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[IP] Re: fat ..... and protein! - an explanation

Hi Wayne... and anyone else struggling with this issue,

	I think I may have found that "clinical explanation" that you are looking
for.  Amazing the joys of life hidden in the pages of a physiology book!
Yes, the fat slows down the absorption of carbs but I too am one of those
pumpers who just CAN'T get the middle of the night sugars right after such a
meal, despite square waves.  I have the same problem with high PROTEIN meals
as well, again despite covering for protein.  I have actually gone to bed
4-5 hrs after eating with a BS of 120, and on a 2 hr check been 300!  That
is an a pretty impressive jump in just a short period of time.  I simply
correct with a 2.4 unit bolus (YES - I LOVE the backlight! :), but never
quite understood what was going on.  Until I found this: p.680-681 "Human
Physiology - From Cells to Systems" 2nd edition.  Remember, what you are
reading describes physiology in the non-diabetic state.

	"A rise in blood amino acid concentration (protein breakdown) stimulates
BOTH glucagon and insulin secretion.  If during absorption of a protein-rich
meal the rise in blood amino acids stimulated only insulin-secretion,
hypoglycemia might result.  Because little carbohydrate is available for
absorption following consumption of a high-protein meal, the amino
acid-induced increase in insulin secretion would drive too much glucose into
the cells, causing a sudden, inappropriate drop in the blood glucose level.
However, the simultaneous increase in glucagon secretion elicited by
elevated blood amino acid levels increases hepatic (liver) glucose
production.  Since the hyperglycemic actions of glucagon counteract the
hypoglycemic actions of insulin, the net result is maintenance of normal
blood glucose levels during absorption of a meal that is high in protein but
low in carbohydrates."

	In english, *lol* - rising amino acid levels (from protein breakdown) cause
the liver to release glucose.  In the non-diabetic state, this would be
protective from hypoglycemia.  In the diabetic state, we are all too
familiar with the results.  I feel SOOOo much better just KNOWING this!  It
doesn't solve the problem, but it explains a LOT!

~Delaine M. Wright, MS, CDE

>Date: Wed, 5 Jan 2000 15:19:50 -0400
>From: email @ redacted
>Subject: [IP] Re: fat

>Susan, you are right that the fat slows the absorption of carbs, but based
on most everyone's experience it does much more than that.  You can exactly
figure out how many carbs are in 2  slices of pizza, and if you just bolus
to cover that amount, square wave or not,  it's a certainty that your BG
will be high in 4 - 8 h.  I've tried to get some information on this from
my endo but he justs quotes the dogma that fat "slows" things down.
Someone needs to take a closer look at this important question.
- -wayne

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