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Re: [IP] bolusing for fat

Ryan, This idea about glucagon was first promoted by Bernstein, 
unfortunately without his reading the literature. It really is not a 
relevant issue for type 1 diabetics who, after a few years of 
diagnosis,  don't produce glucagon any better than they produce 
insulin.  The medical literature supporting this inability of type 1s 
to produce glucagon goes back 30 years.  So the issue regarding 
glucagon after pizza is way beyond controversial for us pumpers--- 
it's dead.

   But there are several recent articles that indicate that fatty 
acids in the blood can decrease insulin sensitivity.  This may be 
working in the extended pizza/bagel effect on BG, but it still seems 
there is something much more important yet to be discovered.  If you 
think it's just the mozarella, just eat a 2 oz block(or more) of it 
and let us know us your BG 2 h later.  My bet is it won't go up more 
than 30 mg/dl.

<<<<<<<<There is a final problem that seems a bit controversial...but I've
witnessed it in myself.  There are certain types of amino acids (found
in protein) that can trigger the body to produce glucagon.  This can
cause a delayed rise in blood glucose that is unrelated to any carbs
actually in the food.  I'm convinced that Pizza is one of these foods,
because bolusing for carbs and protein is not enough.

I did a comparison.  I have eaten the same amount of fat/protein/carbs
from pizza as well as from a Double-cheeseburger value meal.  The
numbers were virtually identical.  ANd yet, the value meal does NOT
cause the delayed rise that pizza does. I'm guessing that amount of
cheese on the pizza causes this "glucagon effect" (as I like to call
it).  I have found that I have to give an extended bolus of 3 units ON
TOP of any bolus I give for the carbs and protein, no matter how much
pizza I eat.  >>>>>>>>>>>>>>
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