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Re: [IP] Chinese

Janet Riganti quoted Richard Bernstein writing:
> 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 glucagon to offset the potential
> excess effect of the insulin.  If you're diabetic, and deficeint in


Thanks for that. It's certainly an original opinion that I have not
heard expressed before. Who is this guy Richard BerRichard
Bernsteinnstein? What research is this based on I wonder? I was
initially rather skeptical of his suggestion that the healthy pancreas
might simultaneously produce both insulin and glucagon, but if the
timescale of their action is different, and if glucagon releases glucose
from different places than insulin stores it, the net effect might be to
shift glucose/glycogen between different storage depots around the body.
Who knows. It's certainly a very complex dynamic system.

I get the opinion that glucagon (the hormone which is effectively the
opposite of insulin, and produced in the pancreas) plays a much bigger
role in our blood sugars than we imagine. It's slightly confused by the
fact than some people with diabetes continue to produce glucagon
effectively, while in others the glucagon production fails along with
the insulin production. I've been unable to find any reliable figures on
how many people continue to produce glucagon. It might be half of us. I
don't know. But it could explain why some people have such trouble with
hypos, and others not. For example, for me a hypo is a non-event.

The stimulation of glucagon production by the mere consumption of bulk
might also be a contribution to the fact that some people require much
more insulin to cover breakfast carbs. Protein is generally thought to
be the culprit for requiring far more insulin in total to cover a
pizza-type meal than a nutritionally equivalent non-pizza meal. It has
been demonstrated that more insulin in total is required; it is not just
due to carb-miscalculation, nor the digestion delaying effect of fats
which would merely require the same insulin over a longer period.

I don't deny that carb-counting is the best way to predict your insulin
requirements. But the true picture is much more complex, which is why we
also test later and make insulin corrections then. So don't be
dispirited if your best calculations don't correctly predict your
insulin requirement all the time. The formula is flawed, but it's the
best we've got!

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