[Ronin]

Fellow Pre-D's (and everyone else):

I've been thinking about what I'm calling "Glucose Load" as a contributor to the overall issues of managing BG levels. While I've read a lot about Glycemic Index, and a lot about where your BG levels "should-be" after eating, but nothing about a corelation between how you manage the ingestion of carbohydrates.

My theory is that we Pre-D's still have a pretty functional pancreas but our bodies are less able to process carbhydrates than a person who is not Pre-D. However, we might be able to process small quantities of carbs over longer periods of time (a.k.a., Grazing).

I have personally tried to spread out my carb intake, particularly at breakfast, and have found that when I spread the total carb load over a period of about 2 hours eating the carbs in small portions about every half hour or so, when I do a BG check around an hour or more after I finished the breakfast routine I'm generally in the mid 80's to mid 90's.

On the other hand when I have a lunch with exactly the same carb content but all at one sitting, my two hour post-prandial readings are generally in the One-Teens to low 120's. My guess is that this is carb-load.

From this I am speculating that the more we spread out the intake of carbs and avoid concentrations of carbs the better our bodies can manage the load and the lower our BG levels will be.

Any other thoughts or observations on this issue?

[rzrbks]

Ronin,

You've basically stated the function and process of a low-carb diet and why people latch onto low carb as the way to go----------for everyone

[Ronin]

Rzrbks:

So, I might be able to have that slice of Death-by-Chocolate Cake as long as it takes me almost all day to eat it. Which might not be a bad idea as it spreads out the enjoyment longer than just wolfing it down.

[tanyatype1]

Ronin - I totally agree.

[BlueSky]

Originally Posted by Ronin

... I've been thinking about what I'm calling "Glucose Load" as a contributor to the overall issues of managing BG levels. ....

There is an arguement that, as a T2 or Pre D, you need to be just as concerned about glycemic load as you are about glycemic index. Spreading a glycemic load over a long period of time might not spike your blood sugar. But it will cause a sustained increase in the insulin level. Insulin levels are thought to play a major mart in the development of diabetic complications, especially cardio vascular disease.

[Ronin]

BlueSky, et al.,

"Insulin levels are thought to play a major mart in the development of diabetic complications, especially cardio vascular disease." Does this mean that insulin is, in and of itself, a bad thing for the body? I thought that insulin facilitates the use of glucose by the body, and that the pancreas has an ability to deliver micro-doses on an as-needed basis -- kind of the principle of the insulin pump.

I'm getting confused again.

[Larry H.]

I don't know the technical details of how any of this works. I see from some charts I have copied that from 70 to 125 two hours after eating would be more or less normal. It would seem by that one could consider a teens to low 120's pretty normal, or within reasonable ranges? I generally try to eat smaller carb loads and amounts in general so that my two hour reading comes in under the 140 cut off that many believe can start to cause problems. The diabeties associations mostly think up to 180 after eating is within an acceptable range. I don't think many here would agree with that though.
Small amounts of the chocolate cake are probably alright so long as they are within your carb limits for the meal.. If I ate all chicken and salad, (which I rarely do), then if I am allowed a total of around 70 carbs for dinner, I have room for a few less desirable carbs if I choose to do so. However after my recent backfire on the pancakes I am pretty sure it needs to stay pretty low. So far if I eat the 4 carb labled ice creams I can have two scoops along with a meal and not see any adverse effects. I do agree with the writer that stated that the levels stay lower when you avoid as many unnecessary carbs as possible.

[shabbie6247]

this thread is already raising some interesting points.

i agree that the more carbs introduced into the body will produce a raised blood glucose level. this we know. as an insulin user who doesnt produce any insulin myself, if i were to eat a slice of death by chocolate cake and spread that over several hours, all that would happen is a continuosly raised blood glucose level that would be difficult to manage with an injection (10 grams here 1 unit, another 10 grams there, another 1 unit). as a pre-diabetic i would suggest that you may be just stressing an already tired organ by sustaining long inducement of carbs to the body.

my own notes show that if i eat 100g+ carbs in one sitting i will more than likely have to correct for a higher reading at 3 hours after taking a shot to cover it. however if i only eat say 50g (or less) carbs i will see a much steadier post prandial figure.

[Larry H.]

Shabbie,

I was more or less aiming at your idea that it might be best to contain a reasonable amount of carbs in one sitting. I also had the thought that maybe it was keeping a long term strain on the system to keep feeding it but wasn't sure as long as the levels remained within reasonable limits. As type II or Pre, neither really can aford those really high meals that it seems type I's can get by with. But your explantion of the effects that creates makes sense too. Unless something else is effecting my readings I usually have been seeing numbers I can accept and I try to eat to those guidelines. But again as this thing progresses I might have to take another look at that. And then something else your sort of hinting at would seem to be that really the lower we can keep things even while we may be able to get by with them, may be better off not pushing the limits as the long term effects may be negative. I have trouble with that as long as the readings fall into what the guidelines say is normal after eating. Everyone has a raised glucose of some kind it seems.

[princesslinda]

I think in both pre-D or full-blown T2, the closer to normal we keep our #'s, the better off we're going to be long-term.

Personally, I aim for the lower ranges of normal. To me, it makes sense that if "normal" A1C is 4-6, 5 would be better than 6, though both would be considered within normal lab values. Same with total cholesterol...i'm at 170 with normals by my lab being under 200....but i'd rather have 150 than 199, though both would be considered normal. If normal post meal range is under 140 (which is what my doctor said was my goal), i'd rather come in at 120 than 140.

Also, since we're not continuously monitoring our blood sugars, we don't really know how high we may spike post meals....if I end up at 140, how do I know that I don't go 160, 180 before coming back down?

Again, i'm speaking in regard to T2(not on insulin) and pre-D's, as I know those with insulin would probably need to do things differently.

Just my 2 cents worth.

[shabbie6247]

in order to work best with our pancreas we need to understand how it works.

in a healthy person......when you eat something the body straight away converts that food into something it can use as energy = glucose

when the liver recognises a rise in blood glucose levels it asks pancreas for an insulin delivery that matches the glucose level in the blood. when liver has finished turning the glucose into energy stored in the muscles and tissues, it tells pancreas to stop delivery of insulin. this process usually is complete 1.5 to 2 hours after a meal.

when this process is impaired thats when we see higher blood glucose levels after our meals. either pancreas was just darned slow at responding, or resisted responding or just plain doesnt work any more because its broken.

it stands to reason that if an organ is not functioning properly one would be foolish to try and make it work harder, surely it would burn out sooner?

dont get me wrong, i eat about 100 to 200 grams (average 120g) of carbs per day, not what you'd call low carb, but i understand my limits, and i try not to push the boundaries. its too late for my pancreas now anyway but i dont want to put myself at risk of complications if i can help it

imho.

(experts please correct if ive not got it all right~ thanks )

[BlueSky]

Originally Posted by Ronin

BlueSky, et al.,

"Insulin levels are thought to play a major mart in the development of diabetic complications, especially cardio vascular disease." Does this mean that insulin is, in and of itself, a bad thing for the body? ....

Insulin is an essential hormone and we can't live without it. And the body wouldn't produce anything that would harm itself, unless there is a malfunction. Insulin resistance is a case in point. The efficiency with which insulin is used deteriorates. And the pancreas responds by producing ever increasing amounts of the stuff. It is the excessively high levels of insulin in the bloodstream that are thought to cause damage.

A healthy young adult should have a fasting insulin level of 10, while someone with metabollic syndrome might have an insulin level of 90. The insulin level is 800% higher than it should be, in spite of there being normal blood glucose. The pancreas has to produce this much insulin to keep blood glucose at normal levels. The cause of metabollic syndrome, and the heart disease that goes with it, is not well understood. Especially as blood glucose is normal in people with metabolic syndrome. But very high insulin levels are increasingly being thought to have a lot to do with the typical heart disease outcome.

Doctors don't even test insulin levels, mainly because there is no pill they can give you or procedure they can do to bring insulin levels down. So they focus on somethung they can measure and control to some extent - blood glucose. But when it comes to metabolic syndrome, pre-d and T2, they are essentially treating the symptom and not the cause. However, we can have a significant impact on our insulin supply/demand situation by minimising carbs and getting lots of exercise. The net effect is to reduce insulin levels.

For a lenghthy but fascinating article on the subject, Google Insulin and its Metabolic Effects by Ron Rosedale.

[Ronin]

Everyone:

This is getting interesting. There seems to be a perception that any amount of carbohydrate load is a "stress" on the system and that the best possible solution is a zero-carbohydrate diet or as close to that as is humanly possible.

While I will admit that the American diet (as well as most diets in industrial and post-industrial nations) can provide a very high glucose load at any single sitting and thereby stress the endocrine system, what I am wondering is -- if carbohydrates are consumed in small doses over extended periods of time what might the result be on overall BG levels?

As a personal experiment I have changed my breakfast regimine to spread the foods eaten over a period of two hours or more. The result is that my one-hour post prandial BG levels have dropped to a range between 85-95 mg/dl whereas before this my one-hour post-prandial was usually in the 120's. The only change was spreading the foods over time. (i.e., I have 140 g. fruit with 60 g. youghrt around 0530, a three egg white omlette with Fat Free cheese and Turkey ham and one slice of low carb toast at 0715 with 0.25 cup of OJ, and black coffee with Equal) I used to eat all of this at 0715 in a single sitting. The separation, I beleive, is responsible for the lowered Post-Prandial BG levels (finally a corelation between what I eat and what happens to my BG levels).

I'm trying to extend the theory to a daily eating plan that has smaller portions and lower doses of Carbohydrates at all meals.

I realize that Type-1's and 1.5's are in a differnt situation (although pumpers might see a value in parsing out the carb load over longer periods of time). To me, this is less stress on my pancreas than simply trying to keep my total daily carbohydrate intake to less than 30 g/day which one (and only one) professional recommends. I don't see this as making my insulin resistant, rather the opposite, combined with my exercise regimine I should keep the endocrine system working closer to the way it was designed to work. For millenia humans ate small amounts of food perodiacally through the day and large loads were rare.

I will admit my tounge-in-cheek reference to a decadent dessert was over-the-top and might have twisted the direction of the thread.

[shabbie6247]

Originally Posted by Ronin

Everyone:

This is getting interesting. There seems to be a perception that any amount of carbohydrate load is a "stress" on the system and that the best possible solution is a zero-carbohydrate diet or as close to that as is humanly possible.

no way! LOW-carb not ZERO-carb! lol the brain/body needs to function with something!

Originally Posted by Ronin

While I will admit that the American diet (as well as most diets in industrial and post-industrial nations) can provide a very high glucose load at any single sitting and thereby stress the endocrine system, what I am wondering is -- if carbohydrates are consumed in small doses over extended periods of time what might the result be on overall BG levels?

apparently the pancreas copes better when there is a gap of around 3 hours between each carb intake. nibbles in between (should you require them )would be very low carb options ie peanuts or cheese.

Originally Posted by Ronin

combined with my exercise regimine I should keep the endocrine system working closer to the way it was designed to work. For millenia humans ate small amounts of food perodiacally through the day and large loads were rare.

i agree with you on this one ronin.

Originally Posted by Ronin

I will admit my tounge-in-cheek reference to a decadent dessert was over-the-top and might have twisted the direction of the thread.

at the end of the day diabetes is a disease that requires work and skill in its daily management. what works for one doesnt necessarily work for another. but low carb has been shown to have the best results on many counts. how we manage this is entirely a personal journey .

[volleyball]

Ronin, your term, glucose load is typically referred glycemic load. If you research that, you'll find lot of info.
Yes, I've said it many times before, as a non type 1, you can eat anything if you spread it out over a long enough period, also having a high glycemic food after a low glycemic food will lower the load, if you will, overall. So have your cake and eat it too. It also helps to have your carbs before a heavy physical activity
A good anology for glucose levels is you're running a mini marathon, it would be hard to run straight out the entire distance. But if you ran slowly, stopped when you needed to, most of us could complete the marathon, It may take you all day but it is a lot less stressful on your body.