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Dr. Richard Bernstein M.D., F.A.C.E., F.A.C.N., C.W.S.
Many years ago a patient asked me why her blood sugar went for
90mg/dl up to 300mg/dl every afternoon after she went swimming. I asked her
what she ate before the swim. bnothing, just a freebie,b she replied. As
it turned out, the bfreebieb was lettuce. When I asked her just how much
lettuce she was eating before her swims, she replied, bA head.b
A head of lettuce contains about 10 grams of carbohydrate which
can raise a Type 1 adultbs blood sugar about 50mg/dl at most. So what
accounts for the other 160mg/dl rise in her blood sugar?
The explanation lies in what I call the Chinese Restaurant
Effect. Often Chinese meals contain large amounts of protein or slow-acting,
low-carbohydrate foods such as bean sprouts, bok choy, mushrooms, bamboo
shoots, and water chestnuts, that can make you feel full.
How can these low-carbohydrate foods affect blood sugar so
The upper part of the small intestine contains cells that release
hormones into the blood stream when they are stretched, as after a large
meal. These hormones signal the pancreas to produce some insulin to prevent
the blood sugar rise that might otherwise follow the digestion of a large
meal. Since a very small amount of insulin released by the pancreas can
cause a large drop in blood sugar, the pancreas simultaneously produces the
less potent hormone glucagon to offset the potential excess effect of the
insulin. If youbre a diabetic and deficient in producing insulin, you might
not release insulin, but you will still release glucagon, which will cause
gluconeogensis1 and glycogenolysis2 and thereby raise your blood sugar.
Thus, if you eat enough to feel stuffed, your blood sugar can go up even if
you eat something indigestible, such as sawdust.
The lessons here are " Don't Stuff Yourself " and "Almost Nothing is
a Freebie (except non-caloric liquids)"
Richard K Bernstein, M.D., F.A.C.E., F.A.C.N., C.W.S.
Gluconeogenesis - conversion of protein to carbohydrare by deamination
This was probably written before we were aware of the loss of alpha cells 
in the pancreas during the autoimmune attack on beta cells, loss of alpha 
cells to some extent also occurs. the release of glucagon in the pancreas 
also signals the beta cells to stop secreating insulin as well, turning off 
the insulin production.
Recent research on non obese diabetic mice show that alpha cells also are 
damaged during the auto immune attack on the beta cells. Even with some 
beta cells intact, the pancreas doesn't make enough insulin to use glucose. 
Insulin seems to stimulate other islet cells on the pancreas to produce 
more insulin. the sum of the production is increased by that effect.
A Bender, M. D.
email @ redacted
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