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Chelle D

Questions about Liver dumps

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Chelle D

Okay,  So I've been using more of the quick acting insulins to get my sugars back down... I don't know if that is related to my question below.. Just wanted to give the info incase it's significant.

 

Question:  Is it a "bad" thing to let your liver correct a low blood sugar with a liver glucose dump?

 

I do get low blood sugars occasionally.  I did notice it when the first time I "KNEW" my liver dumped glucose to correct a low.  I was at work by myself on a Sat.  There's always candies & mints, etc, in various co-workers cubicles, and they always encourage me to use if needed (so I don't have tempting candy at my own desk).  So.. I start my usual low blood sugar symptoms... Tingly nose... & slightly light headed.  THen it got worse.. lips were tingling & my judgement got cloudy.  I knew I was starting to have low.. and didn't have my usual "lunch bag" tote with me (which has my meters & glucose tabs in it). But I knew I needed to eat something. Had no money on me for vending machines.  I walked to bathroom & noticed legs very weak & shakey.. so I thought, "This is IT. I HAVE to get home to eat".  Prayed that I would make it home okay (5 min drive from work)... At no time did my mind even register the candy right in the row!!!..  By the time I got to my car, i was feeling a little less shakey, but new I needed to eat. So, drove home. By the time I was home, I felt completely normal. No face tingling, no light headed, no weak muscles, no cloudy judgement.  I checked blood sugar and it was 220something.  So I knew my liver kicked in and gave me sugar.

 

I wasn't sure how things were supposed to go, so I ate a little bit anyway, just incase that sugar (provided from liver) crashes immediately.

 

That was about 6 months ago.  Since then, i've noticed that I do occasionally feel a little low, but not bad... I'll wait a little bit to check my sugar (like if it's close to lunch time)..  Sometimes, I know I waited too long, and the liver kicked in.  Or , I'll wake up, and my feet are screaming (neuropathy getting worse).. and I'll have blood sugar over 250.  I know it's not from over eating night before, so I figure it's my liver.

 

Is it better to "ride the low" for a little bit (trying to get my A1c to a better overall number) and risk having liver give myself the glucose? Or do I need to check blood sugar as soon as I think I'm feeling "a fake" low.

(Sometimes I feel like I'm getting low & blood sugar is like 110.  So , it wasnt' a low feeling, but more like just nerves or heartburn kicking in.(Like when I'm stressed at work.)

 

I just don't know if the liver dumps will actually make my A1c's worse... or eating too often (keeping range right around 120-160) without ever letting b.s dip under 90 would make the overall A1cs worse

 

Do you get what I'm asking?  Sometimes I have a hard time explaining myself.

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miketurco

Regarding riding out a low to lower your A1c: two things. First, since A1c is (sorta) a three month average, riding out a few lows won't make a difference. Second is I don't know what you're calling a "low."

 

Are you calling 90 a low? That number is actually at the top of the "normal" range. I remember the first few weeks I was able to get my bg down into the mid 80's it felt like a low, but it wasn't. It just took my body time to adjust.

 

I think it's a bad idea to not treat a low. Lows starve your body of the fuel it needs for basic operation and, over time, I have to imagine they'd be damaging. "Riding through one" is of no benefit to your body that I can see.

 

I would (personally) define "low" as <= 60. Hopefully others will kick in here as to what a low actually is.

 

Out of curiosity, and if you don't mind sharing, what are you goals for your BG and A1c levels?

 

Mike

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Chelle D

A1c's are horrid. (Between 7-8)  I know that 80 "feels low" but not really a true low.  

 

I'd like to get my A1c under 7.  Closer to 6.5, but I don't want to go "too fast" as I hear that studies show correcting A1c's immediately (within 3 months) is much harder on heart & is causing heart problems.

 

I generally fluctuate between 7.4 to 7.9 in the past couple year or two, I think.  I just don't know if the liver .. making blood sugars go over 250 is what is having negative imapcts on my A1c numbers... or if it contributes to it.

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miketurco

Yah... 7.5 is a good intermediate goal, but it's been a couple of years and you should be shooting for 6 or less. You're taking a lot of lantus (seems to me, but I'm really not one to say).

 

What is your diet like? Do you count carbs? If you're eating stuff like spaghetti, potatoes, cookies, etc. you really are hurting yourself.

 

250 is a really bad number. I realize we're all different, but I'd do just about anything to avoid that. If you're able to get your numbers down it will take a few weeks for your body to adjust, but in the long run it will save you.

 

May not be a bad idea to up the metformin. Also, 70U lantus + novolog + 20mg glipizide, in addition to the met, that's some fairly heavy medication.

 

Hope this doesn't sound preachy, it's not meant to be. Just throwing out my thoughts. I am really curious as to what your diet is like.

 

Mike

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Todd G.

The insulin and the glip are going to make control difficult. The glip creates an unknown in the insulin equation.

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Chelle D

Yes, heavy meds.  The glip helps me not to have to use as much of the quick acting insulin. $4 glipizide or $100 co pay insulin pens.... Yes,, cost is the  big driver.

 

I do know my liver still kicks in.... What numbers on CMP is the liver function part & what is normal?

 

I know I was told my "Kidney function is still normal"... but just recently signed up for the online view, that I can see my own lab work results.

Now, I've found that my GFR (GRF?)  was 84 LAST year.  Before that , I believe I've tested over 90 always.  THe online results didn't go back that far.  So I tried to find the CMP results that were recently done Jan 30th...  I guess it went to the hematology doctor, instead of primary care.  I know the primary care got a copy, but mailed instead of faxed.  So when I look online, it just showed that I had a CMP, but no results available.

 

I also found that my last two A1c's were 8.4 & 8.1  Argh.  I hate it when they say "all that work came back fine... your blood sugars are still too high."   Seriously?? Tell me HOW high!

 

Sorry, just ranting.

 

Not happy, because she put me on pravastatin.   I'm very scared that it will decrease liver or kidney function... &/or lower my blood sugar controls even more.

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Chelle D

Oh... Qualifying statement;  When I said "ride the low"... I mean., when I'm having fake low symptoms, but sugar still reads over 80 or over 100. I know if I'm shakey and it's under 70, i need to treat a true low.

 

I don't know if I need to start new post?... But, wondering if anyone out there has been put on pravastatin & had any adverse results for blood sugar control?

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TX_Clint

If you are taking a Glip and insulin DO NOT DEPEND ON YOUR LIVER TO DUMP GLUCOSE. Now.. for those that do not use medication that either increases your insulin production or insulin it's a different case. Your liver may generate enough glucose to prevent a true low. It's sounds like you may be reacting to false lows because your body is not accustomed to having normal bg levels. However, you are so right about taking it slow and giving improvement time to take. Best of luck.

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jims_forum

my experience and data I saw using both cgms and caveman fingerprick to

Confirm levels and activity were as follows:

 

1. role of metformin turned out to be a key player and by that my data showed that whenever metformin up to sufficient dose strength in blood, the liver was stopped from doing a dump.

2. If liver doing a dump and metformin comes up to strength while liver doing a dump; the liver stopped adding excess glucose release. All this activity was observed and confirmed on cgms.

 

3. My read/guess was that there was on the liver a low volume glucose port to blood stream that was always on providing a constant feed of keep alive glucose . There was also a high volume port on liver that was controllable by body to add large amounts of glucose upon demand. My guess was the metformin was over riding this high volume port and shutting it down whenever sufficient level of metformin was in blood. For me that was 500mg to 600 mg dose worked all the time. Under that amount, the liver was not stopped from dumping in large amounts of glucose.

4. On my body when liver triggered by two different events, the liver would set about

Adding glucose as hard as it could until from my observations would peter out and stop after liver buffer emptied. This meant blood glucose would peak up to

511/max and then through heart pumping action; the glucose would be diluted out through body and stabilize at 278-311. I also saw that after this event liver could not do another event till liver buffer reloaded.

5. My liver showed signs of slow leakage whereby after all glucose output from digestion, blood glucose would sit there and gradually increase over time till sufficient metformin in blood at which time the slow constant rise of blood glucose stopped and flatlined. My guess was I had a leaky liver.

6. The two events that triggered large liver dump were whenever blood sugar dropped to 50 and under and the second most curious issue of when digestion glucose output was falling off and I ate a small snack at that point. It did not matter that BG was 100 to 200, the liver was seen suddenly jumping in and doing a nasty dump . As previously stated, metformin up to sufficient dose in blood arrested these monkeyshines. Both cases were repeatable and consistent.

 

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DeusXM

 

 

Is it a "bad" thing to let your liver correct a low blood sugar with a liver glucose dump?

 

Yes. It stresses your body immensely, it deprives you of your glycogen stores, and you also can't control it. When your liver dumps glucose, it's acting like the organ version of a person having a hypo at night and then raiding everything in the kitchen.

 

 

 

Is it better to "ride the low" for a little bit (trying to get my A1c to a better overall number) and risk having liver give myself the glucose?

 

No.

 

Ok, I get you're having hypos earlier than you should. But these won't get you a better A1C because they're only temporary and your liver will start pumping out glucose uncontrollably, completely offsetting the lower sugar. You also then run the risk of losing hypo awareness - the more you 'ignore' hypos or the more frequently they happen, the less your body notices them and then suddenly you're at 25mg/dl without warning and just pass out.

 

There are two things you need to.

 

Firstly, you need generally better glucose control. Ask specific questions on here about what's specifically preventing you from getting this as this is a whole topic in itself anyway. 

 

Secondly, when you get these 'phantom' hypos, don't ride them out, but don't overtreat them either. Have nasty glucose tablets with you AT ALL TIMES WITHOUT FAIL. This is a 'don't f*** with' rule for everyone carrying insulin. Then you won't be tempted to snack on them and you will have a quick, measurable way of treating hypos with you at any time. Next time you have a phantom hypo, have a couple of tabs to push yourself up just a little bit above your hypo threshold. If you do this every time you have a phantom hypo, and combine this with better blood sugar control overall (which will come if you don't rely on your liver to raise your glucose anyway), after a few weeks or so you will find your threshold for hypos will drop down to a normal level.

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jims_forum

Very good.

 

For the sub 50 numbers, as indicated by my Doctor suggested watching my BG and when heading sub 100 then add glucose tablets.

 

I call this keeping the liver in the barn and playing external liver buffer. That stopped that but required extra monitoring.

 

The pseudo hypo was stopped by metformin by adding metformin meal doses 1 hour before meal. This with the 2.5 hour up to metformin dose after ingestion stops the pseudo low liver dump. One gets to see liver attempt dump but meformin has liver by throat so the dump avoided and flat line occurs.

 

So far these dumps are now a memory.

 

I also found walking off the excess glucose far better and consistent and not get additional lows from attempt to use insulin .

 

Insulin is a storage hormone that instructs skeletal muscles/fat cells uptake more glucose if room.

If no room; all that excess glucose is trapped in blood system. Simply put insulin simply reparks the glucose somewhere else. It still needs to be burned off.

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georgepds

When I read this my thought was...what a terrible idea to drive a car during a hypoglycemic episode

 

 

I get it ... the author was not thinking straight (desk candy oversight)..butI think we should develop simple safety rules..like

Dont drive and drink

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