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Re: [IP] Glucagon findings and pizza

>Well Ryan, i'm wondering if you could explain more clearly how you 
>use to bolus for pizza,  and how you now do it.   And what your BGs
>were then and now. (Be as specific as possible--by extended I'm 
>assuming you mean square wave?)

Sure!  Okay, for the purposes of this testing, I've used a consistant 
pizza portion instead of the variable-sized pizza slices.  This pizza 
has approximately 100 carbs, plus or minus 10 (which would only cause a 
flucation of 50 mg/dL in BG levels if I were off).  

100 carbs requires, for me, 10 units of insulin (ratio of 1 unit per 10 

Before, to address the delayed high several hours post-pizza, I would 
give 10 units immediately, and 3 units as an extended (square wave) 
bolus for 3 hours.  2 hours post-eating, my BG levels would run around 
130-150.  2 hours after that, I would see a slight rise, sometimes up 
to 180.  This is in comparison to when I don't give the extra 3 units, 
resulting in rising blood sugars that I typically catch at 300, but 
have seen go to 400 before I caught it.

Very recently, I switched to this new scheme.  Eating the same 100 carb 
pizza, I give 5 units immediately, and then 5 units as an extended 
bolus (total of 10 units) for 3 hours.  My 2 hour post-pizza reading 
was still in the 140-150 range (specifically, 146 in my most recent 
attempt).  My 4-hour post-pizza reading was actually about 130.  

So, the result was less insulin, same carbs, and lower BG levels.  
>   However, despite your using the glucagon theory to base these 
>changes, you still must recognize that there is no evidence I've seen 
>that would show glucagon is released in response to eating ANY food, 
>let alone mozzarella cheese.  And from an evolutionary point of view, 
>it seems to make little sense to have evolved a system that releases 
>a hormone that increases liver glucose production at the time when 
>you just have eaten.   So just because you find a bolus method that 
>works, doesn't really support a role for glucagon at all.

I've found numerous studies, including at least ONE you provided, that 
said that glucagon IS produced in response to arginine, which is an 
amino acid found in many protein-rich foods.  The lack of a study to 
specifically correlate food to glucagon production doesn't mean it 
isn't true...just that it hasn't been studied.  There are no studies to 
show that food DOESN'T trigger glucagon production either.  However, 
since it is known that the amino acids in many foods DO stimulate 
glucagon production, it is not hard to see that the foods themselves 
(indirectly) do so.

As far the the "evolutionary sense" (which, I personally believe it is 
a CREATED design, not an evolutionary one), it makes perfect sense.

(I once again provide a disclaimer that this is theory here...)  

When you eat food that is high in protein, a normal person would 
release insulin to compensate.  This insulin in the blood stream not 
only allows the body to use the carbs, but also inhibits glucagon 
production.  (This is a KNOWN and measurable phenomenon of 
glucagon/insulin interaction.)  So, glucagon would not be released 
because the body naturally produces insulin.

However, if the insulin levels drop due to lack of carbs, the body 
STILL needs carbs in order to continue producing energy for the body.  
So, as insulin levels drop, glucagon is released to stimulate 
glycagen.  This raises carb levels in the bloodstream so that more 
insulin can be produced to allow the body to use the glycagen.  This, 
in fact, is what happens when prolonged exercise is done if you don't 
continue to eat (again, has been documented and observed in normals).

Of course, the PROBLEM, really, is that Type 1 diabetics do not have an 
automatic insulin response to be able to shut of the glucagon 
production, nor to use up the glycagen that is released as a result.  
For a normal person, though, it is a perfectly balanced system that 
keeps BG levels consistant at times of activity, inactivity, eating, 
and fasting.  And, in fact, I recall reading that in normals, if you 
eat foods with little or no carbs (i.e., foods higher in protein and 
fat), the body still has to generate carbs in order to provide energy.  
Insulin levels would remain low due to low carbs in the bloodstream, 
which then allows for glucagon production to stimulate glycagen 
release. But, what stimulates the glucagon release itself?  Well, 
arginine is one known amino acid.

It's all quite fascinating theory.  I'll look forward to see how it all 
pans out.  I already sent details of this to my endo.  Hopefully, I'll 
hear back from him.  I'll keep people posted.
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