All, I figured I'd post this as I know there are a few diabetics on here. This is a phenomenon that has plagued me for years and I've never understood how this can happen or why it happens. AI, if it can be trusted, provided me with an answer that I wanted to share with you all with the hopes that it benefits somebody else.
A little backdrop is necessary here. As you all know, I run my blood sugars in a very tight range achieving A1Cs in the 4.5 - 4.8 range over the last 20 years. My usual routine is to eat dinner, wait for 45 minutes to let food digest and then I lift for an hour or so. On Thursday, my sugar dropped immediately after my dinner and to avoid waiting, I ate some food that would "nip it in the bud" and allow me to get my workout done. In short, I ate a little too much and I saw my blood sugars rise to the 140-150 range over a short period of time before I was able to bring it down with insulin. This short-term spike, according to AI, triggered a phenomenon called "acute glucose toxicity."
The next day, my usual breakfast intake which I cover with 4 units of Humulin R insulin (and usually results in me having to supplement at some point with sugar to address eventual hypoglycemia) was woefully insufficient. I ended up having to address a hard spike in my blood sugar which peaked out at 120 but I needed 4 units of Humulin R and 8.5 units of Humalog to keep it under wraps. Normally, this amount of insulin would send me into hypoglycemic shock, but it barely kept me from rising above 120.
I have seen this pattern many times before where I'm left befuddled as to how this can be. How can it require so much more insulin even though I'm eating the same food. It has been very frustrating over the years and can take anywhere from a week or two to bring it back into range. When I'm in range, I can tell you what my blood sugar is within a point or two at any point in the day it is that predictable.
I won't post all of what it spit out because it is lengthy but will focus only on the high points. I asked AI and this is what it produced:
1. Acute insulin resistance from hyperglycemia ("glucose toxicity") - When blood glucose rises above your normal range, even for a short period, it directly impairs insulin signaling at the cellular level. High glucose reduces insulin receptor responsiveness; muscle and fat cells take up less glucose per unit of insulin; the liver becomes less sensitive to insulin's "stop making glucose" signal. This can develop within hours, not days.
It goes on to read that the liver becomes harder to shut off and may dump glucose so you're constantly fighting ongoing glucose production. It also says insulin absorption is reduced. It further reads that this happens more to people under very tight control because their "baseline insulin sensitivity is high; deviations stand out dramatically; their correction factors are tuned for euglycemia, not stress physiology, etc.
I don't know whether this will help anyone else but is sure helped me. This phenomenon has plagued me for years and drives me to not tinker too much with diet and just stick with what I know works. One bad judgement call the other night has sent me off on at least a week of micromanaging and heavy dosing to just try and bring it back into range. At least now I know why this occurs.
The good news is this can be reversed but it does take a lot of effort.
A little backdrop is necessary here. As you all know, I run my blood sugars in a very tight range achieving A1Cs in the 4.5 - 4.8 range over the last 20 years. My usual routine is to eat dinner, wait for 45 minutes to let food digest and then I lift for an hour or so. On Thursday, my sugar dropped immediately after my dinner and to avoid waiting, I ate some food that would "nip it in the bud" and allow me to get my workout done. In short, I ate a little too much and I saw my blood sugars rise to the 140-150 range over a short period of time before I was able to bring it down with insulin. This short-term spike, according to AI, triggered a phenomenon called "acute glucose toxicity."
The next day, my usual breakfast intake which I cover with 4 units of Humulin R insulin (and usually results in me having to supplement at some point with sugar to address eventual hypoglycemia) was woefully insufficient. I ended up having to address a hard spike in my blood sugar which peaked out at 120 but I needed 4 units of Humulin R and 8.5 units of Humalog to keep it under wraps. Normally, this amount of insulin would send me into hypoglycemic shock, but it barely kept me from rising above 120.
I have seen this pattern many times before where I'm left befuddled as to how this can be. How can it require so much more insulin even though I'm eating the same food. It has been very frustrating over the years and can take anywhere from a week or two to bring it back into range. When I'm in range, I can tell you what my blood sugar is within a point or two at any point in the day it is that predictable.
I won't post all of what it spit out because it is lengthy but will focus only on the high points. I asked AI and this is what it produced:
1. Acute insulin resistance from hyperglycemia ("glucose toxicity") - When blood glucose rises above your normal range, even for a short period, it directly impairs insulin signaling at the cellular level. High glucose reduces insulin receptor responsiveness; muscle and fat cells take up less glucose per unit of insulin; the liver becomes less sensitive to insulin's "stop making glucose" signal. This can develop within hours, not days.
It goes on to read that the liver becomes harder to shut off and may dump glucose so you're constantly fighting ongoing glucose production. It also says insulin absorption is reduced. It further reads that this happens more to people under very tight control because their "baseline insulin sensitivity is high; deviations stand out dramatically; their correction factors are tuned for euglycemia, not stress physiology, etc.
I don't know whether this will help anyone else but is sure helped me. This phenomenon has plagued me for years and drives me to not tinker too much with diet and just stick with what I know works. One bad judgement call the other night has sent me off on at least a week of micromanaging and heavy dosing to just try and bring it back into range. At least now I know why this occurs.
The good news is this can be reversed but it does take a lot of effort.