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[IP] "Downward pressure"

Patrick wrote:

Thanks for the clear and detailed explanation.  That makes good sense and
pretty well fits my understanding.
However, I still do not understand how ANY food (with the possible exception
of alcohol) creates downward pressure. It still seems to me like "a carb is
a carb" and your treatment  needs to be bolus for the right amount of carbs
at the right time."

Patrick, thanks for your note.  For the most part, and in general, yes, your
assumption that "a carb is a carb" is certainly operable, in my opinion.
That is the fundamental foundation for managing blood/glucose balance,
matching carbs with insulin.  However, two perhaps refined but nonetheless
very real, and in many diabetics not insignificant, points are relevant.

One, and more generally known, an equal number of carbs in two different
foods can create two different biochemical results in the body.  The most
common example is orange juice and a plate of pasta.  Orange juice, say 25
carbs worth, will raise blood/sugar in a diabetic most rapidly and a plate
of pasta, say also 25 carbs worth, will raise bg less rapidly initially but
with a relatively longer and more lingering of an effect on upward pressure.
Orange juice will not have the lingering effect as pasta does on long-range
(say 3 to 5 hours later) bg.  If you go out after consuming 25 carbs of
orange juice, all other things constant, and play 2 hours of tennis, you
will be significantly lower than if you had instead consumed 25 carbs of
pasta, for the above-noted reason.  If you've ever seen a paramedic treat a
diabetic having a reaction, notice that the paramedic (after giving a
quick-acting but less-lingering glucose IV) will insist that the diabetic
eat some pasta or other longer-range acting carb.  Same reason.

Two, the nutritional content as well as the carbohydrate count of foods are
valid factors in the biochemical results in the body of the consumption of
foods.  Molasses is extremely rich in nutrients, nutrients that can, if a
diabetic's islets of langerans still functions at some appreciable level,
affect both the performance of their pancreas and the body's interaction
with the bolused/basaled insulin.  Interestingly, both molasses and maple
syrup have similar carb counts but can produce very different bg results due
to the different nutritional content of the two foods. Initially, in
consuming  molasses and in consuming maple syrup (on separate occasions)
will result in, other things constant, an upward movement in bg.  However,
as the relative nutritional content interacts with the body's cells and
organs, different results can soon occur.  This is an extreme example of
what I am talking about; most foods with similar carb counts will have
similar bg results. Some diabetics, of course, will notice little or no
difference between molasses and maple syrup; many, however, will notice a
marked difference. My observations are based on my own experiences and
research over 13 years, what I've learned from diabetes educators in two
different counties and states, and from listening to other diabetics in
various support group settings.

Peace and health,

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