Friday, 20 April 2012

How eating sugar & starch can lower your insulin needs.

This is a bookmarking post. Jason Sandeman is a chef who had a couple of web-sites at Well Done Chef! and Jason Sandeman — Real Food For Your Life. He has Latent Autoimmune Diabetes of Adulthood (LADA), which has resulted in a total loss of his pancreatic beta cells which means that he has to inject insulin.

Now, it's generally believed in low-carb circles (and by myself) that people with Type 1 Diabetes Mellitus (T1DM) should minimise their intake of sugary & starchy carbohydrates as these promote wild fluctuations in blood glucose. See The problem with Diabetes.

Jason wrote the following comment on Richard Nikoley's blog. The relevant part is as follows:-
"Even more weird – now that I have introduced the starches into the diet – I have actually got better control now. I thought my insulin needs would go up – but they haven’t. They’ve gone down."

To which I replied:-"How about this for an explanation? You now have a well-controlled glucose input to your circulation via diet, which has suppressed the poorly-controlled glucose input to your circulation via hepatic glucose production."

Hepatic glucose production (HGP) is increased by Glucagon, Cortisol & Adrenaline/Epinephrine. These are secreted as blood glucose level falls below certain values in order to keep our brains alive. See Blood Glucose, Insulin & Diabetes.

As keeping our brains alive is rather important (!), the mechanism is fairly crude in operation and blood glucose can overshoot in a positive direction, as a bit of glycation is less harmful than brain death. See "Funny turns": What they aren't and what they might be. Hyperglycaemia requires insulin to lower blood glucose back to the normal range.

Therefore, eating some (but not too much) sugar & starch can result in lower blood glucose level and lower insulin secretion. Eating fibre/fiber (a carbohydrate) is also good for keeping blood glucose low, as only just mentioned in Fiber and Insulin Sensitivity. Ain't the human body weird?"


praguestepchild said...

There's a good point I never thought of, it makes sense for the body's feedback systems to err on the side of glucose, for the sake of the brain. Critically damped on the glucose side? Or perhaps over-damped?

Nigel Kinbrum said...

I only did this post because I keep quoting Jason's comment and it takes me an age to find the bluddy thing on Richard's blog 'cos I keep forgetting which post it's in!

As for damping, that depends on muscular insulin sensitivity. Less sensitive = more overshoot. More sensitive = less overshoot.

Exercise is good, mmm-kay?

Jenna said...

I think you're brill!

Nigel Kinbrum said...

Thank you Jenna.

You're very sweet to say that!

Nige (on Blackberry, so keeping replies concise)

marie said...

By jove, I think I've got it! Thank you, Professor :-) really, that's a cool effect to keep in mind.

praguestepchild said...

If we look at the classic car-spring-shocks model of dampening, depleting muscle glucose is going to help add a reservoir to the shocks or the dampening response, but I think that's quickly filled. Overall insulin sensitivity is necessary for the system to be properly damped. And of course not constantly driving your car over potholes (sugar binges) helps also.

Nigel Kinbrum said...

The average person can store up to 400g of muscle glycogen (which can't be used to make blood glucose). As that becomes depleted by high-intensity exercise, muscular insulin sensitivity increases. When there is insufficient glycogen to fuel activity, muscles suck in glucose whatever serum insulin level there is.

praguestepchild said...

Yes, although for the average person it's way less than 400g, let's say 200g. 4 (dietary) calories in a gram of sugar, so that's 800 calories. That's less than two chocolate chip cookies from Starbucks:

What I'm saying is that depleting muscle glucose doesn't come close to cutting it if the dampening system itself is broken.

Nigel Kinbrum said...

The SAD makes a great muscle & liver glycogen filler, so many people who eat it never significantly deplete their glycogen. Which is why many people who eat the SAD have muscular *and* hepatic IR. Being sedentary reduces muscular carb-burning, which makes a bad situation even worse.

Unknown said...

. . .heh.

Given the whole sugar, starch and lower insulin/stable blood glucose theme, can we talk about Ray Peat? I ain't trollin'.

Nigel Kinbrum said...

Kade Storm said...
"can we talk about Ray Peat?"
No. I tried reading his site, but I don't like his verbose writing style. It's like Taubes'.

Unknown said...

Eh. Taubes. Disappoint, despite some good ideas.

Personally, I quite like the exorbitant display of verbosity, but that's a matter of taste.

I have managed to get through quite a few of his pieces, and he isn't really selling this stuff, so I treat it as free food for thought that might offer something worthwhile to take home. Having that said, while some of the ideas can seen outrageous, they are thought provoking no less. At least that's been my experience.

Nigel Kinbrum said...

My attention span & short-term memory ain't what it used to be. By the time I get to the end of a long paragraph, my mind has wandered and I forget what was at the beginning!

Unknown said...

"My attention span & short-term memory ain't what it used to be."

. . .sure.

Anyway, nice post. It's a shame that hepatic glucose production and insulin resistance often become trivialised or overlooked points of discussion in some of these debates.

ProudDaddy said...

Slightly off topic, but have you ever considered the possibility that Impaired Fasting Glucose is caused by excess glucagon? Everyone seems to always ignore the alpha cells.

I would also be interested in your ideas about how insulin resistance develops. Warning: I'm leery of the too much exposure to glucose idea and wonder if fatty liver and muscle are more to blame.

ProudDaddy said...

Oops, ANOTHER senior moment! I already asked you about hyperglucagonemia.

Nigel Kinbrum said...

Gotta be brief.

RE Alpha cells: No.
RE Insulin Resistance: I've done a blog post on that. Check the labels.