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[IP] Re: Large meals and delayed digestion

<Well Ryan, you are not the first to notice this. But the why is still not
answered.  You've almost got it, but your logic just doesn't add up. If you
really bolused for all the carbs he ate, or at least approximated pretty
well, why need extra insulin? Slowing down the digestion doesn't work. You
should have gone low if the carbs were just sitting in your gut. It's true
that eating a lot, even of sugar will eventually saturate breakdown of carbs
and absorption from the gut will be slowed a lot. But then one should need
MUCH less insulin up front. It's also my experience that I need about what i
figure up front, but then need extra insulin later on. There's also some
anecdotes that you get the same effect from just eating vegetables with very
little carbs. This led Dr. Bernstein to conclude that a full stomach caused
glucagon release (and i know how much you love glucagon!), but this is
unlikely because it would have to continue for hours.  Keep trying---If you
can figure this out, you'll make a lot of us happy

The following is from Dr. Bernstein's Diabetes Solution, page 88:

"The explanation lies in what I call the Chinese Restaurant Effect.  Often
Chinese meals contain large amounts of protein or slow-acting,
low-carbohydrate foods such as bean sprouts, bok choy, mushrooms, bamboo
shoots, and water chestnuts, that can make you feel full.

How can these low-carbohydrate foods affect blood sugar do dramatically?

The upper part of the small intestine contains cells that release hormones
into the bloodstream when they are stretched, as after a large meal.  These
hormones signal the pancreas to produce some insulin to prevent the blood
sugar rise that might otherwise follow the digestion of a large meal.  Since
a very small amount of insulin released by the pancreas can cause a large
drop in blood sugar, the pancreas simultaneously produces the less potent
hormone glucagon to offset the potential excess effect of the insulin.  If
you're diabetic and deficient in producing insulin, you might not release
insulin, but you will still release glucagon, which will cause
gluconeogenesis and glycogenolysis and thereby raise your blood sugar.
Thus, if you eat enough to feel stuffed, your blood sugar can go up even if
you eat something undigestible, such as sawdust.  The lesson here is:  Don't
stuff yourself."

People may disagree with Dr. Bernstein, but it sounds like a reasonable
explanation.  It doesn't sound like it's delayed digestion, but the effect
of stimulating glucagon production.  As we all know, once that gets started
it's hard to turn it off, much the way a high morning reading seems to
affect your numbers for the rest of the day.

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