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Re: [IP] old news
>I hate to tell you this, but I, and many others, have been doing this for
>YEARS with ben and jerrys, pizza and other high fat foods....You determine
>the amount of insulin you need for the calculated carbs, but spread them
>over a period of 2-4 or more hours.. You are not using this insulin to
>glucagon - it is for hte carbohydrate that is SLOWLY entering your blood
>stream due to the high fat/protein content in the food you are eating. By
>giving all the insulin at the top of such a meal, you are left with
>relatively little to zero insulin on board 2-4 hours later....so as those
>slowed down carbs hit your blood, your sugar rises, and you are forced to
>take a correction bolus....
The ASSUMPTION has been made in the past that it was fat causing the delayed
rise. In my own experience, this explanation falls flat.
First, if fat were simply delaying the carbs from entering the bloodstream,
then why did I need EXTRA insulin, not just delayed insulin? In fact, if I
don't give the extra insulin, my blood sugar will rise close to 400, and
continue rising (though, I usually catch in by the time it hits 300). And,
as others have reported, the longer you wait to correct for it, the more it
Fat can't account for that. I've also done comparison of various meals and
their fat/protein/carb content. Certain meals with nearly identical
fat/protein/carb content as pizza do NOT cause any sort of delayed rise. In
fact, some meals that have much higher fat content do not cause any sort of
I've seen very little impact that fat has on affecting my BG levels. I do
agree that fat can and does delay the digestion of carbs, but not to the
extent that can explain the delayed rise seen from pizza, etc. Some of the
foods that have the delayed rise aren't even high in fat.
Fat causes a delay in a number of ways. One way is it triggers the body to
slow the digestion process even while the food is still in the stomach.
Another aspect is that as fat enters the blood stream as fatty acids, it CAN
(but not necessarily does) increase insulin resistance. But again, this
should lead to a fairly consistant fat response. But the value meal from
Burger King, for example, which is actually slightly higher in fat than
pizza, does NOT cause any delayed rise.
>i don't agree that this supports your theory. the carbs did not
>fat did not change, the amount of insulin required did not change, what
>changed was your more accurately spacing out of the required insulin
>resulting in a need for a correction bolus.
That isn't true. What I have done up until this recent test was that my
body required EXTRA insulin to account for the delayed rise. I would give
an EXTRA 3 units on top of the units needed to cover the carbs. I would
give these extra units as a bolus extension.
What I tried, instead, was to extend HALF of the bolus for the carbs to 3
hours, and to NOT give the the extra 3 units. This resulted in my BG levels
staying normal and prevented the delayed rise. The extra 3 units were not
necessary at all. (The portion size of the pizza is identical, because of
the type of pizza I was eating, as opposed to just slices.)
What this change did was keep my insulin levels elevated to a higher level
for a longer period of time. THe pizza normally required 10 units plus 3
extra extended to counter the "glucagon effect". This time, I gave 5 units
immediately plus 5 more extended over 3 hours, for a total of 10 units
instead of 13 units. The effect was actually BETTER than when I needed the
extra 3 units on my BG levels.
> If you want to refer back
>through the archives, We have discussed the ben and jerry's effect for
>years....as I have written frequently, my solution has been to take a 1/3
>1/2 of the bolus necessary for the carbs, and then spreading the remaining
>1/2 to 2/3 of a bolus over time....I do not see how you can say this is
>related to glucagon at all!
I'm not saying it IS related to glucagon...I'm saying that glucagon is, thus
far, the only logical explanation that has scientific support. Arginine is
KNOWN to induce glucagon production in both non-diabetics and diabetics.
Arginine is an amino acid found in most foods with protein, though to
varying degrees. THe high amount of cheese and the pepperoni would cause a
significant increase in the amount of arginine that enters the bloodstream.
This, in turn, would trigger the release of glucagon PROVIDING that there is
not an elevated level of insulin in the blood stream.
So, if you have been using an extended bolus for pizza for quite some time,
you have likely been preventing this glucagon release without knowing it,
thinking instead that you were simply countering acting a delay caused by
fat (which still can be the case to a smaller degree).
All of this is merely to point out that the "delay due to fat" explanation
just isn't a good enough answer because too many, including myself, have not
seen evidence of such a problem that correlates to such a huge rise in BG
levels. Nor does the fatty acids increasing insulin resistance, since that
wouldn't explain the need for EXTRA insulin in only some cases, but not
I also don't mean to suggest this is the only explanation. There are
numerous factors that cause various effects on the BG levels. I don't think
any one answer explains everything. I'm merely searching for an answer to
the dramatic delayed rise.
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