULD be featured in the first post on page 100!
Haha, you may have the 100th page @PAV8888. Aside from trying to bump it into the triple digits, I really was excreting the thought process as it was happening.. it's actually STILL happening. I regret having a candy bowl here
Time for a coffee / bathroom break and some distance! I've seen you lifting weights and I don't want you going postal on "chewey"
3 -
@Nony_Mouse , while your new "how to increase my NEAT" method seems to be quite effective at losing weight... I would rather pass and I really hope you figure out a way to resolve
4 -
@Nony_Mouse , while your new "how to increase my NEAT" method seems to be quite effective at losing weight... I would rather pass and I really hope you figure out a way to resolve
Same, esp since I don't have the weight to lose!!2 -
collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
I have to commend you. I've never met anyone that had both damaged alpha and beta cells. I'd love to be on the research team that helps your case because this is something new for me. Overactive glucagon response and impaired insulin is the usual case for many T1s and beta cell damaged T2s.. they're also generally insulin resistant so insulin doses are ungodly high, which does nothing to keep adding more insulin since they generally feel "saved as long as they have their insulin to save them" .. until it stops working and pancreatitis is prevalent with CKD, etc...
At this point, it's almost the extreme of what happens when you're insulin sensitive and dosing must be precise. I'm barely familiar with Dr. Bernstein and I know he is T1 and works with many T1s to control the stereotypical postprandial excursions to cover their bolus intake and overnight, but I haven't interacted in his group long enough to know the nuances.
The alpha cell thing is ... fascinating, and simultaneously annoying. Basically, it means that I have no natural response to hypos, which in turn leads to really bad hypos, with then delayed spikes. I'll get a glucose dump once the adrenaline hits, but not when it's actually useful.
It's part of why when people start talking about beta cells as a treatment route, I just sort of turn it off -- because for me, that would just be a disaster, since there still wouldn't be anything to control the glucose release.
I side-eye Bernstein. He's low-carb preachy, and frankly, I don't need to demonize food groups. I'm sure he's helpful for many, but I can't stand him. My typical carb intake is usually around 200 gm or less -- so not low carb, but also not Standard American Diet carbs.
I think anything less than SAD amounts counts as "low carb" in the sense of that it's not ad lib and rampant. And not that I look to Bernstein, he just sort of popped up first in my mind as a T1 practitioner lol. In your case, you may actually require the carbs since glucagon isn't assisting at all in hypo episodes. And I'm not one to demonize macros at all either, regardless of the way I actually eat.
However, I am interested to know how alpha cell therapy works. It's really a new aspect for me. And I do wish you a lot of success since you living alone isn't optimal.. though I do wonder if having a continuous glucose monitor might be of use to you for timing doses for bolus and exercise, as well as be able to act as a kind of medical alert sent to your device and notify any emergency contacts.
A CGM would be useful, but I refuse to wear a second torso site. Because I run, that eliminates thigh sites, unfortunately (I'd be willing to wear it off label there, but the endos both have insisted that accuracy would be affected). And I don't have the dexterity (or the fat stores) to get it on the back of my arms. The endo was very blunt that at this point, considering the whole picture, he'd prefer to see me saving my torso for the pump sites -- because again, the fat isn't enough on the thighs or arms to support a site there.
I'm getting a new pump this spring, and will likely go ahead with getting approval with the CGM since it's integrated in the model that I want -- it would be easier to do it now, and work on gradual acceptance (or the dexterity to get it on the back of my torso...) with the therapist, than to start from scratch, I think. I know my insurer would approve it, and I used to wear it, but I just can't take the body image impact.
At this point, a truly functional artificial pancreas requiring only one site would be my ideal. I don't believe that we're going to see any meaningful movement on the beta cell/alpha cell front in my lifetime, since to solve that would involve solving the whole autoimmunity picture as well -- how do you get the body to stop attacking the cells? So I'll take the better technology, and continue to amaze my team that I'm running half marathons with marginal effects. (That one took a lot of finagling!)1 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
-
collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
I have to commend you. I've never met anyone that had both damaged alpha and beta cells. I'd love to be on the research team that helps your case because this is something new for me. Overactive glucagon response and impaired insulin is the usual case for many T1s and beta cell damaged T2s.. they're also generally insulin resistant so insulin doses are ungodly high, which does nothing to keep adding more insulin since they generally feel "saved as long as they have their insulin to save them" .. until it stops working and pancreatitis is prevalent with CKD, etc...
At this point, it's almost the extreme of what happens when you're insulin sensitive and dosing must be precise. I'm barely familiar with Dr. Bernstein and I know he is T1 and works with many T1s to control the stereotypical postprandial excursions to cover their bolus intake and overnight, but I haven't interacted in his group long enough to know the nuances.
The alpha cell thing is ... fascinating, and simultaneously annoying. Basically, it means that I have no natural response to hypos, which in turn leads to really bad hypos, with then delayed spikes. I'll get a glucose dump once the adrenaline hits, but not when it's actually useful.
It's part of why when people start talking about beta cells as a treatment route, I just sort of turn it off -- because for me, that would just be a disaster, since there still wouldn't be anything to control the glucose release.
I side-eye Bernstein. He's low-carb preachy, and frankly, I don't need to demonize food groups. I'm sure he's helpful for many, but I can't stand him. My typical carb intake is usually around 200 gm or less -- so not low carb, but also not Standard American Diet carbs.
I think anything less than SAD amounts counts as "low carb" in the sense of that it's not ad lib and rampant. And not that I look to Bernstein, he just sort of popped up first in my mind as a T1 practitioner lol. In your case, you may actually require the carbs since glucagon isn't assisting at all in hypo episodes. And I'm not one to demonize macros at all either, regardless of the way I actually eat.
However, I am interested to know how alpha cell therapy works. It's really a new aspect for me. And I do wish you a lot of success since you living alone isn't optimal.. though I do wonder if having a continuous glucose monitor might be of use to you for timing doses for bolus and exercise, as well as be able to act as a kind of medical alert sent to your device and notify any emergency contacts.
A CGM would be useful, but I refuse to wear a second torso site. Because I run, that eliminates thigh sites, unfortunately (I'd be willing to wear it off label there, but the endos both have insisted that accuracy would be affected). And I don't have the dexterity (or the fat stores) to get it on the back of my arms. The endo was very blunt that at this point, considering the whole picture, he'd prefer to see me saving my torso for the pump sites -- because again, the fat isn't enough on the thighs or arms to support a site there.
I'm getting a new pump this spring, and will likely go ahead with getting approval with the CGM since it's integrated in the model that I want -- it would be easier to do it now, and work on gradual acceptance (or the dexterity to get it on the back of my torso...) with the therapist, than to start from scratch, I think. I know my insurer would approve it, and I used to wear it, but I just can't take the body image impact.
At this point, a truly functional artificial pancreas requiring only one site would be my ideal. I don't believe that we're going to see any meaningful movement on the beta cell/alpha cell front in my lifetime, since to solve that would involve solving the whole autoimmunity picture as well -- how do you get the body to stop attacking the cells? So I'll take the better technology, and continue to amaze my team that I'm running half marathons with marginal effects. (That one took a lot of finagling!)
When you work this out, please let me know 0 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
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Nony_Mouse wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »collectingblues wrote: »Either a two-pound whoosh this morning, or just my blood sugar punking me. (Like, stupidly scary high. WTF, body?) Only time will tell, I suppose.
What's your fasting glucose? I have some running theories about blood sugar spikes with whooshes which incorporate the idea of lipolysis to release extraneous stored glucose within the adipocytes into blood circulation. I'm not sure if it's a feasible theory since I haven't run it across the current thought leaders, but it's just something I have in my head.
It varies, usually depending on how the previous night was, whether there was exercise, whether there was alcohol, etc.
This morning was ... not fantastic. We need to tweak my overnight insulin -- while still being on the side of "we need to make sure I'm not hypoglycemic overnight" -- because I keep waking up high. I could start that on my own, but there are some mornings when I'm fine, so I'm trying to rule out other issues first.
In the interest of teasing out one variable at a time, when you have a chance, perhaps Bill Lagakos's article may be pertinent. He regularly posts on biochemistry and circadian rhythm. Because of him I've followed a bit of circadian entrainment for the better part of 6 months this year, even if I don't quite understand half the crap he describes lol
http://caloriesproper.com/dawn-phenomnomnom/
Yup. Dawn phenomenon is why I'm on a higher dose overnight, peaking at 5:30 a.m.
I've been type 1 for 35 years. Let's just say that, well, it's sort of like Nony and her having researched and tried everything for eczema. I'm comfortable making pump adjustments, and my endocrinologist has given me carte blanche to manage it how I feel best, since I generally have a good history with that. But it gets annoying and difficult when there's no true pattern, and I can't tease out what is actually going on, in absence of other hormonal factors.
Given that leptin governs insulin which also regulates cortisol, which is influenced by stress and physiologically responds to cellular status to demand or reject energy substrates, I'd say a lot of hormonal factors are actually at play.. and there's way too many of them to try to pin down since it's hard to address one without affecting the others. Though, if you and your endo have tried to find some correlation with better results, have you noticed any patterns with days (and preceding nights) that were particularly well controlled with morning numbers?
ETA: This may be geared towards more lada T1.5 or beta cell damaged T2s, but I just thought it was interesting to note in terms of alternative anti-hyperglycemic control
http://caloriesproper.com/glp-101/
Yeah, sadly, in addition to my insulin production being as dead as a doorknob (doornail? I always forget which one it's supposed to be), I also lack the cells that tell the liver to release glucagon to thus start that process. My immune system took out that sector very thoroughly.
All three endos I've had have been stumped -- one even put my logs up (de-identified, of course) in their workroom, with a post-it note of "we've tried X,Y,Z with no results, what would you do?" In the olden days -- and I guess some would still use it, although I despise the term -- I would have been called a brittle diabetic. Nighttime has always been a challenge, typically more on the hypoglycemic end.
So, in the long of it...- Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
- We've got the carb ratio nailed down, but the basal remains an issue overnight. Like, last night, I went to bed at 150, and I woke up at 600. Something happened, but it was a meal I've had before, was meticulously carb counted, etc. My body just ... did not like it last night. The big culprits for late meals are usually pizza, Chinese, and sushi -- it's just hard to get a really good grasp on the insulin timing, and how I extend that bolus. Last night was meatloaf and tater tots (because sometimes, feeding me is like feeding a toddler), so not super fatty or super carby (total meal was 23 gm of carbs, and 14 of fat).
- Exercise is a big factor, but not reliably so. Sometimes I work out at night/in the evenings and I'm fine with the next morning, sometimes ... I'm very much not fine. That's gotten a little better since starting to pull back on some of the calorie restriction, which is letting the glycogen be more available.
- I do start requiring more insulin when it gets colder. I don't know if last night was one of those "OK, now my body thinks it's too cold" situations that's now kicked me over the edge. I usually have to start upping it in January, so it's possible we're just a month early. (It's also then part of what makes summer so difficult, because I will just start dropping and there's no lead up besides "oh, there's three days in a row where I can't fix hypos."
- I'm fairly insulin sensitive. "Typical" adult doses are in the ballpark of a unit per kilo, and I'm at half a unit per kilo.
- Overnights are challenging, and borderline frightening because if I tweak too much, I end up hypo when I wake up. I live alone, so that becomes more of a safety issue. But, it might be worth seeing if this is the winter phenomenon just happening early, and nudging up every so slightly (like, the smallest increase) overnight and see if that helps.
I have to commend you. I've never met anyone that had both damaged alpha and beta cells. I'd love to be on the research team that helps your case because this is something new for me. Overactive glucagon response and impaired insulin is the usual case for many T1s and beta cell damaged T2s.. they're also generally insulin resistant so insulin doses are ungodly high, which does nothing to keep adding more insulin since they generally feel "saved as long as they have their insulin to save them" .. until it stops working and pancreatitis is prevalent with CKD, etc...
At this point, it's almost the extreme of what happens when you're insulin sensitive and dosing must be precise. I'm barely familiar with Dr. Bernstein and I know he is T1 and works with many T1s to control the stereotypical postprandial excursions to cover their bolus intake and overnight, but I haven't interacted in his group long enough to know the nuances.
The alpha cell thing is ... fascinating, and simultaneously annoying. Basically, it means that I have no natural response to hypos, which in turn leads to really bad hypos, with then delayed spikes. I'll get a glucose dump once the adrenaline hits, but not when it's actually useful.
It's part of why when people start talking about beta cells as a treatment route, I just sort of turn it off -- because for me, that would just be a disaster, since there still wouldn't be anything to control the glucose release.
I side-eye Bernstein. He's low-carb preachy, and frankly, I don't need to demonize food groups. I'm sure he's helpful for many, but I can't stand him. My typical carb intake is usually around 200 gm or less -- so not low carb, but also not Standard American Diet carbs.
I think anything less than SAD amounts counts as "low carb" in the sense of that it's not ad lib and rampant. And not that I look to Bernstein, he just sort of popped up first in my mind as a T1 practitioner lol. In your case, you may actually require the carbs since glucagon isn't assisting at all in hypo episodes. And I'm not one to demonize macros at all either, regardless of the way I actually eat.
However, I am interested to know how alpha cell therapy works. It's really a new aspect for me. And I do wish you a lot of success since you living alone isn't optimal.. though I do wonder if having a continuous glucose monitor might be of use to you for timing doses for bolus and exercise, as well as be able to act as a kind of medical alert sent to your device and notify any emergency contacts.
A CGM would be useful, but I refuse to wear a second torso site. Because I run, that eliminates thigh sites, unfortunately (I'd be willing to wear it off label there, but the endos both have insisted that accuracy would be affected). And I don't have the dexterity (or the fat stores) to get it on the back of my arms. The endo was very blunt that at this point, considering the whole picture, he'd prefer to see me saving my torso for the pump sites -- because again, the fat isn't enough on the thighs or arms to support a site there.
I'm getting a new pump this spring, and will likely go ahead with getting approval with the CGM since it's integrated in the model that I want -- it would be easier to do it now, and work on gradual acceptance (or the dexterity to get it on the back of my torso...) with the therapist, than to start from scratch, I think. I know my insurer would approve it, and I used to wear it, but I just can't take the body image impact.
At this point, a truly functional artificial pancreas requiring only one site would be my ideal. I don't believe that we're going to see any meaningful movement on the beta cell/alpha cell front in my lifetime, since to solve that would involve solving the whole autoimmunity picture as well -- how do you get the body to stop attacking the cells? So I'll take the better technology, and continue to amaze my team that I'm running half marathons with marginal effects. (That one took a lot of finagling!)
When you work this out, please let me know
Precisely. There is so much that could be unlocked for treatment of so many conditions if they could figure that part out. Sadly, my expectations with what *I* want for treatment are a bit ahead of the curve. 0 - Calorie restriction has more of a hypoglycemic effect, which would be expected. But then, there's that conundrum of "I'm not supposed to be restricting," with "restrict too much and there's no glycogen stores" with a bonus side of "then I start having cyclical hypos that we can't break out of."
-
Terebynthia wrote: »Popping in to say I am so glad I found this tribe of people who are interested in the science behind all this. Reading and absorbing.
I agree.
Except I've stopped commenting as I have an annoying habit of steering threads completely off topic!
1 -
In aggravated assault triggering news: I loathe... absolutely loathe loud open mouth lip-smacking food chewers. There's one here in my office as I type this and I'm very much wishing for a fly to enter between the open mouth concert sessions.
I see what you tried to do there @anubis609 and arguably, given your contributions to @Nony_Mouse 's thread, you probably SHOULD be featured in the first post on page 100!
Haha, you may have the 100th page @PAV8888. Aside from trying to bump it into the triple digits, I really was excreting the thought process as it was happening.. it's actually STILL happening. I regret having a candy bowl here
Time for a coffee / bathroom break and some distance! I've seen you lifting weights and I don't want you going postal on "chewey"
Well to soothe any thoughts of me lashing out, I'm legally bound to "play nice" for the next 2 years, so there's no immediate worry
You'll also be happy to know she has left my vicinity. I'm letting someone else deal with her. 3 -
Christine_72 wrote: »Terebynthia wrote: »Popping in to say I am so glad I found this tribe of people who are interested in the science behind all this. Reading and absorbing.
I agree.
Except I've stopped commenting as I have an annoying habit of steering threads completely off topic!
There's still subjects that are off topic here??3 -
Okay, shopping joy. Not sure the photos of the dresses are good enough to be able to see what the prints are. Doctor Who fans might be able to get the grey and red one. The purple one is my Christmas dress (that's a clue, it's film).
12 -
PrettyNony_Mouse wrote: »Okay, shopping joy. Not sure the photos of the dresses are good enough to be able to see what the prints are. Doctor Who fans might be able to get the grey and red one. The purple one is my Christmas dress (that's a clue, it's film). 3
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